News and insights brought to you by the International Diabetes Federation

Mother and child eating breakfast

One of the biggest concerns of people recently diagnosed with diabetes is related to food. More specifically, concerns about what is, or what is not “allowed” to be eaten. Diabetes food and nutrition guidance is often given from all sides: family, acquaintances, media and even health professionals, but in many cases this direct advice is incorrect or misinformed.

It might surprise people to learn that diabetes nutrition is not complicated. The foods recommended for people living with diabetes does not differ remarkably from foods recommended for the general population. A healthy and balanced diet, described in dietary guidelines, is the same that is recommended for diabetes metabolic control.

Nevertheless, there are some challenges. Today’s food systems are failing to facilitate the adoption of healthy eating patterns by most individuals. The increased availability of ultra-processed foods, combined with strong, intensive and alluring marketing strategies to advertise them, represent an enormous barrier to the adoption of healthy eating habits.

For example, many giant food industries have launched aggressive marketing campaigns to penetrate consumer bases in emerging economies such as China, India, Brazil and Mexico. These campaigns are so successful that the consumption patterns of the population have changed drastically, moving towards an alarmingly increased diet of nutrient-poor processed foods.1

Besides the heavy and sometimes unethical advertisement strategies, the composition of high processed foods is meticulously studied to increase its consumption through addiction. Ultra-processed products are engineered to be “hyper palatable”. Those properties derive from the main ingredients used: salt, sugar, fat, flavour and other additives. According to Michael Moss, in his acclaimed book: “Salt, Sugar, Fat: How the food giants hooked us”, the food industry employs brain imaging and other advanced sophisticated neurological assessment tools to study the impact of fat, sugar and salt on the pleasure centre in the brain. Food science research has shown that the combinations of those three ingredients can stimulate neural circuits similar to those that are stimulated in cases of drug addiction.2,3

The increased focus on processed food manufacturing also contributes to displace core foods, and threatens nutritional biodiversity. Industrialised food systems have created monocultures, or very large farms that produce one or a few crops as raw materials for the manufacture of ultra-processed foods such as wheat, maize, sugar, palm oil, and corn, used to produce high fructose corn syrup. The cultivation of a few crops in massive amounts occurs at the expense of decreasing local, traditional, and nutritious crops. For instance, between 1963 and 2003, a decline in production was seen for pulses (beans, peas, and chickpeas), and roots and tubers (including cassava, sweet potatoes, yams, taro and plantain).1

For all these reasons, much food production is now divorced from its primary purpose of providing the nutrients that sustain human life in good health.4 Moreover, it becomes clear that adopting a healthy diet is not merely a matter of personal choice. Tools and strategies in the sectors of agriculture, food, nutrition and education should support people, families, and communities to assist them in adopting eating habits that prevent obesity, diabetes and other non-communicable diseases.5

Although recognizing the urgent need for government action to change our actual food system to make healthy eating a feasible practice, there are some practical steps individuals with diabetes who are interested in better nutrition, can take to make healthier choices.

Ultra-processed foods infographic

The following are a few nutritional guidelines to achieve a nutritious diet which is supportive of socially and environmentally sustainable food systems. They are based on nutrition guidelines around the world.5,6,7

  • Avoid ultra-processed foods, even what are often named ‘light’ or ‘diet’ products. Ultra-processed foods are often reformulated and advertised as if they are healthy, labelled as ‘light’ or ‘diet’, or low in fat or sugar, or free from trans fats, or high in fibre or vitamins and minerals. These adjustments may improve the products but still they remain ultra-processed and unhealthy, and certainly not good alternatives to natural or minimally processed foods and freshly made dishes.5
  • Make natural or minimally processed foods the basis of your diet: leafy vegetables, legumes (beans, lentils, peas, chickpeas), fruits (in small portions), wholegrains (unprocessed corn, oat, quinoa, brown rice, buckwheat, millet, sorghum, triticale, rye), roots and tubers (yams, taro, sweet potato).6
  • Other natural or minimally processed foods that can be included in a healthy diet: fish, poultry and other minimally processed meat, and eggs. Alternatively, you can include vegetarian products such as tofu, mushrooms or other vegetarian options available in your region. Recent food-based dietary guidelines emphasise the importance of having a mostly plant-based diet, focusing on seasonal and local foods and reducing red and processed meat.7
  • Include sources of healthy fats: nuts, walnuts, seeds, olive oil, tahini, avocados.6
  • Use natural spices: oregano, turmeric, cumin, pepper, garlic or coriander. They are rich in antioxidants and other beneficial phytochemicals.

Valuable tips to put the above into practice:

  • Try first to slowly re-educate your taste. After years of regular consumption of ultra-processed foods, it is common that some people consider healthy foods “tasteless”. Begin by including a few new healthy products in your everyday life, while decreasing the ultra-processed foods. Use natural spices and seasonings to enhance the taste of vegetables. With perseverance, you will have your natural senses back and be able to appreciate the flavours of nature!
  • Do not be prejudiced to taste new healthy items. When possible, visit fresh markets and grocery stores selling local products, and visit the section of the supermarket where you can find different kinds of beans, lentils, rice. There are so many kinds of rice, why to spend a lifetime eating just one type?

Healthy eating should be a goal for all, not only for people living with chronic conditions, like diabetes. As such, it should have a priority on the agenda of policy makers.

The journey towards a healthy diet begins in the mind. It starts with a willingness to change the way we relate to food and the impact of choices; for individual health, society and future generations.

Eating is a political tool. What we eat defines our future and influences the livelihoods of all people involved in the food system. We influence the food system with the choices we make, and this is a power we need to use wisely and efficiently. In spite of dysfunctional systems, food should remain a means for great change, self-empowerment, health and identity.

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