Manuka Honey

The market for Manuka honey has recently exploded, thanks to the perceived benefits of its natural antibacterial properties. But what evidence is there to support the claims?

In this article, we explore what Manuka honey is, what its properties are, and how it differs from other types of honey.

We also look at the evidence available to assess whether Manuka honey really is the next great superfood.

Historical use of honey

Honey has been used to treat wounds since ancient times, as detailed in a document dating back to 1392. It was believed to help in the fight against infection, but the practice fell out of favor with the advent of antibiotics.

As we face the challenge of a growing worldwide resistance to antibiotics, scientists are examining the properties and potential of honey.

Qualities of Manuka honey

The leaves of the Manuka tree, also known as a tea tree, have been known for centuries among the indigenous tribes of New Zealand and southern Australia for their healing powers.

Bees that collect nectar from this tree make Manuka honey, which harbors some of the healing properties.

All Honey contains antimicrobial properties, but Manuka honey also contains non-hydrogen peroxide, which gives it an even greater antibacterial power.

Some studies have found Manuka honey can also help to boost production of the growth factors white blood cells need to fight infection and to heal tissue.

Manuka honey contains a number of natural chemicals that make it different:

  • Methylglyoxal (MGO): This has been shown to be effective against several bacteria, including Proteus mirabilis and Enterobacter cloacae.
  • Dihydroxyacetone (DHA): This is found in the nectar of Manuka flowers and converts into MGO during the honey production process.
  • Leptosperin: This is a naturally occurring chemical found in the nectar of Manuka plants and a few close relatives.

Manuka honey and wound care

Medical grade honey, used by healthcare professionals as part of a wound dressing, can help some kinds of wounds to heal.

Experts believe that because Manuka honey has added antibacterial and healing properties, it may be even more effective. At the moment, however, there is little evidence to support the theory.

A Cochrane Review looked at all the evidence available to support the use of honey in wound care. Published in 2015, the study said the differences in wound types made it impossible to draw overall conclusions about the effects of honey on healing.

The study found strong evidence that honey heals partial thickness burns around 4 to 5 days more quickly than conventional dressings. There is also evidence indicating that honey is more effective than antiseptic and gauze for healing infected surgical wounds.

Another study concluded that honey has rapid diabetic wound healing properties, but recommended more research to confirm that honey can be used as the first line of treatment for these types of wounds.

While some research does show that honey can help improve certain conditions, more studies are needed to confirm honey’s benefits for:

  • mixed acute and chronic wounds
  • pressure ulcers
  • Fournier’s gangrene
  • venous leg ulcers
  • minor acute wounds
  • Leishmaniasis

Manuka honey and bacteria

Antibiotics are used to prevent and treat bacterial infections all over the world. However, the bacteria the drugs are deployed to kill can adapt and become resistant.
Manuka honey has antibacterial properties and may be able to fight superbugs resistant to most standard antibiotics.

This resistance is currently happening all over the world, and a growing number of infections are becoming harder to treat. This leads to longer hospital stays, higher medical costs, and ultimately, more deaths.

The World Health Organization (WHO) has listed resistance to antibiotics as the one of the biggest threats to global health, food security, and development.

The natural antibacterial properties of honey may be useful in this fight. In the lab, Manuka honey has been shown to be able to inhibit around 60 species of bacteria. These include Escherichia coli (E. coli) and salmonella.

Some studies have shown that Manuka honey can fight so-called superbugs that have become resistant to antibiotics. These include Staphylococcus aureus (MRSA-15) and Pseudomonas aeruginosin.

This line of investigation is still in its infancy. These have been small, lab-based tests which combined medical grade Manuka honey with antibiotics.

There is still a lot of work to be done before scientists can come to a conclusion.

Other health benefits

There are many other potential health benefits of Manuka honey. These include:

  • reducing high cholesterol
  • reducing inflammation
  • reducing acid reflux
  • treating acne

There is, however, limited evidence for its use in these areas.

Using Manuka honey

The medical grade honey used to dress wounds is very different from the honey sold in stores.

Medical grade honey is sterilized, with all impurities removed, and prepared as a dressing. Wounds and infections should always be seen and treated by a healthcare professional.

Store-bought Manuka honey can be used in the same manner as any other honey: on toast, on porridge, or to sweeten drinks.

There is no clear evidence that people who consume Manuka honey in this way will notice any benefit to their health. It is not clear how the active ingredients that provide Manuka honey with its healing properties survive in the gut.

Risks

Honey is usually around 80 percent sugar, mainly supplied by glucose, fructose, and sucrose, so moderate intake is recommended. This is particularly true if you have diabetes.

Due to the recent trend for Manuka honey, it can be expensive, so it is important to make sure you know what you are looking for.

When buying Manuka honey from the store, look for the Unique Manuka Factor (UMF) mark. This means the honey has been produced by one of the 100+ beekeepers, producers, and exporters licensed by the UMF Honey Association.

The number displayed next to the UMF mark represents the quantity of Manuka key markers, leptosperin, DHA, and MGO. Consumers are advised to choose UMF 10+ and above.

Why Is Drinking Water Important?

Most people take drinking water for granted, but keeping hydrated has a huge impact on overall health. Despite how crucial water is, a significant number of people fail to consume recommended levels of fluids each day.

Around 70 percent of the body is comprised of water, and around 71 percent of the planet’s surface is covered by water. Perhaps it is the ubiquitous nature of water that means drinking enough each day is not at the top of many people’s lists of priorities.

Fast facts on drinking water

Here are some key points about drinking water. More detail and supporting information is in the main article.

  • Humans are 70 percent water, and our blood is 90 percent water
  • There is no universally agreed quantity of water that must be consumed daily
  • Water is essential for the kidneys to function
  • When dehydrated, the skin can become more vulnerable to skin disorders and wrinkling
  • In a CDC questionnaire, 7 percent of respondents reported drinking no water at all daily

Why do we need to drink water?

Woman drinking water.
The Institute of Medicine recommends that men achieve a daily fluid intake of around 3 liters and that women take in 2.2 liters.

To function properly, all the cells and organs of the body need water. It is also used to lubricate the joints, protect the spinal cord and other sensitive tissues, regulate body temperature, and assist the passage of food through the intestines.

Although some of the water required by the body is obtained through foods with a high water content – soups, tomatoes, oranges – the majority is gained through drinking water and other beverages.

During everyday functioning, water is lost by the body, and this needs to be replaced. It is noticeable that we lose water through activities such as sweating and urination, but water is even lost when breathing.

Drinking water, be it from the tap or a bottle, is the best source of fluid for the body. Beverages such as milk and juices are also decent sources of fluid, but beverages containing alcohol and caffeine, such as soft drinks, coffee, and beer, are not ideal because they often contain empty calories.

It was previously thought that caffeinated beverages had diuretic properties, meaning that they cause the body to release water. However, studies show that fluid loss because of caffeinated drinks is minimal.

How much water should you drink?

The recommended amount of water to be drunk per day varies from person to person, depending on factors such as how active they are and how much they sweat. There is no universally agreed upon amount of water that must be consumed daily, but there is a general level of consensus as to what a healthy amount is. According to the Institute of Medicine (IOM), an adequate intake for men is approximately 13 cups (3 liters) a day. For women, an adequate intake is around 9 cups (2.2 liters).

Many people will have heard the phrase, “drink eight 8-ounce glasses of water a day,” which works out at around 1.9 liters and is close to the IOM’s recommendation for women. Drinking “8 by 8” is an easy-to-remember amount that can put people on the right track regarding water consumption. Remember, all non-alcoholic fluid counts towards this recommendation.

Water also helps dissolve minerals and nutrients so that they are more accessible to the body, as well as helping transport waste products out of the body. It is these two functions that make water so vital to the kidneys.

How does not drinking enough affect the kidneys?

Cross-section of the kidneys.
The role of the kidneys in keeping the body healthy may be underrated in relation to the heart and lungs.

Every day, the kidneys filter around 120-150 quarts of fluid. Of these, approximately 1-2 quarts are removed from the body in the form of urine, and 198 are recovered by the bloodstream. Water is essential for the kidneys to function.

If the kidneys do not function properly, waste products and excess fluid can build up inside the body.

Untreated, chronic kidney disease can lead to kidney failure, whereby the organs stop working, and either dialysis or kidney transplantation is required.

Urinary tract infections (UTIs) are the second most common type of infection in the body and account for around 8.1 million visits to health care providers in the U.S. every year.

If infections spread to the upper urinary tract, including the kidneys, permanent damage can be caused. Sudden kidney infections (acute) can be life-threatening, particularly if septicemia occurs.

Drinking plenty of water is one of the simplest ways to reduce the risk of developing a UTI and is also recommended to those who have already developed a UTI.

Kidney stones interfere with how the kidneys work and, when present, can complicate UTIs. These complicated UTIs tend to require longer periods of antibiotics to treat them, typically lasting 7-14 days.

The leading cause of kidney stones is a lack of water; they are commonly reported in people who do not drink the recommended daily amount of water. As well as complicating UTIs, research has suggested that kidney stones also increase the risk of chronic kidney disease.

In November 2014, the American College of Physicians issued new guidelines for people who have previously developed kidney stones, stating that increasing fluid intake to enable 2 liters of urination a day could decrease the risk of stone recurrence by at least half with no side effects.

Dehydration – using and losing more water than the body takes in – can also lead to an imbalance in the body’s electrolytes. Electrolytes, such as potassium, phosphate, and sodium, help carry electrical signals between cells. The levels of electrolytes in the body are kept stable by properly functioning kidneys.

When the kidneys are unable to maintain a balance in the levels of electrolytes, these electrical signals become mixed up, which can lead to seizures, involving involuntary muscle movements and loss of consciousness.

In severe cases, dehydration can also result in kidney failure, a potentially life-threatening outcome. Possible complications of chronic kidney failure include anemia, damage to the central nervous system, heart failure, and a compromised immune system.

Effects on other organs

Of course, it is not just the kidneys that are affected by a lack of water; below is a small sample of the other negative consequences dehydration can bring:

  • Blood is more than 90 percent water, therefore, if water is in short supply, blood can become thicker and increase blood pressure.
  • When dehydrated, airways are restricted by the body in an effort to minimize water loss, potentially making asthma and allergies worse.
  • The skin can become more vulnerable to skin disorders and premature wrinkling.
  • The bowel needs water to function correctly. If dehydrated, digestive problems and constipation can become an issue. Dehydration can lead to an overly acidic stomach which makes heartburn more common and can encourage the development of stomach ulcers.
  • Cartilage, found in joints and the disks of the spine, contain around 80 percent water. If dehydration is ongoing, joints can become less good at shock absorption, which leads to joint pain.
  • Dehydration can affect brain structure and function. If dehydration is prolonged, cognitive ability is impaired.

Does the U.S. drink enough water?

A study carried out by the Centers for Disease Control and Prevention (CDC) in 2013 analyzed data from the National Cancer Institute’s 2007 Food Attitudes and Behaviors Survey.

Out of a sample of 3,397 adults, the researchers found the following:

  • 7 percent of adults reported no daily consumption of drinking water
  • 36 percent of adults reported drinking 1-3 cups of drinking water a day
  • 35 percent of adults reported drinking 4-7 cups of drinking water a day
  • 22 percent of adults reported drinking 8 cups or more a day

People were more likely to drink less than 4 cups of drinking water daily if they consumed 1 cup or less of fruits or vegetables a day.

The study only measured the intake of drinking water and, of course, fluid can be gained from other beverages. However, water is the ideal source of fluid because it is calorie-free, caffeine-free, and alcohol-free.

Because 7 percent of respondents reported drinking no water at all daily, and those who drank a low volume of water also consumed less fruit and vegetables, it suggests that there is a certain number of people who are risking their health by not getting enough fluid.

Even if the respondents reporting low levels of water intake were obtaining enough fluid, it is likely that they would be obtaining it from sources that could potentially compromise their health in other ways.

“The biologic requirement for water may be met with plain water or via foods and other beverages,” write the study authors. “Results from previous epidemiologic studies indicate that water intake may be inversely related to the volume of calorically sweetened beverages and other fluid intakes.”

Smoothies for People with Diabetes

Smoothies may seem like a healthful option, but they can be a very bad choice for people who have diabetes.

Many people with diabetes are well-informed about what they can and cannot eat. They know also that choosing premade meals, snacks, and drinks can be challenging. People with diabetes have to be very careful when ordering smoothies in restaurants, as these often contain far too much sugar and not enough protein and fat.

With some modifications, however, smoothies can be enjoyed either at home or at a restaurant.

Things to consider when making a smoothie

People with diabetes must pay careful attention to their carbohydrate intake. Avoiding low-quality carbohydrates, such as sugar or white flour, and using dietary fiber as their guide in choosing carbohydrates, are the best dietary options for them.

A person with diabetes should consider some of the following:

Extra fat can be a good thing

[avocado cucumber and chia seed smoothie]
There are many sources of healthful fats that can be used in smoothies, such as avocado and chia seeds.

The debate can be very confusing between good and bad fat, what is good and bad cholesterol, and the ever-changing guidelines on what offers the best balance between them.

However, in short, some fats are very beneficial to people with diabetes, as they help slow down the speed at which sugar enters the blood.

Some sources of fat that can be added to a morning smoothie include:

  • almond or peanut butter
  • chia seeds
  • avocado
  • raw pecans
  • raw walnuts
  • coconut oil

Include extra protein

Similarly to fat, protein offers many health benefits that are particularly important to people with diabetes. For example, high-protein content slows the absorption of food, which reduces the speed at which sugar enters the bloodstream.

Protein does not always need to come from an animal or animal byproduct. Many foods contain high amounts of protein, and adding them to a smoothie in the morning will offer great benefits.

Some proteins to include in a smoothie include:

  • plain Greek yogurt
  • hemp seeds, and other seeds
  • almonds
  • pea protein
  • whey protein
  • milk

Make the smoothie high in fiber

Soluble fiber found in some carbohydrates is ideal for people with diabetes to consume. Unlike sugar and simple carbohydrates, which cause dangerous spikes and crashes in blood sugar, fiber is much more like protein and fat in that it is harder to breakdown.

[spinach smoothies on a wooden table]
Adding leafy greens like spinach can ensure that a smoothie is nutritious and high in fiber.

This slow digestion means that fiber, along with sugar from carbohydrates, enters the bloodstream over a period of time rather than in quick bursts.

Foods high in fiber that might work well in a smoothie include:

  • most fruits, including raspberries, oranges, nectarines, peaches, and blueberries
  • vegetables, including leafy greens, such as spinach and kale
  • nuts
  • chia seeds

Avoid adding extra sugar

Most people with diabetes know that adding extra sugar to their diet should be avoided. Many foods already have sugar in them, and many others have hidden sugars. For example, canned fruits are preserved in sugar-filled syrups, and honey and maple syrup are also, basically, sugar.

Some alternatives to milk, such as almond or soy milk, may also contain added sugar. When making a smoothie, it is important not to add extra sugar or sweetened ingredients. However, there are ways to make it more flavorful.

Limit carbohydrate servings to three or less

When making a smoothie, a person with diabetes must make sure they know the amount of carbohydrate they are putting it. In general, people with diabetes should look to include 45 grams (g) or less of carbohydrates. Using measuring cups, spoons and the diabetes exchange list, is a good way to measure how many carbohydrates to put in the smoothie.

Low-GI level fruits and vegetables

The glycemic index (GI) measures how quickly a food item will raise blood sugar. Generally, a lower-scoring food means that sugar in it will absorb more slowly than a food with a higher GI.

All fruits and vegetables have different GI scores, as they all contain different amounts of sugar and fiber. Generally, foods with a rating of around 50 or less are considered good.

Glycemic load (GL) is also calculated to compensate for how many grams of carbohydrates are in a typical serving. This gives a more accurate picture of how the food will actually affect people’s blood sugar levels. A GL of less than 10 is low, while a GL greater than 20 is high.

Good smoothie fruits

In terms of making a fruit smoothie, people with diabetes should use fruits that have low GI and GL levels.

[cherry smoothie bowl]
Cherries have a low GI score, making them a delicious and healthful addition to a smoothie.

Here are a few examples of fruits with low GI scores:

  • cherries have a GI Score of 22, and a GL of 3
  • grapefruits have a GI Score of 25 and a GL of 3
  • pears have a GI Score of 38 and a GL of 4.2
  • apples have a GI Score of 38 and a GL of 5.7
  • plums have a GI Score of 39 and a GL of 5.7
  • strawberries have a GI Score of 40 and a GL of 3.8
  • oranges have a GI Score of 42 and a GL of 5.9
  • raspberries have a GI Score of 32 and a GL of 2.6

Good smoothie vegetables

Vegetables also have different GI scores.

Here are a few examples of low scoring vegetables that would be good in a smoothie:

  • green peas have a GI Score of 54 and a GL of 4
  • carrots have a GI Score of 71 but a GL of 6
  • pumpkin has a GI Score of 75 but a GL of 3
  • spinach has a GI Score of 15 and a GL of 0
  • broccoli has a GI Score of 10 and a GL of 0
  • cabbage has a GI Score of 10 and a GL of 0
  • kale has a GI Score of 2-4 and a GL of 0

Other good ingredients to use

A good smoothie often contains more than just fruits, vegetables, and a fat source. Other ingredients can add both flavor and nutrition. Some additional ingredients to think about include:

[raw almond milk in a glass bottle]
Unsweetened almond or soy milk is a good alternative to regular milk for people looking to avoid dairy.
  • unsweetened almond or soy milk
  • ice for extra chill
  • reduced-fat or whole milk
  • a small amount of oatmeal
  • extracts, such as vanilla or almond
  • cinnamon
  • cocoa powder
  • black coffee
  • natural peanut butter (no sugar added)
  • nutmeg
  • ginger
  • turmeric

Considerations for people with diabetes and another health condition

People with diabetes may have other existing conditions to contend with, such as high blood pressure, obesity, celiac disease, and lactose intolerance. These other conditions may limit what kinds of ingredients can be used in a smoothie.

Lactose intolerance

People who are lactose intolerant should avoid adding dairy milk or any byproducts of dairy milk, such as yogurt, to a smoothie. Almond milk or soy milk are good alternatives, and they can be used instead of milk in nearly any smoothie recipe.

Celiac disease

People who have celiac disease are unable to eat anything that contains gluten, a protein found in wheat, rye, and barley. Most smoothies do not contain wheat naturally, but for people who like to add whey protein to their smoothie, it may become an issue.

Whey itself is gluten-free, but some manufacturers add fillers with gluten in them. Either check the label before buying or try other, plant-derived proteins.

Obesity

People who are overweight or obese will need to control their calorie level and emphasize plant foods and fiber. In general, a smoothie that is suitable for a person with diabetes will probably be suitable for a person who is overweight.

High blood pressure

People who have high blood pressure should avoid coffee-based smoothies and stick to vegetable and fruit smoothies instead. There are many foods that people with high blood pressure can eat, including beets, nuts, seeds, vegetables, and fruits. All of these can be good additions to a smoothie.

People with high blood pressure should also avoid foods that contain excess salt.

Other health benefits of smoothies

Smoothies can offer a complete liquid meal. Often drunk at the beginning of the day, they can contain enough protein, carbohydrates, fiber, and fat to keep a person satisfied.

In addition, smoothies can be a good source of vitamins, minerals, and other nutrients that the body needs. The more nutrients a person gets, the better their overall health. Proper nourishment can improve a person’s cholesterol levels, reduce fat, build muscle, promote healthier nervous and circulatory systems, and improve energy levels.

Apple Cider Vinegar and Diabetes

For many years, apple cider vinegar has been linked with an array of health benefits. These have ranged from aiding weight loss to relieving cold symptoms. But does taking it help people with diabetes?

What is apple cider vinegar?

Apple cider vinegar
Apple cider vinegar derives from cider or fresh apples and is produced after a slow process that breaks down sugars.

Vinegar can be made from nearly any carbohydrate. Apple cider vinegar is derived from cider or freshly pressed apple juice.

Like most vinegar, apple cider vinegar is produced by a slow process spanning several weeks or months in which sugars are broken down.

Mother of vinegar is a cobweb-like substance made from yeast and bacteria that builds up during this period. Mother of vinegar gives the vinegar a cloudy appearance and it is only present in unfiltered apple cider vinegar. It is thought to boost the vinegar’s nutritional value.

However, most vinegar is pasteurized. This heating process kills bacteria but prevents the mother of vinegar from forming.

Apple cider vinegar and diabetes

In 1980, there were around 108 million people with diabetes worldwide. Its prevalence has increased greatly over the past few decades to an estimated 422 million. Diabetes is a chronic condition marked by an inability to manage blood sugar levels appropriately.

The hormone responsible for regulating blood sugar levels is called insulin. People with type 1 diabetes are unable to produce this hormone. People with type 2 diabetes are unable to produce enough insulin or respond appropriately to the hormone.

People can also develop a related condition known as prediabetes. This is where an individual may have blood sugar levels that are high, but not yet high enough to be diagnosed with diabetes.

Developing methods that help the body to regulate blood sugar levels efficiently is the most effective strategy in managing diabetes. Maintaining a healthful, balanced diet and regular exercise are crucial lifestyle factors that can help to achieve this.

Some evidence also suggests that consuming apple cider vinegar may be useful in helping people with diabetes to control their blood sugar levels.

One study demonstrated that apple cider vinegar reduced blood sugar levels and had a positive impact on cholesterol in rats with and without diabetes.

Type 2 diabetes

Glucometer
Studies suggest that a small amount of apple cider vinegar may help to reduce blood sugar levels after a spike following a meal high in carbohydrates.

In humans, researchers have looked at how consuming apple cider vinegar alongside a meal high in carbohydrates affected blood sugar levels in participants who had type 2 diabetes, prediabetes, or neither condition.

Meals high in carbohydrates typically cause a spike in blood sugar levels immediately after eating. However, less than an ounce of apple cider vinegar significantly reduced blood sugar levels across all three groups following the meal, compared with the consumption of a placebo drink.

Another study in patients with type 2 diabetes compared apple cider vinegar with water. The authors found that consuming 2 tablespoons of apple cider vinegar with a cheese snack before bedtime was enough to significantly lower blood sugar levels the following morning.

This finding suggests that apple cider vinegar could also help to reduce fasting blood sugar levels. This refers to blood sugar levels after 8 hours without eating or drinking anything except water. Fasting blood sugar levels serve as a baseline measure of a person’s blood sugar levels.

It is thought that a component of apple cider vinegar called acetic acid may slow down the conversion of complex carbohydrates into sugar in the bloodstream.

This provides more time for the sugar to be removed from the bloodstream, allowing the body to keep blood sugar levels constant and limit spikes. This is also a theory underlying the effects of several different diabetes drugs.

Type 1 diabetes

While consuming apple cider vinegar could help people with type 2 diabetes control their blood sugar levels, it could be harmful to those with type 1 diabetes.

The inadequate digestion of food is a common complication for people with diabetes. Called gastroparesis or delayed gastric emptying, it means that food can remain in the stomach for an abnormally long period of time without being digested.

These delays in the digestive process make it harder for the body to consistently control blood sugar levels. A team of Swedish researchers found that apple cider vinegar increased the time in which food remains undigested in the stomach of people with type 1 diabetes.

It is important to note that a majority of the studies within this area have been conducted using small sample sizes and findings have not always been consistent.

A large-scale, randomized control trial to find out how apple cider vinegar affects blood sugar levels in patients with diabetes has yet to be conducted.

Any impact that apple cider vinegar might have on the regulation of blood sugar levels is likely to be relatively small compared with maintaining a healthful, balanced diet and regular exercise.

Based on the available evidence, apple cider vinegar could help people with type 2 diabetes to control their blood sugar levels. More research is needed for large-scale recommendations. Its consumption in moderation has yet to be linked with any significant harms or side effects.

How is it consumed?

Apple cider vinegar on a salad
Apple cider vinegar may be consumed diluted in water or used in marinades and salad dressings.

People who wish to consume apple cider vinegar are best diluting 1 to 2 tablespoons of apple cider vinegar in a large glass of water. It should be consumed before meals and there may be benefits associated with consuming it just before bedtime.

As with most vinegar, it is not recommended to consume undiluted apple cider vinegar. When drunk on its own, it can cause stomach irritation or damage to tooth enamel.

Apple cider vinegar can also be used as a versatile cooking ingredient. It is suitable for use in salad dressings, marinades, sauces, and soups. It works well with many types of meat and fish.

People are most likely to see the distilled varieties of apple cider vinegar on sale, which has a clear, see-through appearance. However, it is better to search for the unfiltered, cloudier varieties as they contain mother of vinegar and are more nutritious.

Summary

People with type 2 diabetes may want to consider diluted apple vinegar cider given that it is safe to consume and may provide some benefit to blood sugar level control. However, the evidence behind its benefits is still lacking.

It is important for people to note that apple cider vinegar should not be considered a quick fix for diabetes. Eating a balanced diet low in carbohydrates, high in fiber, and exercising regularly are the most effective methods of controlling diabetes.

How Should I Organize My Diet To Help My Diabetes?

Diabetes is one of the most commonly occurring long-term medical conditions in the world.

According to the World Health Organization, as of 2014, over 422 million people worldwide have diabetes. Diabetes complications can include blindness, kidney problems, and heart disease.

Similar to many long-term diseases, complications may be prevented with proper management of the condition.

“Diet is one of the key elements in managing diabetes,” Amparo Gonzalez, RN, CDE, of the Johnson and Johnson Diabetes Institute. “People with diabetes need to manage the amounts of carbohydrates, fat, and overall calories they eat daily.”

“When it comes to diet, it’s also important to remember moderation and portion control are essential.”

The basics of diabetes

The two major types of diabetes are type 1 diabetes and type 2 diabetes.

A girl holding a glucometer.
Making the right food choices is important for both type 1 and type 2 diabetes.

Type 1 diabetes often develops early in life, and the cause is not fully understood. Type 1 diabetes occurs when the immune system damages the cells that make a hormone called insulin. The result is insufficient insulin production.

Type 2 diabetes is associated with a sedentary lifestyle and being overweight. It can develop in both children and adults. People with type 2 diabetes do not produce enough insulin, or the insulin they do produce is not used efficiently.

Fortunately, both types of diabetes can be managed through medication and lifestyle choices, such as healthy eating. Making healthy food choices and limiting unsuitable foods is a large part of a diabetes treatment plan.

Important goals for managing diabetes through diet include controlling blood sugar levels and maintaining a healthy weight.

The role of diet in diabetes

After eating, food breaks down into glucose. Glucose is a type of sugar and a major source of energy for the body.

In response to an increase in glucose levels, the body releases insulin. Insulin is an essential hormone because it allows the cells in the body to absorb glucose. It also plays a role in helping the body store protein and fat.

In people who have diabetes, their body may stop making insulin, not make sufficient levels of insulin, or may not use insulin efficiently. Without proper insulin production and use, glucose may not be absorbed by the cells. Instead, glucose levels rise in the bloodstream.

There are a couple of problems when blood sugar levels in the bloodstream become high. The cells don’t get the energy they need, and fatigue can occur.

High blood sugar levels over time can also damage blood vessels in the body. When the blood vessels become damaged, various complications can occur, such as kidney and heart disease, and vision loss.

The good news is that by making the right choices, people can manage their diabetes more effectively, keep glucose levels steady, and lower the risk of possible complications.

How does food affect blood sugar levels?

Different foods affect blood sugar levels differently. The three macronutrients the body uses are fat, protein, and carbohydrates. Carbohydrates affect glucose levels the most. When eaten alone, protein and fat do not have a significant impact on glucose levels.

It’s important to remember that many foods contain a combination of carbohydrates, protein, and fat. Since food can have a significant impact on blood sugar levels, it’s essential to make good food choices and monitor carbohydrate intake.

There is no “one-size-fits-all” diet for people with diabetes. Several individual factors play a role in dietary choices, including whether a person is overweight, has kidney disease, and whether they have type 1 diabetes or type 2 diabetes.

It’s always best to get nutritional advice from a registered dietitian. The guide below provides some general dietary guidelines to help manage diabetes.

Suitable food choices for people with diabetes

It’s difficult to state recommendations for an exact number of grams of nutrients, such as carbohydrates, a person with diabetes should eat.

A glucometer with fruit, vegetables, and grains.
Fresh fruits, vegetables, and whole grains are good choices for people with diabetes.

According to dietary guidelines released by the American Diabetic Association (ADA), there is no conclusive evidence supporting an ideal amount of carbohydrates or other nutrients for people with diabetes.

Instead, an emphasis is placed on choosing healthy foods, including:

Complex carbohydrates

Complex carbohydrates differ from simple carbohydrates. Complex carbohydrates are broken down slowly. They also often contain fiber, and they do not affect blood sugar levels as significantly as simple carbohydrates.

Foods containing complex carbohydrates include:

  • Beans
  • Peas
  • Whole grains
  • Vegetables
  • Fruits
  • Sweet potatoes

Lean protein

The ADA guidelines do not provide a specific protein intake recommendation for blood sugar control. Again, the focus is on healthy choices.

People with diabetes should keep in mind that some sources of protein can be high in fat, which can contribute to weight gain.

The ADA recommend lean sources of protein including:

  • Fish (herring, sardines, salmon, tuna)
  • Eggs
  • Chicken
  • Nuts (cashews, peanuts, soy nuts)
  • Lentils

Healthy fats

Fat is an essential nutrient. Certain types of fat, such as monounsaturated and polyunsaturated fat are considered healthy fats. More important than the quantity of fat is the type of fat eaten, however.

Suitable fat choices include:

  • Sesame seeds
  • Olive oil
  • Avocados
  • Nuts
  • Flaxseed

Unsuitable food choices for people with diabetes

People with diabetes should also be aware of food choices that can cause spikes in blood sugar and contribute to being overweight. When choosing foods, it’s helpful to limit those listed below.

A selection of foods that are bad for people with diabetes.
People with diabetes should limit refined carbohydrates and foods containing hidden sugars.

Refined carbohydrates

Refined carbohydrates may include foods containing processed sugar or refined grains. Most refined carbohydrates have their fiber removed and have limited nutritional value. They also lead to rapid spikes in blood sugar levels.

Refined carbohydrates to be limited include:

  • White bread
  • White rice
  • Cookies
  • Pastries
  • Cereal with added sugar

Trans fat and saturated fat

Excessive amounts of saturated fats and any amount of trans fats are unhealthy for everyone. They can raise “bad” cholesterol and contribute to heart disease.

Foods that are high in trans fat and saturated fat include:

  • Fried food
  • Chips
  • Commercially baked cookies and cakes
  • Vegetable shortening
  • Food containing partially hydrogenated oil

Hidden sugar

People with diabetes should also be aware of foods with hidden sugar. Some foods may look healthy but have a high sugar content on closer inspection.

Always check food labels to determine the sugar and carbohydrate content.

Foods that often contain hidden sugar include:

  • Yogurt
  • Granola
  • Canned fruit packed in syrup
  • Canned pasta sauce
  • Frozen dinners
  • Bottled condiments

Daily and weekly menu planning tips

People with diabetes may benefit from daily and weekly meal planning. Meal planning can help someone choose foods that keep glucose levels steady and help them maintain a healthy weight. Meal planning should also include keeping track of what is eaten.

There are three main ways for people to track what they eat: carbohydrate counting, glycemic index, and the plate method.

Plate method: Divide the plate into three categories. Half the plate should consist of non-starchy vegetables. One-fourth should consist of whole grains and complex starchy food. The remaining fourth of the plate should contain lean protein.

Carb counting: Carbohydrate counting involves planning how many grams of carbohydrates are eaten with each meal and snack.

Glycemic index: The glycemic index categorizes food by how much it increases blood sugar. Foods that have a high glycemic index raise blood sugar more than foods with a low glycemic index. Meal planning using the glycemic index involves choosing foods that are low or medium on the glycemic index.

Whether planning daily or weekly menus, it’s also important for people with diabetes to keep the following in mind:

  • Eating at regularly set times
  • Avoiding skipping meals as it can affect blood sugar levels
  • Spacing meals and snacks out to prevent large changes in blood sugar levels
  • Eating a wide range of foods
  • Thinking about the size of servings
  • Avoiding carbohydrate-only meals that can cause higher blood sugar spikes