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Healthy Eating for Type 2 Diabetes

One of the most frequent questions people with diabetes ask is “What can I eat?” After all, diabetes is at root a metabolic disorder, affecting the way your body derives energy from food. Myths abound when it comes to diabetes and food—one of the most common being that there is a “diabetes diet” that prohibits sugar and lists other items to avoid.

In fact, dietitians and other health professionals give the same dietary advice to people with diabetes as they do to most people, but with extra emphasis on controlling weight and keeping blood sugar, blood pressure, and cholesterol values as close to normal as possible. The basics: eat a well-balanced diet that emphasizes fruit, vegetables, whole grains, and lean protein, while watching total calories and getting regular exercise.

In this report, you’ll learn about the components of a healthy diet, how to work with a dietitian, how to develop a meal plan, and how to fit physical activity into your schedule. You will learn how to recognize portion distortion, make wise choices while dining out, and stay on track with your weight-loss plan. Best of all, we’ve included 40 original recipes so you can put this advice into practice—starting today. 

Prepared by the editors of Harvard Health Publications in consultation with David M. Nathan, M.D., Professor of Medicine, Harvard Medical School, and Director, Diabetes Center and Clinical Research Center, Massachusetts General Hospital; and Kathy McManus, M.S., R.D., L.D.N., Director of Nutrition, Brigham and Women’s Hospital, Harvard Medical School. 46 pages. (2009)

  • Understanding diabetes
    • Who gets diabetes?
    • Avoiding diabetes complications
  • The first-line treatment: Weight loss
    • Weight-loss strategies
    • Calorie-cutting methods
    • Eating away from home
    • Exercise: The essential adjunct
    • Quick tips for portion control
    • Keeping the weight off
    • Online options for dieters
  • The elements of a healthy diet
    • Carbohydrates
    • Fats
    • Proteins
    • Other dietary components
  • Meal-planning basics
    • Meet with a registered dietitian
    • Keep a food diary
    • Calculate your caloric needs
    • Choose a meal plan
    • Track your progress
  • Special bonus section: Healthy recipes
    • Entrees
    • Salads and side dishes
    • Desserts
    • Snacks and sauces
    • Breakfast foods
  • Sample meal plan for a week
  • Recipe index
  • Resources
  • Glossary

According to the American Diabetes Association (ADA), all people newly diagnosed with diabetes should immediately take two steps to control their blood sugar: make lifestyle changes—eating better and exercising more—to lose weight, and take the medication metformin. Experts estimate that losing weight and increasing physical activity are enough to decrease  HbA1c levels by one or two percentage points. Adding metformin can reduce them by another one-and-a-half percentage points. 

The good news is that losing a little—5% to 10%—of your body weight—can help manage diabetes. For example, a woman who is 5 feet, 4 inches tall and weighs 165 pounds would need to lose just 8 to 16 pounds to see noticeable declines in her blood sugar (as well as her blood pressure and cholesterol levels). 

Making a real effort to lose weight pays off, as evidenced by the Look AHEAD trial, a federally funded study involving more than 5,000 overweight or obese people with diabetes at 16 centers across the United States. Half the participants were randomly assigned to follow an intensive lifestyle intervention that required them to eat less and move more, with a goal of losing at least 7% of their body weight within the first year. Specifically, they ate portion-controlled diets (including liquid meal replacements and frozen entrées) and were encouraged to walk or do other moderate-intensity exercise, aiming for a goal of 175 minutes a week. The other participants, who served as the control group, received standard diabetes support and education. 

After one year, people in the intensive lifestyle intervention group had lost an average of 8.6% of their body weight, compared with 0.7% in the control group. With the weight loss came improvements in blood sugar, blood pressure, and HDL (good) cholesterol, as well as a reduced need for medications to control those factors, as described in a 2007 study published in Diabetes Care. What’s more, the lifestyle changes also improved their quality of life, based on questionnaires designed to assess the Look AHEAD participants’ physical and mental health, according to a 2009 study in Archives of Internal Medicine. The greatest gains were physical changes—for example, compared with the control group, people in the lifestyle group were more fit, felt more vital, and had less body pain. They also reported feeling less depressed, with the greatest benefits seen among people who were the most depressed at the start of the study. 

Although lifestyle changes are most effective in the early stages of diabetes, they have an impact even later on as well. Lifestyle changes and weight reduction are especially important for people who are on blood sugar–lowering medications, because some of these drugs make it easier to gain weight. That’s why it’s doubly important for people on such medications to control what they eat.

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