50 Registered Dietitians Share Diabetes Diet & Lifestyle Tips

Here are the four questions we asked our panel of experts:

1. What is the best way to keep energy levels and manage my diabetes while I am on a diet?
2. What would you suggest for picky eaters who have diabetes? How can they manage their blood levels and still enjoy their food?
3. I am thinking of going on a plant's based diet. Is that wise if I have diabetes?
4. How can a dietitian help someone with diabetes?

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1. Elizabeth Ann Shaw

A1: One of the best ways I recommend to clients to keep their energy up while managing their diabetes is to included 3 to 4 food groups with each meal or snack. For instance, if they are planning a mid morning snack, we discuss the need to include a healthy fat and protein for satiety as well as complex carbs for energy and fruits or vegetables for fiber! I usually recommend a plain Greek yogurt with a tablespoon of powdered peanut butter with celery sticks and a handful of high fiber cereal. This combination also provides a variety of textures that increases their satisfaction with their snack choice as well.

A2: I would encourage the diabetic to work closely with their treatment team, specifically their dietitian, to figure out unique combinations of foods they enjoy to include in their diet. For instance, if my client is stuck on grilled chicken, broccoli and a side salad, I would show them how we can use those foods in combination with another food, such as a whole grain tortilla, to create a new combination that is still made from their base comfort foods.

A3: A plant based diet can definitely work as part of a diabetic friendly meal plan. However, you need to work with a professional to help ensure you are meeting your protein needs as well as vitamin B12. I also encourage my clients interested in plant based eating to focus on incorporating nutrient dense foods, such as nuts, that help provide protein, fats and are a low source of carbohydrates. This makes a great accompaniment to dinner, such as a walnut pesto with garbanzo beans and zucchini noodles!

A4: An RDN plays a crucial role for those struggling with diabetes. Not only can an RDN show the client how to enjoy all foods in moderation with their condition, but also how to creatively pair these foods in an accessible, enjoyable and family friendly meal plan.

2. Andrea Hardy

A1: The best advice I give my clients with diabetes is to NOT skip meals - and to make sure they’re balanced! Complex carbohydrate, fat and protein at each meal will keep you full longer, manage blood sugars, and prevent post-meal crashes.

A2: Picky eaters are tricky! Often times, it comes down to lumping all food into one category, not having confidence in the kitchen, or having one negative food exposure and assuming the food will always be like that. I challenge my clients to try ONE new food a week - usually a vegetable - prepared in a new way. I have a 4 part series on adult picky eating on my blog - with some of the most amazing dietitians across North America weighing in. You can find it here: http://ignitenutrition.ca/i-hate-vegetables/

A3: Plant based diets can be GREAT as long as you do them right! Having some food knowledge and guidance is critical when considering a plant based diet. I encourage my clients to include pulses once a day  as they’ve been shown to help manage blood sugars and are a great form of complex carbs. Bottom Line: If you’re wanting to try plant based, but aren’t sure where to start - get some guidance from a dietitian who can give you the basics - so you’re not missing out on any nutrients and so that the transition fits within your lifestyle.

A4: I think a lot of times people assume dietitians are the ‘food police’. We’re going to tell you what to eat, and what not to eat. In reality, we offer SO much more! Personally, my motto is to make practical nutrition changes, that fit into a life you actually enjoy. At the end of the day, it’s often not our lack of food knowledge that is most harmful to our health, but rather our BEHAVIOUR around food. Dietitians are EXPERTS at helping you to modify your food behaviours in a positive way that fits within your life.

3. Dawn Clifford

A1: I’m not a big fan of dieting. Researchers have found that dieting is associated with weight gain, not weight loss. Restricting oneself and trying to ignore hunger cues in order to lose weight, will only result in obsessive thinking about food, a negative body image, and low energy levels throughout the day. The best way to keep energy levels up is to NOT diet. Instead, fuel your body all day long with a nourishing and pleasurable foods. Eat when you’re hungry, choose a balance of food groups, and stop eating when you feel comfortably full and that you’ve had enough to eat. Bring nourishing and pleasurable snacks with you so that you’re ready each time hunger strikes.

A2: The best way to expand your food variety is to keep trying new foods. Repeated exposure of novel foods helps your become more accepting of that new food over time. Mix and match new foods with familiar and pleasurable foods to make them more palatable. For example, if you’re unsure about cauliflower, but you know you like cheese, prepare a cheese sauce to put on top of the cauliflower. You can also play around with how you prepare the foods. You may not like a food raw, but it may be tastier if it’s sautéed in olive oil with a little salt and pepper, or roasted in the oven. With children it takes 8-14 times of exposing the child to the food before the child will accept the food. Whether it’s a picky child or an adult, don’t give up after just a few tries. Keep serving those novel foods in fun and interesting ways.

A3: It’s always a great idea to add more produce into your diet. To maintain blood sugars, it will be important to include foods high in fiber and protein throughout the day. For example, your blood sugars may spike if you sit down and eat a cup of apple sauce. Apple sauce is plant-based but it lacks fiber and protein. However, an apple with some peanut butter or a handful of nuts is a great idea and will likely keep your blood sugars more stable. Find ways to add fiber and plant-based proteins into all your meals and snacks, and your blood sugars will thank you. Examples include: nuts, nut butters, and legumes.

A4: Clients can find all sorts of information on the internet, but is that information correct? A dietitian can help a client separate fact from fiction. More than providing diabetes facts and figures, a dietitians can provide a compassionate listening ear. Clients need a practitioner who will guide them in making small gradual changes over time. Dietitians are well trained in diabetes management, and some dietitians even have advanced training in diabetes and counseling. Find a Registered Dietitian Nutritionist who is an expert in the field and who is also a skilled communicator. An encouraging and supportive dietitian is just who you need to help you navigate your food choices.

4.  Madeline Basler

A1: The best way to keep energy levels up and manage your diabetes is to eat consistently and watch your carbohydrate intake.  You should be aware of how many carbohydrates you should have for meals and snacks and plan to eat three meals and two snacks daily.

A2: For picky eaters find what foods you like and commit to trying something new each week.  There are ways that you can enjoy the foods you love by watching portions and carbohydrate counting as well as testing your BS before and after eating to get an idea of what can effect your BS and how you can fit those foods you love into your day.

A3: You can certainly be a vegetarian if you are diabetic.  Choosing plant based proteins and knowing the carbohydrate content of the foods you are eating will help to give you an individualized plan.

A4: A dietitian can help you control your diabetes by providing education about carbohydrate counting and exchanges so that you can keep your BS within normal limits. They can also help you plan your meals and snacks and timing of those in order to keep your BS steady.

5. Kaleigh McMordie

A1: The best way to manage your blood sugar while maintaining a good energy level with diabetes is to maintain an even, consistent intake of complex carbohydrates. Carbohydrates from whole grains, lowfat dairy, starchy vegetables and fruit in moderate portions throughout the day - every 3 to 4 hours- will ensure a steady release of sugars for all day energy. Refined carbohydrates without fiber, from foods like candy, pastries, and white bread, are more likely to cause a sharp spike and then fall in blood sugar, which leads to an initial burst of energy followed by rapid decline, also referred to as a "sugar crash."

A2: For picky eaters who have diabetes, I'd suggest finding more nutritious version of the foods you like, such as a whole wheat pasta versus white pasta,and keep portions reasonable. Try to pair carbohydrates with protein or healthy fat to slow the release of sugar into your bloodstream. For example, instead of cream cheese, pair half of a whole wheat bagel with peanut butter or smashed avocado. Enjoying the foods you like in small portions will help you feel satisfied, whereas trying to ignore your cravings could lead to a binge later.

A3: You can absolutely go on a plant-based diet with diabetes. Focus on whole and minimally processed foods for the best results, and follow the same principles of spreading your carbs throughout the day. Since many plant-based protein sources like beans and legumes also contain carbohydrates, get a variety of foods at each meal. Consider protein sources such as nuts and nut butter and tofu, and if it isn't against your beliefs, adding eggs and dairy.

A4: Consulting with a dietitian is the best way to ensure successful implementation of a diabetic-friendly meal pattern. A registered dietitian can help you create a custom meal plan that is both healthful and enjoyable while managing your diabetes.

6. Mindy Hermann

A1: The most important thing is to eat meals that are well-balanced, with plenty of vegetables plus modest servings of grains, preferably whole grain, and lean protein. Also look for foods that are high in fiber. Some types of dietary fiber, including a fiber called inulin that comes from chicory root, are not digested by our body so they don't have calories or affect blood glucose levels.

A2: Look for foods that you like within each food group and work toward eating in a balanced way. A good guideline is to make half your plate vegetables and fruit (a registered dietitian can help plan the amount of fruit in your diet), one quarter grain and one quarter protein. Also, try to find a dairy food/beverage or dairy alternative that you like.

A3: Sure. But it's even more important to work with a registered dietitian since a plant-based diet can be higher in carbohydrates, depending on which foods are selected.

A4: (No comment for this)

7. Elaine Allerton

A1: For anyone wanting to reduce calorie intake and manage weight, I suggest using a smaller plate (serving area diameter: 8in/20cm).  Follow the 'healthy plate principals' by filling ½ plate with vegetables/salad (any colour), have ¼ plate of low GI wholegrain/wholemeal starchy carbohydrate (e.g. boiled new potatoes, wholemeal pasta, basmati rice) and ¼ plate of lean protein (e.g. meat, fish, poultry, tofu, quorn).   This combination of fibre and protein will take longer to digest and thus help the individual feel fuller for longer, with a slower release of glucose to the blood stream.

A2: Following the healthy portion plate principals of ½ vegetable/salad, ¼ low GI wholegrain/wholemeal starchy carbohydrates, ¼ plate lean protein enables the ‘picky’ eater to choose the foods that they like within those food groups.  As long as those 3 food groups are present in those proportions, the diet is likely to be nutritionally balanced and suitable for people with diabetes (either Type 1 or Type 2).  Eating 3 meals spaced over the day with equal(ish) amounts of low GI starchy carbohydrates will help manage blood glucose levels, avoiding large spikes/peaks.

A3: When following a plant based diet, there are no greater concerns for an individual with diabetes over someone without diabetes.  Follow the ‘healthy plate principals’ of ½ plate vegetables/salad, ½ plate low GI wholegrain/wholemeal starchy carbohydrate and ¼ plate lean protein.  A plant based diet needs to be well balanced, just like any other eating pattern.  if a plant based diet is excluding all animal products (meat, seafood, poultry, eggs and dairy), there may be concerns around protein, iron, vitamin B12, calcium, vitamin D, omega 3, iodine and zinc intake.

Protein
Soya and quinoa contain all the essential amino acids. Other plant protein sources (beans, chickpeas, hummus, nuts) don’t contain the full complement of essential amino acids. It is relatively easy for a healthy adult vegan to meet their daily protein requirements. An intake of 20g protein at each meal is advised for optimal muscle repair; so you could have 600ml soya milk at breakfast, 150g of quinoa at lunch and 100g of soya mince at supper and meet your protein requirements.  If you have Type 2 diabetes, choose unsweetened soya milk, but make sure it’s fortified with calcium.

Iron
Iron containing foods include: kidney beans, black beans, soybeans, chickpeas. However it wouldn’t be practical to rely on almonds to meet your iron requirements as you’d need to eat over 500g each day giving you 3000kcal! Instead choose a fortified breakfast cereal; a 50g serving of Weetabix would give you 6mg of iron, leaving around 8mg to cover with your choice of 80g lentils, or 100g soya mince, or 150g chickpeas, or 200g tofu, or 250g almonds. Again the volume of nuts required may not be practical! Avoid drinking tea and coffee alongside your iron-containing foods, as the tannins and phenols reduce iron absorption.

Vitamin B12
Fermented soy products, leafy vegetables and seaweed are not reliable sources of B12. A 20g serving of All-Bran would meet your daily B12 requirements or if you REALLY love marmite… have 20g (5 portions) of marmite a day. If you are following an exclusive plant based  diet, you may wish to consider a daily supplement of vitamin B12.

Calcium
Choose a calcium-fortified non-dairy milk. Other vegan calcium sources include: tofu, turnip, sesame seeds/tahini paste. Of this list, tofu is the practical choice, as 50g would meet your daily calcium requirements… you’d need to eat 1.5kg turnips or 100g sesame seeds/tahini paste to get equivalent calcium! Whilst spinach contains calcium, it is not readily available to our bodies, as the oxalates reduce absorption.

Vitamin D
Choose a fortified soya milk or breakfast cereal, but you may wish to read the labels. D3 is from animal sources, whereas the vegan-friendly D2 is less bioavailable to our bodies. Like the rest of the population, you may wish to consider a vitamin D supplement from October to March in the UK, when the sun zenith angles are too low for our skin to synthesise vitamin D from sun exposure.

Omega 3
Flaxseeds, flax oil, walnuts, rapeseed oil are sources of ALA, which converts to EPA/DHA in the body, although this conversion is not very efficient. So as not to impede this conversion process further, you should limit foods high in saturated fat (coconut oil) and linoleic acid (sunflower and corn oil). You may also wish to consider a microalgae supplement with DHA or fortified soya milk.

Iodine
If as a vegan, you are avoiding seafood and dairy produce, a daily supplement in the form of “potassium iodide” could be considered but should not exceed the daily requirement of 150mcg. Do not use seaweed or kelp supplements as an iodine source, as the amount of iodine can vary considerably from the value claimed on the label and can provide excessive iodine. Seaweed is a concentrated source of iodine, but it can provide excessive amounts, therefore eating seaweed more than once a week is not recommended.

Zinc
Whilst aduki beans, brazil nuts, broad beans, red kidney beans and bread are vegan sources of zinc, the volumes required to meet daily zinc requirements are not practical. You’d need to eat 250g aduki beans or 12 slices bread or 700g red kidney beans, whereas 150g of soya mince would meet your daily zinc requirements.

To conclude, whilst a vegan or exclusively plant based diet has some health benefits as it tends to be low in saturated fat, you may wish to consider supplementing the following: iron, B12, vitamin D (from October to March), omega 3, iodine and zinc, as it may be difficult to achieve recommended nutrient intakes without military style meal planning. I’d also advise you to seek individualised nutritional advice from a registered dietitian before taking any supplements.

A4: A dietitian will offer evidence-based nutritional advice and guide the individual through the dietary management options for Type 2 diabetes, enabling them to choose sustainable lifestyle tweaks to meet their health goals.  A dietitian can help someone with insulin dependent diabetes learn to 'carb count' in order to match their insulin to their carbohydrate intake, help calculate insulin, carb ratios and advise of dietary intake around exercise and activity.

8. Cassie Vanderwall

A1: Energy (calories) is derived from food. Therefore, if an individual wants to increase or maintain their energy throughout the day- independent of whether they have diabetes- they need to look to what, when, and how much they are eating.

What: What we eat is critical to stable energy, especially for people with diabetes, and thus composition is key. Meals and snacks that have a sustainable source of Carbohydrate (whole grains, starch, fruit) with a lean protein (egg, meat, poultry, fish, beans, nuts, seeds) can provide the balanced nutrition the body is seeking.

When: Most people find that their body is looking for more food (true hunger) every 3-4 hours

How much: How much, or the serving sizes, will depend on an individual's overall energy needs which are based on their gender, age, weight or desired weight and activity level.

A2: I would start by asking if the picky eating is a problem. Everyone can be a picky eater, but it is important to know if this person is a "problem feeder," which means they like a very limited number of food and may exclude whole food groups. "Picky eaters" can manager their blood sugar and enjoy food by maximizing the foods they do enjoy and applying principles of meal and snack composition. A Healthy meal has at least 3 food groups which include a sustainable source of energy, lean protein and source of fiber (Whole grain, lean protein and vegetable) and solid snack has a source of energy (grain, fruit) with a lean protein.

A3: Yes! There is evidence that plant-based diets can be strong strategies for preventing and managing chronic disease. However, a plant-based diet can often be rich in carbohydrates and thus people with diabetes need to be careful that they maintain a thoughtful energy composition of no more than 50-60% of their calories from carbohydrate. This would reserve energy derived from lean plant-based proteins (beans, peas, nuts, soy) and healthful fats.

A4: A Registered Dietitian (RD) can be a key player on the healthcare team. Most RD's who work alongside people with diabetes are often Certified Diabetes Educators (CDE) and thus able to further apply the nutrition care process to situations specific to diabetes. Dietitians can specifically provided individualized nutrition education and counseling, help people to maximize their energy intake, manage their blood sugars through food and combat complications via medical nutrition therapy.

9. Andrea Ovard

A1: Focusing on getting the RIGHT carbs and in the right amount. We need carbs to fuel our body and provide us with energy but it's important to choose carbohydrates that will provide beneficial nutrients and energy. Choose fresh fruits, whole grains and low-fat diary products. Try to have carbs at every meal but make sure you get lots of veggies and protein as well!

A2: It all comes down to finding things YOU like and experimenting. Give things a try even if you think you're not going to like them. Try seasoning them in different ways. Maybe you don't like raw broccoli but maybe you'd like it steamed with some fresh pepper and garlic powder. Don't be afraid to try new things and switch it up!

A3: One of the most difficult things with following a plant based diet is getting enough protein and not replacing protein with more carbs. If you are going to choose a plant based diet, focus on veggies and sources of protein other than meat - such as nuts/nut butters, tofu and eggs.

A4: Dietitians are great resources to help you better understand what foods have carbs and how to best incorporate them into your diet. They can help you set up a plan to better manage your blood sugars and help you understand what the best sources of carbohydrates are when dealing with your diabetes!

10. Judy Matusky

A1: I like to focus more on developing an eating pattern that is appropriate for your energy needs rather than thinking about your food selections as a diet. Choosing fresh, wholesome food, that you enjoy, is important for everyone. If you want to boost your energy throughout the day, fueling yourself with the right portion and the right balance of food is key. I recommend choosing lean protein, healthy fats and high fiber carbohydrates at all meals and snacks, keeping an eye on portion size to stay within your energy requirements.

A2: Even picky eaters will often have enough foods in their “like” column to support a balanced diet. I create a meal plan that includes at least 3 out of the 5 food categories (those being fruit, vegetables, protein, grains and dairy) for meals and 2 for snacks, with protein being one of those choices. Spreading out meals and snacks throughout the day will help balance blood sugar levels. I might add a general multivitamin/mineral supplement for extra nutrient support if needed.

A3: Plant-based diets can be a very nutritious choice for someone with diabetes but you want to be sure you are selecting nutrient rich foods. French fries and chocolate chip cookies can be plant-based. Including beans and lentils, nuts, nut butters, seeds, and tofu are nutrient-dense, protein-rich choices that will maintain good blood sugar control. Including eggs and low-fat dairy like Greek yogurt may also be an option. For whole grains, I often recommend cooking and cooling them before eating. Resistant starches in cooked then cooled grains may help keep blood sugar levels lower.

A4: Registered and licensed dietitians provide unbiased, evidence-based, research supported nutrition advice. Just as you should seek out a fiduciary when hiring a financial advisor, consider a dietitian your nutrition fiduciary. Dietitians will have your best interest as their top priority.

11. Karen Buch

A1: Small, frequent meals that emphasize a combination of complete protein and sources of fiber, fruits and vegetables can help supply energy throughout the day and satisfy the appetite while keeping calories controlled.

A2: Picky eaters face a challenge to eat the wide variety of foods needed to provide all of the essential macro- and micro-nutrients that the body needs to thrive. A dietitian can help craft a meal pattern geared to meet nutritional needs and manage blood sugar levels. Typically, it will include many of the foods that the person with diabetes has identified that he or she is already willing to eat along with suggestions for new and different foods or preparation techniques to try as part of a new dietary approach that supports diabetes management.

A3: Absolutely. Eating a plant-based diet is a healthy choice for people with and without diabetes. The term plant-based doesn’t mean you have to avoid animal products completely. It simply means you choose to center the majority of your dietary choices on foods that come from plants including fruits, vegetables, whole grains, nuts, seeds, legumes, liquid oils, herbs and spices. Nutritious animal-based foods such as eggs, fish, poultry, reduced-fat dairy foods, lean meats and cheeses can be enjoyed as well.

A4: Registered Dietitian Nutritionists (RDNs) are trained to provide individualized assessment of nutritional needs and to guide a person with diabetes, step-by-step, to make positive diet and lifestyle changes to effectively manage his or her disease.

12. Alanna Waldron

A1: The best way to keep energy levels and to manage diabetes is to eat a balanced diet, consisting of proportionate lean protein, vegetables, whole grains, fruits and dairy (if possible). Eating every 3-5 hours with snacks or small meals including at least some form of lean protein plus complex carbohydrates.

A2: For picky eaters with diabetes, I would suggest thinking about adding on to the current foods they will eat and not thinking about what they can't have. For example, if they want pizza, opt for homemade with whole-grain crust and veggie toppings. This way, they are still enjoying pizza but adding a serving of vegetables and whole grains instead of refined white flour. Another example would be to "hide" veggies in the form of cauliflower "mashed potatoes" or cauliflower "rice" with stir-fry. Gradually making healthier swaps for their favorite foods will help make their blood sugars more manageable.

A3: A plant-based diet is fine for diabetes as long as they are not over consuming refined, simple carbohydrates in place of meat or seafood. Planning ahead and knowing the sources of plant-based, high protein options are crucial.

A4: A dietitian can help with meal planning, ensuring the individual is getting adequate amounts of carbohydrates through carb counting and with the appropriate sources of carbohydrates. They can also help the individual adjust eating habits including eating the correct amount of carbs based on insulin (with type 1 diabetes). Dietitians will also provide meal/snack suggestions based on activity level.

13. Susan Weiner

How can a dietitian help someone with diabetes?

A1: (No comment for this)

A2: (No comment for this)

A3: (No comment for this)

A4: If you have diabetes, or love someone who does, please consider making an appointment with a Registered Dietitian-Nutritionist (RDN), who is also a Certified Diabetes Educator (CDE). An RDN can provide medical nutrition therapy (including diabetes related nutrition information such as carbohydrate counting) as well as help you select nutritious foods. These healthy improvements in your diet may help positively influence your blood glucose levels. Medical Nutrition Therapy includes an assessment of current eating habits and development of an individualized eating plan specifically designed for your specific health conditions, life style and personal preferences. A dietitian can empower you to make long-term changes to your food and nutrition habits. My motto is “small steps lead to big changes”. For example, start with an afternoon snack swap: “Swap-out” afternoon cookies and “ swap-in”  cut up red peppers and broccoli with hummus. Your registered dietitian can help you with these types of practical ideas!

14. Kristyn Hal

A1: Manage your energy levels and diabetes by nourishing your body with healthful foods throughout the day. Poor energy levels can be due to several issues. Just like a plant - our bodies need water! Ensure you are eating often enough in the day and keeping yourself watered.

A2: Check out their cooking methods. How are they eating the food they hate? Could they try a different cooking method or try a new recipe? For example, people often overcook fish to the point that it is dry and chewy - and then they say they don't like fish...I wouldn't like it either when prepared that way. Or, maybe they don't enjoy boiled cauliflower - but have they tried it roasted with some sea salt and a flavoured balsamic vinegar? Have they incorporated some basic spices to enhance the foods flavour while adding in an extra layer of health-promoting antioxidants?

Take a health-inspired cooking class where you can learn that healthful foods can be prepared in a decadent and delicious way! http://energizenutrition.ca/classes/

A3: Going on a plant-based diet implies an all-or-nothing approach to our health. I would encourage people with diabetes, and most adults, to incorporate more plant-based meals into their diets (i.e. - how they eat). Start with one meal - maybe lunch or supper - and enjoy a plant-based chile or soup. Make sure to use a good recipe that uses ingredients and techniques that build flavour. Try this simple recipe: http://pulse.ab.ca/images/uploads/page_files/APG_Grocery_Cards.pdf

A4: Find a dietitian to be your food and nutrition coach. Just like you have investors to help you manage and grow your money long term, a dietitian can help you customize food and nutrition strategies for your life's needs today, tomorrow and in the future. Diabetes requires a long-term management plan. You should expect a longer-term relationship with this dietitian - so find one whom you like and feel can understand and help you address your unique needs. I specialize in helping men and women over 40 achieve vitality and wellness through energizing their nutrition, one bite at a time.

15. Aaron Flores

A1: The best way to keep energy levels up is to really listen to your body after each meal.  Each person is unique, and especially with diabetes, our bodies response can be different to what others do/feel.  I recommend starting with balanced meals (protein, starch, and fat) and playing with proportions at each meal so see what makes you feel best.  With my clients, I stress flexibility with all meals based on time, environment, feelings and access to food.

A2: We all have individual food preferences and what I see commonly in my office is that sometimes those preferences are steeped in feelings of “what I should do” versus what actually happens.  If you are truly a picky eater, that is ok, and like my first answer, I’d recommend each person to be mindful of how your body feels after each meal (without judgement).  This type of mindfulness helps us honor our body which leads us to doing “good things” for it, no matter what food preferences we have.

A3: First off, yes following a plant-based diet can and is a possibility when you have diabetes. Second, I always want to know the “why” of these decisions instead of answering “how”.  That means, for each person, it is important to understand why we are choosing a plant-based diet.  If it comes from a place steeped in diet culture and restriction and possibly, weight loss, then I don’t recommend it.  In my experience, those cases will likely back fire and could lead to more binge eating down the road.  If it comes from a place of ethical and environmental concerns, then I find people tend to stick to it for much longer and it never feels restrictive.  I emphasize each person be flexible with these choices if possible so being a “flexitarian” might be more realistic in the long run.

A4: A dietitian can be invaluable for someone with diabetes.  I recommend finding a dietitian who is also a Certified Diabetes Educator as they have training in the management of diabetes but can so provide assistance and recommendations on insulin adjustment.  As with any medical condition, I highly recommend a dietitian working alongside the medical doctors and nurses to help provide valuable insight to the patient’s specific issues.

16. Kimberly A. Tessmer

A1: It is vital for people with type 2 diabetes to eat consistently throughout the day to control blood sugar levels. Not only does it help with blood sugar but it will help to keep energy levels up throughout the day. Eating small, healthy meals and snacks throughout the day is the best way to manage diabetes and its symptoms. Include healthy carbohydrates and lean proteins to help with blood sugar levels. Plan all of your other food groups into your meals and snacks including whole grains, fruits, vegetables, healthy fats and lean proteins. Count your carbohydrates and keep calories maintained for a healthy weight loss.

A2: Exercising on a regular basis can help boost energy, control blood sugar levels and help you reach and/or maintain a healthier weight. Getting plenty of sleep, managing stress, and drinking plenty of water daily are also great tips in helping to restore energy levels.

See your doctor regularly and if you feel fatigued be sure to discuss it with your doctor to ensure there is no underlying reason for your symptom.

Again, eating small meals consistently throughout the day is number one. Choosing healthy foods that a person with diabetes does like and learning how to incorporate those into their diet is key. No matter what, highly refined foods with lots of sugar are not recommended for someone with diabetes and for that matter, anyone. It is important to find healthier foods that they enjoy and to save the not so healthy foods for special occasions. A person with diabetes must control their blood sugar to help decrease the risk of developing other medical issues. So picky or not they need to find healthy foods that they enjoy and that will fit into their diet. The more a person understands and learns WHY it is so important to eat certain foods, the more willing they will be to make changes that are necessary.

A3: A person with diabetes can definitely go on a plant based diet if they choose. However, it is essential that they learn about foods and the nutrients they need, such as protein, to ensure they are properly managing their diabetes and their nutritional needs are being met. If consuming any animal foods, which are our main source of protein,you need to include a good mix of fruits, vegetables, whole grains, nuts, seeds, and beans on a regular basis. Investigate other sources of protein including plant based milks such as unsweetened almond milk, soy foods such as tofu, quinoa, legumes and nut butters. It is important to choose carbohydrates wisely. Usually a vegan diet is typically higher in carbs so you need to choose carbs that are higher in fiber such as whole grains and beans to help control blood sugars.

A4: There is so much to learn about food and how to eat healthy whether you have diabetes or not. However people with diabetes need to use food to help manage their disease. Dietitians are the professionals at teaching people how to do just that. They can help properly educate, support and motivate those with diabetes. The more people learn, the easier their life becomes. The better people are at managing their blood sugar levels the more they lower their risk for health issues related to diabetes.

17. Helen Bond

A1: Stabilise your blood glucose levels by enjoying regular healthy, balanced meals and nutritious snacks. Don’t go for prolonged periods without eating, and space your breakfast, lunch and dinner at regular intervals to manage your hunger and avoid overeating. That way you’ll avoid blood glucose peaks and troughs, and the resulting drop off in energy and alertness. Go for low GI foods, such as porridge oats, low fat yogurt and milk, pumpernickel and rye bread, sweet potatoes and pulses (chickpeas, red lentils or cannellini beans, for example) to help release glucose and energy slowly. Include protein in meals and snacks to stay fuller for longer.

A2: It is a myth that once diagnosed with diabetes people have to ‘give up’ their favourite foods – and love of eating! The odd treat here and there is absolutely fine, but what is important is to enjoy things in healthy moderation. I always advise people that it’s about lifelong healthy eating and living, taking little decisions along the way that balance pleasure and moderation. My 80/20 rule is simple - if your meals are 80% healthy, then it’s OK to treat yourself with the remaining 20% - and no foods are off limits!

But, bear in mind that you have to live with diabetes for the rest of your life, so it’s in your best interest to observe moderation and portion control for better glucose management and overall health.

A3: Yes, plant food and plant based diets have a number of beneficial characteristics when it comes to managing diabetes. Firstly, they tend to contain fewer calories than animal-based foods – and thanks to a valuable mix of plant based protein and fibre help to fill you up - important for maintaining a healthy weight. Second, eating more fruit, vegetables, pulses and grains provides an array of different vitamins, minerals and plant compounds which all work together to keep your heart and circulatory system healthy - a key consideration for those with diabetes. As a result, many leading health bodies, including the World Health Organisation, emphasise plant based eating in their recommendations to promote good health.

A4: If you’re told you have diabetes, it’s essential that you seek a consultation with a State Registered Dietitian to see what dietary and lifestyle changes can help manage your diabetes, in order to live a long and healthy life. Dietitians are the only qualified professional that assess, diagnose and treat diet and nutrition problems. They are the only nutrition professionals to be regulated by law and governed by an ethical code. You are in safe hands when you see a dietitian, as they always work to the highest standard!

18. Jo Beer

A1: Have low glycaemic index (GI) carbohydrates in your meals and add in some high protein and low GI snacks in between meals such as yoghurt, cottage cheese and crackers, three bean mix.

A2: Portion control and high fibre is the key – look at what of these foods you enjoy on a regular basis and with the help of your dietitian work out how to incorporate these throughout the day.

A3: A plant based diet is a good option for those with diabetes as if done correctly it tends to be high in low GI options, fibre and insoluble fibre – all of which are great for your blood glucose levels.

A4: A dietitian can assist you by assessing your current intake, highlighting what is good and not so good in your diet and producing a tailor made meal plan and dietary goal to help you with your blood glucose levels.

19. Dana L Thompson

A1: The best way to keep your energy levels up while when weight loss is a well planned meal plan.  Counting carbs and distributing them thought the day during meals and snacks keeps blood sugars stable. Meals and snacks will provide the right amount of energy when your body needs it. It is important to make time for meals.  Skipping meals and snacks set a person up for over eating or under eating.  Too many carbs at once raises blood sugar making you feel sluggish.  Skipping meals and snacks limits the energy you have to do exercise or activities which help burn fat.

A2: Picky eaters is a general term for those who fail to eat fruits and vegetables in favor of less nutritious foods.  Try to make a list of fruit and vegetables you do like and make certain they are part of your meal plan daily so at least you will get the benefit of the nutrients, fiber and antioxidants they provide. Good nutrition is as important as blood sugar control to maintain health and prevent the complications of diabetes long term.  If you are a long term pickey eater it is likely your taste will not change, but adding more of what you do like and preparing those foods in different ways keeps you from resorting to less nutritious choices that won't benefit you in the long run.

A3: A plant based diet means many things to many people.  It can mean more fruits and vegetables, and/or less non-junk foods to a vegan diet.  Each person needs to identify what their time and meal planning capabilities are to truly support their goals.  Almost all plant based diets can support a diabetic meal plan.  It is important to understand your nutritional and diabetes management goals before making any drastic changes to your diet.  Consultation with a Registered Dietitian Nutritionist who is a Certified Diabetes Educator (CDE) will help you create your diabetes care plan and provide you with insight as to what type of plant based diet will meet your nutritional and blood glucose control needs. It is important to remember that meal planning in the context of goal setting must be realistic and can be accomplished.  An RDN can help create a program to help you meet those goals and be successful in the management of diabetes.

A4: A Registered Dietitian Nutritionist is uniquely qualified to help people with diabetes create and plan meals which meet therapeutic blood glucose targets.  They recommend meals which meet the clients' nutritional requirements while taking into consideration lifestyle and favorite foods.  An RDN will work hand in hand with a client to help them be successful in meeting their diabetes care goals. Strict or trendy diets or programs that do not monitor or consider the therapeutic blood glucose targets or the lifestyle of the client are doomed to failure for the client. A partnership of care goes much further for patient success.

20. Erin Gregory Hendrickson

A1: Drinking water and munching on healthy snacks throughout the day can help maintain energy levels.  Fiber and protein from nuts, nut butters, berries and root veggies won’t allow a midday crash.

A2: Experimenting with cooking methods, flavors and textures provides options for picky eaters. Tastes change over time and it’s wise to give foods a second chance before writing them off.  Don’t deprive yourself of foods you love, but do be mindful of portion sizes and make sure your meals are balanced.

A3: Research shows a plant-based diet improves cardiovascular health, which positively impacts diabetes.  Although this way of eating promotes most nutrient intake from plants, it’s not restrictive of lean meats like it’s vegetarian and vegan counterparts. RDN approved!

A4: A dietitian can help those with diabetes take control of blood sugar levels and prevent associated health risks.  We provide support, fill knowledge gaps and recommend specific nutrition recommendations based on health goals and needs.

21. Sharon Collison

A1: For those trying to lose weight and manage diabetes, a good strategy to prevent overeating calories and carbohydrates is to eat a meal or snack every 3-4 hours with a total of 3 meals and 2-3 snacks/day that all contain a good balance of protein, carbohydrates and healthy fats.  Keep your grams of carbohydrate at each meal and snack in the range recommended by your registered dietitian/nutritionist (RDN) and try to include approximately 25 grams of protein at each meal as well. Snacks can contain less protein, such as 7-10 grams at each. Choose high-fiber starch/grain foods often such as whole grains, fruits, vegetables, and legumes.

A2: Picky eaters may not be able to enjoy a wide variety of foods.  However, it is just as important for them to count carbohydrate grams and keep their intake as recommended by their dietitian at each meal and snack. I encourage picky eaters to commit to trying at least 2 new foods per month and agreeing to eat each new food that they “tolerated” again with hopes that if they tolerate it at first, they might very well eventually enjoy it.

A3: There is some evidence that a plant based diet can help manage both body weight and diabetes. One controlled study found that a vegan diet was just as effective as a standard diabetic diet at improving blood sugars.  However, this was just one study and there were several limitations to the study including a short treatment time period of only 3 months and most of the participants were female.  Since each individual’s dietary choices and food preferences vary greatly, it is not realistic to recommend vegan diets to all diabetic patients. For a person who eats meat frequently, changing to a vegan diet may not be realistic. Simply increasing intake of plant-based foods and decreasing intake of animal foods might improve overall health and blood sugars without the need to be strictly vegan. However, if a vegan diet is desired, it’s certainly worth a try with the support of a registered dietitian who can help ensure nutrient needs are met.

A4: An RDN provides individual nutrition counseling  based on a particular person’s health and lifestyle.  The RDN takes into consideration each person’s specific treatment goals, personal preferences including culture, religion, traditions, food preferences, and economics, as well as the person’s ability and willingness to make lifestyle changes when counseling and educating those with diabetes. Using this information, an RDN will develop a meal plan for each patient to improve blood sugars and also address additional goals such as weight loss, improvement in blood lipids or blood pressure, improvement in sports performance/energy levels, and food allergies/ intolerances/”pickiness”.  In addition, the RDN can educate the patient on nutrition label reading, carbohydrate counting, how to estimate appropriate portions when eating out, and cooking techniques/recipes for easy-to-prepare healthy meals. Meeting one-on-one with an RDN is critical for anyone with diabetes.

 22. Lisa Hugh

A1: It is really important to eat balanced meals and to eat the right amount of carbs at each meal. At a very minimum, meals and snacks should include some protein and some carbohydrate. Each meal should have roughly the same amount of grams of carbohydrate. This doesn't mean eating exactly the same foods every day, but the amount of carbohydrates per meal should stay the same.

A2: For picky eaters, planning meals can be really difficult if they are thinking about what they dont like and what they can't have. Instead, think about what you need: How many carbs do I need at this meal? Also, think about what you like? What fruit, vegetables, complex carbohydrates, lean proteins, and healthy fats do I like? Now, see how these can fit together

A3: A plant based diet can be really healhty or really unhealthy (french fries and diet soda for lunch). Just because a meal or diet is vegetarian or plant based doesn't mean it is the right diet or meal for you. The diet should include protein sources, complex carbohydrates, fruits, vegetables, and healthy fats.

A4: A Registered Dietitian can help you figure out how to personalize your diet. There are a lot of wonderful resources on healthy diabetic diets but if the diet doesn't match your preferences, routine, work schedule, food allergies, family needs, etc, then the diet is not healthy FOR YOU. A Registered Dietitian can also help fine tune your diet. For example, I had a client today who improved his HBA1C from 11 to 7.5. Overall he was following a consistent diet pattern for his meals, he ate regular snacks, he was physically active, and was taking his medications as ordered but hit a plateau. In discussing his diet we figured out that he stopped eating fruit after he was advised that it had too much sugar. But he had a physically demanding outdoors job and was hungry between meals. He was eating snack cakes and honey buns from the gas station. I helped him understand the amount of carbohydrates and sugars in his current snack vs in a snack that included fruit and protein. Another client had a healthy diet and changed from sweet tea to unsweetened tea. But she was adding in a flavored syrup for flavor but didn't realize that it was a hidden source of sugar in her diet.

23. Nancy Clark

A1: Fuel adequately during the active parts of your day and eat a little lighter at night.  Exercsie after having eaten, so you have energy to exercise.

A2: They need to find enough nutrient-rich foods that they like and eat them on a schedule, being sure to combine carbs with protein.

A3: Yes, as long as you get enough plant protein.

A4: Help them learn how to manage food, health and weight.

24. Patricia Chuey

A1: Eat well balanced meals and snacks. In meals, that means half the plate as vegetables with a serving of quality protein and a small serving of whole grains. In snacks, this means eating both protein and carbohydrate together. For example, half an apple and a few almonds rather than just the fruit. Staying well hydrated and eating evenly and consistently throughout the day, not allowing more than about 4 hours to pass between eating also helps sustain energy. Staying active, managing stress, sleeping well and fresh air are also important in staying energized.

A2: Keep a list on the fridge of all of the healthy meals and snacks that you DO enjoy so when you get the urge to eat, you will have an idea of what to choose. Eat as wide of a variety as possible but even with a limited variety of choices, ensure meals and snacks are well balanced and distributed evenly throughout the day.

A3: I am thinking of going on a plant's based diet. Is that wise if I have diabetes? Yes, a plant-based diet is an excellent way to go if you ensure all meals and snacks include both protein and carbohydrate foods. Nuts, seeds, nut butters, tofu, dried beans, dried peas, chickpeas and lentils are excellent plant sources of protein. If still eating eggs and fish, they are also great quality protein foods.

A4: How can a dietitian help someone with diabetes? A dietitian will review what you are currently eating and how you are feeling. She/he will work with you to ensure your food intake meets your energy and nutritional needs while promoting optimal blood sugar levels and excellent diabetes management. She/he will factor in your unique needs in terms of health, exercise, age, food budget, likes, dislikes, allergies, intolerances and many other issues that impact food choices.

25. Crystal Michelle Cascio

A1: When I think of the term “diet”, I tend to think of something short-term. I like to use “diabetic lifestyle” when discussing positive lifestyle changes to help better manage blood sugar levels, as it really is a lifelong (and worthwhile!) process.

A2: A diabetic lifestyle is one that actually promotes a balance in our energy levels throughout the day. An integral part of eating for diabetes control is consuming consistent, balanced meals. Eating in this way I would argue is one of the best ways to help control energy levels! The key is to avoid feelings of extreme hunger and fullness. Staying hydrated throughout the day is also a must for controlling our energy levels while living a diabetic lifestyle.

Alongside nutrition, the importance of adequate rest and stress management cannot be overstated to help balance our energy levels throughout the day.

When I work with picky eaters who have diabetes, we often sit down and make a list of ALL the possible healthy food options that they do enjoy (even if it’s not many!) for these food categories I feel are essential for controlling diabetes:

• Minimally processed whole grains and starches
• Healthy fats
• Fruits
• Vegetables
• Proteins

Usually we can find at least a handful from each category that they enjoy! When we are cutting back on sugary foods and drinks, our taste buds change in a matter of weeks. I always emphasize to patients that foods you may have not liked before you may enjoy now, as the taste buds have adapted to tolerate less sugar compared to before. Remember: a diabetic diet is meant to be enjoyed, as it is filled with so many delicious, minimally processed, whole foods!

A3: A plant-based diet is definitely a wonderful diet option for those living with diabetes who are interesting in pursuing this option.  They key to plant-based diets is ensuring you are getting all of the different nutrients your body needs for overall health and to control blood sugar levels from a variety of plant-based foods. I cannot emphasize variety enough, as this is essential on a plant-based diet!

A4: A Registered Dietitian can help someone with diabetes by providing a personalized nutrition plan to not only control blood sugar levels, but to promote overall health and quality of life.

26. Kelli Shallal

A1: I don't believe in diets or diabetic diets.  When I start coaching a client who would like to reverse their condition I tell them there is no diabetic diet, it is the way almost everyone should be eating.  The exception being athletes who require a significant increase in carbohydrates.  It is important to eat enough calories and balanced meals so that energy levels stay up, whether the goal is weight loss or not. You should never cut your calories so low that you become tired and lose energy.

A2: Stop thinking of it as a diet and focus on eating the foods you like in balanced portions.

A3: I think it depends on your definition of plant-based diets.  I consider any meal that contains over half the meal made up of plants as plant-based, even if it includes other foods. As with any meal pattern or style of eating, it is important to have a balanced intake of fat, carbohydrate, and protein at every meal.

A4: A dietitian is a highly trained medical professional that will stay on top of the science and provide you with an evidenced-based approach, no cleanses, gimmicks or extremity.  I work with my clients to come up with meals they like, to manage eating out, and to customize a supplement protocol.  In general, the clients who work with me are not yet insulin dependent and so our goal is always to reverse the condition or decrease the amount of medication required.  In addition to nutrition education, we also tackle food behavior such as intuitive eating so they develop confidence in their plan and food choices

27. Danielle Beck

A1: It’s particularly important for those managing diabetes to maintain regular eating patterns. Skipping meals is not only detrimental to blood sugar levels, but can lead to excessive hunger and over-eating later in the day.

A2: As with all picky eaters, I suggest making small, gradual efforts to introduce new foods into their diet. With diabetes, it’s more critical to maintain stable blood sugar levels, so high-carbohydrate meals should be scaled to fit the individual’s needs. Take, for instance, a person with diabetes who has been regularly drinking 4 glasses of soda per day. A more feasible goal may be to first replace two of those glasses with diet soda. Making long-term dietary changes can be difficult, and starting small is usually a more sustainable approach. Once those changes have become habitual, subsequent goals can be set.

A3: Plant-based diets can provide many health benefits and are encouraged for those with diabetes. It’s important to first understand the foundation of a healthy plant-based diet - fruits, vegetables, whole grains, legumes, nuts, and seeds in their less-processed form have many health-promoting properties. Those with diabetes should be particularly mindful to combine protein and/or fat-rich foods with carbohydrate-rich foods to reduce the glycemic response. For instance, as a snack, pairing an apple with peanut butter. Or, proportioning your plate to contain half vegetables, a quarter plant-based protein like beans or tofu, and a quarter whole grains. It’s advisable to consistently monitor your blood sugar levels and make changes accordingly.

A4: Dietitians are trained in clinical nutrition therapy, which is critical for those with medical conditions. For nutritional guidance, it’s best to consult with a R.D. who can use their expertise to make individualized recommendations. Additionally, dietitians have counseling experience. So while someone with diabetes may feel confident in their knowledge of which foods they should eat and avoid, it can be beneficial having an R.D. work with them to help set and achieve their goals.

28. Stefania Palmeri

A1: As a dietitian, I try to take a non-weight based approach to counseling and focus on nourishing the body with the right mix of nutrients instead of restricting calories. Most people on a diet feel they have low energy because they are likely not receiving enough calories or nutrients through the day.  If an individual with diabetes is looking to manage their weight and improve energy, I would recommend eating regularly (every 3-4 hours), including a protein source at each meal and snack, and being mindful of their choices.  Being mindful requires someone to identify if they feel genuine hunger (stomach growling) or appetite (I like it, I crave it).  If their craving is driven by appetite, ask why – are you bored?  tired? stressed?  This helps to reduce extra food choices that our body may not necessarily need.

A2: In the short-term, picky eaters can use foods that they do enjoy to model the plate method.  Ensure each meal includes ¼ whole grains or starch, like brown rice, quinoa or sweet potato; ¼ lean protein, like chicken, fish; and ½ plate of vegetables at lunch and dinner.  Breakfast can be varied slightly from this model to include protein from dairy, eggs, or nut butters, and a fruit.

In the long-term, I highly recommend picky eaters work with a dietitian to explore new ways to liberalize their diet.  There may be different ways to integrate foods they didn’t think they would enjoy.   Eating the same foods every day, even if they do fit the plate method, limits one’s nutrient intake and can be boring for a client.  Introducing just one new food in a way that a person feels comfortable can have a huge impact on their nutrient intake and enjoyment of a meal.  For example, if someone dislikes dark green vegetables but manages to mix in spinach into smoothies, pasta sauces, or omelettes, they have added in serving of vegetables, plus a great source of iron and folate.

A3: Absolutely, provided it is done in a balanced manner.  Vegetarian and vegan diets are higher in fibre and lower in saturated fats.  For clients with diabetes, this often results in improved A1C readings and a reduction in heart disease risk.

When clients first start to think about a vegetarian diet, I encourage them to be particularly aware of protein-rich foods as it is critical for stabilizing blood sugars.  Without enough protein, clients may notice they lose muscle mass, don’t feel as satisfied after meals, and have increased cravings for and reliance on starchy foods (e.g. white pasta, white rice bowls, etc.).  This typically elevates their blood sugar levels. In order to follow a plant-based diet, one must be comfortable eating nuts, seeds, legumes, and alternatives like tofu and soy milk, daily.

Those on insulin may want to consult a dietitian to review how to calculate net carbohydrates for new foods, as the increase in fibre in foods like legumes may cause their blood sugars to react differently than they expected.

I also recommend a vitamin B12 supplement, as this nutrient is exclusively found in animal proteins. Without enough vitamin B12, an individual may feel more tired than normal or experience tingling sensations in their hands and feet.  I encourage clients to have their vitamin B12 levels tested regularly, also because metformin and other drugs, can create a B12 deficiency.

A4: There are multiple ways a dietitian can help someone with diabetes. A dietitian can help improve your blood sugar control and take the fear out of eating.  Many people with diabetes receive mixed messaging from media. They may be afraid to eat carbohydrates from grains, sweet fruits like grapes, or feel they need to resort to drastic diets to manage their blood sugars.  I have always been trained to believe that you control your diabetes; the diabetes does not control you.  Dietitians can help you figure out how to take control of your disease, including how and why foods can impact your blood sugars.  Those on insulin can benefit from looking at how to read labels, calculate carbohydrate exchanges, and use this to dose their insulin accurately.  Even those who have had diabetes for many years may benefit from dietitian support to help manage the long-term consequences of diabetes, including heart and kidney disease.

29. Erin Palinski-Wade

A1: If weight loss is your goal, make sure that you do not skip meals or drastically cut calories in an effort to lose weight faster, which both can drain energy and cause erratic blood glucose levels. Eating small, frequent meals and snacks rich in lean protein, healthy fats, and fiber can stabilize blood glucose levels, helping to provide steady energy throughout the day. Avoid foods rich in added sugars and refined carbohydrates such as white bread, which can spike then crash blood sugar levels resulting in inconsistent energy levels and increased hunger and cravings.

A2: Most foods can be enjoyed with diabetes, however you must space out your intake of carbohydrates throughout the day to prevent spikes and crashes in blood glucose levels. If you have specific foods you love to eat that may have a negative impact on blood glucose levels such as foods rich in added sugars, white flour, or large amounts of saturated fats, consider swapping them for great tasting options that may not have a negative impact on health. For instance, if you crave chips, choose a variety made with 100% whole grain flour such as chips made with bean flour or whole-wheat flour. Pasta lovers can swap out white flour pasta for brown rice pasta, chickpea pasta, or whole-wheat pasta. Chocolate lovers can swap the candy bar for a KIND Nuts & Spices Dark Chocolate and Sea Salt bar which satisfies the sweet and salty craving with only 5 grams of sugar using only ingredients you can see and pronounce while providing a source of healthy fat, fiber, and protein to promote fullness.

A3: Absolutely! Plant based diets have been associated with a reduced risk of heart disease (a major risk for individuals with diabetes). A plant-based diet filled with vegetables, fruits, beans, lentils, nuts, seeds, avocado, and plant-based oils can allow you to meet your nutritional needs without spiking blood glucose levels. No matter if your diet includes animal proteins or not, spacing out your carbohydrate intake is keep to blood glucose control. Balance your plate by filling one half with non-starchy vegetables, one quarter with whole grains, and one quarter with a mix of plant-based proteins and healthy fats.

A4: Every individual with diabetes is unique. A dietitian specialized in diabetes can help you to determine your health and blood glucose goals, the amount of carbohydrate appropriate for you to consume at each meal and snack, and show you how to incorporate your favorite foods into your meal plan while maintaining healthy blood glucose levels.

30. Emily Fonnesbeck

A1: As a non-diet dietitian, I would actually recommend focusing more on how you feel or function than how well you are sticking to a diet.  This means I encourage you to focus on eating in ways that support energy levels.  Chances are that if you are feeling well, your other body process - including blood sugar management - are working adequately too.  This will take a little more trial and error than being told exactly how to eat, but if you tune into the feedback your body is giving you (hunger, fullness, satisfaction, pain, fatigue, etc), you have all you need to know in order to self-moderate your food choices for overall well being.

A2: It’s very common to associate healthy eating with restrictive, flavorless meals. In reality, healthful eating patterns are flexible and encourage balance and consistency. Managing blood sugar becomes easier with balanced meals, which will include a protein, carbohydrate, fat and a fruit and/or vegetable.  You have wiggle room to add flavorful ingredients like butter, oils, dressings, sauces and other higher fat condiments.  You may find that nutrient-dense foods are more appealing when they are cooked and prepared in ways which are satisfying.

Also, fiber will be helpful in delaying the release of glucose into the blood stream.  Often individuals with diabetes become unnecessarily restrictive with carbohydrates.  Spreading them out during the day and emphasizing those with a higher fiber content will allow for more satisfaction at meals, more sustainable energy between meals and more flexibility for types of meals.  Think of meals you already enjoy and look for a higher fiber carbohydrate alternative like  whole grain bread on your sandwich, whole grain pasta at dinner and brown rice in your stir fry.  And remember, the recommendation is to make ½ of your grains each day whole grains so you have wiggle room there too!

A3: We have so much data that supports the health benefits of a plant based diet, including for diabetes.  If you are interested in trying it, feel free!  In fact, I really like the term “plant-based” as a broad recommendation for building meals around plant foods, that’s a great recommendation for everyone. Plant based diets are possible for anyone and really isn’t indicative of someone choosing to exclude or include animal products.  You can get the benefits of a plant based diet without it needing to feel restrictive.   It can leave room for one’s food preferences, access to certain foods and inclusion of animal proteins if one desires.  (I should also note that it is quite possible to meet all your nutritional needs on a vegetarian or vegan meal plan. You may want to consult with a dietitian to ensure you are meeting all recommendations.)

A4: Nutrition plays a vital role in our health.  A Registered Dietitian is the nutrition expert and is well-trained in Medical Nutrition Therapy which can be applied in any health or wellness concern.  We are also able to help you notice behaviors, beliefs or thoughts about food that could be preventing you from establishing normal and healthy food patterns.  While there are many food opinions, testimonials and trends, dietitians use research and experience to ensure you are getting evidenced based care.

31. Lauren Renlund

A1: I believe one of the best ways is to incorporate nutritious snacks into your diet. A healthy snack can help boost your energy levels, provide you with important nutrients and help to manage blood sugar levels. 1-3 healthy snacks per day can be beneficial. Try including both fibre and protein in your snacks. For example, carrots with hummus, or an apple with peanut butter.

A2: It takes time to get used to new foods. Don't give up on a food right away if you don't love it. Keep on trying that food, even if it is just one bite, and hopefully, over time you will start to truly enjoy it.

A3: A plant-based diet can be very nutritious and appropriate for diabetes when done right. Make sure to still include sources of protein such as tofu, edamame, nuts, seeds, soy milk and lentils. I would also recommend talking to your dietitian before making this change to make sure you are still getting all of the nutrients you need.

A4: It can be hard to make changes to your diet but working with a dietitian can make it easier. A dietitian can support you every step of the way and give you evidence-based nutrition tips to improve your health. There is also a lot of conflicting information about diabetes on the internet. A dietitian can help evaluate for you what information is fact and fiction.

32. Lynn Cicero

A1: Keep up energy levels – Energy tends to sag along with blood sugar levels. Low blood sugar can cause excessive hunger. Being overly hungry, leads to making poor food choices. To prevent blood sugar from taking a nose dive, try two small snacks in between three meals. If you plan an hour of vigorous exercise, include a pre-workout snack.

A2: Picky eaters – try looking for recipes that dress up the veggies. We don’t eat hamburgers plain. Why eat vegetables plain? There are quick veggie fixes available as www.whatscooking/fns/nih.gov. The site also allows the user to make their own custom cookbook.

A3: Plant based diets for DM – Plant based are very low in fat and high in fiber. Fiber slows the absorption of food allowing the body to handle the incoming carbohydrates. Plant based diets are also generally low in cholesterol. Given that heart disease occurs with Diabetes, avoiding fat and cholesterol while increasing fiber is a good thing. Depending on the stringency of the diet, it may lack key nutrients such as B12. It is wise to consult with a Registered Dietitian to be sure your plan is adequate.

A4: How does an RD help?- An RD is knowledgeable about the medical aspects of DM and is able to translate those recommendations to practical food choices. The best diet is one that takes into account lifestyle factors. The RD also provides ongoing support to continue the necessary changes.

33. Vashti Verbowski

A1: Meal timing and eating balanced meals (including low-glycemic starches, protein, and vegetables or fruit) are the best ways to keep energy levels up, while also managing blood sugar levels.  By eating consistently throughout the day (and NOT skipping meals), your body will have a steady supply of fuel to keep energy levels up and maintain consistent blood sugar levels.  Balancing your plate also helps with energy levels, since starches supply you with energy, and proteins and fats slow how quickly your food is digested, resulting in longer lasting energy and better blood sugar control as well.  Higher fibre, lower glycemic starches also keep your energy levels up for longer.  For example, a balanced breakfast might look like a bowl of rolled or steel cut oats (a low glycemic index starch) made with milk or hemp hearts (for protein) and frozen or fresh blueberries.

If you are also trying to lose weight, it makes it easier to control your portion sizes when you eat 3 main meals vs. one or two meals each day.  When we skip a meal, we might be ignoring important body cues that tell us we are hungry, and chances are, we may feel over-hungry and overeat at the next meal, again ignoring those body cues (which are telling us we are full this time).  This is a frustrating situation to be in - your body doesn't know when it will get the next meal, and consequently, you may not feel in control of how much you eat when you get that next meal.  Instead, by eating regular meals throughout the day, your body becomes accustomed to the routine and has the right amount of time between meals to get hungry and feel full after eating.

Snacks between meals are also important for some individuals with diabetes, especially those who are active or who take insulin and need to keep their blood sugars levels up.  Avoid processed foods for snacks, and go for whole foods instead, such as unsalted/unflavoured nuts, plain yogurt with fruit on top, cheese with whole grain bread or crackers, or fresh vegetables with hummus for dipping.

A2: Eating is one of many pleasures in life and living with diabetes doesn't mean you cannot enjoy your food.  Choose foods you like, but remember to balance your plate, and avoid highly processed foods and refined flours/cereals as much as possible.  If all your favourite foods happen to be packaged or processed, then consider signing up for a cooking class to broaden your horizons!  Sometimes we just need to learn new ways to prepare food.  Personally, I was never a fan of cauliflower until I learned that I could roast it.  If you do indulge on occasion (that's just part of life), you can lower your blood sugars by doing some exercise afterwards.  Or, if you want a sweet snack, like chocolate or a cookie, try having a smaller portion of the sweet stuff and balance it out with some protein, like a small handful of nuts.

A3: Plant based diets are great for managing diabetes, but just like any other diet, we can make poor choices that spike blood sugar levels.  It's important to choose low glycemic index options (such as whole grains, sweet potatoes, beans, and lentils) and avoid processed foods (such as white bread and refined cereals).  Ensuring your meals are balanced is still important on a plant-based diet, so be sure to include a source of plant protein at each meal (such as legumes, lentils, nuts, dairy products, or soy products).  If vegetarianism is new to you, see a dietitian to help you make healthy choices to meet your nutrition needs and control blood sugar levels.

A4: A dietitian will take into account how you currently eat, your lifestyle, and any other health issues or challenges you face.  Based on your needs and personal goals, a dietitian can help you make realistic lifestyle adjustments to manage diabetes.  With a dietitian, you can develop a plan of action that allows you to eat foods you enjoy, while also working towards your health and nutrition goals

34. Aimee Ramler

A1: Eating regular meals (and snacks for some people) throughout the day will ensure that energy levels are maintained. Eating regularly is important both for diabetes and weight management control. However equally as important as eating regularly, is ensuring that appropriate foods and serving sizes are taken into consideration. Different foods and portion sizes will have different effects on a person’s blood glucose levels.

Aiming for meals that consist of low glycemic index (GI) choices and an overall low glycemic load, will assist in promoting better diabetes management and aim to provide longer lasting energy until the next meal. Low GI foods such as wholegrain breads, dairy products and most types of fresh fruit will enter the blood stream slowly and likely cause less of a spike in blood glucose levels. Choosing foods low in GI and watching portion sizes will assist to provide meals with a low glyaemic load.

A2: Picky eaters, once they have an understanding of what food groups their preferred foods are from, can still manage their diabetes and blood glucose levels appropriately. If they enjoy foods that provide a range of carbohydrates, fats, proteins, fruit and vegetables, then they should be able to maintain their blood levels and enjoy their food. Dietitians can provide advice based on your food preferences to help you manage your diabetes.

A3: A plant based diet primarily involves eating foods derived from plants, such as whole grains, vegetables, legumes and fruits, and avoiding animal products. As long as this diet is well balanced and provides regular sources of carbohydrates, proteins, and fats, then a person with diabetes could follow this diet. It is important to speak with a dietitian before making a significant change to your diet, as they can ensure that you are still eating sufficient nutrients to maintain health. Patients that experience hypoglycaemia (low blood glucose) will still need to ensure that they are treating these episodes appropriately.

A4: Dietitians can provide a person with diabetes a better understanding of the relationship between diabetes and food. Everyone’s needs are different, and a dietitian can tailor a person’s food preferences to improve their diabetes control. A dietitian can help by suggesting appropriate dietary changes that will likely have an improvement on diabetes control.

35. Jennifer M. Ephraim

A1: Choosing the right foods, not skipping meals, exercising, and adequate rest are great techniques to help diabetics maintain energy levels throughout the day.

A2: Depending on the severity of their food neophobia, picky eaters can pose quite a challenge for their Registered Dietitian. For the most part, as long as they are not restricting themselves to sweet foods, a meal plan may be devised around the foods they enjoy eating. The introduction of foods that are normally not enjoyed but prepared and processed in a different manner through the utilization of new recipes may also be one way in helping to expand an individual’s palate. A perfect example that I have encountered is an individual who is prediabetic and avoids raw tomato but will only consume it in a tabouli salad.

A3: As long as your plant diet is not primarily comprised of starchy foods then, yes, a plant based diet would be greatly beneficial in helping to manage your diabetes. Plant based diets more commonly known as vegetarian or vegan diets, can aid in weight loss, help prevent complications of diabetes and the added fiber in these diets can better manage blood glucose control. Vitamin B12 deficiency can be a problem for vegetarians, and especially so for vegans as the nutrient is found in animal food products only. For that reason, it is recommended to supplement the diet with vitamin B12.

A4: A dietitian, and specifically one who is also a Certified Diabetes Educator (CDE), can coach and provide valuable input regarding strategies in changing life styles to help better manage blood glucose levels.

36. Joe Leech

A1: You have to cut back on any junk foods or foods with added sugar. A low-carb diet is also an eating pattern to consider, as there is considerable evidence now that it can have great benefits for those with diabetes. But making diet changes if you are on diabetes medications can be dangerous, so speak to your doctor first.

A2: They have to learn to cook their own food as much as possible. Cooking at home from raw ingredients typically results in a much healthier meal than buying out. Of course you would only cook meals that you know you will like, but try to make healthier versions. Or try some new recipes entirely.

A3: Yes this is an eating pattern that is also proven to help with diabetes management, and an alternative to a low carb diet which can be more animal-foods based.

Any eating pattern that cuts down on pre-made foods and junk foods etc will be a wise change.

A4: They can create a tailored meal plan for you based on your food preferences and lifestyle. Then you have a set plan (more or less) that you can follow and someone to contact when questions arise.

37. Janet Bond Brill

A1: Eat nutrient-dense, small, frequent meals (mini-meals) with a healthy carb, healthy fat and a lean protein such as: raw veggies with hummus dip or an apple with peanut butter.

A2: Look for healthy foods that you enjoy and eat them! Cook at home, focus on plant-based meals and use an authentic extra virgin olive oil as your main fat.

A3: Extremely wise as a nutritious plant-based diet is heart healthy and diabetics are at very high risk of dying from heart disease.

A4: Dietitians are invaluable for helping diabetic patients choose and plan an individualized heart-healthy diet that the person enjoys and can live with. They are the source for educating people with diabetes on how to manage the disease and still enjoy life! The cornerstone of treatment for diabetes is a healthy lifestyle (diet and exercise).

38. Ginny Erwin

A1: Do not skip meals.

Plan your meals and snacks every day.

Make sure you have all your nutrients covered- protein, carbohydrates, and fats.

Balancing your meals and snacks with activity will help you keep your blood sugars in control, and provide your body with unlimited energy and improve performance.

A2: Calling someone a “picky eater” is a negative way to label people. We all have our own food preferences, and we need to respect that fact. What is important is that we encourage people to try new foods, and be open to having new food experiences. In my private practice, I encourage people to try new foods, and experiment with new flavors that taste just as good as some of their own taste preferences. Many times, when people try new foods and new textures they discover they feel better, and notice certain foods help control their blood sugars better than other foods.

A3: Eating a plant based diet is great way to help stabilize blood sugars. Building meals around vegetables, beans, nuts and seeds, eggs, grains, and other sources of vegetable proteins can provide all the essential nutrients a body needs. New studies are showing that a plant based diet is good for people who have diabetes.

A4: A dietitian that has experience working with people who have diabetes is very important. Dietitians have the credentials to prescribe diets, and understand all the components that go into eating a healthy well balanced diet. Working with a dietitian is a great way to learn about your own food and lifestyle habits, which is very important to understanding how to manage your diabetes.

39. Mary Ellen Phipps

A1: The best way to maintain energy levels and manage your diabetes at the same time is to make sure that every time you eat a food with carbohydrate, you’re also eating some protein or fat. Protein and fat can help prevent blood sugar spikes, and the subsequent crash that comes after a spike. For example, don’t eat a piece of fruit or a rice cake by itself… eat half the amount you were planning on but add some nuts, nut butter, cheese, plain Greek yogurt, a hard boiled egg, etc. Or opt for foods that have multiple nutrients like beans (protein and carbs), yogurt (protein and carbs, or nuts (protein, fat, and some carbs).

A2: The key to managing blood sugar levels is what I referenced above, making sure that you’re not eating carbohydrate by itself. If you, or someone you know, is a picky eater, you can still enjoy the foods you normally love, but try to add some protein or fat sources in each time you eat. Also, exercise plays a huge role in managing your diabetes. Exercise helps your body respond to the carbohydrate, protein, and fat that you eat better and more efficiently, resulting in much more stable blood sugar levels over time.

A3: Definitely! Anyone can enjoy a plant based diet, even people with diabetes. One common pitfall when people switch to a plant based diet is eating too much carbohydrate. This can be avoided by identifying your favorite plant-based protein foods, as well as some great healthy plant based fats and always having them on hand. Some examples include: nuts, nut butters, seeds, beans, lentils, tofu, tempeh, quinoa, avocado, etc.

A4: A dietitian can help you learn how:

• To combine foods and different food groups to best manage your diabetes
• The food you eat will affect your medication (if you take any) and vice versa
• Exercise can help
• To meal plan correctly, but also in a realistic and budget conscious way
• It’s important for someone with diabetes to know how to do all of these things. There is a lot of information readily available on the internet… some great resources and some not so great.
• A dietitian can help you weed through what is true and what isn’t, and also help you personalize what you read and learn to your specific needs and situation.

40. Jackie Newgent

A1: Enjoy meals at regularly spaced intervals throughout the day—that includes planned snacks, too. Good carbs should be spread throughout the day as evenly as possible to help keep blood sugar levels stable. Sorry, that means no saving up carbs for dinner to have a never-ending pasta feast! Do make sure that there is a lean protein source (plant proteins count, too!) at every meal and snack; this helps to stabilize energy and keep you satisfied. And make sure to follow the golden rule: Don’t go more than 5 waking hours without a meal or snack!

A2: If you’re a picky eater, you can absolutely still enjoy favorites. But you may need to make some minor tweaks, like switching from a white burger bun to a whole grain burger bun and from a greasy beef burger patty to a not-so-greasy turkey burger patty. One tweak at a time is fine … small changes can add up to big health differences in the long run. Just try your best to fill half of every meal-time plate with non-starchy veggies … whichever ones you like, such as zucchini, tomatoes, mushrooms, asparagus, cauliflower, broccoli, spinach or kale, and whichever way you like them, including raw, steamed, grilled, roasted or sautéed!

A3: Yes, I highly encourage a plant-based diet for diabetes! There is substantial research to support the diabetes-associated benefits you can obtain from a plant-centered eating approach, including weight management and cardio-protective benefits. I advise speaking with a dietitian about diet changes to make to assure they’re healthful, portioned appropriately and, in certain cases, gradual. And if you have to closely manage your potassium or phosphorus intake, you’ll want to make sure to obtain a detailed meal plan to follow so that your intake of these minerals is managed properly as you make diet changes.

A4: A registered dietitian nutritionist (RDN) or registered dietitian (RD) provides medical nutrition therapy to help you manage your diabetes as well as make sure that you’re meeting all of your nutrient needs. They can provide individual advice that’s just right just for you and your overall diabetes needs, including creating a personalized meal plan, taking into account all of your health needs, lab values, medications, and physical activity level. A dietitian is also able to provide recipe ideas or direct you to respected sources for diabetes-friendly recipes, like those in my book, The All-Natural Diabetes Cookbook!

41. Lynsey Argota

A1: First of all, make sure you are eating balanced meals and frequently enough.  If you are going longer than 3-4hrs between meals and snacks, your blood sugar maintenance will not be optimal and you set yourself up for over eating which will also not be optimal for blood sugar maintenance.  Balanced meals consist of a protein source, a carbohydrate source and a fat source.  Fruits and veggies do contain some carbs so make sure you stay within your budget for carbs.  If you are not already, keep your carbohydrate intake consistent.  For example, if you have 45-60g of carbs at breakfast, have 45-60 at lunch and dinner.  Also keep snacks between 15-30g of carbs.  Believe it or not adding in some physical activity will actually boost your energy levels as well as your mood and immune function.

A2: For picky eaters, make sure you are eating the things that you like, in moderation and in the portion sizes that fit into your carbohydrate budget.  If you have to start out eating the same thing daily to stay in your carb budget, do so and expand at your leisure to include more things that you like that fit into your carb budget.

A3: Plant based diets are great, have many health benefits and is totally possible with diabetes. The only thing to remember is keeping in your carbohydrate budget for meals and snacks.  The thing about plant based diets is great because they have lots of fiber which help to stabilize blood sugar levels, provide satiety (keep you feeling fuller longer) and help to reduce cholesterol levels.

A4: Registered Dietitians can help people with diabetes learn which foods have carbs, learn how to count carbs, learn about meal timing, and trouble shoot meal planning and preparation.   We can also help educate patients on how their food intake, physical activity and medications interact. There was actually a study that showed the more time a patient spent with an RD, the better their blood sugar management was.   There are RDs with a specialization in Diabetes Self Management Education which are the best of the best resources when it comes to Diabetes care and that title is Certified Diabetes Educator (CDE).

42. Amy Kubal

A1: It is important to eat three balanced meals at regular intervals. Your meals should contain a palm-sized serving of lean protein, carbohydrates - primarily in the form of non-starchy vegetables and moderate amounts of healthy fats such as avocado, olives, olive oil, nuts and seeds. This will give your body the fuel and nutrients it needs to keep you feeling energized without relying on sugar and caffeine. Also, regular exercise and adequate sleep are super important if you want to keep the pep in your step.

A2: Many people insist that they “don’t like vegetables” or other healthy, nutrient-rich foods but it may be that they haven’t given these foods a fair shot. Trying different preparation methods, using herbs and spices to add flavor and experimenting with new recipes can completely change their perceptions. Additionally, in today’s world we have grown accustomed to hyper-palatable – high sugar, high sodium, fat-rich processed foods and therefore we don’t appreciate the flavors in real whole foods. Often by cutting out or significantly reducing intakes of hyper-palatable foods and increasing intakes of simple lean proteins, non-starchy vegetables and healthy fats many folks find that their tastes change. It takes time – but it’s worth the investment. Soon you may find yourself saying, “Pass the broccoli”!

A3: A plant based diet can work for people with diabetes but it is important to consider that many plant based proteins also come with a dose of carbohydrates. Beans, legumes and grains touted as high protein (quinoa, spelt, teff, etc.) are also carbohydrate rich and will impact blood sugar levels. Additionally, many ‘vegetarian’ packaged meat substitutes are highly processed and contain some not so great ingredients. It will take a great deal of thought and planning to ensure adequate protein and nutrients are provided, while still keeping carbohydrate in an acceptable range to balance blood sugars. It is possible to go meat free, just not easy or necessarily advisable in most cases.

A4: A dietitian can help people with diabetes find a sustainable nutrition plan that allows them to manage blood sugar, optimize health and still enjoy food. As a nutrition professional a Registered Dietitian is one of the most powerful tools someone with diabetes can have in their tool box!

43. Stephanie Worth

A1: A well-rounded, healthful diet will help keep energy levels up. This means that each meal should contain whole grains (within carbohydrate limits), a protein source, and most of your plate being fruits (again, within carbohydrate limits) and vegetables. Without proper nutrients, our body doesn't thrive as it should. High or low blood sugars can make you feel fatigued, so strive for consistent carbohydrate at each meal to help beat that sluggish feeling.

A2: Most people can control blood sugars by simply watching their portion sizes or choosing a healthier alternative. This could be as simple as going from 2 pieces of toast, to 1 piece of toast. Having Diabetes doesn't mean getting rid of favorite foods! It simply means, let's take a look at how much of these foods I am currently eating and how can I decrease or exchange these foods for something more healthful without sacrificing taste. From personal experience I find that most people don't like a food because of the one single time they tried it. Think about why you didn't like it. Was it because of the flavor? Try flavoring it with other herbs or spices next time. Was it because of the texture? Try a different cooking method. Get creative.

A3: A plant based diet could definitely be beneficial for someone with Diabetes as long as it is done in a healthful way. Portion sizes would still need to be considered, as well as making sure that we are providing our body with adequate nutrients to avoid deficiencies. A plant based diet fills our meals with whole grains, vegetables, fruits and legumes rather than with high fat animal products or highly processed foods.

A4: A Dietitian can evaluate lifestyle, review current diet/eating habits to create individualized meal plan and goals. Dietitians who are Certified Diabetes Educators can also assist with educating patients on their insulin schedules and/or insulin pumps. RD's are experts in nutrition and can tailor to the patient's individual nutritional needs or concerns with the goal of preventing disease progression.

44. Janine Faber

A1: The best way to keep energy levels up while managing blood glucose levels is to have a meal or a snack every 3 or 4 hours and include protein such as nut butters, beans, lean meat, nuts, and cheese in these meals and snacks. Also, choose nutrient-rich foods including whole grains, fruit, vegetables, low-fat milk and lean protein. Less nutrient-rich options may have more sugar and less fiber which will not provide sustained energy.

A2: For people that have diabetes and are pickier about the foods they eat, I would encourage them to try new foods. Incorporating a variety of foods in the day helps provide the body with different nutrients. First, I would recommend to try different forms of foods such as fresh, canned, frozen or dried. For example, I grew up eating canned asparagus which wasn’t as flavorful to me, but I love fresh asparagus. People often believe that fresh food is best, but canned, frozen and dried foods can be just as healthy or even healthier in some cases. Look for items with limited or no sugar and salt added. For my second tip, I would recommend using herbs and spices with foods. They are an excellent way to add a flavor boost without adding extra sugar or salt. I love adding dried rosemary to my roasted fresh asparagus or try sprinkling turmeric on cauliflower. My third tip would be to experiment with recipes. Look online, in cooking magazines or in cookbooks for recipes that sound exciting.

A3: Focusing on plant-based foods while managing diabetes is a good option. It will take some initial planning, but it can easily be done. It is important to first look at plant protein you can easily include in your meals and snacks. Including protein throughout the day helps to keep your energy levels up, your blood glucose levels steady and aids in keeping you full. Some examples of plant proteins include nuts, nut butters, beans, and seeds. Another aspect to focus on in following a plant-based meal approach is the nutrients which animal products provide and determining which plant-based foods offer those nutrients. This way, you will not become nutrient-deficient. One example is vitamin B12 which is found in animal products. Look to fortified foods, such as cereals, for this nutrient and talk to your dietitian about possible supplements. Another nutrient to focus on is calcium which is found in dairy products. Leafy greens including kale and spinach are a great source. Working with a dietitian will help you in getting the nutrients you need while focusing on plant-based meals and snacks.

A4: Registered dietitians are an excellent guide and partner in helping to manage diabetes. Dietitians can assist with meal planning, healthier meal ideas, reading product food labels, showing healthier food choices in the supermarket, and planning for special occasions and eating out. They can also talk about portion sizes and healthy meal preparation. Dietitians are a wonderful support in helping to reach healthy eating, weight and blood glucose goals.

45. Emily Cheera

A1: Low energy and tiredness are common complaints I hear from clients who come to me and say they’ve been dieting. Typically, we discover two major things: they are not eating enough in general, and they are trying to eat as little during the day as possible that they end up overeating in the evening. Eating less than about 1,200 calories per day can slow the metabolism, the opposite effect we want, so make sure you’re not dipping below that level. Also, spread your calories and carbohydrates throughout the day to keep blood sugar levels stable and energy levels up.

A2: For adults with diabetes who are picky eaters, I recommend pushing yourself to try new foods and new recipes. You will likely be surprised to find how many of them you enjoy. For example, many of my clients say they don’t like vegetables. However, when I suggest they try roasting them, they realize that they do like the taste of asparagus, Brussels sprouts, and carrots when they’re prepared a certain way. Experiment and find healthier foods you enjoy.

A3: There are many styles of eating that can work for diabetes, plant-based included. Plant-based diets are high in carbohydrates, so the selection of carbohydrates is important. Focus on whole foods. The less processed the better. By choosing whole grains, legumes, fruits, and vegetables instead of refined grains and sugar, your body will benefit from

A4: Often my new clients come to me very confused by all the nutrition advice they read online. A dietitian can help clarify those concerns, create a personalized plan for you, and help you make small changes over time that will lead to lifelong healthy habits. There are many eating styles that can work for diabetes, but the most important factor for long-term success is finding a style that is personalized to fit your needs.

46. Monica Lebre

A1: The best way to keep energy levels up is to eat at consistent time intervals throughout the day. Being sure to include a breakfast, lunch, dinner daily and some small healthy snacks in between meals if you get hungry.

A2: It’s okay to be a picky eater as long as there are some foods in each “category” that you like. For example, you don’t have to like every vegetable, but liking some vegetables and incorporating them into your daily diet along with healthy carbohydrates, fats and fruits. It’s also important to remember to always try different foods, our taste buds change and adapt to what we are used to eating, so don’t give up on a food after just trying it once!

A3: Absolutely! Being a diabetic doesn’t have to stop you from going on a plant based diet. There are so many positive affects to following a plan based diet that it is healthy to do so. The goal is still to ensure healthy balanced meals and consistent carbohydrate intake for optimal blood sugar control.

A4: A dietitian can help you to manage your blood sugars with diabetes. They can help you incorporate a healthy lifestyle, healthy foods in order to maintain a healthy weight and optimal blood sugar control with diet, medication and insulin as needed. A dietitian is specially trained in how food interacts with your body so that you can feel your best!

47. Toni A. Marinucci

A1: A common misconception with diabetes is the thought that a person who is diabetic should avoid carbohydrates in general but that is not the case. In order to maintain energy levels, someone with diabetes should consume carbohydrates consistently throughout the day however in a portioned amount. The type of carbohydrates are important as well. For example complex carbohydrates and whole grain starches will usually contain more fiber than simple or refined carbohydrates, which helps to better control blood sugars. The closer blood glucose is controlled in the body, the less tired a person with diabetes will feel.

A2: Picky eaters are always a challenge for a dietitian because even if a dietitian is filled with ideas, recommendations and suggestions, the individual has to be willing to meet the RD in the middle. My recommendation to picky eaters is to explore in the kitchen, take a cooking class, and/or try at least one new diabetic friendly food each week. Also, be open to trying foods you didn’t like as a kid. Our taste buds change over time and maybe the way you had it prepared originally wasn’t made in a way you would enjoy it now.

A3: Depending on the individual it may be difficult to control blood sugars on plant based diet because all plant based proteins contain carbohydrates. However since they also contain fiber blood sugars can be managed when the right amount is chosen. Portion control and balance are important to understand on any diet but especially for a plant based diabetic diet. Working with a dietitian to ensure proper carbohydrate counting and supplementation of protein would be beneficial for the individual considering this diet.

A4: A dietitian can help someone with diabetes in many ways. Most diabetics know what they can’t eat but a dietitian can teach them which foods they can eat. Dietitians can help someone with diabetes learn how to balance their plate, count carbohydrates, and individualized the plan to meet their personal needs and lifestyle goals.

48. Sarah Hortman

A1: When eating to manage weight in a healthy way to sustain energy, focus on balanced nourishment that is not overly restrictive. A dietitian can provide information on the appropriate amount of nutrients, calories and how that translates into portion sizes of different foods. Choose foods that are nutrient dense such as a variety of vegetables, fruit, whole grains, lean protein including legumes, low fat dairy and heart healthy fat such as those found in plants and fish. Physical activity is an important addition, as it will change body composition by increasing muscle mass and reducing body fat. This combination of a diet that balances food variety, and appropriate portions plus physical activity increases metabolism, making your body more efficient. Ultimately, this balances blood sugar levels and reduces cravings, resulting in an increased energy level.

A2: Everyone has their personal food preferences and that’s normal. However, if your diet is lacking variety and needs increased nutrient dense foods for a well-rounded diet, start with foods that are similar to the healthy choices you already enjoy. Many Americans, 9 out of 10, are not consuming the recommended daily servings of vegetables. Try different preparation methods such as oven roasted, grilled or steamed which changes the taste and texture of foods and you may be surprised to find you like a food you never enjoyed before when it is prepared a different way. To “retrain” your taste buds, cut the saturation of salt and sugar that masks the natural flavors of food through aromatic additions such as citrus, herbs, spices and onion/garlic. These ingredients have their own unique antioxidants for a boost to health. Finally, practice mindful eating. Take time to build a habit of enjoying the sensory experience of savoring the unique flavor profiles of healthy foods. These strategies work within the dietary pattern recommended for diabetes, which is a healthy way of eating that everyone can benefit from – appropriate portions and combinations of nutrient rich whole carbohydrates, vegetables, fruit, lean protein sources including legumes, low fat dairy and healthy fat sources.

A3: A plant-based diet such as a vegetarian diet can be a healthy choice for an individual with diabetes. The benefits of a plant-based diet include a low intake of saturated fat and salt and an increased intake of whole grains, vegetables, fruits, legumes, nuts and seeds. These nutrient and antioxidant- rich, high fiber, lean protein and healthy fat choices stabilize blood sugar levels and reduce calories. Vegetarian diets lower the risk and can help manage chronic diseases including cardiovascular disease, type 2 diabetes, obesity, certain cancers and hypertension.

A4: A dietitian will guide each individual in the right direction for healthy success. Dietitians are a supportive team member, working with you and often with your primary care provider. Sound individual nutrition solutions incorporate personal preferences, resources and health needs into an evidence-based, realistic, long-term plan for good health.

49. Ana Reisdorf

A1: Even if you are on a diet and trying to lose weight, you still need to be eating enough calories. A lot of people think that less is more and they will lose weight faster the more they cut back. This usually backfires, especially if you have diabetes, you could end up with a severely low blood sugar.

Instead, aim to eat 3 meals a day with a balance of whole food carbohydrates (fruits, vegetables, and whole grains) and protein to help you stay full. Eat snacks based on your hunger. Snacks should also be balanced with protein and carbohydrates.

A2: You can still eat foods you enjoy and manage your diabetes. The key is to balance carbohydrate intake with protein and be sure to include plenty of veggies that don't have as much of an effect on blood sugar. Also, it is a good idea to experiment and learn which foods work for you and which don't. You can do this by testing your blood sugar two hours after a meal to determine if the food caused your blood sugar to spike or not. Keep a record of foods that work and those that don't as it will be different for everyone.

A3: Yes, it could help, I have experienced many patients lower their blood sugar by eating a well-balanced vegetarian or plant-based diet. BUT, I think people who do "plant-based" diets tend to eat too many carbohydrates to help them stay full, which will not help manage their diabetes. If you want to eat plant-based, your diet really should be mostly plants. Also, make sure you are getting enough protein and accounting for the carbohydrates in the plant-based protein sources. Beans are a source of protein, but they are also high in carbs, so they need to be balanced with other foods to regulate blood sugar.

A4: A dietitian can help with meal planning, troubleshooting high/low numbers, and overall education about diabetes. Dietitians can also help with weight loss or provide ideas of how to fit a diabetic diet into your lifestyle. They can also help with motivation, accountability, and staying on track. Every diabetic should have a dietitian on their care team.

50. Victoria Goodman

A1: I think the best way to keep energy levels and manage diabetes while being on a diet is to consume a meal or a snack every 2 ½ to 3 hours throughout the day. I also recommend consuming a lean protein source with each meal and snack, as well as increasing total dietary fiber intake.

A2: There are several strategies for picky eaters who have diabetes and wish to manage their blood sugar levels and still enjoy their food. Odors, tastes, and textures of foods can be problematic for picky eaters. Some of my favorite strategies include: experimenting with new foods and recipes, adding new ingredients to foods already preferred (add different sauteed vegetables as a topping to a baked potato, for example),experiment with new foods several times until it becomes more familiar and enjoyed and taking small steps, as changing dietary habits can be challenging.

A3: A plant based diet can be enjoyed if one has diabetes. Not only is a plant based diet decreased in saturated fat and cholesterol, it also provides increased fiber and antioxidants. All of these are important for good health. A plant based diet also provides for adequate protein, found in beans and legumes, tofu, nuts and seeds and whole grains. I recommend a wide variety of plant based foods as well as regular meal and snack times if considering following a plant based diet.

A4: A dietitian can guide an individual with dietary and lifestyle changes, and develop a personalized treatment plan, which can help someone with diabetes. A dietitian can also help someone with diabetes to gain a better understanding how dietary and lifestyle habits influence blood sugar control.

TheDiabetesCouncil Article | Reviewed by Dr. Christine Traxler MD on June 01, 2020