Best diabetes diets: An expert Registered Dietitian advises

Key Points

• Diabetes is a chronic condition related to insulin dysfunction or low insulin production.
• Unmanaged diabetes can lead to heart disease, strokes, kidney damage, nerve and eye damage, and other serious health issues.
• A diabetes-friendly diet offers health benefits even if you are on Ozempic or other diabetes weight loss medications.
• A Registered Dietitian can provide personalized meal plans and nutrition counseling to help you control your blood sugar levels and more.

Diabetes rates are on the rise in the United States, with an estimated 40 million Americans now living with the condition. 

This chronic disease is complex and can lead to inflammation, heart disease, and damage to several organs, including the kidneys, eyes, and more.

The foods you eat and avoid, and lifestyle changes can make a huge difference in managing diabetes.

Let's examine different eating plans for diabetes, including the Mediterranean and low-carb diets. Here, Registered Dietitian Rita Faycurry, RD, offers insights based on her experience helping people lower their blood sugar levels and manage diabetes.

Balancing the diabetes plate

According to the American Diabetes Association (ADA), balancing your plate is straightforward and helps manage blood sugar levels effectively. The Academy of Nutrition and Dietetics (AND) also supports this.

Here’s how to balance your plate:

• Fill half your plate with non-starchy vegetables such as leafy greens, carrots, and peppers.
• Dedicate a quarter to lean protein sources like chicken, fish, or beans.
• Use the remaining quarter for carbohydrates, focusing on whole grains, legumes, or starchy vegetables.
• Include a piece of fruit or dairy on the side, depending on your meal plan and carbohydrate goals.

This method not only simplifies meal planning but also ensures a well-rounded intake of nutrients essential for managing diabetes.

Eat

• Whole grains like brown rice
• Whole vegetables
• Whole fruit
• Healthy fats like avocados, nut butter, and olive oil
• Lean meats like chicken breast and turkey breast
• Fish like salmon and tuna are rich in omega-3 fatty acids, which are heart-healthy
• Vegetarian protein sources like lentils, mung bean sprouts, Greek yogurt, and tofu.

Minimize

• Starchy vegetables (or pair them with lean meats)
• High-fat dairy
• Processed meats like salami, pepperoni, sausages, bologna, and bacon
• Food rich in saturated fats like egg yolks and liver.

Avoid

• Ultra-processed foods like refined breads
• Salty foods
• Foods rich in added sugars
• Alcohol.

Other lifestyle changes that can help you manage diabetes are:

• Eat at regular intervals
• Have dinner early
• Focus on portion sizes
• Lose weight
• Avoid or quit tobacco
• Reduce your stress levels
• Get adequate and regular sleep
• Get moderate exercise daily
• Move regularly throughout the day
• Hydrate (with plain water).

Mediterranean diet for diabetes

Registered Dietitian Rita Faycurry, RD, explains, “I recommend the Mediterranean diet because, unlike many other diets, it is well-balanced and nutrition-dense. It focuses on whole, minimally processed foods and is great for heart health and diabetes management, as long as the portions and frequency of meals are managed well.”

Here’s an overview of the Mediterranean diet:

• Whole foods at the core: It prioritizes fresh fruits, vegetables, whole grains, and nuts.
• Healthy fats: Olive oil is a staple, replacing less healthy fats like butter.
• Fish and poultry over red meat: Seafood and chicken are preferred, with red meat enjoyed less frequently.
• Moderation and variety: It encourages a diverse intake of food but in moderate quantities.
• Lifestyle component: More than just food, it promotes regular physical activity daily and sharing meals with others as a community.

Keto diet (low-carbohydrate) for diabetes

The keto diet is a high-fat, low-carbohydrate eating plan that prompts the body to burn fat for fuel instead of carbohydrates. Some medical professionals and diabetes experts advocate using keto to lower A1C levels and manage diabetes, particularly for obese people.

However, there are pros and cons to it, and it is important to be aware of them before you consider this diet. It is also recommended that you consult your healthcare provider before you begin such a diet.

Pros

There are studies that show a ketogenic diet can help people with type 2 diabetes and obesity lose weight, improve metabolic health, and achieve other benefits.

The pros of the keto diet for managing blood sugar are that meals are designed to be rich in protein and fats, which do not lead to a huge spike in insulin levels. This can help stabilize blood sugar levels, which in turn assists in managing your diabetes effectively.

Cons

Hard to sustain

Faycurry RD elaborates, “One of the biggest cons of the keto diet is that to achieve ketosis—where your body burns fat instead of carbs—you need extremely restrictive eating plans. This may make it very hard to sustain in the long term.”

Indeed, a review of over 120 studies involving 22,000 adults found that most regained their weight within a year across various diets, including low-carb, high-fat plans like Atkins and keto.

Risk of hypoglycemia

Another big risk is that people with diabetes on keto may risk hypoglycemia or low blood sugar levels, which causes irregular heartbeats, dizziness, and fainting. A diet high in saturated fats, like the keto diet, could potentially elevate cholesterol levels (low-density lipoprotein or LDL).

Possible eating disorder trigger

If you have an eating disorder or have disordered eating patterns, a restrictive diet like keto may be a trigger for an eating disorder.

DASH diet for diabetes

The DASH diet, short for Dietary Approaches to Stop Hypertension, is a flexible and balanced eating plan.

Here’s an overview of the DASH diet:

• Emphasizes whole fruits and vegetables: It promotes a diet rich in fruits and vegetables alongside whole grains.
• Low in unhealthy fats: The plan encourages low intake of saturated fats and cholesterol.
• Rich in minerals: Focuses on foods high in calcium, potassium, zinc, and magnesium, which are crucial for diabetes control and heart health.
• Moderate salt consumption: It aims to lower salt intake to help reduce blood pressure.
• Inclusive of lean proteins: Includes fish, poultry, and legumes for protein sources.

Similar to the Mediterranean diet, this diet is good for heart health. Together with the right portion sizes, water, and exercise, it can help lower high blood pressure and cholesterol and control blood sugar levels.

Note: A diabetes diet is beneficial even if you are on diabetes weight loss medications like Ozempic, Mounjaro, and more.

Blue Zone diet for diabetes

The Blue Zone diet is inspired by the eating habits of people living in regions known as Blue Zones, where inhabitants live exceptionally long and healthy lives.

Here’s the essence of a Blue Zone diet meal plan:

• Plant-based focus: The diet is primarily plant-based, with a heavy emphasis on beans, legumes, fruits, and whole vegetables like leafy greens.
• Whole foods: It promotes consuming whole foods like whole grains that are minimally processed.
• Limited meat consumption: Meat is eaten sparingly, typically only a few times per month. Processed meats are not generally included.
• Healthy fats: Incorporates healthy fats from sources like olive oil and nuts.
• Moderate amounts of dairy and added sugars: Dairy is consumed in moderation, and sugary foods are kept to a minimum.
• Locally-sourced produce: The diet promotes eating locally sourced and seasonal vegetables and fruits.

This way of eating is not just about longevity but also about enhancing overall health through natural, simple food choices. 

Blue Zone living also recommends:

• Eating until you are 80% full
• Staying active
• Being an active part of a community to build purpose.

Faycurry, RD, says,” The bottom line is that most diabetes diets emphasize a similar foundation for meal plans: increase whole foods and cut back on added sugars, saturated fats, starchy foods, and ultra-processed items. Their recommendations on eggs, dairy, and meat may vary.”

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.