Embracing the Middle Ground with Food and T2D

Embracing the Middle Ground with Food and T2D

You get diagnosed with type 2 diabetes (T2D). Suddenly you’re consulting your go-to friend Dr. Google (admit it— everyone does it) at all hours of the day and night. I’d bet your first question is “What to eat when you have diabetes….” You find suggestions for all the “right” things to eat. And, of course, all the “wrong” things— including a list of what “not to eat” (which has everything you’ve ever loved on it). Ugh. Now, if you’re like many folks I’ve worked with over the years, you’ll go one of two directions:  a) you’ll get stuck by focusing on the foods Google has told you to give up or b) you’ll embrace restrictive diets and eating patterns.

You’re not alone. Like I mentioned— a lot of folks get stuck in all-or-nothing approaches to diabetes management—-especially when it comes to food. What people often forget, however, is the middle ground (which holds lots of options) between those two approaches. In fact, the middle ground can often be a place where quality of life and diabetes self-care live together. Sound too good to be true? Let’s run a couple of examples.

Example 1: Restrictive Diets (and their shortcomings)

Let’s say you decide to try a restrictive diet that’s very, very low in carbohydrate—keto or paleo, etc. You hope to see healthier blood sugars, perhaps lose some weight. Maybe you do. However, if you’re like most people trying new diets, it’s tough maintaining restrictive eating patterns long-term.  A systemic review published in 2020 looked at over 120 diet studies. This review found most of the 22,000 participants across these studies stopped dieting in six months or less. Benefits that participants saw initially (weight loss, cholesterol improvements, etc.) disappeared by one year (with one exception on the Mediterranean diet). The added piece to consider? Potential harm. In general, the more extreme an eating pattern, the higher the risk for your body to have too much of some nutrients and not enough of others— which can alter the body’s ability to work well. Many restrictive eating programs that are promoted in medical offices include frequent labs and checkups for this reason.

How to Develop Healthier Eating Patterns for Diabetes

Now, the question I often ask people trying to work on healthier eating patterns for diabetes, is where are you starting from? How well are you doing on the basics of healthy eating (you know— eating fruits and veggies, avoiding sugary drinks/snacks, eating whole grains, healthy fats and proteins—that stuff). If you’re like 88% of U.S. adults you’re falling short on at least the fruits and veggies. If you’re struggling with the basics, extreme eating patterns get really tough because they’re even more work! Instead of going to extreme changes, consider focusing on the basics of healthy eating. Would it likely help your blood sugars (as well as improve your overall health)? Yep. Would it be a bit easier to maintain? Probably. Would the potentially harmful risks of extreme eating be reduced? Yep. In short, health habits don’t have to be extreme to be effective.

Example 2: Getting Stuck, and Getting Unstuck

Imagine you have a deep appreciation for chocolate (who doesn’t love chocolate?). After your Google consult, all you can think about when it comes to chocolate is, “I shouldn’t have this, I can’t have this, I can’t have too much of this, etc.” Chocolate is just one example— it could be soda, potato chips, etc. Opposite of making extreme changes, you get stuck. You fixate on a particular food item and are unable to consider eating pattern changes outside of that item. Similar to making extreme changes, you’re likely overlooking the numerous options in the middle ground.

Again, start by asking yourself where you’re starting from on healthy eating patterns. Are you meeting those basic goals of healthful eating with diabetes? There are so many options to explore with increasing fiber (legumes, whole grains, vegetables, fruits) as well as healthy fats and proteins (lean meats, fish, nuts, avocados, etc). Most registered dietitian nutritionists (RDNs) will tell you there’s no food that’s off-limits with T2D. Focusing on adding things to your eating patterns, rather than eliminating foods, opens up a world of possibilities. I’d venture a guess that by increasing healthful foods, your chocolate (or other food love) intake will diminish.

The Takeaway?

The middle ground isn’t so bad, and it holds a lot of options. Diabetes management, like diabetes itself, is a spectrum. That means your decisions about eating patterns might change and grow over time. You may experience both of the above examples at different times in your life. Be realistic with yourself (if changes need to be made, they need to be made), but also be gracious with yourself and be curious. What kinds of new foods can you try? New methods of cooking? What new adventure with food awaits you?


Additional Resources:

Success or Sabotage: How to Snack Smartly!

A Tutorial on Diet and Nutrition for Those Living with Type 2 Diabetes

What to Eat? Diabetes and Nutrition

Are Weight Conversations in Diabetes Doing More Harm Than Good?

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