Sunday, June 30, 2013

Is Fruit a Good Snack for a Person With Diabetes?

Hi Laurie. I really liked your response to the January 2013 post on pre-diabetes and wanted to ask a similar question. I'm prediabetic, I've had both the tests you mentioned (fasting blood glucose and Hemoglobin A1C) and they came back indicating I was at a prediabetic stage. I met with a diabetic nurse, but she didn't really give me any helpful advice that pertained to me and my eating habits. I'm very slim and I love to exercise. I also eat pretty healthy (75% of the time), but I have a big sweet tooth. I've cut out things like banana chips, honey cashew/peanuts and desserts at restaurants. But I love to eat fruit and that's my preferred snack between meals. Is this still okay even though it's pure carbs? I tried to snack on vegetables, but I just don't enjoy it at all. Thank you, Lisa (link from I'm Trying to Prevent Diabetes)

Hi Lisa,
I'm glad to hear you are being so proactive with this condition. It can save you so many health problems down the road!

Your number one priority would be to get a prescription from your doctor to meet with a Registered Dietitian. Most hospitals have out-patient dietitians, or you may find one in private practice in your area through the Academy of Nutrition and Dietetics (AND) or other dietitian directories (https://www.eatright.org/programs/rdfinder)
Ideally you will be given a specific calorie level to meet your needs, and then the dietitian will determine the number of carbohydrates to include daily, and help design a meal plan with you to spread the carb servings over the day.
For example, in an 1800-calorie meal plan, there would be about 225 grams of carbohydrate per day (about 15 'servings'). A meal plan would be set up to choose 4 "carbs" at breakfast, for instance, such as 3/4 cup cereal flakes, 1 cup skim milk, 1 slice of whole wheat toast and 1/2 banana, and then a certain number of carbs at each other meal and snack to total 15.
A serving of fruit would count as one carb serving, just like a slice of bread would, or a serving of pasta or a handful of mini-pretzels. 
A couple of points to note here-- the fruit is likely going to add some essential nutrients like vitamins, minerals and fiber that other foods (like pretzels) won't, so it may be considered a healthier choice. However, each individual reacts differently to a variety of carbohydrate sources. So you could find that eating 10 cherries causes your blood sugar to spike; or maybe grapes do but bananas don't. Some people find that watermelon raises their blood sugar but ice cream doesn't! So it's extremely individualistic to note the reactions of various foods on blood glucose levels (despite glycemic index numbers).
It would take a period of checking your blood sugar at home in a variety of situations to figure out what snacks are better for you, personally.
Another point is that when a person eats carbs alone (like fruit or pretzels) the glucose level is likely to rise more quickly. Including a protein or fat source along with a piece of fruit (like cheese, peanut butter, or nuts) may blunt that reaction.
Bottom line--fruits are good for you in many ways, but no one has a "free" license to eat fruit with abandon. They contain carbohydrates and calories, and must be taken with moderation just like anything else.