Diabetes is a very common disease. There is a good probability that either some of us are diabetic or pre-diabetic, or somebody we know suffers from it.
It is well known that our food choices and diets play a major role in managing this disease. If we search the internet, we will find a lot of information on diabetic diets. Doctors too caution us enough about diets and supermarkets are flooded with various types of foods for diabetics.
However, the understanding is still limited in people about various foods and their impact on diabetes. Most of us think that simply avoiding sugar in diets is the best way to manage diabetes. However, sugar is only one of the aspects of a diabetic diet. Nutrition is an important factor in diabetes management. We need to ensure that we eat a balanced diet containing various nutrients in the right proportion. In the absence of it, there is a risk that we might create problems in some other department of our health.
In this blog, we will look at important nutrients present in our foods that can have a significant impact on the management of diabetes.
Nutrients in our foods
Our food consists of macronutrients and micronutrients.
Carbohydrates (usually shortened as carbs), fats, and proteins are called macronutrients and are primarily responsible for providing energy to our body in addition to performing other vital functions. Micronutrients, though not a source of energy, are various vitamins and minerals and are essential in a diabetic diet. Before going into what a diabetic diet should contain, let’s briefly discuss macronutrients.
Carbohydrates (Carbs)
Carbohydrates are the primary source of energy for our bodies. Carbohydrates provide glucose that is converted into energy. Certain body cells, such as brain cells and red blood cells, prefer glucose as an energy source. Dairy products and plant-based foods such as vegetables, fruits, and grains (but not meat) contain varying levels of carbs, which are classified as either simple or complex carbs.
Simple carbs are the natural and added sugars found in fruits, vegetables, grains, milk, and refined or processed foods such as pastries, sodas, etc. These sugars are further classified as monosaccharides (a.k.a. simple sugars) and disaccharides.
Monosaccharide sugars comprise glucose, fructose, and galactose whereas disaccharide sugars comprise lactose, sucrose, and maltose.
During digestion, carbohydrates are converted into simple sugars, glucose, fructose, and galactose (further converted into glucose by the liver). Because simple sugars are easily absorbed by the body, they raise blood glucose levels almost immediately. In response to elevated glucose levels, the pancreas releases insulin, which in turn helps convert blood glucose into energy. It is for this reason that you would have often observed athletes consuming glucose-based drinks to obtain instant energy during physical exercise.
Simple carbs are therefore considered to be high on the glycemic index and are known to provide “empty calories” but no nutrients.
On the other hand, complex carbs are based on starchy foods (unprocessed and unrefined foods) that take time to digest and convert into glucose, but once processed, eventually act as simple carbs.
Complex carbs do not spike blood sugar levels like simple carbs, which is why they are classified as low glycemic index foods. These carbs take time to digest, so we feel full or satiated for a longer period, which also helps us to lose weight.
Additionally, complex carbs provide fiber, minerals, and vitamins to the body and are found in whole grains (which contain all three parts of the grain, viz., germ, endosperm, and bran) and starchy vegetables.
The carbs that are digestible, either quickly or slowly, were discussed above, but other carbs are not digested or absorbed in the small intestine.
Dietary fiber is one of them. As it is non-digestible, there is no spike in blood glucose thus helping in diabetes management. Dietary fiber is of two types: soluble fiber and non-soluble fiber. Soluble fiber, as the name implies, dissolves in water and helps improve digestion, reduces blood cholesterol, and slows down the absorption of glucose in the blood. Insoluble fiber, on the other hand, gives the body to stool and makes it soft and easy to pass, preventing constipation.
Sugar alcohols, also known as artificial sweeteners, are also non-digestible carbs. They are low on the glycemic index and provide fewer calories per gram as compared to table sugar.
A point to be remembered is that blood glucose is typically exhausted in 4-6 hours after a meal. Our body then uses glucose stored away in glycogen stores in our liver and muscles. Once the stored glucose is exhausted, the stored fats are used for future energy demands.
Fats
Fats consist of fatty acids and are found in animal and plant-based foods and in various cooking oils. There are two types of fats, saturated and unsaturated, depending on the type of fatty acid they contain. Further, there are two types of unsaturated fats: monounsaturated and polyunsaturated.
Fats are an integral part of the lining of body cells and are also responsible for cushioning our internal organs, nutrient absorption, brain, and nerve function, and more importantly, meeting the body’s energy needs when it runs out of glucose.
Fats take longer to digest than carbs. Fats can be converted into energy to meet immediate body needs, or if energy demand has already been fully met with carbs, fats are then stored in fat stores.
An important point to be noted here is that fats provide twice the number of calories per gram when compared to carbs or proteins. Therefore, weight watchers need to watch their fat intake.
Proteins
Proteins are part of body cells and help build muscles and grow the body. They are made from twenty different amino acids. Nine amino acids must come from food, the rest are synthesized within the body. A small portion of amino acids may be used to make energy while the majority of it is used for creating new proteins.
Amino acids, unlike glucose and fats, are never stored in the body. When in excess, amino acids are converted to fats and stored in the fat stores.
Plan your diet carefully
Diabetics need to keep their blood glucose in control. And we now know that carbs are the main source of glucose. But can we cut out carbs fully from our diet? While you should consult a qualified dietitian for recommendations, a few things should be remembered here.
Some body cells prefer glucose to make energy. We also discussed the importance of complex carbs and dietary fiber before. Complex carbs are also an important source of vitamins and minerals. Hence, excluding carbs from the diet should not be necessary.
The intake of carbs should rather be moderated and also monitored. In managing diabetes, it is very important to consider the amount of carbs in our diet, the quality of those carbs, and the interval between meals. Since blood glucose usually exhausts within 4-6 hours, eating several evenly-spaced smaller meals rather than a few larger ones can help manage diabetes efficiently.
A low-carb diet may also lead to energy deficiency due to the body running out of glucose. It will then break down muscle proteins to make glucose which is not very desirable.
Further, during long periods of starvation, the body breaks down fats to make energy and also produces a very efficient fuel called ketones needed for certain body cells like the ones in the brain. The Keto diet, popular among weight watchers, also works on a similar principle. This diet is typically high in fats and low in carbs to trigger ketosis, i.e., the burning of fats.
Diabetics too can consider the keto diet. The Keto diet changes the way the body stores and uses energy. Instead of relying on carbs for glucose, the body adapts to make energy from fats. We know that fats take time to digest and do not cause a spike in blood glucose.
Diabetics, however, need to be careful. Lack of insulin or uncontrolled blood glucose can anyway trigger ketosis (even when not on the keto diet), which if prolonged, can result in a dangerous condition known as ketoacidosis.
Even with the keto diet, no matter how much keto-adapted our body becomes, some parts of the brain still require glucose. Hence the need for carbs will always remain.
With this awareness about the nutrients, we hope you will be able to constructively engage with your doctor and dietician to live a healthy and enjoyable life.
Although we did not discuss micronutrients in detail, diabetics should always eat a balanced diet, replete with various nutrients, while paying special attention to carb intake.
Be sure to measure the amount of various nutrients and calories you consume before making any major changes to your diet. These measurements will help set targets and monitor progress. The next blog, Food choices diabetics have discusses the various foods which are appropriate for diabetics.
If you are interested, you may also want to read the blog Bolster your Body Defenses which emphasizes the importance of including various antioxidants in your diet to prevent chronic diseases such as diabetes.