Archive for February, 2011

I am a Nutrition Editor at, a website designed to help people with diabetes.  Here is a question I recently received:


I love cereal and with my new diagnosis of type 2 diabetes, I’m wondering if I can still have cereal in my diet.  Are there any types to avoid?”


People with diabetes can have cereal.  Of course you will want to factor it in to your total carbohydrate allotment for each meal as you would with any carbohydrate.  If you are looking to compare cereals to find out how to get the most nutrients, fiber, and protein jam packed into one serving, then read on for some tips…

How To Choose The Right Cereal:

  1. Carbohydrate:  Look at the carbohydrate breakdown and then look at the ingredient list.  If there is a high amount of sugar and then in the ingredient list you see “high fructose corn syrup” – put the box down and run away as fast as you can.  In general, the first ingredient should be whole grain or whole oat flour or something with the word “whole” in it.  This usually helps bring the “sugar” content down and the good “slow-digesting” carbohydrate level up.  Try to look for cereals with the lowest amount of sugar (about 5 grams or less).
  2. Fiber: Look for cereals that have at least 3 grams of fiber, preferably 5 or more grams.
  3. Protein: It is usually a good idea to get a protein source at every meal.  Look for cereals with a higher amount of protein.  Kashi Go Lean Crunch cereal has 9 grams of protein (which is a lot more than most cereals).  If the cereal you purchase contains a low amount of protein – try adding a few slivered almonds or a teaspoon or two of almond butter (or peanut butter) for a little protein boost.
  4. Serving Size: Check the serving size – especially when counting carbohydrates. If the serving size is ½ cup (and equivalent to 30g) of carbohydrates and you consume 1 cup, be sure to do the math and note that you are consuming 60g of carbohydrate.  Also, if you are having milk with your cereal, factor in the carbohydrates from that too (1 cup skim milk = 12 grams of carbohydrate).   Work with your Diabetes Educator or a Registered Dietitian to go over carbohydrate counting.

Finding the “perfect” cereal may take some time at first.  Now that you have some tools on how to read cereal labels, you can take some time in the cereal aisle to find a good selection for you.  I have been reading cereal labels for quite a few years now and I always find that Kashi brand cereals work best for me.  If you find others that you like, let us know by posting a comment here.  Another option is to try hot cooked cereal such as oatmeal or barley.  I like to use quinoa flakes because they cook in only 90 seconds.  I flavor it with cinnamon and a handful of nuts or a teaspoon of nut butter.  You may also want to check your blood sugar after eating the cereal and determine which is best for you by looking at your numbers to see if they are at an acceptable level.

Thank you for the question and please keep us posted on what cereal works for you.


I am a Nutrition Editor at, a website designed to help people with diabetes.  Here is a question I recently received:


I have diabetes and am wondering about whether stevia is safe for me to use.  Could you let me know which sweeteners will not have an effect on my blood sugar and if stevia is ok for me to use?”


OK, I have been looking through scientific research for stevia and artificial sweeteners and there is good and bad news.  The good news is that I have not found studies that report any side effects or spikes in blood sugar from consuming artificial sweeteners.  The bad news is that the studies were small and may not have been of the highest quality (and sometimes the subjects did not even have diabetes).

Yes the FDA has approved the use of some non-nutritive sweeteners and they are considered to be safe.  However, it is possible that side effects could appear after their studies were done.

I would say if you use artificial sweeteners, then check your blood sugar to get an idea if it is having an effect on you.  Also, be aware of how many different types of foods artificial sweeteners can be found in.  Here is a short list of foods (there are many more):

Aspartame – a.k.a  Equal, NutraSweet Diet Coke, Dannon Light Yogurt, Swiss
Miss Fat Free Hot Cocoa Mix, and BreathSavers.
Acesulfame-K – a.k.a  acesulfame potassium, Sunette, Sweet One, Sweet ‘n Safe Acesulfame-K is found in about 4,000 foods, including chewing gum, desserts, alcoholic beverages, syrups, candies, sauces, and yogurt. In the US it is found in Hershey’s Lite Syrup and Fat Free Dutch Chocolate Hot Cocoa, Trident gum and sugar free Jell-O.
Saccharin – a.k.a  Sweet’N Low, Sugar Twin It is found in non-food products such as Listerine, Crest Toothpaste, Robitussin cough syrup, and Carefree chewing gum. It is also in salad dressing, jam, jelly, preserves and baked goods.
Sucralose – a.k.a. Splenda Sucralose is available in tabletop sweeteners (one well-known brand is Splenda®) and also as an ingredient in many products, including a variety of beverages, baked goods, desserts, dairy products, canned fruits, syrups and condiments
Stevia – a.k.a. Truvia, SweetLeaf Stevia is over 100  times sweeter than sugar – a little goes a long way.  It can be found in: Sprite Green, a range of teas produced by Celestial Seasonings, Sobe Lifewater produced by Pepsi.

So looking at the above list a person could potentially have an artificial sweetener at every meal.  For example:

Breakfast:  syrup on pancakes, coffee with Splenda, or an artificial sweetener on oatmeal

Snack:  chewing gum throughout the day

Lunch:  condiments on a sandwich, or diet soda

Snack:  sugar-free jello, gum, or  BreathSavers

Dinner:  salad dressing

Snack:  Dannon Light Yogurt

As you can see, the artificial sweetener consumption can add up quickly.  A suggestion might be to write down the foods you eat for one day and see how many times a day you are consuming artificial sweeteners.  If you are consuming it at many of your meals, try to consider making a change.  For example, if you are using a salad dressing with artificial sweeteners, consider using freshly squeezed lemon or oil/vinegar as a substitute.  If your breakfast contains artificial sweeteners in your coffee AND oatmeal, try taking the sweetener out of one item.  For example, put the sweetener in your coffee and add flavor to the oatmeal with cinnamon.

What Is Stevia?: Stevia is a plant that is native to South America.  It is probably best known as a source of natural sweeteners.  In foods, stevia is used as a non-caloric sweetener and flavor enhancer. Stevia was originally available as a “dietary supplement” in the U.S. It wasn’t allowed as a “food additive” until 2008. That’s when the federal Food and Drug Administration (FDA) granted Generally Recognized as Safe (GRAS) status to rebaudioside A, one of the chemicals in stevia that makes it sweet.  Some developing research suggests that some of the chemicals contained in stevia might lower blood sugar levels and could interfere with blood sugar control.  However, other research disagrees.  If you have diabetes and take stevia or any of the sweeteners it contains, monitor your blood sugar closely and report your findings to your healthcare provider.

Can You Get Something For Nothing? Remember, there is a cost for everything we put in our bodies.  We see calorie- and sugar-free sweeteners and believe that there isn’t a cost, but maybe there is. We cannot ingest unlimited amounts of these artificial sweeteners  – they may add calories in excessive quantities or they may cause digestive issues (anybody ever get diarrhea from chewing an excessive amount of sugar-free gum, perhaps it was the artificial sweetener…).

You probably get the hint by now, the answer is:  use artificial sweeteners in moderation, keep track of your blood sugars when using them, be conscious of how many foods you consume contain these additives, and do not believe everything these companies tell you about their product (remember, their number one goal is to get you to buy their product and make some money).

Thank you for the question.

I am a Nutrition Editor at, a website designed to help people with diabetes.  Here is a question I recently received:


I found out I have pre-diabetes.  I’m very confused and don’t know what I should do to treat it.  My friend told me to avoid all fruits.  Could you help me with how to treat my new diagnosis and if it’s ok to eat fruit?”


Pre-diabetes is where blood sugar levels are elevated, but aren’t high enough to be called type 2 diabetes.  The good news is that people with pre-diabetes don’t necessarily go on to develop diabetes IF appropriate lifestyle changes are made. 

If you want to avoid future type 2 diabetes, what’s the best way to treat pre-diabetes…

How Important is Diet?  It should come as no surprise that diet plays an important role in treating pre-diabetes.  Diet not only contributes to obesity, one of the greatest risk factors for type 2 diabetes, but it also directly affects blood sugar levels.  Dietary changes are necessary to avoiding type 2 diabetes. 

What’s the Best Diet to Eat With Pre-diabetes?  People with pre-diabetes have some degree of insulin resistance which makes it more difficult for them to process carbohydrates.  Because of this, fast-digesting carbohydrates such as potatoes, white rice, and white bread should be replaced with slow-digesting carbohydrates such as fiber-rich whole grain breads, brown rice, whole grain cereals, and vegetables.  These foods are not only nutritionally rich but have less effect on insulin and blood sugar levels than do their starchier counterparts (still need to watch portion sizes).  It is also important to limit the number of sugar or honey sweetened desserts, particularly ones that are high in fat.  Not only do sweet, fatty foods add calories, they can cause rapid rises in blood sugar, further stressing the already troubled pancreas.  For protein, try lean protein from animal sources such as broiled fresh fish, baked chicken, and turkey.  Vegetarian sources of protein will also help to cut down on fat and calories.  Vegetarian proteins include: tempeh, tofu, beans and lentils, and seitan (no, it’s not the devil, it’s wheat gluten and it’s high in protein).  There are so many vegetarian sources on the internet these days that can provide tasty recipes for vegetarian protein sources. (I like, but you may want to search around for others).  Drink nonfat dairy and lots of water.  Avoid sodas and beverages loaded with sugar. Do not eat any trans fats (trans fats are usually found in fried foods).

What About Fruits?  Fruit is healthy because it contains fiber and lots of vitamins, antioxidants and minerals. However, fruits also contain carbohydrates, which mean that your insulin requirement will be increased. For a person at risk of pre-diabetes turning into type 2 diabetes, the goal is to keep insulin requirements as low as possible. Because fruit contains essential carbohydrates, it needs to be included in your meal plan. Talk with a dietitian about a meal plan that works for you with the proper amount of fruit.   A good idea is to replace fruit juice with fresh fruit (up to 3 servings per day).

What About Physical Activity?  Of course, you’ll want to combine these dietary changes with thirty to forty minutes of aerobic activity at least five times a week.   Choose an activity you enjoy and don’t be afraid to vary your routine to prevent boredom.   Take a brisk daily walk.   Ride your bike. Swim laps.   If you can’t fit in a long workout, break it up into smaller sessions spread throughout the day.

What About My Weight?  Extra bodyfat contributes to “insulin resistance” and pre-diabetes. If you’re overweight, losing just 5 to 10 percent of your body weight — only 10 to 20 pounds (4.5 to 9 kilograms) if you weigh 200 pounds (91 kilograms) — can reduce the risk of developing type 2 diabetes. To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits. Motivate yourself by remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem.  Look for areas in which you can cut your calorie intake by 250 to 500 calories per day.  For example, you can:

  • Reduce your portion sizes.
  • Reduce your intake of high carbohydrate foods such as cookies, other desserts, bread, pasta, tortillas, rice, crackers, pretzels and chips.
  • Choose calorie-free beverages in place of regular sodas, fruit juices, lemonade, smoothies, sweetened coffee and tea drinks, and alcohol.
  • Choose low-calorie dressings or use regular salad dressing sparingly.
  • Limit nuts to a small handful (1/4 cup or less) per day.


Regularly getting a good night of sleep may reduce insulin resistance, try to get at least six hours or more of sleep each night.  These simple lifestyle changes may be all you need to prevent Pre-diabetes from progressing to diabetes. Don’t forget to visit your doctor every six months for blood work to follow your blood sugar levels.

Thank you for the question.  It is great that you have invested in yourself and are asking the right questions to make great changes!

Pizza and Diabetes

Posted: February 6, 2011 by amygilman in Nutrition Q & Amy

I am a Nutrition Editor at, a website designed to help people with diabetes.  Here is a question I recently received:


Friday nights my family & I have dinner at our favorite pizza restaurant.  Now that I’ve been diagnosed with diabetes I don’t know what to order.  Could you help me with what (if anything) I can order?”


Great question!  Pizza can be a tricky meal because those slices can go down so quickly and before you know it, we have consumed half the pie!  Keep in mind that ONE slice of pizza has about 2.5 servings/exchanges of carbohydrates (plus one medium fat and one fat) for a thin crust, cheese pizza.  Some people with diabetes count their carbohydrates (carbs) and may have an allotted 4 servings/exchanges of carbs for dinner, for example.  If this person ate two slices of pizza, they would not only be over their allotted carb amount for that meal (2 slices = 5 carb exchanges), but they would also have a high amount of fat for one meal and no vegetable intake (assuming it’s a cheese pizza).

I have some tips to allow you to enjoy your special night with the family, while staying in the carb allotment and getting vegetables in.  Stick to one slice of pizza and eat it slowly.  Use a knife and fork if that will help you eat it slower.  Many pizza places have side dishes such as a garden salad or a steamed vegetable such as broccoli.  I suggest getting both of these to help fill you up.  Ask for the salad dressing on the side to control the amount of added calories and fat that you consume.  If the pizza place that you go to does not offer the suggested sides, try bringing your own vegetables such as baby carrots.  I have done this before.  I have even packed a salad in a Tupperware container and a fruit such as a pear (or any fruit of choice).  Drinking plenty of water during the meal will help fill you up as well.

Cheers to you having healthy Friday night dinners and quality time with the family!  Thank you for the question.