Fighting For a Food Philosophy: What Should I Eat?
by kerri morrone sparling
"What should I eat?"
This is a question that just tumbles out of the mouths of people with diabetes. Managing diabetes is a constant quest to balance blood sugars against food, leaving us always wondering. “Will that meal make me high?” “Will that food affect my blood sugars the same way it did last time?” “What should I eat?”
With a couple decades of diabetes under my belt, I’ve attempted my share of food management tools. I’ve used the little food scales and pocket-sized measuring cups. I have tried to log every morsel I consume. And I’ve also tried some structured diets provided by my dietician at Joslin (only to become bored within a week or so and then return to my old habits).
Checking out the recommendations made by health organizations doesn’t help much, either. Different diabetes sources change their views on food with the tides of studies and newswire releases. Coffee is good! Don’t drink coffee! Eat less meat! Get enough iron! Don’t eat any carbs! Have some whole wheat bread! Drink milk! Avoid dairy! Watch out for peanut butter! Get more omega-3s!
Once your head stops spinning, you realize you’re eating nothing but sugar-free popsicles and cat food.
It became clear that it wasn’t a “diabetes diet” that I needed, but more of a food philosophy. I needed a mindset that didn’t feel so constraining (like the word “diet”), and I sure as hell didn’t want another restriction in my life. After a few months of careful thought, some experimentation, and a realistic assessment of my expectations, I developed my food philosophy. “The Philosophy,” my husband and I say jokingly, imagining the sound of a sonorous GONG! after the words are uttered. (We take our foolishness very seriously in my home.)
ingredients of a food philosophy
The Philosophy (gong) is that a lower carbohydrate, higher protein diet is what works best to keep my blood sugars under control. It seems that eating healthily, and taking (or attempting to properly calculate) the right amount of insulin to cover what I’m consuming, is the key to managing my numbers- and not constantly berating myself for any perceived “slip ups.” But aside from the insulin factor, my husband and I share a very similar diet, eating low-carb, high protein, and plenty of vegetables. It’s easier to follow a food philosophy when you have in-house support – that support can make all the willpower difference. Our collective family philosophy is that eating healthy is good for everyone, not just people with diabetes. And eventually, this mindset becomes a way of life.
I don’t generally eat a lot of carb-dense food, but if I’m going for broke and diving into a bowl of pasta, I try to picture the portion sizes in my head. Whenever I see a nutritionist, I ask for a refresher on what a “real” portion size looks like, because it’s easy to forget (or embellish)! Sometimes, when I’m cooking at home, I measure my food and take careful note visually of the serving size. That helps me better estimate portions when I’m at a restaurant.
I also don’t incorporate many of the “diabetic” foods into my diet. Thanks to the constant stream of information from our food editor at work, I’m leaning towards the perception that making things “low-carb” and “low-fat” removes the carbs and fat but replaces them with chemical substances. I’m doing my best to make as many organic choices as possible. I use sugar substitutes (i.e. Splenda, Equal, Stevia, ZSweet) in my coffee, but I try to use them in moderation and I opt for the organic ones when I can. (I do chew sugar-free gum, though. Some habits are hard to break, even for the sake of The Philosophy!)
But it’s not like I’m sitting around chewing on organic tree root and drinking filtered water. I eat. A lot. I am ridiculously snacky, often found munching on fresh green beans, apples, almonds, walnuts, cheese sticks, and Greek yogurt. For dessert? Oh, sugar-free Jell-O, angel food cake, or berries with cool whip. But sometimes a cup of coffee is a good stand-in for a dessert. Either way, every few hours I’m eating, and it’s usually something reasonably healthy.
getting through tough patches
But there are definitely days when following The Philosophy (gong) isn’t so easy. Thankfully, I have some tools at my disposal to help navigate moments when I’m splurging a little. Back in the days of NPH and Regular insulin, I avoided foods like pasta sauce, pizza, and high-sugar items because insulin just couldn’t keep up with those kinds of carby demands. The absorptions and peaks of those insulins weren’t as predictable as today’s Humalog and Novolog, so my diet was more scheduled and strict than it is now. Today, using my insulin pump and a cartridge of rapid-acting insulin, I’m able to better-manage those “forbidden foods.” Eating high-carb foods like pasta and pizza on Saturdays (a strategy used by my husband and one that I follow) helps me keep my carb indulgences to a minimum, knowing that I can satisfy my cravings on the weekend. And when I do find my face in a bowl of pasta (awesome), I make use of the square-wave bolus on my MiniMed pump. But there are also moments of serious splurging, and at those times, you just have to eat the (three) brownie(s) and deal with the aftermath. If these splurges are few and far between, things are still manageable.
The most frustrating thing about food is that certain foods affect me one way on one day, then completely differently on another. It’s downright maddening. But it helps to have those handy, aforementioned management tools (i.e. glucose meter, fast-acting carbs or insulin, and a CGM) to deal with these moments. It also helps to have friends and family who “get it.” And when all else fails, it’s good to just let out a nice, loud “AARGH!”
Everyone’s method of managing diabetes is different – there is no definitive “right” or “wrong” way to do it. Diabetes is a uniquely and individually managed condition, so your answer to “What should I eat?” may be different from another person with diabetes. The best way to view this food conundrum is not as a diet, but as a lifestyle. Think about what works best for your life, talk to your doctors, and work toward developing your own Philosophy.