Dietitians Answer Questions About Energy Levels, Picky Eaters, Plant Based Diet & More For Those With Type 2 And Prediabetes

Interested in finding out what the experts have to say about keeping and managing your energy levels when you are dieting? Whether going on a plant based diet as a person with diabetes is wise or how can a dietician help you if you have diabetes?

We recently asked 59 registered dieticians to answer four of our readers’ most asked questions when it comes to dieting, energy levels and diabetes.

Read their responses below and do not forget to leave us a comment with your thoughts on the piece and if you have any other questions we can feature on our next Q&A with experts.

Please note that most of the answers apply to those with prediabetes and diabetes type 2. Consult with your healthcare professional before making any dietary changes.

Here are the exact questions we asked our 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. Amanda Kruse RD, CD

A1: When discussing dietary changes for weight loss, the first thing I ask is: How do you plan to do it? When I hear general statements such as, "eating better" or "eating less" it doesn't give the best picture of the choices someone plans to make (or potentially plans they haven't fully thought out yet). For persons with Diabetes, this is even more important since food is the necessary component in blood sugar regulation.

To keep energy levels up and blood sugar within a healthy range, I suggest:

1. Developing a mindset of eating more fruits and vegetables versus less "bad foods".
2. Eat from every food group but be cognizant of carbohydrate intake. Many foods have carbohydrate in some amount except for meat; focus on the total meal versus one component. For example, you can choose carbohydrate foods that already contain protein or fat like dairy products and beans or pair foods like apples and whole wheat crackers with a protein food like string cheese or peanut butter.
3. Eat consistently. Fasting isn't an appropriate method of weight loss when keeping your blood sugar in check.
4. Get moving! A healthy lifestyle means more than including healthful foods. Be sure to include a physical activity like yoga, walking, or even cleaning your house in your daily routine.

A2: Picky eaters, young and old, rejoice! The important part about balanced eating is variety and so determining which food groups your go-to foods fit into can help you to assess where your nutrients might be lacking. No salads? Dark, leafy greens contain vitamins A, C, E, and K, along with antioxidants that are vital for our health - ditch cold salads and add spinach, kale, and collards to scrambled eggs and spaghetti sauce instead. Fiber and iron are also high in these greens, but they can also be found in legumes like black beans and hummus. It's all about identifying how to fill the gaps - something a Registered Dietitian can help you to do!

Feel like you're just hooked on "bad foods" or high-carb foods that throw your blood sugar out of whack? Smart swaps will allow you to get closer to your goals without sacrificing what you love. Pasta lovers - swap for whole grain pasta and go heavy with a sauce filled with meat, beans, and veggies; ¾ cup whole grain pasta + 1 cup tomato sauce w/spinach, mushrooms, turkey meat, peppers, onions (and whatever other frozen veggies you can find) makes a filling dish! Sweets calling your name? Try sprinkling a few chocolate chips on a Tbsp of peanut butter or better yet mixing Greek yogurt with raspberries and a few chocolate chips. Pairing protein foods and healthy fats with sugary treats can help minimize impact.

A3: Plant-based diets can safely find a place in the life of a person with Diabetes. The important piece for anyone going vegetarian or vegan is to ensure they're still eating a variety of foods. Sure fruits and veggies are easy to spot, but what happens when you're out at a restaurant known for their burgers? A veggie patty will likely be a go-to but because it will be packed with beans, soy, and other protein-rich plant foods you'll need to take into consideration the amount of carbs from there. Go for the veggie burger with a salad and take off that top bun to control carb intake. This saves calories and carbs that allow for a few French fries.

In day-to-day life, though, the biggest concern is missing nutrients. Vegetarians can live off Oreos and Pizza just like anyone else, so select which foods you'll have on hand from each food group. I suggest starting the transition slow - no meat on Mondays - and making small changes like adding in beans to your favorite chili and then slowly cutting back the meat or topping stir-fry with cashews and an egg instead of tossing in chicken or steak.

A4: Dietitians are experts trained not only on nutrition, but how everything you eat impacts your body. A Dietitian is not the food police - they're on your team to help you to live a healthier lifestyle. Food should be celebrated and enjoyed, not feared, and a Dietitian can help to make sure that your diabetes doesn't take that away from you through recipe modifications, small lifestyle changes, blood sugar goals, and more.

2. Bethany Frazier RD, LDN

A1: I recommend eating frequently. When planning a snack between meals be sure that it is a good balance of carbs with a protein or fat. Try a fruit smoothie made with greek yogurt, or an apple and peanut butter.

A2: Most of us live to eat, not just eat to live. I think it is important to enjoy the foods that you eat. Most foods can be enjoyed by individuals with diabetes but may need to be a smaller portion than you have eaten in the past. Try slowing down, it takes 10 chews for our brains to register the flavors of the foods we are eating. This can be the key to really enjoying the foods. You don't have to eat the whole plate of pasta or entire piece of cheesecake to really enjoy it.

A3: A plant based diet can absolutely be appropriate for someone with diabetes. Be sure to include good sources of protein, like beans, nuts, and dairy products. Keep in mind that most plant-based sources of protein have some carbohydrate in them.

A4: Diabetes can be a frustrating diagnosis for many people, because we are forced to focus on the content of the food, not just if it tastes or sounds good. Dietitians are the nutrition experts, who can help you navigate the challenges of meal planning, and finding ways to include your old favorites into your diet.

3. Melinda Boyd, MPH, MHR, RD

A1: Make sure to get enough of the right carbohydrates. Whole grains and vegetables that are packed with fiber are great sources of energy. Avoid the fast acting carbohydrates you find in foods with added sugars, like candy and baked goods. Add in some lean protein and heart healthy fats (like the kind found in olive oil, avocado, and nuts) to help sustain the energy you get from carbohydrates between meals. Also, don't skip out on between meal snacks. This can prevent blood sugars from dropping too low between meals, which means losing your energy levels during the day. Same principles work with snacks- high fiber carbohydrates, lean proteins and heart healthy fats.

A2: Start off by knowing which foods you do and don't like, then build your meal plan from there. You may not get a lot of variety to start with but you will know which foods you can eat and still maintain stable blood sugars. Know which of those foods contain carbohydrates and learn more about the proper portion size for each. This way you aren't overdoing it on any of those foods. While you may think you are a picky eater, don't give up on trying on new foods. You never know what may surprise you! Trying new foods and learning more about healthy carbohydrate sources will benefit your health in the long run. Remember, trying a new food doesn't mean you have to keep eating it if you decide you really don't like it. Just don't be afraid to take the first step and try it out.

A3: A plant based diet can definitely be a healthy choice for someone with diabetes. Many low carbohydrate vegetables can easily be incorporated along with the right amounts of starchy veggies and whole grains. A plant based diet has the potential to be high in fiber, which means you are focusing on the right types of carbohydrates. Plant based protein sources don't have to be high in carbohydrate, but some are, like beans. Just make sure to account for that carbohydrate when you are planning your meals. There are other plant based protein sources that are low in carbohydrate or carbohydrate free, so you won't need to worry about getting enough protein. It takes a little bit of planning at first as you learn more about being plant-based, but after that you will find it is easy to have a healthy plant based diet that helps control your diabetes.

A4: A dietitian is an essential part of the healthcare team for anyone with diabetes. They can help someone with diabetes by helping them find the right foods for their diet that not just keeps their blood sugars in a healthy range, but also provides them with all of the right nutrients they need to manage their health. Dietitians are trained to help with meal planning that balances carbohydrate intake with healthy fat and protein sources. They can help navigate dining out, holiday meals, and healthy snacking. Also, they can empower clients with diabetes to take charge of their health and use their knowledge of food to make beneficial choices every day.

4. Bruno Treves

A1: First of all, there are tons of different diets and so it makes a huge difference depending on what someone is eating. I personally never had diabetes so I can't tell you what works or doesn't work for me.

That being said, I think that the best way to keep energy levels up is by listening to our bodies. If we are tired we should rest, if sleep is needed then so be it. When hungry eat, when bored, play... life is simple. 🙂

I think fruits are the easiest food to digest and the best one in terms of quick, simple and safe supply of nutrients to the body. Whenever I eat fruit I feel great.

Some people think fruit leads to diabetes, others say that fruit cures diabetes. I have no proof of either, I just follow what makes sense to me. Right now fruit is what makes the most sense to me for holistic well-being. That is why I became a fruitarian. =D

A2: Again, I am going against the crowds here by sharing that my understanding is that fruit is the way to go for people with diabetes, I know of people who put their diabetes in check by eating a high fruit diet.

I understand some picky eaters may not like fruit. To them, I would suggest to make sure they are getting the highest quality of fruit available. Local, ripe, raw, organic and fresh. If you are a human and you don't like any fruit, then I think we have a big problem and more intense help may be needed. If you don't live close to fruit-giving climates then you have the perfect excuse to move "back" to the tropics... 😉

A3: There is a bunch of doctors, dietitians and nutritionists out there telling everyone that plant based diets are the best diets in the world. I partially agree with them, I think plant based diets are way better than consuming animal products. Good books on this include "How Not to Die" and, of course, "Dr. Neal Barnard's Program for Reversing Diabetes" ().

However, I think that among all plant based diets, the fruitarian diet is superior given that it is very likely that all humans are frugivores. Most people would disagree with this thought, but I am sticking to it.

A4: Each dietitian has its own background and will lean towards different approaches. I think that the most important thing is to listen and empathize with people who have diabetes. After that, I think it is important to support and honor each person's choices. I am not a dietitian but I believe in the benefits of the fruitarian diet. From what I have heard, the fruitarian diet may very well cure diabetes. Dr. Robert Morse and Dr. Doug Graham can testify on that.

5. Heidi McIndoo, MS RD LDN

A1: One of the best ways to mantain energy levels and blood sugar levels are to eat frequently--don't go longer than 3-4 waking hours without eating. When you eat, be sure to choose a combination of protein and carbs. This will give you energy but also prevent a rabid rise and drop of blood sugar levels. In addition, when you eat more frequently, you can eat smaller meals. This too will help prevent blood sugar spikes.

A2: Try to find as many foods from each food group you like. Then try new and different ways to prepare and eat them. This will add some variety to your diet. In addition, challenge yourself to try new foods. Give them a fair shot by trying them more than once and trying them prepared in different ways.

A3: Not a problem at all as long as you ensure that you're getting adequate plant based proteins throughout the day. Otherwise, continue to follow a balanced, healthy, eating plan and avoid added sugars.

A4: A registered dietitian can help someone with diabetes by teaching necessary lifestyle and behavior changes to manage their diabetes. An rd can also review their current eating habits and help identify realistic goals to improving them.

6. Catherine Conway, MS, RDN, CDN, CDE

A1: Personally, I really hate the word diet. It somehow implies being on some plan of eating and then not on it. I much prefer finding a happy balance that an individual can live with day to day. The most important thing is not to skip meals. Skipping meals leads to overeating later and low energy levels. I recommend having meals at regularly scheduled times and always carrying or have access to an appropriate snack in case there is a long time between meals.

A2: This is really my specialty as I mainly work with individuals who have an Intellectual or Developmental Disability and they can be very picky eaters. I always ask "What is your favorite food?" It is important to figure out ways to include them and still maintain blood sugars within goals. I have found that once favorite foods are not totally forbidden individuals are usually more open to making some other changes.

A3: My first question would be "what do you mean by plant's based diet?" This is a very trendy word right now that could mean anything from adding an occasional vegetable, reducing animal food intake, or going vegetarian or vegan.I certainly would advocate for more plant-based whole foods rather than highly processed ones. The more plant foods and less animal foods the greater the health benefits. When an individual bases their meals on plant foods they are consuming more fiber, vitamins, minerals and the powerful phytochemicals that help fight diseases. Research shows that plant-based diets are cost-effective, low-risk interventions that may lower body mass index, blood pressure, HbA1C and cholesterol levels. All of these factors are of concern to a person with diabetes. I have found it continues to be very helpful to count carbohydrates no matter what eating plan you are following.

A4: A Registered Dietitian Nutritionist (RDN) especially one that is also a Certified Diabetes Educator (CDE) should be on your team. They can help you create an individualized food plan that will work for you and your lifestyle; understand how food and nutrients affect your body to successfully manage the disease; help manage medications and insulin; plan exercise and other lifestyle changes and set and prioritize goals. Meeting with a RDN, CDE is not a one-shot deal. To get the most benefit it is wise to plan several meetings. It is covered by Medicare and most insurance plans. Take advantage of our expertise.

7. April Murray, RD

A1: Having diabetes can making have consistent energy levels challenging especially when high and low blood glucose may cause diabetic individuals to feel tired and lethargic. When a diabetic individual is attempting to lose weight, it is important to eat every 2-3 hours, including meals and snacks. A great snack I recommend is 1oz wheat crackers with peanut butter. Avoid eating carbohydrates by themselves- always be sure to combine food groups, for instance a protein with a carbohydrate.

A2: Picky diabetics should consider working with a registered dietitian nutritionist to figure out how their favorite foods can fit into an individualized, diabetic-friendly diet plan. There are so many ways to flavor and prepare foods to make them more delicious! I know people who don't think they like salmon until they try it prepared in a certain way. I also remind picky eaters that taste buds do change and that the more you try a food, the more likely you are to find it enjoyable.

A3: Yes, people with diabetes can choose to follow a plant-based diet- but need to make sure they are eating enough protein. A plant based diet, if followed inappropriately, may be deficient in protein and amino acids. Proteins are not only the building blocks of our bodies but also help prevent rapid increases in blood sugar and help the sugar absorb into the cells at a consistent rate. Include plant based proteins such as beans, tofu, tempeh, lentils, and nut butter, foods which are all great sources of plant-based protein.

A4: Diabetics can learn to enjoy their favorite foods (even carbohydrates) in moderation by practicing mindful eating. Many dietitian help develops personalized meal plans with the goal of maintaining blood sugar levels and preventing further complications.

8. Noor Al Refae, RD

A1: Changing our dietary habits by cutting down on calories and portion sizes can be difficult, especially if you are unsure of the right way to do it. It's important to know that as we lose weight, we don't just lose fat, we also lose muscle mass. Muscles are important for metabolism, blood glucose control, and our strength. You can help maintain your muscle mass and energy by ensuring you consume enough protein, such as chicken, turkey, fish etc.

Dietary advice depends on the type of diabetes you have and how it is currently being managed. Depending on this, I'd recommend reducing portion sizes of carbohydrates such as pasta, bread, rice and potatoes if you are having them in large quantities. Carbohydrates will affect your blood glucose levels and ideally, we want to keep them as stable as possible. Increase your vegetables and salads on your plate to make up for the reduced portion size of the carbohydrates.

A2: Ultimately you need to change your eating behaviors if picky eating means you go for unhealthier foods and this is something that can be worked on if you are serious about your health. Snacking on foods throughout the day is also not helpful when blood glucose is running high, so you need to break the habit and introduce nutritious meals which will fill you up. Like everyone else, any heavily processed foods, Trans fats, and high sugar foods should ideally be reduced and replaced.

A3: When changing what you eat, you should consider all factors such as why you want to change, is it long term and will it meet your nutritional needs. Starting a plant based diet is not an issue with diabetes and like everyone else; you have the choice of the foods you consume. Just bear in mind that overall your diet will normally be lower in protein and will need consideration to ensure it is nutritionally complete, especially in certain B vitamins.

A4: Dietitians are experts in nutrition and use evidence-based research to support the advice we give. A specialist dietician is able to help you control your blood glucose levels by suggesting dietary changes and help prevent complications of your condition. We know that everyone is different from their medical conditions to the food they like and dislike, we, therefore, take this into account with the advice we give you to enable you to meet your goal and keep you healthy.

9. Anna Daniels, RD

A1: It is important that if you a diabetic following a calorie controlled diet that you continue to eat regular healthy meals. Depending on what medication you are on it is important not to restrict your intake to any extreme that leaves you feeling hungry and therefore lacking in energy. Therefore make sure you eat regular nutritionally balanced meals which contain protein, carbohydrate, and fiber-rich vegetables. When choosing carbohydrates try to choose fiber-rich low GI whole grain carbohydrates that will give you slow release energy over time and keep you feeling satisfied for longer, always paying attention to portion size.

A2: Choose foods that you love whilst trying to ensure these are healthy, by trying to make small changes like adding in more vegetables. Do try to avoid processed foods with added sugars. Focus on making sure that carbohydrate foods and portions overall aren't too large and therefore won't negatively impact your blood sugar levels.

A3: Plant based diets have many health benefits if followed correctly. However it is very important to ensure that your diet is balanced, it can quite easily become to focused on one macronutrient and miss out nutrients. Therefore planning meals based on fiber-rich pulses along with vegetables and whole grains can have huge health benefits. Speak to your dietitian if you plan on following a plant based diet to ensure that you don't become deficient in anything.

A4: A dietitian will give evidenced based advice that is tailored and specific to you as an individual. Along with focusing on diet and intake, there will be a focus on behavior change. Dietitians also help give you true and evidenced based advice, with so much advice on the internet you can make sure it's going to be correct!

10. Kristi Coughlin, MS, RDN, LD

A1: Eat. I often find clients get stuck on what it is they can and cannot eat. This causes them to become paralyzed in making decisions so they skip meals. As a result, energy levels are low because the body does not have the proper fuel. Remember, not eating can cause just as much harm as eating the wrong foods.

A2: Try, try again. You may say that you do not like a food, but how many times did you actually try the food? In order to say you do not like a food item, you must try it 10 to 14 times! Even more important, you have to try the foods at different stages in your life and prepared different ways. A personal story here: When I was growing up, I despised cooked carrots. I disliked cooked carrots so much I didn't eat any kind of carrot for 20 years. Finally, I decided to practice what I preach - I tried carrots multiples times and cooked different ways. Now I love carrots, especially roasted! Read more about my story here: http://bit.ly/2mcwqrN

If you are having trouble managing your blood sugar levels and still enjoying your food, try making small, easy-to-manage changes to your diet. For example, if you are trying to incorporate whole wheat pasta into your dinners, but are having a hard time adjusting to the taste, try using ½ whole wheat pasta and ½ regular pasta. This way you are getting the best of both worlds while still making positive progress. Side note, cook the whole wheat pasta a couple minutes before you add the regular pasta noodles. Whole wheat pasta takes a little longer to cook - as you can see, I use this trick in my house!

A3: Eating a plant based diet is definitely a wise decision! The sugars found in fruits and starchy vegetables are different than the ones in sweets and treats, such as candy, soda, and baked goods. Not all sugars are created equally - sugars found in fresh fruits and starchy vegetables are there in conjunction with fiber. Fiber is an important component of any diet, especially for these three reasons: help with controlling blood sugars, weight management, and improving your digestive health. Here is a little more information on how a plant based diet - full of fiber - is beneficial to your health:

1. Controlling blood sugars may seem counter intuitive when we are talking about foods that contain sugar, such as fruits and starchy vegetables. However, the fiber found in these foods help to slowly release the sugars into your bloodstream which results in improved blood sugar control. Blood sugars slowly rise over time instead of spiking right after eating.
2. Weight control through fiber = satiety. This means you feel fuller longer. As a result, you won't be reaching for another snack out of the break room or pantry an hour after eating. If you feel fuller longer, and successfully stay out of the break room longer, you can stabilize your body weight (or even lose weight).
3. Improving digestive health by making bowel movements softer and easier to pass. Yep, that bathroom experience will be more pleasant. Don't forget to drink lots of water. Eating a high fiber diet without adequate water intake may result in constipation - counter productive to the goal here. Also, be sure to slowly increase your fiber intake over time. Eating too much fiber in a short period of time, especially if you are not used to it, will result in digestive upset, such as abdominal cramps or gas.

A4: A dietitian can help with a person with diabetes in many different ways. Most importantly, we can help to provide accurate, evidence-based nutrition information regarding your diet and controlling diabetes. We can also help by offering ideas, tips, and tricks to improve your diet which results in better control of your blood sugars. Dietitians can also offer help with meal planning, modifying your favorite recipes, teaching you to read nutrition labels, and much more - the possibilities are endless. Personally, I offer 100% online nutrition consultations to help improve your diet and lifestyle to improve your health.

11. Cynthia Miranda, RD

A1: The best way to maintain energy levels when following a diabetic, or carbohydrate-controlled, diet, is to avoid skipping meals. Small, frequent, and balanced meals about every 3-4 hours are ideal for maintaining stable blood sugar levels and avoiding any dips in energy. Exercise is also very important for boosting energy, even if it is just a short, daily walk.

A2: In the case of a picky eater, I would always suggest working one-on-one with a Registered Dietitian who specializes in diabetes to help. An RD can educate the patient on how to meet their needs with the foods they like, help the patient discover creative and delicious ways to enjoy foods that maybe they don't like (especially vegetables), and still ensure that they are meeting their needs. An RD can also help make sure the patient is utilizing portion control when it comes to carbohydrates.

A3: It is absolutely okay to go on a plant-based diet when one has diabetes! Fiber-rich plant foods are essential for controlling blood sugar throughout the day. This is because fiber passes through the GI tract slowly, thus helping slow down the absorption of other carbohydrates from your food. It would be wise to work closely with an RD to make sure you are including protein-rich plant-based foods in your diet as well - such as whole grains, quinoa, nuts, seeds, beans, lentils, chickpeas, tofu, etc.

A4: Controlling carbohydrate intake and learning about portion control may be overwhelming for some patients. A dietitian can help identify dietary patterns a person may have - such as skipping meals, eating excessive portions or consuming either an excessive amount or not enough of a certain food group. Once identified, an RD can provide personalized advice that fits a person's lifestyle and helps the patient establish lasting, positive changes to their diets. A dietitian can help familiarize patients with what a carbohydrate-controlled meal should look like, as well as ease some of the anxiety a patient may have around having to change their habits. A dietitian can show a patient that their favorite foods can still be enjoyed, as long as the patient chooses appropriate food pairings and utilizes portion control.

12. Kelly McGuffin, MS, RDN

A1: I always recommend protein with each meal. It's important to pair food especially when it comes to carbohydrates. Make sure carbs have a partner...lean protein, healthy fat, etc to prevent sugar spikes. Examples....a small apple and 1 tablespoon PB or whole wheat crackers and 1 oz cheese This will help to stabilize blood sugars thus keeping energy levels elevated.

A2: For picky eaters....introduce a new food with familiar foods. I recommend the polite bite...Try it and see if you like it. You may be surprised. If that doesn't work sneak in those healthy foods such as in smoothies...adding spinach or kale (the fruit will mask the taste)...don't forget to add a protein source; try ground flaxseed sprinkled on your salad (my family thinks it's part of the dressing), or cauliflower mashed potatoes.

A3: Yes, if you have diabetes you can be a vegetarian. Be sure to meet with a Registered Dietitian to review your meal plan. It's important to make sure you watch your intake of carbohydrates at each meal and balance it out with plant based proteins. To minimize carbohydrates try beans and cauliflower rice.

A4: A dietitian can be a great asset to help determine the amount of carbohydrates, protein, fat, fiber, etc you need per day. They can work with you on creating a meal plan based on your food preferences. Remember...all foods can fit. The key is portion control.

13. Dr Stephanie Fade, PhD RD

A1: Firstly if you are overweight, losing weight is the best way to improve your health and control your blood sugars. If you are on medication for your diabetes (insulin or tablets) you should get some advice from your dietitian before starting your diet to make sure that your eating pattern works well with your medication.

If you don't take any medication the key is to become more mindful about when hunger tends to strike. This will be different for everyone and will depend on your lifestyle and exercise patterns. Try rating your hunger on a scale of 1 - not hungry at all to 5 - feeling weak and ravenous. Look at how your hunger links with your meal and snack pattern and make some tweaks to keep hunger at bay. You might find that you need to eat a little bit more in the mornings and less in the evening or vice versa, everyone is different. If you need to snack stick to low fat, low sugar, high fibre choices such as some chopped up veggies with low fat hummus or salsa or berry fruits and fat free natural yogurt. Basing your meals around good sources of fibre such as salad/veggies, brown rice, wholemeal pasta/couscous/bread or wholegrain unsweetened breakfast cereals will help fill you up. Low fat protein foods like egg, low fat dairy products, lean meat, fish or pulses at each meal will help you to feel fuller for longer too.

A2: Make a list of healthy foods that your already enjoy and then note their characteristics. Perhaps they are spicy or maybe bland, perhaps they are smooth or maybe crunchy. This will help you understand your preferences and will make it easier to look for new healthy foods that you might enjoy. You could also get together with some friends who have diabetes or just trying to lose some weight and have a recipe swap night. Ask everyone to cook their favourite healthy dish and bring some along for everyone to try. You might discover something new and delicious. Just make sure everyone understands that you are all trying to eat healthily and that you are all agreed that means low fat, low sugar, low salt and high fibre. You could ask a Dietitian to come along and check your recipes and perhaps suggest a few tweaks.

A3: We should all be eating more plants as there is plenty of evidence that it will help lower our weight and reduce our risk of high blood pressure, cancer and cardiovascular disease as well as helping us build strong bones. There is no need to go completely vegan or vegetarian, as low fat animal products are a healthy choice. However increasing the amount of fruit, vegetables, nuts, seeds and wholegrains we eat is a good thing. If you really want to go vegan for ethical reasons then get some advice from a dietitian to make sure your diet is balanced.

A4: Dietitians are able to give highly individualized advice and support based on the latest scientific evidence. Everyone is different and dietitians are experienced in looking at your lifestyle and mindset and helping you find a way of eating that works for you. If you have diabetes it is important that you manage your weight and blood sugars but just like everyone else you also need a balanced diet. A dietitian will be able to check your diet for deficiencies and help you understand how you can correct them using healthy foods that will also be great for your diabetes.

14. Kendra Tolbert MS, RDN, CLC

A1: There are so many things that affect your energy levels and how you feel while managing diabetes. Building resistance to stress, being well rested, and enjoying life can go a long way in helping you feel energized.

Of course, food also plays a huge role in keeping your energy levels up.

Choose to eat a variety of colorful vegetables, nuts, seeds and other healthy sources of fat and protein, slow carbs, herbs and spices. That way you'll get the vitamins, minerals, and energy your body needs so you can feel your best.

A2: Definitely give different ethnic cuisines a try. Sometimes foods you haven't liked in the past taste totally different when prepared in a different way, with different spices.

Many people who hate spinach love it once it's blended into a yummy pesto, paired with chicken and pasta. Suddenly, that food you hate isn't so bad when it's combined with flavors you love.

There's this unfortunate prevailing belief that healthy eating or eating when you have diabetes is all about eating foods you don't enjoy. Nothing could be further from the truth. Bland and boring are not the same thing as healthy.

Eat foods you enjoy. Just make sure your meals include vegetables, healthy sources of fat (say it with me, fat is my friend), herbs, and spices to control how quickly your blood sugar rises. The fiber from the vegetables and the fat prevent your blood sugar from spiking. And you still get to eat the foods you love.

A3: A plant based diet can be a very wise choice for people with diabetes. I would even say for most people, it's ideal. Remember, plant based doesn't only mean vegan or even vegetarian. It means the majority of the food you eat are plants. That's a good idea for all of us.

Plant based diets are full of nutrients that combat inflammation, help to balance blood sugar, lower cholesterol, and support good health. The key is to make sure your plant based diet is made up of a variety of colorful fruit, vegetables, beans, peas, legumes, nuts, seeds, and whole grains.

You don't want to end up eating a bunch of heavily processed faux meat and refined grains. Sure, they're technically plant based, but a diet built on those types of foods isn't what nutritionists and dietitians are talking about when they recommend a plant based diet.

A4: Dietitians are great at helping people cut through all the noise when it comes to diabetes nutrition. There's loads of info out there and it can be hard to know what's true and how to apply it all.

A dietitian can help you come up with a doable plan that's unique to you and your life. We're also great at clearing up myths and misconceptions. Speak with your doctor, endocrinologist, or insurance provider if you're looking for a dietitian to help you make changes.

15. Michelle Berman, MS, RDN, CDE

A1: First of all, let's not think of it as diet. A diet is something you do for a while, then go back to the old way. Learning how to eat healthfully while controlling blood sugar with sustainable changes is the goal. I teach my patients to control blood sugar levels by eating three (3) meals a day, approximately 4 ½ to 5 hours apart, and to include carbohydrates along with other foods. The goal of eating 3 balanced meals takes into consideration the patient's circadian rhythm and sustains energy. Eating too frequently or skipping meals leads to consistently elevated blood sugar levels, fluctuations in energy levels and can result in diabetic complications.

A2: There are no foods that are off limits. A person's food preferences must be included in their meal plan. A nutrition plan should be a plan they can live with for a lifetime. Making healthy choices, while following an individualized plan, leads to blood sugar control and results in improved overall health.

A3: Plant based diets have been shown to manage blood sugar, control weight, prevent heart disease, and increase longevity. If meals are consistent and well balanced, a plant based plan can be a healthy option for anyone, including diabetics.

A4: Diabetes is a complex condition. A Registered Dietitian Nutritionist (RDN) is the medical professional who is trained to consider the whole person and to develop a realistic diabetes management plan. The RDN and the patient work together to help the patient understand diabetes, manage medications, including food preferences and their lifestyle, to design an individualized, realistic plan.

16. Jill West, RDN

A1: For breakfast, make sure you get a protein source, such as cottage cheese, Greek yogurt, or egg whites combined with a moderate portion of a high fiber carbohydrate, such as fruit or high fiber whole grains to provide energy and keep you full until lunch.

For lunch and dinner, use The Healthy Plate Strategy: ½ of your plate vegetables, ¼ of your plate carbohydrate (fruit or whole grains) and ¼ of your plate lean protein. Drink plenty of water and pay close attention to your hunger.

For an afternoon snack, first check in on your hunger level and eat a snack only if you're truly hungry. Choose heart healthy nuts or low fat string cheese as part of your snack to curb hunger without raising your blood sugar.

Be sure to talk with your doctor about the medications you're taking. As you change your diet and begin to lose weight, your doctor may need to lower the dosage of some of your medications to prevent low blood sugars, so staying in close contact with your doctor and a registered dietitian nutritionist (RDN) are very important.

A2: This is definitely challenging, but there are ways to minimize the stress and prepare meals that work for everyone in the family!

1. Try family-style meals: make a meal that offers one or two protein choices, a starch choice, a fruit and a vegetable or two. Each family member can mix and match the foods they will eat and allows the child with diabetes to determine how much carbohydrate is on his or her plate and provide insulin to match.
2. If family-style meals aren't an option, provide an alternative meal that provides protein, carbohydrate and vegetables to manage blood sugar and are foods you know your child will eat. For example, the alternative meal might be a turkey sandwich with baby carrots. The sandwich provides a carbohydrate + protein combination and the carrots (or other vegetable) provides fiber. A glass of milk provides additional protein to round out the meal.

A3: A plant-based diet offers many great health benefits, but it's not for everyone. If you plan to try a plant-based diet, I recommend you work closely with your doctor and a Registered Dietitian Nutritionist (RDN), especially if you take diabetes medications. A significant change in diet can cause changes in blood sugar that are important to know how best to prepare for. It's also important to ensure you're getting enough protein, vitamins and minerals if you want to continue a plant-based diet long-term. A RDN can help you plan which foods you need daily to manage your diabetes and meet your nutritional needs so you have the energy, nutrition and good health now and for many years ahead.

A4: A Registered Dietitian Nutritionist (RDN) works together with the parent and child, or adult, with diabetes to provide a personalized food plan based on their specific health needs, food preferences and lifestyle. Instead of a "one-size-fits-all" approach, the RDNworks with you to provide specific suggestions that are practical and realistic.

For example, a child who plays sports or is very active, will need a different food plan to manage blood sugars than a child who enjoys less active interests, such as reading or playing music. Both are really great interests, but the food plan is very different. Understanding the food preferences, lifestyle, medical information and specific health goals for the child, the RDN can help parents serve healthy meals that kids will eat, while decreasing meal time stress and improving blood sugars.

The same is true for adults with diabetes. Based on food preferences, work schedules, interests, and activity, the RDN provides personalized, practical suggestions to help you achieve your health goals.

17. Jacqueline King, MS, RDN, CDE, FADA

A1: Having had diabetes for 50 years and also as a dietitian, certified diabetes educator, I have found that the best way to maintain energy and keep your diabetes in good control is to:

1. Eat meals every 4-5 hours.
2. Include carbohydrates at each meal.
3. Eat a variety of foods at each meal using the MyPlate Guidelines.
4. Take supplemental vitamins and minerals if your physician suspects a greater need due to your lab values.
5. Exercise regularly- at least 3 hours each week and insure that you are getting enough carbohydrate for the exercise.
6. Make sure that you get a good night's sleep. The recommended amount of sleep is a minimum of 7 hours each night.
7. If you are not feeling refreshed after a night's sleep or you are falling asleep during the day, get evaluated for sleep apnea.

A2: If a patient with diabetes is a picky eater, it is wise to work with a dietitian, certified diabetes educator to insure you are getting adequate nutrition and you are not lacking nutrients that your body needs. It is often helpful to go over all of the foods you are eating and also ones that you would be willing to eat. After coming up with these foods, a diet plan can be worked for you with your input. Then, try incorporating foods that you do not usually eat. It is important to look at food texture, smell, and taste , since these areissues that often lie behind picky eating behavior. Together the patient and dietitian can begin to incorporate new foods that you can begin to eat weekly. Usually having an assignment to try one new food each week is useful. As you begin to expand your dietary choices, you will often find that it becomes easier. Remember to focus on getting healthier and keeping your diabetes in better control. If picky eating jeopardizes diabetes control, working with an eating disorder therapist would be helpful. Working with a therapist would be helpful in diagnosing an eating disorder or other issues such as obsessive compulsive disorder.

A3: The American Diabetes Association endorses the use of a plant-based diet for patients with diabetes in the 2017 Standards of Medical Care in Diabetes.

Plant based diets are helpful in lowering blood pressure, reducing heart disease and cancer risk, lowering cholesterol levels, and helping with weight control. These are all important factors for the general public as well as those with diabetes.

Plant-based diets are also environmentally friendly and will be crucial in the years to come in reducing use of land, water, and greenhouse gases to the atmosphere.

A4: Registered dietitians, especially those who are certified diabetes educators are a helpful addition to any diabetes medical team. The registered dietitian is helpful in evaluating your nutritional history and also looking at your blood sugars to see if dietary changes are necessary to maximize your diabetes control. Dietitians can also look at your exercise schedule and evaluate its impact on your glucose control. Dietary changes may need to be made to minimize hypoglycemic risk. Dietitians are also helpful as a medical alley guiding you to be able to lose weight in a healthful manner without jeopardizing your diabetes control.

18. Andrea Paul

A1: The best way to keep your energy levels up, keep your blood sugars within ideal ranges, and therefore manage your diabetes is consistent timing and carbohydrate content of your meals and snacks. It's recommended to go no longer than 4-6 hours between eating. If you go longer than that, you run the risk of having a low blood sugar, which is dangerous. With or without diabetes, it is important not to go too long without putting some fuel (food) in the tank to keep your energy levels up and avoid getting overly, ravenously hungry, which can lead to over eating at the next meal. Carbohydrate content is equally important to keeping blood sugars within normal ranges, meaning you want to have similar amount of carbohydrates at breakfast, lunch and dinner, and similar amounts for snacks. The amount of carbohydrate is different for everyone, but generally a good place to start is 45-60g of carbohydrates per meal and between 15-30g carbohydrates for snacks. However, again, it varies from person to person depending on things like weight, height, and activity level.

A2: If you are or have a "picky eater" who also has diabetes, it can be challenging, but not impossible. I suggest focusing on the foods that the fussy eater does enjoy; you could even keep a list, and list the carbohydrate content of a serving of those foods so you know how to balance the plate for the correct amount of carbohydrates. Another suggestion is to make small adjustments to key foods. For example, if the person really enjoys bread, choosing 100% whole grain bread over one made from refined grains offers more nutrition from naturally-occuring nutrients as well as more fiber.

A3: Choosing more plant-based foods such as whole grains, plant proteins, fruits, and vegetables is a healthful choice for everyone! For those with diabetes, they are at an increased risk of heart disease, and plant-based diets are typically lower in saturated fat and refined carbohydrates, and higher in unsaturated fats, fiber - two things that are associated with decreasing the risk of heart disease. Fiber also slows digestion of food, which means a slower increase in blood sugars and staying satisfied longer. One thing to keep in mind is that many plant-based proteins, such as beans, are a source of carbohydrates in addition to protein, so this should be considered when planning meals or going to eat at restaurants. At a Mexican restaurant for example, you may come across meals that include beans, rice, tortillas, chips, and corn, and few non-starchy vegetables. If possible, try to order something like veggie fajitas with beans and rice on the side; you get a good serving of non-starchy vegetables and can control the amount of beans, rice and tortillas, and therefore control the carbohydrate content of your meal.

As a side note, if you aren't in becoming vegetarian, but are interested in eating more plant-based foods to expand your palate or for the health benefits, a good start is to include at least one vegetarian meal, like a "Meatless Monday" into your weekly schedule!

A4: Dietitians are the food and nutrition experts and can absolutely assist someone in managing their diabetes. From my experience, many people who have pre diabetes or diabetes unfortunately do not always get much nutrition education after being diagnosed, so they may live with diabetes for several years without really understanding the disease or how different foods impact their blood sugar. Dietitians can educate someone with diabetes on carbohydrate foods and their content, balancing carbohydrates from meal to meal and throughout the day, how to fuel for physical activity when you have diabetes, and helping identifying why blood sugars are high or low at certain times of the day and what to do about it. Many dietitians choose to specialize in diabetes and become a CDE or Certified Diabetes Educator, which requires many hours of practical training, passing an exam, and continuing education to maintain their CDE certification.

19. Michele Redmond, MS, RDN

A1: First, don't diet. Typically, diets will cut calories, your source of energy, and result in water losses at early stages ("false" weight loss) leading to energy lows from dehydration. Ultimately the high failure rate or success/fail/repeat model of dieting is also exhausting and stressful to your emotional energy.

Instead of dieting, consider creating your own healthier food culture by eating and tasting food mindfully and inviting more nutrient-rich, high fiber foods you love into your daily life. Many dietitian nutritionists specialize in enjoying food while losing or maintaining a goal weight without feeling low energy - so there are options!

A2: "Picky eaters" may be an unfair term since taste preferences can have genetic, health-related and emotional causes. About 25 percent of people, accused of being "picky eaters", genetically can't help how they taste food due to high concentrations of taste receptors (making them hypertasters). Hypertasters perceive certain food taste qualities (salty, sour, bitter, sweet and savory/umami compounds in foods) more intensely, not pleasantly, than "tolerant tasters" or "non-tasters".

I've taught patients with diabetes that knowing how they taste food, interpret flavors and identify textures can impact their health. This knowledge can help some "picky eaters" be less fearful of new foods (food neophobia) or willing to try a "disliked" food again that's prepared in a new way or uses a new spice or other flavorful ingredient. This flavor brain-training expands the brain's recognition of a more foods.

Ultimately, once someone understands how they perceive taste components in foods, appreciate flavor element options and know their texture tolerances, it's possible to expand the diversity of one's daily foods. Food appreciation and diversity is linked higher intake of phytonutrients, antioxidants, fiber and other great nutrients that support the health of someone with diabetes.

A3: A plant-based diet offers many opportunities for a naturally nutrient-rich eating lifestyle. When vegetables and grains take the center of the plate, fiber is one automatic bonus. Plus, many minerals beneficial to people with diabetes are high in vegetables and some grains. Plants lack some key nutrients or offer low amounts that can be easily supplemented or managed with some planning.

A4: Registered dietitian nutritionists who clinically work with or coach people with diabetes have a significant amount of education and experience and practice evidenced-based medicine.

20. Tony Stephan

A1: Whenever working with a diabetic client looking to lose weight I start by increasing their fiber and protein intake to help keep blood glucose levels stable and improve energy. Combining higher fiber foods and protein together is not only more satiating, but it also prevents a large blood sugar spike and crash which can lead to low energy levels.

A2: Like anything balance is key. I would always have a protein at every meal to mitigate any blood sugar spikes. When you combine protein and carbohydrates together, the amino acids from the protein doesn't make the blood sugar response as intense from the carbohydrate source, keeping blood sugar levels more stable when compared to just eating a carb alone. So if someone wanted pasta for dinner, I would keep the portion size down and have lean ground turkey meat balls with it for a protein source.

A3: I think a plant based diet can be very beneficial especially if its high in micronutrients and fiber! Just ensure adequate healthy fats and protein intake to meet your daily needs.

A4: Working with a Registered Dietitian is essential especially with meal timing and medications or insulin used with a diabetic. A dietitian can help a diabetic customize their daily intake for nutrition to achieve their goals and help manage their diabetes.

21. Lisa Underwood, MBA, MS, RDN

A1: While on any diet, it is important to evaluate all key areas that affect energy levels such as sleep, stress, and fluid intake. I recommend that patients try to maintain a meal schedule and eat meals every 4-6 hours with planned snacks to improve energy levels.

A2: Picky eaters should be involved in their food choices and diet management. Eat the foods that you like! All foods should be enjoyed with attention to the maintenance of blood glucose (sugar) levels by adequate testing, medication, and working with a doctor, nurse, and Registered Dietitian Nutritionist (RDN).

A3: Yes. A diabetic patient can enjoy a plant based diet. All food preferences and eating patterns can be planned with a Registered Dietitian Nutritionist (RDN). Attention to adequate protein and vitamins needs to be addressed to ensure a healthy diet.

A4: Registered Dietitian Nutritionists (RDN) are educated and trained to coach patients to change behavior and adopt new and healthy life style habits. Working with a dietitian, a new diabetic will receive individualized care that is developed to the patient's specific health concerns and food preferences. For information on the qualifications and training of a RDN go to http://www.eatright.org/resource/health/diseases-and-conditions/diabetes/how-an-rdn-can-help-with-diabetes

22. Robin Plotkin, RDN

A1: For optimal energy, the gold standard is to choose a combination of fiber rich foods with protein and healthy fats for meals and snacks. For those with living with diabetes, it's important to pay close attention to the portion sizes of carbohydrates.

A2: Start by picking foods that you love, and then consider if any changes or additions can be made to make it more nutritious. Often times, an open mind and a willingness to try new foods will make the biggest difference in blood sugar management.

A3: For those who choose a plant based diet, the same guidelines hold true in terms of meal patterns -a combination of fiber rich foods with protein and healthy fats-and paying close attention to serving sizes of carbohydrates. Because there are so many plant based ingredients available, it's easier today to find foods that are unique, delicious and fit into a healthy meal plan. The more plants in the diet, the better - and that holds true for everyone!

A4: A Registered Dietitian Nutritionist (RDN)can help those living with diabetes maintain healthy blood sugars by developing a personal food plan using foods that you like to eat and prepare. A RDN who is also a Certified Diabetes Educator (CDE), is an expert in diabetes education.

23. Lucille Beseler, MS, RDN, LDN, CDE, FAND

A1: Following an appropriate and balanced diet is key to manage blood sugars and maintain energy levels to feel your best. To most people, the word "diet" has a negative meaning. That said, we want to avoid overly restrictive diets because, in the long run, they can lead to nutrition deficiencies, low energy levels and unpredictable blood sugars. Meeting with a registered dietitian nutritionist will help people with diabetes develop a healthy relationship with food. You don't need to follow a crazy diet or starve to death to lose weight and feel healthy. An RDN can teach people with diabetes the right portion sizes for age and activity, foods to include and foods to avoid, how to read a nutrition label and even teach cooking strategies to boost flavor without adding calories. In diabetes, there is no "one diet fits all" approach. Everyone is different, that is why individualization is key.

A2: Eating a varied and well-balance diet is a central theme of any healthy lifestyle. Variety, amount and nutrition are key works found in the new Dietary Guidelines for Americans. Unfortunately, that is not always possible for some people, especially if they are selective eaters. If you are a picky eater, it will be important to know the carbohydrate amount in the typical foods consumed, that way insulin or medications can be adjusted appropriately. Matching insulin to carbohydrates is a strategy many people with diabetes use to dose insulin and maintain blood sugars in target. Others include: reading nutrition labels, measuring carbohydrate in foods or using an exchange system in effort to avoid high blood sugars. Having an open mind to try new foods can help increase food acceptance even later in life. Studies show people who incorporate a variety of non-starchy veggies, fruits, lean proteins as well as high-fiber grains will tend to have a better control of their diabetes and lower risk of developing complications. However, diabetes should not stop you from enjoying the foods you like: It's a matter of understanding how those foods affect your blood sugars and how to manage it effectively.

A3: Yes! A vegetarian diet, appropriately planned with the guidance of a registered dietitian nutritionist, can be nutritious and healthful for people at all stages of life. Vegetarian and vegan dietary patterns - especially higher intakes of fruit or vegetables, particularly green vegetables - lower your risk of developing Type 2 diabetes, compared with meat eaters, and are effective therapeutic tools if you already have diabetes.

A4: Research shows that medical nutrition therapy - the nutrition-based treatment provided by a registered dietitian nutritionist - is effective in treating diabetes. MNT includes a nutrition diagnosis as well as therapeutic and counseling services. Meeting regularly with an RDN is associated with improved cholesterol levels, weight management success, decreased need for medications and a reduced risk for other diseases. While MNT has its greatest impact when you are first diagnosed, it is never too late to put together a medical team including an RDN, physician, diabetes nurse and other health care professionals who can help manage and treat your diabetes. An RDN can determine which nutrition therapies are best for each individual, and help you develop both short- and long-term plans. Effective nutrition therapy interventions include carbohydrate counting, simplified meal plans, healthy food choices, individualized meal planning strategies, exchange lists and behavior strategies.

24. Shamera Robinson, RD

A1: Don't skip meals! We have heard it before, but consistent and balanced meals are the best way to keep those energy levels high throughout the day. This means eating regular meals that contain items from different food groups. If you go long periods of time without eating or only consuming one type of food, then your blood sugar can be negatively impacted.

Are you restricting your calories? How about eliminating carbohydrates? We often associate diets with cutting back. However, following a diet that is too restrictive can be harmful for your blood glucose levels and for your body. Be sure that any diet you follow encourages a healthy intake.

A2: Food is meant to be enjoyed. There is always room to keep your favorite foods in moderation, while finding ways to add new ones. Remember, it can take several times of trying a new food before your body acquires a taste for it. How often do you try herbs and seasoning blends to spice up flavor? Have you experimented with cooking methods? If you do not like steamed vegetables, then throw them on the grill or roast them in the oven for a different taste.

It can be intimidating to add new foods to your diet, but don't give up! Different foods offer different nutrients. Your body needs a variety of vitamins and minerals to function properly. I challenge you to take your favorite recipe and add one new thing to it. You might just find some new favorites!

A3: A plant-based diet can help you increase consumption of fruits, vegetables, whole grains, and plant-based protein. However, animal products do not have to be completely eliminated from your diet. There are many ways to healthfully include lean meats into your routine.

Focusing on a plant-based food regimen has many proven health benefits, but it is important to monitor carbohydrate intake. You can still experience hyperglycemia, or high blood sugar, when eating too many grains, fruits, and/or starchy vegetables (i.e. beans, corn, potatoes, etc.) No matter what diet you choose, moderation should always be considered.

A4: Learning to manage diabetes can be tricky, but it is possible. A dietitian can help you understand how food can impact your numbers. In addition, a registered dietitian can work with you to create an individualized plan that uses diet to achieve stable blood glucose control. It is time to make your food work for you and not against you!

25. Holli Lapes, RD, LD/N

A1: An eating pattern that combines protein and healthy fat with your carbohydrate containing meals and snacks will help to stabilize the effect of carbohydrates on your blood stream. In other words, if you don't want to experience the highs and lows of blood sugar - it's important to combine these 3 macronutrients. For example, if someone eats a bunch of carbs without some protein and fat, their blood sugar will probably skyrocket followed by a crash that will leave the person feeling sluggish.

A2: Maximize on the nutritious foods that you do enjoy. For instance, if the only vegetables you like are lettuce and cauliflower, then be sure to include those vegetables in your meals and snacks as often as you can. It's better than eating no vegetables! Although, variety is key when it comes to healthy eating. So, try a new food (or a food that you have tried in the past but didn't like the first time) at least once per week. Did you know it takes approximately 7 tried to like a new food? It also depends on how the food is prepared and seasoned. Maybe you didn't enjoy kale the first time because it was seasoned or dressed with a flavor you aren't fond of. Consider a dietitian your troubleshoot guide. An RD can help you strategize until you reach your goal!

A3: Absolutely. A plant based diet is a fantastic way to eat. It can even help you lose weight and lower your risk for chronic diseases such as heart disease. Losing weight is an important strategy for optimal blood sugar control. However, it can be challenging to follow this type of eating pattern. A dietitian will help make this transition much smoother by providing tips, recipes and ensuring that the person is getting all the nutrients they need.

A4: A dietitian can teach the person with diabetes about the Glycemic Index/Glycemic Load. Foods that have a low glycemic index will release glucose (sugar) more steadily in the bloodstream. The glycemic load of a food will help you determine how muchglucose the food will deliver to your bloodstream. This is a helpful tool that can be used to determine how a food will impact your blood sugar levels. Diabetics may be practicing carbohydrate counting but should also utilize the glycemic load method. Some dietitians may even provide a customized meal plan for the individual, although it's import that the person learns how to count carbs themselves as well. As they say, teach the person to fish rather than giving them the fish.

26. Gita Patel MS RDN CDE CLT LD

A1: Maintain a balance between food intake and physical activity of your choice. I tell my patients.... Energy "Use it or you lose it". Eat a light snack if you need to between meals. Enjoy eating more of the nutrient dense, low calorie low carbohydrate vegetables and fruits for snacks and with meals. Berries can also be a good snack since they are nutrient dense and low carbohydrate. Eat berries with a few nuts as a between meal snack. ¼ cup of beans salad can be satisfying and won't raise your blood sugar.

A2: Find berries, low carbohydrate fruits, vegetables, nuts, seeds and beans you do like and will eat, they are low carbohydrate, low calorie and nutrient dense. Eat cold beans in salads or as side dishes. The cold beans have Resistant starch which will not raise your post meal blood sugar. There are a large variety of beans, lentils and legumes to choose from. Humus or bean dips with vegetables, beans with vegetables soup, make a good snack.

A3: Yes, a plant-based diet is the best thing you can do for health in diabetes. Plant foods are the only source of phytonutrients and fiber in our diet, both of which promote health. Phytonutrients provide antioxidants and fiber feeds the good microbes in our gut. There is a lot of research on the benefits of plant based eating for health in diabetes. I suggest you work with a Registered dietitian if you need help.

A4: Dietitians are trained nutrition professionals, especially those who are Certified Diabetes Educators often-called CDEs and they can help and guide individuals with diabetes in their health and nutrition needs.

27. Lisa Jones, MA,RDN,LDN,FAND

A1: Eat a high-complex carbohydrate, low-fat, high-fiber diet including fruits and vegetables. This reduces the need for insulin and lowers the level of fats in the blood. Fiber helps to reduce blood sugar surges.

A2: Picky eaters are more likely to follow a diet or lifestyle change if it is designed to fit their current lifestyle. The meal plan should accommodate work and activity schedules. First, determine food likes and dislikes and come up with a meal plan together. Most likely, their food preferences can still be accommodated while being mindful of portion sizes.

A3: Diabetes can still be managed with a plant-based diet by consuming other sources of protein. For example, lentils are a good source of protein, carbohydrates, and fiber. Seeds (sunflower, sesame, pumpkin) are also protein-rich, and can help manage blood sugar levels.

A4: A Registered Dietitian Nutritionist (RDN) can create an individualized plan for those individuals who are willing to commit to a healthier lifestyle change in order to better manage their diabetes.

28. Kelly Ciovacco, MS, RD, LDN

A1: The biggest misconception out there is that someone with diabetes should be avoiding carbohydrates! Carbohydrates are the body's primary fuel source, and we all need carbohydrates to power our metabolism and feed our brains. The key for diabetes is to choose the RIGHT carbs and in the RIGHT portions. Don't feel like you need to follow a "diet" in order to manage diabetes. It all boils down to well-balanced nutrition that includes all the food groups: lean proteins, whole grains, fruits, veggies, and dairy. By choosing complex carbohydrates with fiber, such as fruit or whole grains, and monitoring portion sizes, weight loss may be a nice bonus if that is your goal. But in order to maintain energy levels and keep you blood sugar consistent, it is so important to eat regular meals and snacks every day.

A2: Picky eater? No problem! If you have a limited variety of foods, try to focus on at least choosing a carbohydrate source and a protein source at every meal and snack. Fruits and vegetables are always smart choices so include those whenever possible.

A3: Following a vegetarian diet? No problem! There are several plant-based protein sources that can help elongate the digestion of carbohydrates in your body. Examples include beans, nuts, edamame, whole grains, Greek or Icelandic yogurt, milk, and legumes.

A4: A dietitian is your #1 source for information on diabetes that is not only accurate, but also reasonable! If you are someone who has been avoiding grapes because you heard they were too high in sugar, or someone who has been cutting out carbs altogether, you would be a perfect candidate to work 1-on-1 with a dietitian. We're here to listen to you, provide you with individualized guidance, and most of all - no judgment involved! Dietitians are the nutrition experts who can help you achieve your personal goals, whatever they may be!

29. Rachael Hartley RD, LD, CDE, CLT

A1: While low carbohydrate diets are popularly used for diabetes management, they often result in low energy, since carbohydrate is the body's preferred source of fuel. Instead of cutting out carbohydrates, focus on getting consistent amounts through the day and choosing source of carbohydrate that are minimally processed and rich in fiber, which will not only help stabilize glucose levels but give your body sustainable energy.

A2: Start with the foods you enjoy, then focus on learning how to prepare them in a more diabetes friendly-way. Don't eat foods you don't like just because they happen to be more diabetes-friendly.

A3: Quite a bit of research has shown moving your diet towards a more plant-based pattern is beneficial for blood sugar control. However, there's no need to go vegetarian or vegan to get those benefits. Simply focus on eating more plants (fruits, vegetables, whole grains, beans, nuts and seeds) and less animal foods. And continue to pay attention to the quality of carbohydrate sources you're choosing.

A4: A dietitian can help someone with diabetes discover a way of eating that helps control blood sugar levels, reduces the risk of side effects and is enjoyable. They can also help you learn how to make sustainable changes to your eating habits.

30. Julie Seale RD

A1: I don't recommend diets. Even people with diabetes can eat all foods. The key is finding balance. By listening to hunger and fullness and paying attention to how you feel after eating (along with blood sugar monitoring, if that's recommended for you), you can learn which foods are best for you to have on a regular basis. Dieting can cause dips in blood sugar. This can lead to low energy levels and hypoglycemia. Conversly, food restriction (diets) can also lead to binge eating (which will raise blood sugar levels).

A2: I recommend balancing your taste buds with nutrition. There are general principles to keep in mind when trying to manage your blood sugars. However, the individual foods eaten is up to you, based on many things, including access to food and personal preferences. A dietitian can help you incorporate your favourite foods into a nutritious diet.

A3: A plant-based diet can be very nutritious. They are often high in fruits and vegetables, but not always. You will have to pay special attention to certain nutrients like protein and omega-3 fats, since you are no longer eating meat, fish and poultry. Try having pulses (chick peas, kidney beans, lentils, etc), as they provide protein and soluble fibre (soluble fibre can help lower post-prandial blood sugar and LDL cholesterol). If you give up all animal products, then calcium, Vitamin B12 and Vitamin D are also nutrients that you will need to ensure you get in other ways. From a diabetes perspective, these diets can sometimes be higher in carbohydrates -- aim for whole grains and whole fruits and veggies more often than refined grains, sweets and fruit juice.

A4: A dietitian will meet with you to review your lifestyle and usual diet. She/he will explain the role of carbohydrates in the body and how your body processes them. A dietitian will work with you to come up with a plan that's sustainable for you.

31. Liz Marr, MS, RDN, FAND

A1: Small meals throughout the day will help with managing blood sugars and help you sustain energy throughout the day. Space your meals and calories evenly throughout over the day to help with managing blood sugar and keep your energy going. Most important, don't drop your calorie level too low. Unless you've been told to lose weight more rapidly, aim to lose no more than about 1 pound per week, which means a calorie deficit of about 500 per day, through both diet and exercise. At that level, it's easy to keep your energy up.

A2: People with diabetes can enjoy a wide range of foods. If your child with diabetes is a picky eater think about ways to involve them in making healthy choices by offer meal-time options, helping with food preparation or growing a backyard vegetable garden. Be persistent - it some times takes multiple tries before a child accepts a new food. Recognize that a picky palate can persist over time and you may need to see help from an expert, such as a registered dietitian.

A3: Vegetarian diets help reduce risk of heart disease, diabetes and certain types of cancers and may help with weight loss. If you have diabetes and want to eat a plant-based diet, you still need to manage portions and make nutritious choices. Think about whole grains, legumes and plenty of fruits and vegetables. It's important to eat adequate protein; plant-based sources include tofu and other soy products, legumes and nuts. A plant-based diet may be higher in carbohydrates so if you are shifting from an omnivorous diet to one that is plant-based you may need to adjust your insulin or other medications to keep your blood glucose levels under control.

A4: A dietitian can be very helpful by working with you to help establish diet goals that will help you manage your diabetes and consider other important aspects like other health issues, weight loss, favorite foods and food traditions, family meals, budget and time constraints, eating out, and the like. It's not easy to change your diet, so don't be afraid to ask the experts for help.

32. Jill Nussinow, MS, RDN

A1: We are all on a diet but I think that you are referring to a weight loss diet. I suggest eating every few hours and not skipping meals. I find that eating a lot of fresh food such as low carbohydrate vegetables such as lettuce, cucumber, zucchini, spinach, broccoli and greens helps with energy levels. Since they are so low in calories you can eat a lot of them and feel satiated.

A2: Picky eater are almost always going to have a more difficult time with food. Sometimes people who are particular about what they eat don't realize that they possibly like more foods than they are eating because they just avoid the foods that they think that they don't like. I suggest trying one new "healthier" food a week. Like it? Eat it more often. Don't like it? Don't eat it.

No one can force you eat to foods that you don't like.

A3: For many people who have diabetes, eating a plant-based diet with good choices (avoiding sugar, white products such as rice and bread, as well as limiting or avoiding flour-based products) can help stabilize blood sugars.

A4: A dietitian can work with you to zero in on which foods are best for you and how to put together an eating plan that works to help you manage your diabetes. A dietitian can answer questions that you have about food, nutrition and diabetes management for better health.

33. Kelda Kast Reimers, RD, LD/LDN

A1: Our bodies get energy from the fat, protein and carbohydrates found in the food we eat. People with diabetes need to pay close attention to the servings of carbohydrates they enjoy with each meal and snack, because carbohydrate foods directly influence blood glucose levels. Generally, if you follow the Plate Method and make half of your plate non-starchy vegetables, a quarter of the plate protein food and the last quarter carbohydrate containing foods (such as whole grains or starchy vegetables like potatoes), you will maintain high energy and balance blood sugar levels. Snacks should contain a high-fiber carbohydrate food and a protein food to maintain high energy and fill you up between meals. For example, try an apple with peanut butter or whole grain crackers with low fat cheese.

A2: Enjoying a wide variety of healthy foods is an important part of maintaining good overall health. Plus, managing diabetes is easier when there are many non-carbohydrate containing foods that are accepted.

Young kids who are picky eaters may need up to two-dozen exposures to a new food before they are willing to accept it. A strategy parents can try with their picky eater, is to serve a new food along side favorite foods and provide the same new food every day for a few weeks so it becomes more familiar and less "scary." It's usually not helpful to force or bribe a child to try a new food, but parents can show their kids how much then enjoy trying new foods. Modeling this good behavior goes a long way with kids. Be patient, and keep trying. Eventually a child will try something new.

Adults with diabetes who are picky eaters need to understand how foods impact their blood sugar, and should aim to try new foods (especially vegetables!) regularly in order to find out which they like best. Preparation methods can be adjusted, too, in order to find new flavor combinations. For example, steamed broccoli is not for me - but I'll eat roasted broccoli any day (try my recipe, below).

Roasted Broccoli
1 pound of broccoli florets
½ red onion, thinly sliced
1 tablespoon olive oil
½ teaspoon of sea salt (or to taste)

Pre heat oven to 400 degrees. Put broccoli florets and onion slices in a single layer on a baking sheet. Drizzle with olive oil and season salt -- toss evenly coat. Roast for 15-20 minutes or until florets begin to caramelize slightly. Serve warm, or enjoy chilled.

Try this method with other vegetables such as cauliflower or Brussels sprouts.

A3: Plant foods - whole grains, fruits, vegetables, beans, nuts and seeds - are all healthy options and can each be enjoyed by people with diabetes. All plant foods contain fiber, which helps slow down how quickly the glucose from your food is absorbed into your blood stream. Plant based diets are healthy, but those with diabetes should be mindful of their portions of whole grains and fruit because of their carbohydrate content.

A4: People with diabetes should consider their endocrinologist and their dietitian as teammates in their journey to manage blood sugar levels. Blood sugar is kept within normal range when a well planed, carbohydrate-controlled diet compliments the unique medication or insulin regimen for each patient. Dietitians are good at meal planning, making grocery lists, explaining which foods contain carbohydrate and how to plan for moments of high or low blood sugar. Don't be shy to reach out to a dietitian with any food related question - we are always happy to help!

34. Diana Cullum-Dugan, RDN LDN RYT

A1: My all-time recommendation is to eat 4 meals a day that contain around the same amount of calories. For instance, if your body needs 1600 calories a day to maintain the energy and vitality to do the things you love, plan 400 calories for each meal. If dinner is social, catch-up family time , ease 50 calories from the other three meals and increase dinner to 550 calories.

A2: Picky eaters tend to omit vegetables and fruit. Introduce a new vegetable each week with several preparation methods. While steamed vegetables may taste bland, oven-roasted Brussels' sprouts, cauliflower, new potatoes and carrots drizzled with olive oil and a little salt and pepper may offer the wow factor for picky eaters. Experiment with fresh and frozen fruit - simmer blueberries or stew apples for delicious pancake toppings. Microwave frozen cherries and add Greek yogurt and lightly sweetened granola for another breakfast treat.

A3: A plant based diet is perfect for diabetes. It lays a foundation of color and that means powerful vitamins and minerals for energy and metabolism. Eat a rainbow of vegetables and fruits, then layer in whole grains, beans and lentils, and low-fat dairy and eggs if desired. Plant-based diets can include lean meats like chicken, turkey, beef and fish in small portions.

A4: Registered dietitians are the experts in how nutrition works in your body and offer solution-oriented behavioral change tactics that ensure a well-balanced diet. Dietitians support you in planning your food choices and can help you overcome obstacles that get in your way of feeling powerful and energetic. Dietitians believe you can be your very best and will be there for you for as long as you need to feel you've got this!

35. Lauren O'Connor, MS, RDN, RYT

A1: In order to keep energy levels up, I suggest eating at regular intervals - every 3-4 hours. Snacks should include plenty of fiber and/or protein and may include a little healthy fat to help manage blood sugars. (For example: apple slices with a TBSP of peanut butter.)

A2: Picky eaters can benefit by planning their meals and snacks ahead of time. I suggest preparing overnight oats for a simple grab-n-go breakfast: ⅓ cup raw oats + ¼ cup plain nonfat yogurt or low at ricotta + ¼-½ cup berries + ½ cup milk or unsweetened alternative. This no-brainer that includes a good balance of carbs, fiber, and protein.

A3: Plant based is definitely do-able. Just be sure to include high protein veggie sources such as broccoli, lentils, peas, spinach, kale & other dark leafy greens; minimal healthy fats such as avocado, nuts & seeds; and complex carbohydrates such as quinoa and brown rice. You can use veggie-based protein powders in smoothies, soups and even homemade low-carb pancakes or muffins for more protein, but be sure not to rely too heavily on these as whole, unprocessed foods should be the bulk of the diet.

A4: A dietitian can help you choose the types of foods and combos that will give you the best balance of nutrition for your dietary needs/preferences.

36. Kelley Biondolillo RD LD

A1: My first thought on this is "diets" typically are not the best approach. Slow changes in eating habits and calorie consumption leading to more permanent habits will have the best success. If weight loss is the goal, decreasing total calories is critical, but the type of calorie is also quite important. Unprocessed foods including whole grains, vegetables, plant based proteins, beans, lean meats, fish and dairy will help with energy and diabetes management. Additionally, exercise is critical in both increasing energy levels and maintaining good blood sugar control.

A2: Each individual is different and we all have preferences. While it is important to respect these preferences, I also encourage those "picky" eaters to have an open mind. Keeping a balance of preferred foods and and slowly adding in new items works well. It can also be very helpful for "picky" eaters to look through cook books and cooking magazines to identify some new recipes and foods they's like to try as this can help expand the variety in their diet.

A3: Yes, it absolutely is wise and actually beneficial! Many have had much success and major health improvements switching to a plant based diet. It is important to talk with your doctor or a dietitian when make big changes in your diet as your medication needs may change.

A4: Dietitians are by far the best resource for people with diabetes. They can help plan meals with their patients ensuring good blood glucose control and often times, significant reduction in the disease. Some RD's also have a CDE credential (Certified Diabetes Educator). They are especially skilled in working with diabetic patients. It is important for those with diabetes to do their own research and seek professional help. An ongoing professional relationship with a registered dietitian or health coach can make a significant difference in the health of someone with diabetes.

37. Natalie Meador, MPH, RDN, LDN

A1: Some of the best ways to keep energy levels up when following a meal plan for diabetes is to make sure that each meal or snack contains a balanced combination of complex carbs (fruits, veggies, whole grains), lean protein (chicken, fish, lean cuts of pork or beef) and heart healthy fats (olive oil, avocado, nuts or seeds). Balanced meal combinations provide adequate amounts of fiber, protein and fat to stabilize your blood sugars and provide a steady flow of energy throughout the day.

A2: Picky eaters should continue to enjoy the foods that like, but they need to strive for balanced combinations of complex carbs, lean protein and heart healthy fats. Portion sizes are key, and picky eaters should try to increase the variability of their foods to ensure adequate intakes of vitamins and minerals.

A3: Plant based diets are an excellent choice for people with diabetes. However, people with diabetes should consult with a registered dietitian nutritionist (RDN) to ensure that their diet is adequate in protein and key vitamins and minerals such as calcium, iron, vitamin B12 and zinc so that deficiencies to not arise

A4: RDNs coach people with diabetes in the areas of food selection, meal planning, and behavioral change. When working with a RDN, you get the best of both worlds: someone with the expert knowledge of food composition and someone who understands the challenge of behavioral change. RDNs are the qualified experts who educate people with diabetes on nutritional science so they can improve their quality of life.

38. Ann M. Silver, MS, RDN, CDE, CDN

A1: To manage your diabetes, you are not really on a "diet" per se, but making modification of your food choices to improve your blood sugar (glucose). If you are eating properly by balancing your carbs with protein and fat to manage your weight and keeping your blood sugar close to goal you should not experience a decrease in your energy level.

If you feel a lack of energy you want to figure why. One reason for low energy is high blood sugars. This is because the glucose in the blood is not getting into the cells. The cells need the glucose for their "fuel" for energy. Excess glucose circulating in the blood stream is called high blood sugar or hyperglycemia.

Another reason for feeling a lack of energy can depend on your choice carb foods. Carbs foods that are low in fiber and more processed such as white bread, white rice and pasta produce a more sedating feeling. They may make you feel sleepy-like a couple hours after eating. Carb foods higher in fiber are less likely to make you feel tired. Keep in mind you don't want a meal that is exclusively carbs. Balance your carbs by eating protein and fat and keeping your blood sugars in check will make you feel great and give you energy.

A2: Picky eaters with diabetes, just like a person without diabetes, should try to experiment with food. Food you have not tasted in a long time may actually taste different. You might find foods you did not like you now like, especially if you have not tried those foods in a long time and even since childhood.

Foods prepared in different ways can make food more enticing. When eating with someone who has a food you don't usually eat ask for one bite. See if it is as you remember it. You might be pleasantly surprised or confirm the fact you still don't like the food.

How can they manage their blood levels and still enjoy their food?

Managing blood sugars is about the amount of carbs in relation to protein and fat when you eat. In general, eating more non-starchy vegetables (all the veggies except the starchy ones like corn, peas, potatoes (white and sweet) and winter squash) are always a great fall back. Non-starchy vegetables are low in carbs and will not raise blood sugars.

A good and objective way to see how food impacts your blood sugar is to test your blood sugar between 1½ to 2 hours from the first bite at a meal. If your blood sugar is at goal great! If your blood sugar is high or low you will need to adjust your carbs down or up accordingly. Of course keep in mind other things like insulin, stress and physical activity that can also play a role in your blood sugars. If you have difficulty in achieving good blood levels it may be time to meet with a Registered Dietitian Nutritionist (RDN), who also holds credentials as a Certified Diabetes Educator (CDE) to help you to manage your blood sugar levels while eating the foods you enjoy.

A3: As a person with diabetes you can follow a plant-based diet. It may be a little challenging because one can tend to rely more on carbs, but it can be done. Being on a plant based diet will requiring planning and getting used to different food choices. What will be most important is to see the impact of your food choices on your blood sugar and adjusting the food to maintain good blood sugars. Research is showing eating a plant-based diet has numerous health benefits. Meeting with a RDN, CDE especially one who eats a plant-based diet can plan your meals and provide recipe ideas.

A4: A dietitian (RDN) who is also a CDE can really help a person with diabetes because they know about food and understand what is involved to control diabetes. They will review your labs, your self-blood glucose monitoring (if you are), your medications, your food journals and other important and relevant information. A RDN, CDE will help you understand diabetes and what in your life (not only food) that affects your diabetes management. They will help you come up with plan tailored to you to improve your diabetes and maybe even require less diabetes medication. Many insurance companies including Medicare cover meeting with a dietitian for diabetes. It's certainly worth the visit for your health!

39. James Lucas III MS, RD

A1: The best way to keep energy levels and manage diabetes while following a diet would be to have a balance between adequate nutritional intake, rest and physical activity. All three of these components can help to support energy levels. Nutritional intake will ensure that you have the appropriate amount of fat, carbohydrates and protein to support macronutrient needs to properly fuel your activities of daily living and the demands of physiological functions such as breathing and metabolic functions. Secondarily you want to ensure that your diet is sufficient in micronutrients such as iron, vitamin D, vitamin B12 and others that are important for cellular function which helps to ensure that your body has the most optimal opportunity to utilize the fuel/energy/food that you ingest. Meeting with a Registered Dietitian or having your blood nutrient levels such as vitamin D check will be important to ensure adequacy. Exercise will help to increase your energy levels by increasing blood flow, nutrient delivery and oxygenation to the brain, muscles and heart when exercising on a consistent basis. Last but not least, having adequate rest is essential to ensure proper restoration of cellular energy, to allow the body to repair to properly utilize energy and also to restore balance for adequate immune function. A minimum of 5 hours of sleep should be obtain per night.

A2: For picky eaters who have diabetes who would still like to enjoy their food and not give up favorites. It's all about flexibility, timing and balance. You will have to become a smart consume and realize where you stand for the day in relation to your macronutrient needs. You want to aim to consume adequate protein, fat and carbohydrates throughout the day. If you are use to choosing more sweets and are picky about adding something like vegetables to your diet (particularly non-starchy vegetables such as onions, carrots, broccoli, asparagus, tomatoes, brussel sprouts) then you should strive to be creative. Utilizing nutritional modifications will be an important and crucial component to controlling or even perhaps reversing the condition. It will likely be a balance between greater nutritional modifications, greater exercise or a combination of both to help you manage your blood sugars. All foods can fit into a healthy diet and you may not have to totally give up your favorite foods or add a bunch of vegetables that you have struggled to eat or avoid most of your life. It will be a matter of eating less of some of the more diabetic inducing foods and beverages and finding a way to incorporate more of the diabetic friendly foods. For instance; during breakfast you may be able to consider 1 whole eggs with 2 egg whites add spinach and tomatoes to incorporate more vegetables. You can also incorporate some tasty recipes of some of the foods that you may not favor so much. Also, try joining a support group or consult with a dietitian to get more ideas of ways to incorporate less favorable foods into your diet.

A3: Increasing your intake of plant base foods always sounds like a great idea, and it may be, especially if your baseline diet is chalk full of mostly meats with very little to no vegetable intake. The plant base diet particularly when your eating more fruits and vegetables has been associated with an overall greater reduction in the risk for developing disease, so I am all for adding more non-starchy vegetables and a whole fruit or two once per day in-between meals. With that being said though...too much of anything isn't good for you. Some individuals may go to the extreme and completely eliminate all protein base animal foods such as fish, chicken, eggs and beef where some important nutritional/ macro and micronutrient components can be contributory to supporting optimal cellular function and energy levels. Additionally, protein plays a crucial role in regulating blood sugars and changing the glycemic load when eating a rich carbohydrate meal. Also, if not cautious plant base foods can be high in carbohydrates, which could raise your blood sugars. Remember that a large percentage of sugar/blood glucose is stored where? In the muscle tissues, approximately 90% of ingested glucose is stored in muscle as glycogen. The muscle is made up of proteins, you want to maintain that muscle tissue and even build upon it to allow you body to have a greater reservoir to store glycogen or glucose or sugars. If you ate a lot of plant base foods with very little to no protein, you run the risk of losing more protein or lean body mass or muscle. This will come in the form of weight loss, which can help improve insulin sensitivity, however you may be losing some of your strength, muscle functionality which could lead to more frailness over time. I would definitely recommend starting or sticking to a strenuous resistance training program while following a mostly plant base diet to help maintain the muscle mass. The best philosophy in my Registered Dietitian opinion is to have balance and moderation. Note that animal base foods provide essential nutrients to the body such as vitamin B12, which you can not find in many rich sources from a plant base perspective, so if nature has intented for us to consume animal protein, because of the protein, vitamin B12, iron, CLA, etc, then why not include some animal and plant base foods to create the ultimate ideal potential situation for greater blood glucose management and homeostasis.

A4: A dietitian can help someone with diabetes by providing them with evidence base, credible, reliable information about how foods may affect your blood sugars, health and potential longevity. Dietitians are the experts on food and nutrition and can help you make an informed choice about the foods that you select to help manage diabetes. Dietitians are trained professions that should have experience working acutely with patients diagnoses with diabetes in addition to counseling skills to help make individual, customized and personalized adjustments to your nutritional regimen to help you to optimize on your health and diabetes control.

40. Rivanna Stuhler, RD

A1: As a general rule, I don't believe in diets, because many aren't sustainable in the long term. I do, however, believe in small, realistic, and manageable changes to your overall diet, because this will help you manage/gain/lose weight (whatever your particular goal happens to be) in a healthy way, and help you learn to manage your diabetes. The most important things to consider are 1. eating breakfast every day, 2. making sure not to skip meals, and 3. learning more about balance and portion sizes so that you don't eat too much at every meal.

A2: No matter how picky, making sure that you eat carbohydrates through the day to safely manage your blood sugar is essential. I always recommend trying new foods slowly, and as a family, particularly when working with children. Make sure to include a carbohydrate source that your child enjoys and will reliably eat, and then add other foods and flavours one by one. Involve your child in cooking and food preparation, and try different flavours. You may find that your child enjoys very strong flavours. No matter what, keep offering new foods - one day your child may try something new and actually like it!

A3: There's absolutely nothing wrong with a balanced vegetarian diet for someone living with diabetes. Some sources of plant proteins, like beans and lentils, contain carbohydrate too, so you may need to reduce your portions of carbohydrate-rich foods (i.e. rice, pasta etc.) when making meals with plant-based sources of protein. The most important thing, as with all dietary modifications, is to make sure you have a good source of carbohydrate at all meals, and then balance (protein, fat, vitamins, minerals) from the rest of the food you eat!

A4: Dietitians are trained in safe, evidence-based management of diabetes. They can help teach you the fundamentals of managing your diet while living with diabetes, and can then help you optimize the diet to best meet your individual needs and preferences. A dietitian can teach you about portion sizes, and how to read nutrition labels, and can also help you ensure that your (or your child's) diet is safe and complete in the presence of food allergies/intolerances and/or picky eating behaviours.

41. Darla Balthaser, RDN, CDN, LDN

A1: Getting consistent physical activity daily actually helps to keep energy levels up. Just make sure your activity goals match your personal fitness ability. Meaning don't over or under do it! Also making sure to have well planned snacks throughout the day that contain combined nutrients (carbs, fat and protein) will help maintain blood sugar levels and provide consistent energy.

A2: Keep a food journal that includes a list of favorite and not so favorite foods. Maybe add in a new ingredient each week but prepare it in a new way to you and see if that changes your taste for it. You could explore the internet, book stores or libraries for recipes and ideas.

By using portion control of certain foods it is easy to eat well and enjoy your food. The plate method or MyPlate is a great resource for portioning meals. You can choose your favorite protein and carb to fit half the plate and then load the rest of the plate with all the non-starchy vegetables you can handle! The fiber in those veggies will help to keep you full and satisfied.

A3: Yes! Well-planned plant-based diets are a great way to manage diabetes. They contain beans, which include some of the best starches for maintaining blood sugar levels, fiber and protein. They are generally low in fat and high in vitamins and minerals.

A4: A dietitian can help with the meal planning, tracking and coaching portion of your care! He or she can customize your care with your personal health goals in mind while making sure the diet you choose is well balanced to meet your nutrient needs. A dietitian may also be able to help with physical activity, smoking cessation, appropriate hydration, sleep and any other life goals you may have. With regular check ups the dietitian will be able to make any necessary tweaks to the plan to keep you on track on your health journey!

42. Rebecca Subbiah RDN

A1: Diet for diabetes is the same healthy eating plan we should all follow try not to see it as a diet, but a lifestyle. Regular nutritious meals balanced with activity with maintain energy levels.

A2: There are so many choices and cuisines from around the world you will find recipes you love and enjoy food just have a sense of adventure.

A3: Sure vegetarians can manage diabetes well just eat sensible portions of plant based carbohydrates and use plant based sources of protein.

A4: They can give you a Taylor made plan / tips taking into account your lifestyle, culture, preferences and most importantly support you on your journey towards optimal health.

43. Angie Dye, MS, RDN, CSSD, LDN

A1: Sometimes when dieting, we think about all the forbidden foods or things we are focused on avoiding. When the object is to manage diabetes and feel energetic, it is wonderful to instead place the focus on the abundance of foods that we can include throughout the day to fuel and nourish our bodies. Setting small, attainable goals of including foods that keep energy levels stable, such as complex carbohydrates, lean proteins and plenty of fruits and vegetables is a great place to start. For some, this might mean setting a goal of packing lunches and snacks and for others it might be trying some new and interesting dinner ideas instead of grabbing take-out.

A2: Picky eating is not necessarily problematic unless major food groups are excluded. When this happens, it is difficult to obtain all of the vitamins, minerals and macronutrients that we need to maintain our health. A good picky eating strategy is to choose several favorite or familiar foods at each meal, but perhaps challenge yourself to include something new that may have a health benefit. For example, many of my clients who are self-proclaimed picky eaters do not like any vegetables. I encourage them to create a dinner plate that includes 2 favorite foods such as chicken and rice, but also includes a small portion of a new vegetable to try. Over time that feared vegetable may become a favorite food, too.

A3: There is information about the benefits of a plant based diet every where we turn these days, and for good reason. Plant based diets have been shown to decrease the risk of many chronic diseases, including heart disease, diabetes, obesity and certain types of cancer. However, going completely plant-based overnight can be a challenge. I like to encourage my patients to start by trying plant-based eating one day per week, perhaps on Meatless Monday. There are significant health and environmental benefits to eating even 3 plant-based meals out of the 21 meals per week. If you find you feel great and have good glycemic control on Meatless Monday, try including more and more plant-based meals, as you are comfortable.

A4: Many of my patients don't know where to start because there is such a large body of information available today about how to manage diabetes. From magazines to books to well-meaning relatives, my patients with diabetes are constantly exposed to mixed messages about the most current and effective ways to stay healthy. Registered Dietitians are nutrition experts and can help sort through myths and facts and help you set attainable and sustainable goals to achieve lasting health.

44. Digna Irizarry-Cassens, MHA, RDN, CLT

A1: Here is my take:

• Take daily short walks of at least 20 minutes. If you need to divide your walks into 2 -3 times a day.
• Eat 5 to 6 meals a day containing complex carbohydrates and lean proteins.
• Skip juice, eat fruits instead to increase your fiber content.
• Start the day with a tall glass of water, then a whole grain and lean protein small meal to break your fast.
• Keep snacks small - ½ oz to 1 oz lean protein & 15 grams complex carbohydrate are best.
• Keep snacks to 100 to 150 kcals depending between meals and 250 kcals before bedtime

A2: It's essential to have a list of preferred foods and focus on having those primarily. Your registered dietitian nutritionist can help you design a personalized eating plan to include just the foods you like.

There are convenient, easy to use lists that group foods by nutrient groups. Using these lists you can find those that are of similar nutrient value to those you dislike. For example, one grouping lists carbohydrate foods and the portion providing 15 grams of carbohydrate, so you can easily substitute one carbohydrate food for another.

A3: Yes. There are many resources available to help those preferring to eat only plant based food. However since legumes are higher than animal protein in complex carbohydrates, adjustments may be needed.

The advantage to eating a plant based diet is that fiber intake is increased, which benefits blood sugar levels and bowel regulation, and in the end is a better plan for most if not all persons with diabetes.

A4: The RDN is the best source of nutrition information. Your physician and healthcare team prescribe and design your general diabetes healthcare plan, but only a registered dietitian nutritionist with knowledge of nutrition, foods and cooking methods can help you design a personalized meal plan that's to your liking and will be with you for life. We can answer your questions and help you plan so you have peace of mind and enjoy your food.

45. S. Katrice Mayo, MS, RDN

A1: The best way to keep energy levels up while dieting is to have a nutrition prescription that includes the following:

1. Eating a high quality breakfast. It should include high fiber foods and good quality proteins some examples are quinoa porridge or oatmeal made with low-fat organic milk or plant-based milks, nuts (if not allergic) and fruit.
2. Eat on time, meaning eating at the same times daily.
3. Eat all meals with protein.
4. Eat all meals with fiber. Here is a nice high fiber food list compliment's of Today's Dietitian: http://www.todaysdietitian.com/newarchives/063008p28.shtml.
5. Manage stress by making time for something fun or enjoy some quiet time via mediation, prayer, music therapy, art therapy or read a book.

A2: Picky eaters in general should see a dietitian who specializes in cooking demonstrations and recipes. If the picky eater is willing, this will give them an opportunity to try different food pairings, textures and flavors. The key to all of this is having an open mind and willingness to expand the palate and try new foods. If this can be done, then blood level management can get better as the palate is expanded.

A3: Yes and no which is why nutrition personalization is paramount. Here are some reasons why it is a good idea and some precautionary things to keep in mind:

1. Plants, including herbs and spices, are the original medicine and help fight chronic inflammation.
2. Folks who eat a majority plant based diet have a better quality of life, good weight control and age biologically slower due to phytochemical antioxidant power found in plants.
3. Good sources of plant based protein are found in beans, lentils, tofu, cooked spinach and broccoli and some nut butters.
4. If the majority of the diet consists of fruit and starch vegetables such as peas, potatoes, corn and winter squashes, high sugar yogurt and milk then a plant-based diet would not be a good idea.
5. Be sure to take a good quality multivitamin or B-complex vitamin as well as plant-based omega-3 fatty acid supplement to prevent vitamin B12 deficiency and obtain essential fatty acids EPA & DHA.

A4: A dietitian can create a personalized nutrition plan that takes into account all a of person's past medical history, current medications, lab work, sleep hygiene, stress management, supplements, body weight and movement lifestyle. A dietitian help keep you motivated to make a lifestyle change and reach your goals. A service I provide is kitchen detoxification. I like to see what a person has in their pantry, cabinets and refrigerator and come to a mutual agreement of getting rid of foods that can harmful with slow change to better diet lifestyle.

46. Cathy Wang RD

A1: Eat a meal with low GI grains, a protein source, and plenty of leafy vegetables every 4-6 hours to make sure you're getting something fuel your body. Reducing portion sizes can help with weight loss, and if you find yourself feeling hungry between meals, get a small snack between 100-200 calories to tide you over. Some good options are: a small handful of almonds, 3 whole grain crackers + 1 tbsp peanut butter, 1 medium sized apple, or 100-175 mL of yogurt (1-3% milk fat).

Sometimes it's hard to notice your energy levels dipping low until you're really hungry. If that's the case, intentionally check in with your body every 2-3 hours to see if you need a snack (set an alarm on your phone can help). This can be helpful for people who have busy schedules or irregular meal times.

I would not recommend intermittent fasting or the ketogenic diet for people with diabetes -- both increases the likelihood for low blood sugars.

A2: I would suggest sorting the foods you like into 3 lists: carbohydrate containing foods (grains, fruits, beans), protein containing foods (beans, soy products, meat, fish, dairy, nuts, seeds), and vegetables. Choose 1 carbohydrate containing food, one protein containing food, and two vegetables for your meals. This way, you're eating foods you like while getting the nutrition you need.

For bonus points, aim for whole grain or low GI carbohydrates such as barley, parboiled rice, whole grain pasta, quinoa, beans, legumes, or pumpernickel bread,

Making healthier substitutions to your current favourite dishes can make a big difference in your health without changing the taste. For example, try using whole grain pasta instead of white pasta; make bolognese pasta sauce with half ground meat and half lentils; look for no sugar added peanut butter; and dilute fruit juices with water to keep the taste without the sugar.

If you're thinking about trying new foods, start with foods that are similar to the ones that you already like. For example, if you like sour cream dip, why not try a sour dip made with yogurt, like tzatziki, or perhaps low-fat cottage cheese?

A3: A well planned plant-based diet is great for people with diabetes. Generally speaking, vegetarian diets are lower in saturated fat, cholesterol, and higher in fibre compared to the average North American diet. Vegetarian diets are associated with lower risks of heart disease, colon cancer, and dementia in studies, and they are better for the environment too.

To make sure you're getting the nutrients you need, choose beans, lentils, soy products (tofu, tempeh, soy milk), and nuts to replace meat and seafood. Eat more walnuts, flax seeds, chia seeds, hemp seeds, and leafy green vegetables to get your share of omega-3 fats found in fatty fish. You may consider a vegetarian omega-3 supplement, such as one made from algae.

You don't have to become fully vegetarian or vegan to reap the benefits of a plant based diet. Choose to substitute firm tofu for chicken in a stir-fry or wrap, have bean chili instead of meat chili, and make a veggie sandwich with hummus, cheese, red bell peppers, and avocado.

A4: A dietitian works with you to come up with a eating plan based on your lifestyle, eating habits, and scientific evidence. Nutrition counselling by a registered dietitian can help lower Hgb A1C by 1-2%, help with weight management, and reduce co-morbidities such as high blood pressure. We don't just tell you what to eat, we'll also listen to your challenges and help you come up with solutions that fit.

47. Ariana Haidari, RD, CD

A1: Consistant, planned food/carbohydrate intake over the course of the day. Find 2-3 snacks that work for you, and start here. Keeping when you know how certain foods affect your blood sugar, it is easier to control your blood sugar over all. Controlled blood sugar meals that it does not spike or fall more than a few mg/dL.

Having a strategy for meals during the day can help set you up for success with healthy eating over all, but it is especially important when managing blood sugar. By planning out your meals and snacks in advance, you can avoid getting trapped in a situation with limited options.

A2: Managing diabetes doesn't mean you don't have options. It is all about choices, and finding a way to make your choices fit into your meal plan. It is important to determine the carbohydrate content of the staple foods in your diet, and understanding how those foods affect your blood sugar. From there, you can work with a registered dietitian to build complete meals with a balance of protein, carbohydrate, and healthy fats.

A3: A plant-based diet typically means one that is rich is vegetables, fruits, whole grains, nuts, seeds, and legumes (think black beans, chickpeas, and peanuts). Plant based doesn't necessarily mean 100% free of animal products - eggs, cheese, yogurt, and lean meats are great sources of protein, vitamins, and micronutrients not often found in plants, such as choline. A plant based diet can be helpful because it tends to be high in fiber, which keeps us full and may help Type 2 diabetics lose weight. It is important to remember, however, that with diabetes, it is always important to know how certain foods will affect your own personal blood sugar levels. The best way to know which foods are best for you is to closely monitor your insulin and keep track of which foods cause spikes.

A4: which brings me to the last point - the role of the Registered Dietitian! Dietitians have a vast and detailed knowledge of both physiology and food. A dietitian can be a great ally to helping patients with diabetes understand what is going on in their bodies and how to adapt their lifestyle to control diabetes - not the other way around. A registered dietitian can help understand which foods cause your blood sugar to rise, provide recipes and culinary knowledge to help patients enjoy their foods, and even recommend specific brands or grocery stores that carry brands or products patients may find helpful. A registered dietitian empowers her or his patients to take charge of their diabetes!

48. Brenda Stephens, RDN, PhD

A1: First of all, I do not recommend dieting for weight loss. I believe in a "weight neutral" approach to managing diabetes. My approach involves helping you make food choices that are both satisfying and nourishing by tuning into your body's signals and honoring them. Of course, some basic planning principles need to be applied to be sure you will have the foods you need when you need them.

A2: As long as a picky eater enjoys at least a moderate amount of variety in foods, it's possible to work with their preferences when deciding what to eat and when for best management of blood glucose levels. I would encourage experimenting a little to possibly expand one's list of acceptable foods, but initially just starting out with foods that are already enjoyed.

A3: Plant-based diets have a lot going for them, but limiting one's diet to plant foods does limit variety in food choices. One of the major sources of protein in a totally vegetarian diet is beans, and that protein comes packaged along with carbs and fiber. Another major plant source of protein is nuts, which are also high in fiber and fat, but lower in carbs. Including dairy and eggs greatly expands options for food sources of protein, while avoiding reliance on killing any animals. Many of us actually get more protein than we truly need, but getting sufficient amounts of protein (say around 20% of calories from protein) and including a significant amount of protein when eating carbohydrates appears to be helpful in keeping blood sugar levels within desired ranges.

A4: A dietitian can help you come up with an eating plan that is tailored to your needs - your food preferences, your lifestyle, your medications, etc. We can also help you make adjustments in the plan if you need to improve it for better glucose control, or change it due to changes in exercise or other lifestyle factors.

49. Carolyn Tampe, RDN, CDE, PA-C

A1: The best way to keep energy levels up is to eat several times throughout the day (at least 3 with possible snacks if there will be extended periods without eating). Try to include nutrient dense foods from all the macronutrient groups (carbohydrates, protein and fat) with each meal. Keep in mind there is no ideal percent of macronutrients that is recommended for people with diabetes and diets should be individualized with assistance from a Registered Dietitian Nutritionist. Additionally, keeping blood sugar levels in your target range will help keep energy from dropping.

A2: Picky eaters should focus on the most nutrient-dense foods out of the foods they enjoy. In order to manage blood sugars (on insulin) they should become familiar with the carbohydrate content of those foods and match insulin accordingly.

A3: According to the American Diabetes Association, plant-based diets are a meal planning option for people with diabetes. Plant-based diets may even off an advantage for people with diabetes. According to a systematic review of 6 studies that was published in 2014, consumption of vegetarian diets was associated with a significant reduction in hemoglobin A1c (a marker of diabetes control) compared with consumption of comparator diets in those with type 2 diabetes. Additionally, plant-based diets are associated with lower cholesterol, blood pressure and body weight, all of which benefit those with diabetes.

A4: A dietitian can assist someone with diabetes by tailoring a meal-plan to their medication or insulin regimen. A dietitian can also help create an individualized meal plan that meets the patients goals in terms of cholesterol reduction, weight loss and glucose control that aligns with patient preferences.

50. Gina Sunderland, MSc, RD

A1: One of the best ways to maintain your energy levels is to eat regular meals and snacks. If your meals are more than 6 hours apart, include a healthy snack to keep you energized. Some of my favourites include: raw veggies with hummus, an apple and a handful of almonds, multi grain crackers and cheese, or Greek yogurt with berries.

Regular physical activity, like a daily walk can also help you maintain your energy and manage your blood sugars. I encourageclients to think of physical activity like taking a diabetes pill -it helps with bloodsugar control.Working muscles will use glucose directly as fuel,lowering blood sugars, and at the same time physical activity provides you with an increased energy. A win, win!

A2: Being a picky eater can make eating and meal planning challenging especially when you have diabetes.Some of my tried and true favourite suggestions for "picky eaters" include creating meals and snacks around your favourite food choices.If you love brown rice, but you struggle with including a variety of vegetables in your diet,try making a brown rice pilaf that includes new vegetables.

Another strategy is to try one new recipe a week, or sign-up for a diabetes cooking class. Cooking classes are a great way to learn new recipes and try new foods! Or consider a "food exchange" with a friend that also has diabetes, such as a weekly soup exchange. You make a blended vegetable soup, and your friend makes a minestrone or barley soup - you both get to try new foods!

A3: A diet consisting of plant-based foods can provide the nutrition your body needs, even when you have diabetes!

When embracing a plant based diet consider starting by going meatless one day a week. Focus on eating foods like whole grains, pulses, nuts, seeds, vegetables, whole fruits, and plant-based oils like canola, and olive oils that contain healthy fats.

Be sure to include sources of protein, they are important for building and maintainmuscles, and for helping to manage your blood sugars, because proteins are digested more slowly than carbohydrates.

Some great plant-based protein choices include: soy and soy products like tofu, tempeh, pulses (kidney, black and white beans), peas (chickpeas and black-eyed peas) and lentils (red, brown and green lentils) and nuts and seeds.

A4: A registered dietitian is a key member of your diabetes care team, and can help you with all issues food related! A dietitian can provide you with personalized tips that suit your lifestyle and food choices and can educate you on important diabetes management tools such as carbohydrate counting. Dietitians have the expertise to help you plan healthy, diabetes friendly meals, trouble shoot areas of your diet you are having difficulty with, and can ensure you are getting all the nutrients your body needs to maintain your optimal health!

51. Sarah Rice MHA, RDN

A1: The best way to to keep energy levels up is not to go too long between meals and snacks. Energy levels can dip if you skip breakfast, or worse, breakfast and lunch, as a way to cut calories. Be sure to eat something when you get up - doesn't need to be a traditional breakfast... try 2 slices or whole grain toast with nut butter, a cup of yogurt sprinkled with ground flax meal, or a whole grain waffle with a glass of unsweetened almond beverage. These will add fiber to help keep your blood sugar more even though your morning rush.

A2: In working with picky eaters, I help clients find foods that you do enjoy, and modify them (either adjust the portion if they are high in added sugars or carbohydrate) to be incorporated on a regular basis into your daily eating habits. Seeing a Registered Dietitian can help fit the foods you love around your diabetic meal plan.

A3: A plant-based diet is an excellent way to reduce inflammation throughout your body, and a great way to decrease saturated fat in your diet. Most plant-based foods are high in fiber, which is perfect for persons with diabetes. I would highly encourage a well-planned plant-based diet that includes lots of higher-protein grains, nuts, seeds and legumes throughout the day.

A4: Dietitians are experienced, licensed professionals who can personalize all your meals and snacks to fit your busy lifestyle and favorite foods, giving you great outcomes and peace of mind that you are doing your body right by eating the right way for your diabetes. They are truly your compass to help weed out fads and unsound advice. An RD will help you make lasting, sustainable changes so you can see your best self, wherever you are newly diagnosed with diabetes or just looking for more choices and variety in your current eating plan.

52. Kathy Siegel, RDN, CDN

A1: Part of managing your diabetes includes maintaining a healthy weight. When it is recommended you follow a diet that encourages weight loss, focus on foods that are nutrient dense to sustain energy. Aim to make half of your plate vegetables, one quarter of your plate lean protein and the remaining quarter whole grains such as quinoa, sorghum or freekeh. Of course healthy fats in small portions, such as nuts, olive oil or avocado, will help satisfy your hunger and keep you feeling fuller longer. Adding protein at breakfast is also important to maintain your energy - combining lean proteins and healthy carbs will prevent a late morning sluggish feeling. Try a savory breakfast of cottage cheese, diced tomatoes, avocado and cilantro. Lastly, it's imperative you get enough sleep to maintain your energy, as well as to help manage your appetite. Recent studies have shown lack of sleep may affect the secretion of cortisol, a hormone that regulates your appetite, leaving you feeling hungry even when you are full.

A2: Many picky eaters struggle with consuming healthier food choices such as vegetables and whole grains. I often hear they don't like the taste or smell. My suggestion is to bring the aroma and tastes of your favorite dishes to these healthy choices. Do you crave Italian food, Indian cuisine or Mexican dishes? Add the spice that creates your favorite taste to the healthier vegetables and whole grains. Toss vegetables and grains with the herbs and spices you crave with a drizzle of olive oil. Fresh herbs and spices will add a lot of flavor to the once boring foods you know your body needs, creating a new found love for healthier choices.

A3: Numerous studies have shown links between eating a plant-based diet and decreased incidence of chronic diseases. Consuming plant-based foods may help lower inflammation that causes chronic disease as well as insulin resistance. Is it too drastic of a lifestyle change to eat Vegan or Vegetarian all of the time? No problem! You can still reap the health benefits by adding in more plant-based meals. Simply limiting your consumption of meat and adding in more plant-based meals can create a positive change. Look for plant-based foods that are also packed with protein such as legumes, nuts, seeds, quinoa, and ancient grain freekeh. Eating well balanced meals including protein, fiber, and healthy fats is still the top priority to best manage your diabetes. A Registered Dietitian can help you make this transition.

A4: Following a healthy lifestyle is the foundation of managing diabetes. Proper nutrition is one of the major cornerstones - healthy foods can help you manage your blood sugar levels, as well as avoid pitfalls. A Registered Dietitian is an integral part of your diabetes management team. A Registered Dietitian will teach you how to best manage your diabetes, assessing your current diet and lifestyle, and giving you the tools and resources to successfully live a healthy lifestyle - every person's plan is individual.

53. Taylor Fisher, RD

A1: Even while on a diet you can keep your energy levels normal by keep-ing your carbohydrate intake consistent at each meal. Remember that diabetes as well as diets don't mean eliminating carbohydrate - it means balancing them out appropriately in a way that is best for you, the individual. Eliminating carbs at one or two meals and then packing them all into the next meal only leads to ups and downs in blood su-gars, which causes the energy dips and lethargy. To keep energy levels consistent throughout the day make sure to include a similar balance of carbs at each meal, through a mix of whole grains, starchy vegetables, fruits, and lower fat dairy.

A2: For picky eaters with diabetes, I would recommend that they pinpoint what fueling foods they do enjoy. Then determine which of those foods contain carbohydrates (the grains & starches, the fruits, milk, yogurt, etc.), and then space them evenly throughout meals and snacks during the day. Just make sure to keep the sugary calorie-dense and nutrient-void carbohydrate items (like donuts, cookies, cakes, etc.) to a minimum. I always tell people, whether diabetes is a factor or not, to remember all the fantastic herbs and spices out there. Herbs and spices like basil, rosemary, cinnamon, sage, cumin, etc. can add depth, sweetness, and spice without the extra calories, fat and simple carbohydrates (from processed sugars).

A3: Yes, you can still go on a plant-based diet if you have diabetes. Just make sure you know which of your foods and meat substitutes contain carbohydrates so that you can count them in your meals and snacks appropriately. Make sure the foods like grains and yogurts that you eat count too. You can boost your protein intake with a little bit of cooked quinoa and a low fat Greek yogurt. And that protein (and fiber in the case of quinoa) helps slow absorption in the bloodstream and therefore creates a slower rise in blood sugars.

A4: A dietitian can help someone with diabetes by teaching them about food, not just telling them about it. I think it's important that individuals know what foods contain carbohydrates and that they understand portion sizes in order to make confident decisions on their own. I think it's important to walk with a person newly diagnosed with diabetes for several months, troubleshooting along the way. Managing diabetes and blood sugars is a process and a lifestyle change. One quick session is often times not enough.

54. Cindy Huggins, MS, RDN, LD

A1: I think it is important to note that there is no such thing as a "diabetic diet". Everyone should adopt the food and nutrition guidelines dietitians and CDEs give to people with diabetes. Having said that, the number one way one can keep energy levels up is to never skip meals. This means eating a nutrient-rich meal every 4-5 hours and if needed a snack in between meals. Food is our fuel and we have to make sure our bodies "fuel tank" does not run on empty. A nutrient-rich meal may include: 3 ounces of lean protein like pork tenderloin, ½ Cup of a starchy vegetable like mashed sweet potatoes made with 1-2 teaspoons of trans fat-free margarine and cinnamon to taste, ½ Cup of a non-starchy vegetable likes green beans or a small side salad with reduced-fat dressing, 6-8 oz of low-fat milk or milk product like yogurt, and/or 1 Cup of fresh fruit like mixed berries with a dollop of whipped topping.

A2: It is important to enjoy food and the culture that comes with it. Nobody wants to feel eating is a chore. It is recommended for everyone who has diabetes to seek out education from a diabetes self-management training program or if there is not one in your area see a registered dietitian nutritionist for individual attention on controlling blood sugars. These practitioners have the skill-set to help individuals eat the food they love to eat just understanding what it does in the body and the foods to pair with it to promote optimal blood sugar control.

A3: A plant-based diet approach to controlling blood sugars has many great benefits for people with diabetes. Fiber is a friend in so many ways and certain plants pack-in powerful fiber benefits. Because this will eliminate meat, it is essential to ensure certain nutrients are met in a plant-based diet. Protein, vitamin B-12, and iron are a few nutrients that may be lacking. Legumes, nuts, soy products, and fortified grains can provide the body with essential nutrients that may be lacking in a plant-based diet. Before supplementing it is always recommended to meet with your physician. A sample plant-based meal may include: ½ Cup black beans, ½ Cup rice or quinoa, 6 inch corn tortilla, 1-2 ounces of cheese, and fresh salsa.

A4: I always tell my clients, "My goal is to get you out of my office still eating the things you like to eat, just understanding what they do in the body." As a profession we love food and we want everyone to enjoy the food they eat. Our role is to help individuals set small goals to achieve big results. Along the way to these big results, RDNs provide support, motivation, and education.

55. Carla D Spencer MBA RD LD CN

A1: I personally don't recommend that people "go on a diet" for weight loss or diabetes management. The word "diet" carries with it the stigma of rules and restrictions, the idea that there are things you can have and things you absolutely can't. I believe that as long as you make smart choices and practice moderation, all foods can fit into a healthy diet. Taking care of your body isn't about depriving yourself; it's about treating yourself with patience, respect, compassion, and determination.

That being said, there are a lot of different factors that can influence your energy levels when you have diabetes, so there's not one simple "trick" to having more energy. If you're experiencing noticeable fatigue on a daily basis, your first step should be to call your doctor and set up an appointment to be seen. Your fatigue could be caused by an underlying problem that is indirectly related to your diabetes, like sleep apnea or high blood pressure.

As far as your diet goes, believe it or not, getting too few calories can make you feel just as tired as getting too many, and without a steady caloric intake, your body can't consistently stabilize your blood sugar levels. Make sure you are getting the right kinds of foods - plenty of vegetables, fruits, whole grains, and lean proteins - and that you get the right combination of foods at each meal. For example, high-fiber complex carbohydrates like beans, whole grains, and starchy vegetables will give you an energy boost without spiking your blood sugar.

A2: The key here is understanding which foods fall into which food group and how each of those food groups affects blood sugar levels. As long as your favorite foods fit into the right food groups, and as long as you cover all the necessary food groups at every meal, you can feel free to honor your preferences by including the foods you love most.

For example, let's say you really like corn on the cob, and you plan on making cheese quesadillas at dinner with a baked potato and corn on the cob for side dishes. Corn and potatoes are technically vegetables, but they're high in carbohydrates, which actually puts them in the same food group as other starches like tortillas and bread. That means at this meal you've got an overabundance of carbohydrates.

A better way to enjoy all your favorite foods would be to go ahead and bake the cheese quesadillas, top them with red pepper strips for a serving of vegetables, and then have a salad with Greek yogurt dressing on the side. That way, you're covering all your food groups: tortilla = starch, cheese = protein, red peppers = vegetable, salad = vegetable.

Save your baked potato (a starch) for lunch the next day, cover it with cottage cheese for protein, and have a handful of baby carrots and some strawberries to cover all your food groups. Then, have the corn (a starch) for dinner the next night, with a baked chicken breast for protein and a serving of steamed broccoli or brussel sprouts for your vegetable.

The truth is that we really need to consume nutrients from a variety of foods in order for our bodies to function at their best. There's just no substitute for nutrient-rich fruits and vegetables. Start by making a list of all the foods you really do love, and then categorize them according to food group. A great way to grow your list of favorites is to try a new food every few days; if you don't like it the way it's prepared, try preparing it another way before giving up on it completely.

A3: Plant based eater can maintain their preference with careful planning of meals. The important piece is to plan....plan specific foods, specific patterns, specific times, specific nutrients.

A plant-based diet can be a wonderful choice for diabetics, if - and that's a big, important "if" - it is planned and followed correctly. Plants are much denser in nutrients and much lower in fat and calorie content than meat sources, making plant-based diets a great way to lose weight and improve cardiovascular health. But due to the nature of blood sugar control, diabetics also need to get plenty of protein, and that's a little harder to do on a plant-based diet - though definitely not impossible. To make sure you're getting enough of the right nutrients on a plant-based diet, your meals must be carefully planned.

A4: For people with diabetes, a registered dietitian can be an excellent source of information, guidance, and support. There are dozens of factors that contribute to your blood sugar levels, and they're not all under your control, so when you try to manage your diabetes all on your own, it can feel like playing an endless guessing game. With advanced culinary skills and in-depth knowledge about diabetes and other diseases, a registered dietitian can help you identify problem areas in your diet, rule out some of the guesswork, and develop a customized plan to help you solve the issues you're struggling with in a way that works best for you.

56. Adam Hudson, RD

A1: Focus on eating nutrient dense food. Eat foods that will contribute to feeling of fullness where the energy can be released slowly in the body and make it available to use, rather than quick bursts of energy. These quick bursts often come from processed foods that lack fibre and other beneficial nutrients that are provided naturally in whole foods.

A2: Being open minded is a good place to start. Many picky eaters have had bad experiences with the foods that are not tolerated or accepted. They were forced to eat them growing up or they have not had the good fortune of having these foods prepared in a variety of delicious ways. Being open to trying these foods again is always encouraged. If it is a property of that food, for instance the texture or smell, try preparing that food in a different method. Shave Brussels-sprouts and eat them in a coleslaw raw or roast parsnips to develop more sweetness. Learning how to be creative in the kitchen will go a long way to including new foods that you will actually enjoy. If you still can't stomach the thought of a Brussel sprout after trying them in a variety of ways, move on, forget about it and try something else!

A3: A plant based diet has been linked to many positive findings including lower cholesterol, blood pressure, rates of coronary heart disease and incidences of Type II diabetes. I think a common misconception is the belief that eating an exclusive plant based diet will result in lack of protein. However, protein is found in many meatless foods such as beans, legumes, pulses, nuts and seeds and if planned properly, can meet required daily needs. These foods may seem unfamiliar at first, and this re-emphasizes the need for being open to trying new foods and being open to experimenting with them in the kitchen! Other nutrients such as B12, iron, omega 3 and calcium need to be considered as well, as many of these nutrients are predominantly found in animal products.

A4: A diabetes diagnosis can be very overwhelming. Comments of "no more favourite foods" or "no more sugar" are often shared from clients within our health centre. These statements are often addressed by the our centres dietitians by working hard to include some favourite foods into every clients meal plan. Moderation is key! Talking to a dietitian will help clarify what changes need to be made with regards to food choice, food prep, and food purchasing. Dietitians will provide the education and practical skills needed to help navigate through what can be a very confusing food world! As well, they in partnership with registered nurses so that they can help manage medications and monitor blood sugar levels.

57. Olivia Wagner, MS, RDN, LDN

A1: Timing! Aim for meal or snack with a source of protein and plant based fat every 3-4 hours. This is important for preventing drastic spikes and falls in your blood sugar that can lead to low energy and poor management of diabetes. Try snacking on ¼ cup of raw nuts during the largest gap between your meals and at meal times be sure to incorporate 3-4 oz of protein (or ~1 cup of beans or legumes) along with a plant based fat source like avocado, olive oil, nuts, or seeds.

A2: Consistency! Keeping meals and snacks readily available for convenient eating that both the patient enjoys and knows supports their blood sugar levels will be essential. I suggest keeping snacks on hand and prepping a few options for meals at the start of the week for confident eating with diabetes. A dietitian is a great resource for guiding a picky eater to more optimal options for their health that they will still enjoy!

A3: A few things to be mindful of when following a plant based diet with diabetes:

1. Incorporating enough plant based protein (ie. beans and legumes, organic tofu, nuts and seeds).
2. Mindfulness of the portion size of carbohydrate rich foods at a meal time (i.e. rice beans, fruit, oats, bread) and the amount of fiber provided.
3. Incorporating plant based fats (nuts, seeds, avocado, olives, olive oil)

A plant based diet can quickly become focused around refined carbohydrate from sandwiches and pasta if there isn't planning around meal and snack choices.

A few tips! Think produce and plant based protein at meal times to support blood sugar stability and fullness. Produce, specifically from non-starchy vegetables, will provide fluid and fiber, while the plant based protein will help to increase satiety and slow the digestion of carbohydrate. Instead of topping black beans on rice, try swapping the rice for chopped romaine lettuce and pico de gallo, and topping with ¼ cup pumpkin seeds for added protein, fat, and crunch! Choosing fiber dense, vitamin rich carbohydrate options, with a little bit of fat will be a winning combination!

A4: A dietitian will guide a patient through the nutritional changes to best support blood sugar management. With a patient's health goals and management of diabetes in mind, a dietitian will provide personalized recommendations for behavior change within the context of their lifestyle, food preferences, and financial needs. A recipe for success!

58. Alicia M Jerome MS, RD, LD

A1: Always think about complementing carbs with protein and/or fiber. Instead of a whole banana, eat half the banana and add a tablespoon of peanut butter. Instead of cereal, orange juice and toast for breakfast, choose scrambled eggs on toast with some avocado. The combination keeps energy levels and blood sugars stable.

A2: With any client, I start with what they do like or what they will eat and then we gradually add foods that can complement their go-to favorites. Sometimes it's a matter of not knowing you liked something. I've had client's who gagged at the thought of raw cauliflower but would devour mashed cauliflower. It's finding each person's "next step".

A3: A plant based diet can be effective at managing diabetes. For those new to a plant based diet, there might be a slight learning curve. I still keep to my recommendation of complementing carbs with protein and/or fiber. We just find plant based proteins instead of animal based.

A4: A dietitian takes all the science, the media headlines, and the client's lifestyle and creates a sustainable plan and education for that individual person. One person may find a vegetarian lifestyle is their preference while another may gravitate toward the Mediterranean style. A dietitian can take all the confusion and simply help a person take their "next step".

59. Sandra Jorgensen MPH,RDN,CDE

A1: I don't encourage diabetic patients to be on a "diet". You will be eating sensible, well balanced meals that includes carbohydrates, proteins and fats.However, each diabetic to me is unique, thus the ratio and amount of food they eat should be customized. To help with that, I would suggest picking random meals to do a before and after blood glucose test to see how your body responds to the meal. For example, you can start with picking a breakfast to check, as most people eat very similar breakfast everyday. First, do a fasting blood sugar check and then a 2 hour post breakfast check. Fasting or before meals should be less than 110 mg/dl and post meal should be 140mg/dl (Type 2 Diabetes Glucose Management Goals | outpatient.aace.com) Doing so will give you insights into how the combination and types of foods are affecting your blood sugars. You can then adjust accordingly. This help keeps blood sugar even without the extreme highs and lows. Just by doing that, most of my patients are able to feel better and actually have more energy all day.

A2: I think we are all picky eaters to a certain degree. There are emotional, cultural, social, religious etc. reasons that shapes our eating. Going back to balanced meals, I will have people choose what they like for carbohydrates, proteins, fats and work from there. However, managed blood sugars is a starting point not the end point.

A3: As I previously stated, everyone is unique. I do recommend wholesome, unprocessed foods whether you choose to be vegetarian or not.

A4: An unbiased, open minded and evidence based dietitian can support a diabetic in customizing what works for that individual.

Here is what Elisabeth Almekinder our certified diabetes educator had to say about picky eaters and energy levels while on diabetes diet:

Knowing that kids don’t always eat when we want them to, and knowing the dangers of having insulin on board and no food, I caution parents of kids with diabetes to give the insulin after they are sure that their child has eaten a sufficient meal. This is true for toddlers, but also works for older children. It’s a safety measure that parents can use that gives them insurance against low blood glucose.

At play, they may be particularly at risk for low blood glucose, especially if your picky child is so busy that they cannot be bothered to stop for a snack. By then, insulin is already on board, so what do you do?

For the busy yet picky child with Type 1 diabetes, regular meals and snacks are a must for getting through the day without dangerous low blood glucose. Take your child to the grocery store, and let them help to pick out healthy 15 gram carbohydrate snack options that they like. To keep them from making unhealthy choices, offer them a choice between two healthy options.

Offer a healthy snack of their choice prior to activities. Carry extra snacks on outings. When offering kids with diabetes new foods, offer a small amount at a time early in the day when they are not tired, and try not to fall into the trap of pleading with them to eat new foods.

Helping to prepare foods gives kids with diabetes a reason to try new foods, because they made it themselves. Be sure to model good behaviors for your toddler. You can’t expect them to try Brussels sprouts if you won’t eat them. It takes up to ten times of offering a food before some children will try it, so keep putting it on the table.

Try a pizza, salad, or taco bar, with different toppings and sauces, and teach kids to count the carbohydrates in the topping they add. Most kids love this idea, and will beg for “taco bar” night, etc.

If you are worried that your child is not getting enough protein, try a protein drink mix that isn’t high in carbohydrates. You can pick up tasty flavors, like chocolate, vanilla, and strawberry.

If you eat small, frequent meals, you can keep your energy levels going better when on a diet with diabetes.

Generally, you will shrink your plate from a 9 inch size to a 6 inch size, and eat smaller portions of food. Make sure to incorporate a protein, carbohydrate, and vegetable serving, and 3 snacks between meals per day. Snack with a high protein snack or a 15 gram carbohydrate snack.

Make sure to get your exercise in, as exercise makes your body forget about eating for a while. It also will help you to use your insulin better. This helps your body get the energy from the food. This will definitely increase your energy levels while on a diet with diabetes.

Make sure to stay hydrated, and drink plenty of non-caloric beverages. Mainly, you should be drinking water while on a diet. In addition to hydration, it will help your body to manage any high blood glucose levels, which contribute to fatigue.

When you are still hungry, and feel like no matter what you eat, you are never full, be sure to check your blood glucose levels. Your hunger may be related to a high blood glucose, and treating it may take your hunger away. As said, high blood glucose also contributes to fatigue, and will zap your energy levels while on a diet with diabetes.

Avoid skipping meals, or getting rid of carbohydrates altogether. Don’t start a very low carbohydrate diet. These tend to make your body produce ketone bodies, or waste products. These have to go somewhere, so they go out in the kidneys. Eventually, this can damage the kidneys. It’s better to get heathy carbohydrates, in the form of whole grains. Hopefully this article helps you understand the benefits of these diet choices.

Disclaimer: The views and opinions expressed in this article are those of the contributors and do not necessarily reflect the official policy or position of TheDiabetesCouncil.com.

TheDiabetesCouncil Article | Reviewed by Dr. Christine Traxler MD on May 24, 2020