What To Know About Weight Loss And Diabetes
Pictured Recipe: Vegetable Weight-Loss Soup
Research shows that losing weight can help you hit your blood glucose targets and control or slow progression of your prediabetes or type 2 diabetes. Studies haven’t shown a low-carb diet to be more effective than a low-fat diet for long-term weight loss and maintenance. But you do need to maintain a calorie deficit if you want to lose weight.
Two large, multi-year studies funded by National Institutes of Health-the Diabetes Prevention Program in prediabetes and Look AHEAD in type 2 diabetes-used a lower-calorie eating plan and encouraged people to be more aware of their fat consumption by counting fat grams and calories. They didn’t focus on carbs. Both studies showed that people who lost weight-and kept it off-experienced numerous health benefits over the years. Both studies also encouraged physical activity almost every day.
Joslin also recommends 60-90 minutes of moderate-intensity physical activity most days of the week. This includes both cardio and strength training. Muscle burns calories, so if you’re only doing cardio, consider upping the resistance training to get more calorie burn throughout the day.
Carbs To Lower Blood Sugar In Prediabetes
Regardless of the total number of prediabetes carbs per day that you have, you will get better results if you choose healthier sources and stay aware of portion sizes. Look for high-fiber, high-nutrient sources, and know that a serving size may be smaller than you think!
Healthy Carbs for Prediabetes
Data Synthesis And Analysis
We considered the HR and its 95%CI as the effect size for the present study. Relative risks were considered equal to HR. We first performed a pairwise meta-analysis by combining the reported effect sizes for the highest compared with the lowest category of dietary carbohydrate or LCDS in each study. Study-specific results were combined with a random-effects model. The Cochran Q and I2 statistic were used to test for presence of heterogeneity.
Subgroup analyses of dietary carbohydrates were performed based on sex, geographic location, number of cases, duration of follow-up and adjustments for main confounders including body mass index , smoking status, alcohol drinking, and energy and fiber intakes. P value for subgroup difference was generated using meta-regression analysis. Subgroup analyses of LCDS were performed based on sex, study location, and duration of follow-up. Publication bias was assessed by visual inspection of funnel plot and Eggers and Beggs tests, when at least 10 studies were available. To determine whether the pooled effect size was influenced heavily by a single cohort, sensitivity analysis was done by step-by-step omission of each cohort at a time.
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Busting A Few Nutrition Myths
Avoid grain-based foods: You do not need to eat whole grain foods to get fibre and good carbs. You can obtain plenty of fibre from vegetables, nuts and seeds. Grain-based foods, even whole grains are high in carbs and will raise blood sugar.
Enjoy dairy: Dairy products are fine to eat, even full fat varieties. There is no evidence to show these are bad for our health. In fact, new evidence suggests they are very beneficial. In terms of carbs, cheese and cottage cheese are lower in carbs than milk and yogurt.
Become a detective: When you go shopping, dont rely on front-of-pack labelling. Food companies are great at enticing you to purchase foods, or telling you that a food is healthy, but it may not be true. The only way youll know is to read food labels and learn to understand the nutrition facts panel. When looking at nutrition labels, dont just look at the total calories, observe the amount of carbs, fibre and how much sugar an item contains.
Carbs are more important than calories: Focusing on carb control is more important than counting calories. When you can observe your daily intake of carbs and lower them, you will see results pretty quickly. People following a low carb diet often achieve substantial weight loss as well.
Metabolic Responses To Exercise In Diabetes
As expected, athletes with type 1 diabetes are different from their non-diabetic counterparts, as they have an insulin secretion deficiency and, consequently, their counterregulatory hormones respond differently. Patients with diabetes treated with insulin should learn to mimic their own natural insulin secretory rhythm, in response to physiological changes induced by exercise.
Any patient with diabetes and, especially, diabetic athletes should prevent problems arising from poor insulin dosage. If an athlete with diabetes starts exercise with a significant insulin deficiency, his/her response to exercise may trigger a hyperglycemic overcompensation, even ketosis, since a lack of insulin induces: 1) increased hepatic glucose production 2) decreased peripheral glucose utilization and 3) excessive lipolysis with an increase in free fatty acid production.
If an athlete with diabetes, under any circumstances, experiences an excess of insulin when exercising, his/her response to it can trigger hypoglycaemia, due to: 1) decreased hepatic glucose production 2) increased peripheral glucose utilization and 3) reduced lipolysis .
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Recommendations For Carbohydrate Supplementation In Diabetic Athletes
Nutritional guidelines for athletes with diabetes are similar to those for all athletes, in accordance with the activity performed. Thus, the recommended total amounts of macro and micronutrients should be calculated taking into account the characteristics of each individual as well as the specific requirements of the different stages of training or competition. However, in the case of carbohydrates, in addition to overall quantitative control, the distribution of these carbohydrates throughout the day takes on even more importance, according to the exercise habits and insulin dosage followed by each athlete.
Carbohydrates represent the main nutrient for both ensuring optimal muscle work and for maintaining blood glucose levels as close to normal as possible. Since reserves of carbohydrates in the body are limited, nutritional strategies must aim at maintaining or quickly replenishing these deposits once consumed through physical exercise. In this sense, dietary guidelines that heavily restrict carbohydrates are not recommended, as they would decrease athletic performance and at the same time increase the risk of hypoglycemia.
Why Choose Carbohydrates With Fiber Rather Than Sugar
Pictured Recipe: Strawberry & Tuna Spinach Salad
Remember that carbohydrates can be further broken down into fiber and sugar. Research shows Americans eat too much added sugar and not enough fruits, vegetables, whole grains and low-fat dairy foods. Added sugar is anything that’s not plain dairy or fruit. The American Heart Association recommends women eat less than 24 grams of added sugar per day and men consume no more than 36 grams per day .
Instead, try to prioritize carbohydrates that provide fiber. Aim to get 25-35 grams of feel-full fiber each day. Focus on the quality of carbs you eat, aiming to make half your plate nonstarchy vegetables, a quarter of your plate whole grains and a quarter of your plate protein at most meals. Reduce your consumption of low-fiber, sugary foods and beverages, including desserts, muffins, soda, sugary coffee beverages, fruit juice, ice cream and baked goods, which add carbs without much nutrition.
The above recipe for Strawberry & Tuna Spinach Salad provides 20 grams of protein and 10 grams of fiber for a healthy, satisfying meal that’s also diabetes-friendly.
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Serving Size Vs Portion Size
Now letâs talk about serving size versus portion size.
A serving size is the portion of food for which the nutrition information has been calculated. So, a label for black beans might show a serving size of 1/2 cup and a carb count of 21 grams.
If the amount you actually eat, your portion size, is 1 cup of black beans, youâll need to double the carb count.
Pay close attention to serving size when counting carbs. If youâre not somewhere you can easily measure, know that the size of your fist is about 1 cup and a handful is about 1/2 cup.
Gestational Diabetes Treatment Plan
Many women with gestational diabetes have healthy pregnancies and healthy babies because they follow the treatment plan that their health care providers set up for them.
One of the most important things you can do to help ensure a healthy pregnancy is to make regular health care appointments and keep them.
A general treatment plan to control gestational diabetes may include these items:
- Knowing your blood sugar level and keeping it under control
- Eating a healthy, balanced diet
- Getting regular, moderate physical activity
- Maintaining a healthy weight gain
- Keeping daily records of your diet, physical activity, and glucose levels
- Taking medications as prescribed, you may need a medication if:
- Your blood sugar level is too high.
- Your blood sugar level is high too many times.
- Your blood sugar level remains high, but you are not gaining much weight or are not eating poorly.
- You cannot safely add physical activity to your treatment plan.
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Practical Tips For Protein Intake
- Include a source of lean protein with each meal
- Good sources of lean animal protein, such as skinless poultry, lower fat cuts of beef or pork, fish or egg , and reduced fat dairy products (1 c low fat or skim milk/yogurt, 1 oz cheese = 1 oz protein
- Plant protein sources such as tofu, tempeh, legumes, or meat alternative products are options but be aware of possible higher sodium content
- Nuts or seeds: 1 oz equals 24 almonds, 18 medium cashews, 12 hazelnuts or filberts, 8 medium Brazil nuts, 12 macadamia nuts, 35 peanuts, 15 pecan halves and 14 English walnut halves
- Nut butters 2 Tbsps. equals 1oz protein
- Protein should be a supplement to vegetables, fruits and whole grains in a meal, not the entire meal
How Do You Count Carbs
Carb counting at its most basic level involves counting the number of grams of carbohydrate in a meal and matching that to your dose of insulin.
If you take mealtime insulin, that means first accounting for each carbohydrate gram you eat and dosing mealtime insulin based on that count. You will use what’s known as an insulin-to-carb ratio to calculate how much insulin you should take in order to manage your blood sugars after eating. This advanced form of carb counting is recommended for people on intensive insulin therapy by shots or pump, such as those with type 1 and some people with type 2.
While people with type 2 diabetes who don’t take mealtime insulin may not need detailed carb counting to keep their blood sugars in line, some prefer to do it. While some choose to stick with traditional carb counting, there are others who do a more basic version of carb counting based on “carbohydrate choices,” where one choice contains about 15 grams of carb. Still others use the Diabetes Plate Method to eat a reasonable portion of carb-containing foods at each meal by limiting whole grains, starchy vegetables, fruits or dairy to a quarter of the plate.
How Many Carbs Per Day For A Diabetic
According to the American Diabetes Association, lifestyle management is personalized for each person with diabetes.
It follows that your daily carbohydrate intake depends entirely on you and your unique situation, including your underlying level of insulin resistance, activity level, the type of carbohydrates youre consuming, your target for overall caloric intake.
In general, a diet high in whole carbohydrates will include about 70-80% or more of your daily calories from carbohydrates. The remaining 10-15% of calories come from fat and protein.
To find this number, take your target caloric intake, and multiply it by 0.7 or 0.8. This will give you the number of calories that should come from carbohydrates. Then, since there are 4 calories in a gram of carbohydrates, you can divide this number by 4 to get your target grams of carbohydrate per day.
However, there are some situations in which you may want to tweak this number or build to it slowly.
Personalize Your Carb Intake For Diabetes
If youd like to learn more about how you can reverse diabetes, lower high blood sugar, and get the health benefits of simply eating a more healthy diet, you can reach out to our coaches through our coaching program.
Our diabetes educators are experts with years of experience and the latest research and can work with you, your healthcare professional, and your registered dietitian to develop a healthy diet that works for you.
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Mastering Diabetes has strict guidelines for scientific references in our articles. We rely on peer-reviewed studies, academic research institutions, governmental organizations, and reputable medical organizations. We do our best to avoid using non evidence-based references in all articles. The references in this article are listed below.
5. Lifestyle Management: Standards of Medical Care in Diabetes2019 | Diabetes Care. .
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Grams Of Carbs Per Day For Prediabetics
Here are some common numbers for the recommended carb intake for prediabetics per day. As you can see, they vary quite a bit!
- Under 20 to 50 grams of carbohydrates per day: very low-carb ketogenic diet.
- 130 grams: Adequate Intake .
- 150-200 grams per day, or 30-40% of total calories on a 2,000-calorie diet: the American Diabetes Associations description of a standard low-carb diet.
- 244 grams per day: average daily intake of Americans over 20 years old.
- 300 grams per day, or 60% of total calories on a 2,000-calorie diet: the daily value that you see on nutrition labels.
- They can help you lose weight.
- They can discourage sugary foods.
- They can discourage low-nutrient, refined starches, such as white bread and pasta, and potatoes.
- They can help lower blood sugar, especially in the short term.
- They can discourage processed foods.
- They can be hard to follow over the long-term.
- They can be high in unhealthy choices, such as fatty and processed meats, butter, and cream.
- They can exclude healthy foods, such as whole grains, beans, and fruit.
- They could raise cholesterol or cause harm to your kidneys or bones.
Carbs For Prediabetic Meals And Snacks
There is something else to consider: meal planning. Its not only a question of how many carbs to have each day, and which ones to have, but when to have them. The best bet for controlling blood sugar and hunger is to spread them throughout the day.
- A turkey burger on a whole-grain bun with lean turkey burger, lettuce, tomato, and avocado, with a side of baby carrots.
- ¾ cup of Wheaties with ½ oz. of sliced almonds, ¾ cup blueberries, and 1 cup of unsweetened almond milk.
- 2/3 cup cooked whole-wheat pasta tossed with 2 teaspoons of olive oil, fresh basil, 2 cups of spinach, and 3 oz. cooked salmon.
For most snacks, you might aim for 1 to 2 servings . Then add a source of protein and/or healthy fat, and always keep non-starchy vegetables in mind! For example
- ½ cup fat-free, low-sodium refried beans with diced tomatoes and 1 oz. melted cheese.
- 1 small baked sweet potato topped with broccoli and Greek yogurt.
- ½ sliced large apple with 1 tablespoon of peanut butter.
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What’s The Deal With Low
Low-carb diets are often trending, and if you have diabetes, it might be tempting to try it out. But be aware: It’s difficult to study low-carb diets because there is no consensus on how many carbs a low-carb diet contains. In general, it’s less than 45 percent of calories from carbs, but could be as low as 10 percent, like in the ketogenic diet.
If you’re eating for diabetes, you also have to consider what’s being studied-the effect of a low-carb diet on blood sugar control? Insulin sensitivity? Weight loss? A1C? Cholesterol levels?
In the short term, low-carb diets lead to weight loss and improved blood sugar control. However, one study found that after one year, there was no difference in weight lost or A1C levels between those who ate a low-carb diet and those who ate a low-fat diet.
Here’s something else to think about: When people eat low-carb diets, they tend to eat more fat and protein. Choosing saturated fats like red meat and dairy can raise cholesterol levels. So while you might improve your blood sugars eating low-carb, you could worsen your heart health in the process.
Carb Counting And Diabetes
Carbohydrates, or carbs, are naturally found in certain foods. For example, grains, sweets, starches, legumes and dairy all contain different amounts of carbs. Get up to speed on the three types of carbs, and what foods have them.
When foods and drinks with carbs are digested, the carbs break down into glucose to fuel our cells, and the body’s blood glucose, or blood sugar, level rises. In people without diabetes, blood sugar levels rise after eating but the body’s insulin response keeps levels from rising too high.
If you have diabetes, the process doesn’t work as designed. How carb counting can help your blood glucose control depends on your treatment regimen and whether or not your body makes insulin.
- Type 1: If you have type 1 diabetes, your pancreas no longer makes insulin, so you need to take background insulin as well as offset the carbs in your food with mealtime insulin doses. To do this, you have to know exactly how many carbohydrate grams are in your mealcue carb counting!
- Type 2: Because people with type 2 diabetes are resistant to insulin and may not produce enough of it, its important that you be mindful of your carb intake. To avoid blood sugar spikes, it helps to eat a consistent amount of carbs at meals throughout the day, rather than all at once. People taking oral medications may use a more basic form of carb counting than those on insulin.
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