Authors: Carol Svec
Food Cures (33 page)
FAQS
I used to read a lot about chromium picolinate supplements. Are they valuable for people with diabetes?
Back in the 1990s, chromium picolinate was popular as a simple treatment that scientists thought might help improve glycemic control and insulin sensitivity. Most of the studies that supported that claim had been done on laboratory animals, which is never the same as investigating the effects of a treatment on people. More recently, the picture for chromium picolinate has turned much less optimistic. In 2006, scientists reported that they were unable to find any benefit of chromium picolinate supplements in people with type 2 diabetes, even when relatively high dosages were tested. A major review of all high-quality studies found that the data were ultimately inconclusive—no one can say with any degree of certainty whether chromium is helpful or not. More research will need to be done, but as of right now, I can’t recommend chromium supplements for diabetes control.
SUPPLEMENTS
For years, scientists have been hunting for a “magic bullet” to treat diabetes—one or more nutrients that could be taken in supplement form to improve glycemic control. As of now, the search is still on. Researchers have tested all logical possibilities, including antioxidants, vitamin E, and fish oil. Results are confusing and inconsistent, sometimes showing a benefit, and sometimes showing that taking a particular supplement actually makes blood sugar control worse.
The follow supplements are generally considered safe, and have quite a bit of supporting research. But diabetes management and blood glucose control can be tricky and tenuous. Before taking
any
supplement, talk with your endocrinologist, especially if you are already taking a hypoglycemic or insulin-sensitizing medication.
- Multivitamin.
If you want to assure that you get your daily supply of all vitamins and minerals, consider taking a multivitamin. Look for a brand that contains 100% DV of most nutrients. If you are a man, or a women who is no longer menstruating, choose a “senior” formula, which doesn’t contain iron. I cannot recommend taking high doses of any individual vitamins at this time.- Calcium, with vitamin D
3
and magnesium.
In addition to taking a multivitamin, women may want to consider taking supplements of calcium with vitamin D
3
(cholecalciferol, the most potent form) and magnesium. Vitamin D
3
is important because it allows the body to absorb and use calcium. Magnesium is important because people seldom get enough of this important mineral through food or a multivitamin pill.
Women
should aim to get 1,000 to 1,200 milligrams calcium daily from food and supplements, plus a total of 800 IU vitamin D
3
and 400 milligrams magnesium per day. Because calcium is better absorbed when you take no more than 600 milligrams at a time, calcium supplements need to be taken twice a day, what is called a divided dose. Take half the day’s dosage in the morning, and the other half later in the day (with food if it is a calcium carbonate).
Men
should aim to get no more than 1,000 milligrams of calcium from food sources only (about two to three servings), because some research shows a possible link to increased calcium intake and prostate cancer. However, vitamin D and magnesium are just as important for men as they are for women—aim to get a total of 800 IU vitamin D
3
, and 400 milligrams magnesium per day. (Although calcium supplements are not recommended, men can consider taking a separate vitamin D
3
and magnesium supplement—after checking with their endocrinologist.)- Water-soluble cinnamon extract.
Perhaps the most promising new supplement for people with diabetes is
Cinnulin PF
, a capsule that contains a water-soluble cinnamon extract. Several studies have shown that cinnamon can increase the power of insulin, and may lower fasting glucose levels. Scientists are still investigating what substances give cinnamon its disease-fighting force, and more studies need to be completed before it becomes a common treatment, but if recent research holds up, fasting glucose can be reduced by up to 29 percent. From cinnamon! Sprinkling a little on your skim milk cocoa won’t do the trick, though. New research reports that saliva harms some of the active ingredients in the spice so in order for it to work, you have to take it in capsule form. Cinnulin PF contains a water-soluble extract that has had the toxins removed while retaining the diabetes-fighting active ingredients. The manufacturer recommends taking 250 milligrams per day; I recommend talking with your doctor first.
Follow this program if you have diabetes or prediabetes.
STEP 1…START WITH THE BASICS
These are the first things you should do to regain control over your blood glucose and manage diabetes.
- Begin a program of exercise.
- If you smoke, quit.
- If you have diabetes, be a good patient—monitor your blood glucose levels, take your medications, and gather a great medical team.
- Start keeping a food log.
STEP 2…YOUR ULTIMATE GROCERY LIST
A diabetes food plan is about eating high-quality carbs instead of low-quality carbs, choosing healthy fats instead of trans fats or saturated fats, and eating plenty of foods rich in soluble fiber, vitamin D, calcium, and magnesium. I’ve also added some high-quality (lean) proteins you should choose instead of high-fat varieties, plus some foods used as ingredients in the meal plans and recipes. You don’t have to purchase every item…but these foods should make up the bulk of what you eat for the week. If you find yourself getting bored, try some unfamiliar foods from these groups—they may become favorites.
FRUIT
ALL fresh fruit, but especially:
Apples
Apricots (fresh, not dried)
Bananas
Berries (blackberries, raspberries, strawberries)
Cantaloupe
Grapefruit
Oranges
Peaches
Pears
VEGETABLES
ALL vegetables, but especially:
Artichoke hearts
Avocado
Beans (black, kidney, lima, navy, pinto, white, garbanzo)
Beets
Bok choy
Broccoli
Brussels sprouts
Cabbage
Carrots
Cauliflower
Chickpeas (garbanzo beans)
Corn
Kale
Lentils
Mushrooms (especially shiitake)
Olives
Onions
Peas
Peas, split
Peas, sugar snap
Potatoes, sweet
Potatoes, white
Seaweed
Soybeans (edamame)
Spinach
Swiss chard
Tomatoes
Yams
SEAFOOD
ALL seafood and fish, but especially:
Anchovies
Herring
Mackerel (not king)
Oysters, Pacific
Salmon, wild (with bones)
Sardines (with bones)
Trout, rainbow
LEAN MEATS/EGGS/SOY FOODS
Beef, ground (lean only)
Beef, lean
Chicken breast
Eggs, omega-3—fortified
Ham, lean
Pork tenderloin
Tempeh
Tofu with calcium
Turkey bacon
Turkey breast
Turkey burger
Veal
Veggie burger
NUTS AND SEEDS (PREFERABLY UNSALTED)
Almonds
Brazil nuts
Butternuts (white walnuts)
Cashews
Flaxseed, ground
Hazelnuts
Macadamia nuts
Peanut butter
Peanuts
Pecans
Pine nuts
Pistachio nuts
Psyllium seeds, ground
Pumpkin seeds
Sesame seeds
Soy nuts
Sunflower seeds
Walnuts
WHOLE GRAINS
Amaranth
Barley
Bread, reduced-calorie whole wheat (45 calories or less per slice)
Breads, whole grain (including English muffins, 70-calorie mini-pita, crackers)
Cereals, fortified whole grain
Millet
Oat bran
Oatmeal
Quinoa
Rice (brown, wild)
Rice bran
Rice cakes
Tempeh
Tortillas (tomato, whole grain, or spinach)
Waffles, calcium-fortified whole grain
Wheat berries
DAIRY
Cheese (fat-free, reduced-fat)
Cheese (for meal plan): fat-free or reduced-fat Cheddar, Swiss, mozzarella
Cheese, goat (preferably reduced-fat)
Cheese, Parmesan or Romano
Cream cheese (fat-free, reduced-fat)
Margarine spread, vitamin D-fortified, reduced-fat soft tub, trans fat-free
Milk (fat-free, 1% reduced-fat)
Sour cream (reduced-fat, fat-free)
Soy milk, enriched/ fortified
Yogurt (fat-free, low-fat with artificial sweetener)
MISCELLANEOUS
Almond extract
Baking powder
Baking soda
Broth, chicken, low-sodium, low-fat
Cinnamon, ground
Cocktail sauce
Cocoa powder, unsweetened
Cornstarch
Dressing, salad, reduced-calorie (Caesar, vinaigrette)
Espresso powder, instant
Flour, all-purpose
Flour, whole wheat pastry
Garlic
Garlic powder
Hummus
Jell-O gelatin, sugar-free, low-calorie
Ketchup
Maple extract
Mayonnaise, reduced-fat
Mustard, Dijon
Nonstick cooking spray
Nutmeg
Oil, canola
Oil, flaxseed
Oil, olive
Oil, sesame
Oil, walnut
Onion powder
Paprika
Pepper, black
Popsicles, sugar-free
Salt substitute
Soy crisps
Soy sauce, reduced-sodium
Steak sauce
Sugar substitute (such as Equal or Splenda)
Vanilla extract
Vinegar
STEP 3…GOING ABOVE AND BEYOND
If you want to do everything you can to prevent or control diabetes, here are some additional things you might try:
- Consider taking a multivitamin. Women may consider taking a calcium supplement with vitamin D
3
and magnesium built in. Men may consider taking vitamin D
3
and magnesium, without calcium.- Talk with your doctor if you want to consider taking cinnamon supplements.
- Avoid eating foods high in saturated fats, including butter, ice cream, whole milk, cheese, and fatty meats. Also, avoid trans fats.
- Drink alcohol in moderation, if at all.
- Take extra care of your teeth and feet.
- Seek treatment for sleep apnea, or excessive daytime sleepiness.
DAYTIME SLEEPINESS
If you find yourself becoming sleepy during the day, don’t automatically assume that it is due to insomnia from sleep apnea. I had a client who became unbearably sleepy every day around 3:00 p.m. His blood sugars, which he tested twice each day (once in the morning and once at night), were always well within normal, thanks to his combination of diet, exercise, and glucose-lowering medications. He sought help for sleep apnea and continued with a stellar eating plan, but weeks later, he was still crashing in the afternoon. Finally, he tested his blood sugar at 3:00 p.m. To everyone’s surprise, his blood sugar was very low—below 60. His doctor adjusted his medication, and he regained his energy. If you find yourself losing the battle to stay awake in the middle of the day, test your blood sugar. If it is low, work with your physician to find a way to level it out. In my office, the mantra is: When in doubt, test your sugars.
