September 2010 Issue

Diabetes-Friendly Snacking Options
By Lenora Dannelke
Today’s Dietitian
Vol. 12 No. 9 P. 12

Grabbing a quick bite between meals isn’t off-limits for people with diabetes. “Snacking can really contribute to a healthy diet. It ensures that our body gets the fuel that it needs regularly throughout the day—and that’s true for everybody, diabetes or not,” says Beverley Manganelli, RD, BS, CDE, manager of community nutrition services at Hunterdon Medical Center in Flemington, N.J. “What’s different for someone with diabetes is, obviously, what kind of medications they’re on and their blood sugar control. Snacking can definitely impact that, so you need to pay a little more attention to the things that you choose. Although there are no ‘never’ foods, you do want to get a nutritious bang for your buck.”

Because carbohydrate is the nutrient that impacts blood sugar the most, monitoring intake is crucial. “Generally, snacks can be between 15 and 30 g [of carbohydrate], but that’s based on individual needs and what that patient works out with their registered dietitian,” says Manganelli. Caloric intake needs to be addressed as well, especially since many people with type 2 diabetes need to lose weight. However, a patient already at a good weight who works at an active job may need more carbohydrates.

Older patients with long-standing diabetes often struggle with the idea that they can work sugar into their food plan. “They’re used to the old way of thinking,” says Lindsay Fortman, RD, CDE, of Memorial Healthcare’s Diabetes & Outpatient Nutrition Counseling Center in Owosso, Mich. “But with being allowed to eat anything—it’s portion size that matters—we are seeing better compliance.”

Time It Right
Grazing throughout the day, however, may negatively impact blood sugar. Constantly taking in carbohydrates and extra calories can result in consistently high blood sugar, which leads to weight gain—and that also affects blood sugar. “For that reason, having a scheduled snack time may be good for diabetics,” Manganelli says. “If they’re eating a midmorning snack, they may need to take a prelunch blood sugar to see what it’s doing.” The same applies to midafternoon snacks and dinner. “That way, they have a big picture of their blood sugar throughout the day,” she says. The goal is pattern management that requires less-frequent checking.

While most dieters seeking to lose weight avoid evening snacks, people with diabetes may benefit from eating after dinner. “Usually we encourage a bedtime snack to keep the liver from pumping out stored glucose,” Fortman says. “Typically, patients will have a better glucose reading in the morning if they get in a 1- to 2-carb-choice snack at night.”

Satisfy Cravings

Fiber and Whole Grains
“I’m a huge fiber advocate,” says Fortman. “Not only is fiber great for satiety, but there are a lot of studies recently that show that fiber is good for preventing cardiovascular disease and lowering cholesterol and that it regulates the grehlin level, which is a hormone that stimulates hunger. And, especially important to diabetics, fiber is a form of carb, but it’s not completely broken down into glucose like the starches in sugars.”

Patients should look for whole-wheat products, such as EarthGrains Thin Buns. “Those are not as heavy and dense as some whole-wheat breads. That makes them a good choice for patients who like ‘the good old white bread,’” says Fortman. A moderate amount of natural peanut butter, which is low in sodium and free of trans fats, makes an excellent topping for these 100-calorie buns. For variety, snackers can switch to almond butter or SunButter, a spread made from sunflower seeds.

Whole grain crackers are also a good option. However, since sitting down with a box may lead to overindulgence, patients should measure servings into snack bags, a cost-effective alternative to commercial packs.

Quinoa, barley, brown rice, or whole-wheat couscous prepared in a salad offers a tasty alternative to pasta salad.

Protein Power
“You might want to insert a lean protein in your snack to make it more satisfying, and that can hold you over better,” says Manganelli, who recommends higher-protein Greek yogurt, which is becoming more popular and widely available. Snackers who tend toward the savory can season the plain variety with a flavoring such as curry powder, then use it as a dip for raw, nonstarchy vegetables such as carrots, celery, and broccoli. Dippers can also indulge in hummus or whip up some homemade black bean salsa, which will be fresher and perhaps more healthful and contain less sodium than commercial varieties.

As another option, 1 oz of low-fat cheese or lean meat can be combined with a carbohydrate choice for a healthful snack. “A common misconception among patients is that if they eat a food that only has protein, that will help their glucose level. In fact, it has very little effect,” Fortman says. “I’ve had lots of patients who have been on [the] Atkins Diet … who think they’re doing a good job by eating things like pork rinds. But it doesn’t help their glucose level at all.”

Berry Good Options
People should choose fruits with a higher fiber content, such as fresh berries. “You can have a little more of those as a carb choice,” says Fortman. “For example, you could eat a whole cup of raspberries, blueberries, and strawberries vs. half a banana.”

Apples are a portable fruit with plenty of fiber. And mixing fruit and Greek yogurt into a smoothie turns healthful choices into a fun, flavorful snack.

Chocolate Choices
When it comes to chocolate, Fortman says, “The darker, the better because it’s going to have more flavonols, which is an antioxidant that has been shown to prevent cardiovascular disease and certain types of cancers.”

A growing variety of high-quality dark chocolates provides a spectrum of gourmet tastes to savor.

Customized Snacking
Patients working with a certified diabetes educator can put together an individualized eating plan that stabilizes their blood sugar level without making them feel deprived.

“If there is a patient with an Indian background or a Hispanic background, we have educational materials that provide the carbohydrate counts of foods they would normally eat,” says Manganelli. “We work very hard to meet those needs. But everybody has different preferences, so a big part of instruction time is finding out what they like and how it fits into a meal plan. We always have to be creative. People leave the office pleasantly surprised at what they can do.”

Reputable online resources for patients who want to be hands-on in exploring nutritious snack options include www.eatright.org and www.diabetes.org. The fee-based website CalorieKing.com also has an extensive, searchable database of foods and nutritional content. iPhone users can get carb-count information on the go because, yes, there’s an app for that.

— Lenora Dannelke, a freelance writer based in Allentown, Pa., covers food and travel for numerous publications.