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Using the Diabetes Food Pyramid

The Diabetes Food Pyramid has six sections for food groups.  These sections vary in size.  The largest group -- grains, beans, and starchy vegetables -- is on the bottom.  This means that you should eat more servings of grains, beans, and starchy vegetables than of any of the other foods.  The smallest group -- fats, sweets, and alcohol -- is at the top of the pyramid.  This tells you to eat very few servings from these food groups.

Eat servings from all the food groups other than the fats, sweets, and alcohol, every day.  Eat the recommended number of servings on the pyramid within each food group.  The exact number of servings you need depends on your diabetes goals, calorie and nutrition needs, your lifestyle, and the foods you like to eat.  Divide the number of servings you should eat among the meals and snacks you eat each day.  The Diabetes Food Pyramid makes it easier to remember what to eat.  For a healthy meal plan that is based on your individual needs, you should work with a registered dietitian (RD) with expertise in diabetes management.  To find an RD with diabetes expertise, read the section below titled For More Help and Support.

The First Step

For most people, a great first step to healthier eating habits is to make a few simple changes.  Perhaps you decide to eat more fruits and vegetables and to go lighter on the meats and sweets.  If you make these changes and stick to them, pat yourself on the back.  Before you make more changes, make sure you maintain the ones you have made. When you are ready, decide on the next change.  Keep it easy to accomplish.

As you continue to change your eating habits to manage your diabetes, the diabetes food pyramid can help you and your whole family eat healthier.  Here are some more healthy eating tips:

  • Eat a wide variety of foods every day.  Try new foods.  Eating a wide variety of foods, even from the same food group, helps you get all the nutrients to be in good health.  For example, within the fruit group, bananas are a good source of potassium and oranges are a good source of vitamin C.

  • Be physically active every day.   Try to accumulate 30 minutes of physical activity each day.  Start slowly, by taking the stairs and walking more, or doing more yardwork. 

  • Eat high-fiber foods such as fruits, vegetables, whole grains and beans.   These are the foods you should primarily eat.  They provide lots of vitamins, minerals, and fiber, yet they provide the least concentrated sources of calories.

  • Use less added fat.   It is well known that eating many foods that are high in fat, particularly ones with too much saturated fat and dietary cholesterol, can contribute to the development of clogged and narrowed arteries.  This can lead to heart disease and people with diabetes are at an even greater risk for developing heart disease.

  • Use less added sugar.   Sugary foods, like jelly beans and regular soft drinks, and sweets, like ice cream and cookies, are not healthy for anyone.  They provide a bunch of calories with little or no nutrients. Yet sugary foods and sweets are enjoyable to eat.  Strike a balance -- practice moderation.

  • Use less added salt and sodium.   Americans eat more salt and sodium than they need. Most of the sodium we eat comes from processed foods like cold cuts, prepared foods, canned soups, and pickles.  To keep your salt and sodium intake moderate, shake the salt shaker lightly and use more fresh and unprocessed foods.

  • If you choose to drink alcohol, limit the amount and drink it with food.   Check with your health care professional about an amount that's safe for you.

Next Step ... Learn More

Starches and Diabetes

Eat more starches!  It is healthiest for everyone to eat more whole grains, beans, and starchy vegetables such as peas, corn, potatoes and winter squash.  Starches are good for you because they have very little fat, saturated fat, or cholesterol.   

Vegetables and Diabetes

When it comes to vegetables, people with diabetes should eat at least three servings a day.  Vegetables are healthy, chock full of vitamins and minerals, and some give you much needed fiber.  The best part: vegetables are naturally low in calories.  

Questions about fruit keep coming up.  Will fruit juice increase blood glucose levels more quickly than a piece of fruit?  Should you avoid fruit in the morning because your blood glucose might be higher than at other times in the day?  Is it better to eat fruit with meals rather than snacks?

People with diabetes are at the same risk for osteoporosis as the general public.  Fat-free (skim) and low-fat (1%) milk and yogurt will provide the calcium you need without saturated fat and cholesterol.  

Protein (Meat, Poultry, Seafood, Cheese, Eggs, Etc.) and Diabetes

People with diabetes have no less or more need for protein than the general public.  The American Diabetes Association nutrition guidelines suggest eating between 10 and 20% of your calories as protein.  The Recommended Daily Allowance (RDA) for protein is 0.8 grams per kilogram of body weight.

Fat and Diabetes

Fat ought to make up about 30% of your calories. The total amount of fat you eat should be based on the foods you like and your goals for eating healthy and blood lipid (blood fats) and glucose control.  You need an individualized meal plan. 

Sugar and Diabetes

Research studies show that, gram for gram, sugars, like table sugar, do not raise blood glucose any more quickly than do other carbohydrates, like potatoes, rice or pasta.  This research holds true for people with type 1 and type 2 diabetes.

Alcohol and Diabetes

Beyond all the health and safety concerns about alcohol, if you have diabetes and are on diabetes medications that lower blood glucose, you need to practice caution.  The action of insulin and some diabetes pills, sulfonylureas and meglitinides (Prandin), is to lower blood glucose by making more insulin.  So, you should not drink when your blood glucose is low or when your stomach is empty.

For More Help and Support

To find out exactly how much of what types of foods you should eat, we suggest you work with a registered dietitian (RD) who has experience working with people who have diabetes. This person can help support your efforts to change your eating habits and control your blood glucose level. To find a registered dietitian near you:

1. Locate the names of American Diabetes Association Recognized Diabetes Education Programs in your area or call 1-800-DIABETES (1-800-342-2383).

2. Call The American Dietetic Association at 1-800-366-1655. Ask for the names of dietitians in your area that specialize in diabetes.

3. Call the American Association of Diabetes Educators, at 1-800-TEAM-UP4 (1-800-832-6874).  Ask for the names of several diabetes educators in your zip code.

Taken from the August 1999 issue of Diabetes Forecast.  Written by Hope S. Warshaw, MMSc, RD, CDE, a nationally recognized expert on healthy eating and diabetes.  


Diabetes Meal Planning Made Easy, 2nd Edition Put the food pyramid to work for your busy lifestyle. Diabetes Meal Planning Made Easy helps you learn about the new diabetes nutrition recommendations and master the intricacies of each food group in the new pyramid. You'll learn how much of what foods to eat to fit your personal nutrition needs.
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