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Food Groups

Foods are divided into various food groups:

CARBOHYDRATES are also known as starches and grains. These include breads, rice, cereals, pastas, rice, oats, rye and barley. Grains are an excellent source of complex carbohydrates (starch) and fibre. High fibre products and whole grains are recommended because they are the most filling.

FRUITS contain their own "sugars", and some people avoid them, believing them to be bad for their blood sugar. This reasoning is not correct. The vitamins, fibre, and sensation of filling your stomach with very few calories (and no fat) make fruit an ideal food. Fresh fruits are the best choice because they have the highest level of intact fibre. A diet high in fruit tends to be low in fat, which ultimately allows insulin to work better, resulting in lower blood glucose. However, it’s probably reasonable to have a single fruit at one sitting, because of the sugar content.

Food processing such as cooking, juicing and canning reduces the fibre content of fruit. Fruit juice is essentially sugar and water, with some vitamins. Juices should be taken in small amounts only (less than 1 glassful per day) and only as part of a mixed meal, since the sugar content is so concentrated and no fibre is present. However, since the sugars in juice and other liquids are absorbed quickly they are ideal for treating low blood sugar levels (see below).

VEGETABLES provide fibre, complex carbohydrates and many vitamins and minerals, and are usually low in calories.

DAIRY/MILK includes milk, cheese, cottage cheese, yogurt, etc. Excellent source of minerals (especially calcium), and protein.

PROTEINS are also called "meat and alternates." Foods high in protein include the meat from animals and fish. Protein is also present in animal products such as milk and eggs, and in nuts. Meats and alternates provide protein, which is digested and absorbed more slowly than carbohydrates. Meat may also provide a large amount of fat. Choose lean or extra-lean meats because the amount of hidden fat is much lower than in marbled meat. Meat substitutes like beans are recommended because they are low in fat and high in fibre. They are also inexpensive and easy to prepare.

FATS include the visible fat on meat, skin from poultry, butter, margarine, non-skimmed milk, ice cream, gravies, salad dressing (unless it is specifically marked as low-fat or non-fat), oils, cream sauces, chocolate, pastries of all kinds, icing, most fast foods and deep-fried items (e.g. French fries, potato chips and doughnuts). When we talk about lowering the fat content of the diet, these items should be reduced as much as possible.

Why is it Important to Know which Foods are in which Food Groups?

  1. It is important to know where the fats are in order to reduce or eliminate them.

  2. A balanced meal should have at least three items from different food groups (note that we don’t count fat as one of the food groups). Try to divide your plate into thirds, putting one food group in each section.

  3. Meals should be consistent. In other words, breakfast should have roughly the same content each day, but not necessarily the same foods. One morning, breakfast could be cereal, milk, and juice. Another morning, it could contain toast with cheese, and an orange. Although these meals do not contain the same items, they have the same contents: a grain, milk, and a fruit. In this way, great variety can be introduced into the meal while keeping the general content the same. In a similar manner, the content of lunches should be roughly the same from day to day, as should suppers. By doing so, the blood-glucose response to a meal is similar from day to day, making it easier to match medications to what the blood glucose is doing. This is particularly important for people on insulin.

Dietary principles (meal plans) are similar for Type 1 and Type 2 diabetics, with a few differences. The Type 1 diabetic tends to be lean, while the Type 2 is usually overweight. The Type 2 diabetic often requires fewer calories and less fat, since a primary goal is to lose weight. A major emphasis for the individual with Type 2 diabetes is to lower the fat content in the diet. If someone on insulin or certain pills misses a snack or a part of a meal, blood glucose can go too low, again emphasizing the need for consistency.

The Role of the Dietitian

A dietitian can be enormously helpful planning out meals, and teaching you which foods are equivalent and can be "exchanged". You will learn how to read labels, and calculate the amount of fat you are (and should be) eating. This may take a few hours of teaching, but in the long run, will be well worth it.

Dietitians can also teach you the interactions of foods, exercise, and medications for diabetes, what to do when you are nauseated and can’t eat your regular meals, what to do with your meal plan for shift work and travel, and what to do for changes in activity, or the unexpected.

Common Dietary Questions and Answers:

Am I allowed any sugar?

The surprising answer is yes. Sugar can be substituted for starches or fruits. However, the calories in sugar are concentrated. A teaspoon of sugar may have the same number of calories as a piece of fruit. Now, compare putting two teaspoons of sugar in your coffee to eating two fruits. The fruits fill you up, and supply vitamins and fibre. The sugar doesn’t fill you up, leaving you hungry and increasing the chance you’ll consume too many calories and gain weight. Adding a sweetener, though, allows you to have sweet coffee, and to get the benefits by eating the fruits as well. So as a general rule, we prefer sweeteners to allow you to use your calories in a better way. By the same reasoning we prefer drinks to be diet pops/sodas, or other diet drinks. Fruit juices are of course acceptable, but they count as a fruit, and are not "free" as are diet drinks.

Note that the amounts of all low-calorie sweeteners used in a typical meal plan are totally safe, despite a lot of advertising to the contrary. (Advertisers tend to make such claims when trying to sell another product.) There is no evidence of harm from sweeteners when they are consumed in typical amounts on a day-to-day basis.

Am I allowed any alcohol?

Alcohol is allowed in meal plans unless there is a strong reason to deny it. A few words of advice though:

  1. Check with your doctor whether it is acceptable to use alcohol, and if so, how much.

  2. Alcohol can raise or lower the blood glucose in an unpredictable fashion. We cannot tell what alcohol will do to an individual’s blood glucose on any given day. Since blood glucose may go down, we suggest that alcohol be consumed only while eating (so your blood glucose can’t go too far down). Since it can also raise your glucose, we suggest that it replace a fruit or starch from your meal (but not on a regular basis).

  3. Avoid sweet mixes, which may increase your blood glucose too much.

  4. If you are mixing a drink, use diet drinks.

  5. Avoid alcohols that are clearly sweet, such as liqueurs or sweet wines.

  6. Alcohol has calories. If you are trying to lose weight, you should avoid alcohol.

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