Eating habits as important as meds for diabetic blood sugar control

University Park, Pa. -- For those with type 2 diabetes, the most prevalent kind, a person's eating habits -- their basic eating practices, selections while dining out, meal planning and carbohydrate and vegetable strategies -- matter as much or more as medicine for maintaining blood sugar control, says a Penn State researcher.

Carla Miller, assistant professor of nutritional sciences, says, "Our recent study identified 15 common underlying food habits related to blood sugar control that people with diabetes were following. Among the people who participated in the study, the 15 food habits explained over 50 percent of the variability in their blood sugar levels over extended periods."

The study is described in "Food Habits Are Related to Glycemic Control Among People With Type 2 Diabetes Mellitus" published in a recent issue of the Journal of the American Dietetic Association. The authors are Margaret R. Savoca, Miller's former graduate student at the University of North Carolina at Greensboro; Miller and David A. Ludwig, co-investigator, Georgia Prevention Institute, Medical College of Georgia.

In the study, the researchers conducted one-on-one interviews with each participant that were audio-recorded and transcribed. The researchers asked about the participants's illness history, diabetes education and past and present eating practices; environment influences on food choices and meal patterns; and the challenges of maintaining healthful eating habits. There were 89 participants: 62 percent women, 48 percent African American, and 43 percent below 200 percent of the poverty level.

The participants also had a blood test for glycated hemoglobin to assess blood sugar control. Glycated hemoglobin indicates the average level of blood sugar during the previous two to three months unlike the standard test, which indicates the blood sugar level only at the time at which it's taken. The current study is the first to examine eating habits and their relation to glycated hemoglobin levels.

The researchers reviewed the transcripts and grouped the food habits of people who were successful at controlling their blood sugar as well as the habits of those who weren't into four categories.

Miller notes that 15 food habits emerged: 12 Do's in the Basic Eating Practices, Meal Planning and Carbohydrate and Vegetable Strategies categories and 3 Don'ts -- all challenges of eating out.

The Do's in the Basic Eating Practices category are: Limiting high-sugar containing foods; limiting portion sizes of food; limiting the size and frequency of desserts; reducing high-fat foods; choosing low-fat foods; choosing low-fat menu selections; and eating low-fat foods for breakfast.

The Do's in the Meal Planning category are: Eating regularly (three meals a day); eating low-fat foods for lunch; planning meals (using shopping lists, planning a weekly menu, taking meals to work or on trips).

The Do's in the Carbohydrate and Vegetable category are: Eating two vegetables for dinner; eating large amounts of vegetables and limiting specific carbohydrates (bread, pasta, rice, crackers or potatoes).

The Don'ts in the Challenges of Dining Out category are: Eating at buffet, fast-food and large chain restaurants; choosing high-fat or high carbohydrate menu selections, and eating high-fat sources of protein (red meat, fried entrees and processed meat).

Miller notes, "People with diabetes need to take their medication but this study shows that what you eat clearly affects your blood sugar above and beyond medication. We think that knowledge of these specific food habits can help people with diabetes with dietary self-management and in achieving dietary goals. If people follow the do's, they can achieve normal blood sugar levels."

Funding from the North Carolina Institute of Nutrition supported the study.