Nutrition and physical activity are important parts of a healthy lifestyle when you have diabetes. Along with other benefits, following a healthy meal plan and being active can help you keep your blood glucose level, also called blood sugar, in your target range. To manage your blood glucose, you need to balance what you eat and drink with physical activity and diabetes medicine, if you take any. What you choose to eat, how much you eat, and when you eat are all important in keeping your blood glucose level in the range that your health care team recommends.
Becoming more active and making changes in what you eat and drink can seem challenging at first. You may find it easier to start with small changes and get help from your family, friends, and health care team.
Eating well and being physically active most days of the week can help you
You may worry that having diabetes means going without foods you enjoy. The good news is that you can still eat your favorite foods, but you might need to eat smaller portions or enjoy them less often. Your health care team will help create a diabetes meal plan for you that meets your needs and likes.
The key to eating with diabetes is to eat a variety of healthy foods from all food groups, in the amounts your meal plan outlines.
The food groups are
Learn more about the food groups at the U.S. Department of Agriculture’s (USDA) ChooseMyPlate.gov.
Eat foods with heart-healthy fats, which mainly come from these foods:
Use oils when cooking food instead of butter, cream, shortening, lard, or stick margarine.Choose healthy fats, such as from nuts, seeds, and olive oil.
Foods and drinks to limit include
Drink water instead of sweetened beverages. Consider using a sugar substitute in your coffee or tea.
If you drink alcohol, drink moderately-no more than one drink a day if you’re a woman or two drinks a day if you’re a man. If you use insulin or diabetes medicines that increase the amount of insulin your body makes, alcohol can make your blood glucose level drop too low. This is especially true if you haven’t eaten in a while. It’s best to eat some food when you drink alcohol.
Some people with diabetes need to eat at about the same time each day. Others can be more flexible with the timing of their meals. Depending on your diabetes medicines or type of insulin, you may need to eat the same amount of carbohydrates at the same time each day. If you take "mealtime" insulin, your eating schedule can be more flexible.
If you use certain diabetes medicines or insulin and you skip or delay a meal, your blood glucose level can drop too low. Ask your health care team when you should eat and whether you should eat before and after physical activity.
Eating the right amount of food will also help you manage your blood glucose level and your weight. Your health care team can help you figure out how much food and how many calories you should eat each day.
If you are overweight or have obesity, work with your health care team to create a weight-loss plan.
The Body Weight Planner can help you tailor your calorie and physical activity plans to reach and maintain your goal weight.
To lose weight, you need to eat fewer calories and replace less healthy foods with foods lower in calories, fat, and sugar.
If you have diabetes, are overweight or obese, and are planning to have a baby, you should try to lose any excess weight before you become pregnant. Learn more about planning for pregnancy if you have diabetes.
Two common ways to help you plan how much to eat if you have diabetes are the plate method and carbohydrate counting, also called carb counting. Check with your health care team about the method that’s best for you.
The plate method helps you control your portion sizes. You don't need to count calories. The plate method shows the amount of each food group you should eat. This method works best for lunch and dinner.
Use a 9-inch plate. Put nonstarchy vegetables on half of the plate; a meat or other protein on one-fourth of the plate; and a grain or other starch on the last one-fourth. Starches include starchy vegetables such as corn and peas. You also may eat a small bowl of fruit or a piece of fruit, and drink a small glass of milk as included in your meal plan.
The plate method shows the amount of each food group you should eat.
You can find many different combinations of food and more details about using the plate method from the American Diabetes Association’s Create Your Plate.
Your daily eating plan also may include small snacks between meals.
Carbohydrate counting involves keeping track of the amount of carbohydrates you eat and drink each day. Because carbohydrates turn into glucose in your body, they affect your blood glucose level more than other foods do. Carb counting can help you manage your blood glucose level. If you take insulin, counting carbohydrates can help you know how much insulin to take.
Carbohydrate counting is a meal planning tool for people with diabetes who take insulin, but not all people with diabetes need to count carbohydrates. Your health care team can help you create a personal eating plan that will best meet your needs.
The amount of carbohydrates in foods is measured in grams. To count carbohydrate grams in what you eat, you’ll need to
Most carbohydrates come from starches, fruits, milk, and sweets. Try to limit carbohydrates with added sugars or those with refined grains, such as white bread and white rice. Instead, eat carbohydrates from fruit, vegetables, whole grains, beans, and low-fat or nonfat milk.
Choose healthy carbohydrates, such as fruit, vegetables, whole grains, beans, and low-fat milk, as part of your diabetes meal plan.
In addition to using the plate method and carb counting, you may want to visit a registered dietitian (RD) for medical nutrition therapy.
Medical nutrition therapy is a service provided by an RD to create personal eating plans based on your needs and likes. For people with diabetes, medical nutrition therapy has been shown to improve diabetes management. Medicare pays for medical nutrition therapy for people with diabetes If you have insurance other than Medicare, ask if it covers medical nutrition therapy for diabetes.
No clear proof exists that taking dietary supplements such as vitamins, minerals, herbs, or spices can help manage diabetes.1 You may need supplements if you cannot get enough vitamins and minerals from foods. Talk with your health care provider before you take any dietary supplement since some can cause side effects or affect how your medicines work.2
Physical activity is an important part of managing your blood glucose level and staying healthy. Being active has many health benefits.
Physical activity
If you are overweight, combining physical activity with a reduced-calorie eating plan can lead to even more benefits. In the Look AHEAD: Action for Health in Diabetes study,1 overweight adults with type 2 diabetes who ate less and moved more had greater long-term health benefits compared to those who didn’t make these changes. These benefits included improved cholesterol levels, less sleep apnea, and being able to move around more easily.
Even small amounts of physical activity can help. Experts suggest that you aim for at least 30 minutes of moderate or vigorous physical activity 5 days of the week.3 Moderate activity feels somewhat hard, and vigorous activity is intense and feels hard. If you want to lose weight or maintain weight loss, you may need to do 60 minutes or more of physical activity 5 days of the week.3
Be patient. It may take a few weeks of physical activity before you see changes in your health.
Be sure to drink water before, during, and after exercise to stay well hydrated. The following are some other tips for safe physical activity when you have diabetes.
Drink water when you exercise to stay well hydrated.
Talk with your health care team before you start a new physical activity routine, especially if you have other health problems. Your health care team will tell you a target range for your blood glucose level and suggest how you can be active safely.
Your health care team also can help you decide the best time of day for you to do physical activity based on your daily schedule, meal plan, and diabetes medicines. If you take insulin, you need to balance the activity that you do with your insulin doses and meals so you don’t get low blood glucose.
Because physical activity lowers your blood glucose, you should protect yourself against low blood glucose levels, also called hypoglycemia. You are most likely to have hypoglycemia if you take insulin or certain other diabetes medicines, such as a sulfonylurea. Hypoglycemia also can occur after a long intense workout or if you have skipped a meal before being active. Hypoglycemia can happen during or up to 24 hours after physical activity.
Planning is key to preventing hypoglycemia. For instance, if you take insulin, your health care provider might suggest you take less insulin or eat a small snack with carbohydrates before, during, or after physical activity, especially intense activity.4
You may need to check your blood glucose level before, during, and right after you are physically active.
If you have type 1 diabetes, avoid vigorous physical activity when you have ketones in your blood or urine. Ketones are chemicals your body might make when your blood glucose level is too high, a condition called hyperglycemia, and your insulin level is too low. If you are physically active when you have ketones in your blood or urine, your blood glucose level may go even higher. Ask your health care team what level of ketones are dangerous for you and how to test for them. Ketones are uncommon in people with type 2 diabetes.
People with diabetes may have problems with their feet because of poor blood flow and nerve damage that can result from high blood glucose levels. To help prevent foot problems, you should wear comfortable, supportive shoes and take care of your feet before, during, and after physical activity.
Most kinds of physical activity can help you take care of your diabetes. Certain activities may be unsafe for some people, such as those with low vision or nerve damage to their feet. Ask your health care team what physical activities are safe for you. Many people choose walking with friends or family members for their activity.
Doing different types of physical activity each week will give you the most health benefits. Mixing it up also helps reduce boredom and lower your chance of getting hurt. Try these options for physical activity.
If you have been inactive or you are trying a new activity, start slowly, with 5 to 10 minutes a day. Then add a little more time each week. Increase daily activity by spending less time in front of a TV or other screen. Try these simple ways to add physical activities in your life each day:
If you are sitting for a long time, such as working at a desk or watching TV, do some light activity for 3 minutes or more every half hour.5 Light activities include
Aerobic exercise is activity that makes your heart beat faster and makes you breathe harder. You should aim for doing aerobic exercise for 30 minutes a day most days of the week. You do not have to do all the activity at one time. You can split up these minutes into a few times throughout the day.
To get the most out of your activity, exercise at a moderate to vigorous level. Try
Talk with your health care team about how to warm up and cool down before and after you exercise.
Strength training is a light or moderate physical activity that builds muscle and helps keep your bones healthy. Strength training is important for both men and women. When you have more muscle and less body fat, you'll burn more calories. Burning more calories can help you lose and keep off extra weight.
You can do strength training with hand weights, elastic bands, or weight machines. Try to do strength training two to three times a week. Start with a light weight. Slowly increase the size of your weights as your muscles become stronger.
You can do strength training with hand weights, elastic bands, or weight machines.
Stretching exercises are light or moderate physical activity. When you stretch, you increase your flexibility, lower your stress, and help prevent sore muscles.
You can choose from many types of stretching exercises. Yoga is a type of stretching that focuses on your breathing and helps you relax. Even if you have problems moving or balancing, certain types of yoga can help. For instance, chair yoga has stretches you can do when sitting in a chair or holding onto a chair while standing. Your health care team can suggest whether yoga is right for you.
Drinking enough liquid, mainly water, is the most important thing you can do to prevent kidney stones. Unless you have kidney failure, many health care professionals recommend that you drink six to eight, 8-ounce glasses a day. Talk with a health care professional about how much liquid you should drink.
Studies have shown that the Dietary Approaches to Stop Hypertension (DASH) diet can reduce the risk of kidney stones. Learn more about the DASH diet.2
Studies have shown that being overweight increases your risk of kidney stones. A dietitian can help you plan meals to help you lose weight.
Yes. If you have already had kidney stones, ask your health care professional which type of kidney stone you had. Based on the type of kidney stone you had, you may be able to prevent kidney stones by making changes in how much sodium, animal protein, calcium, or oxalate is in the food you eat.
You may need to change what you eat and drink for these types of kidney stones:
A dietitian who specializes in kidney stone prevention can help you plan meals to prevent kidney stones. Find a dietitian who can help you.
Reduce oxalate
If you’ve had calcium oxalate stones, you may want to avoid these foods to help reduce the amount of oxalate in your urine:
Talk with a health care professional about other food sources of oxalate and how much oxalate should be in what you eat.
Reduce sodium
Your chance of developing kidney stones increases when you eat more sodium. Sodium is a part of salt. Sodium is in many canned, packaged, and fast foods. It is also in many condiments, seasonings, and meats.
Talk with a health care professional about how much sodium should be in what you eat. See tips to reduce your sodium intake.
Limit animal protein
Eating animal protein may increase your chances of developing kidney stones.
A health care professional may tell you to limit eating animal protein, including
Although you may need to limit how much animal protein you eat each day, you still need to make sure you get enough protein. Consider replacing some of the meat and animal protein you would typically eat with beans, dried peas, and lentils, which are plant-based foods that are high in protein and low in oxalate.
Talk with a health care professional about how much total protein you should eat and how much should come from animal or plant-based foods.
Get enough calcium from foods
Even though calcium sounds like it would be the cause of calcium stones, it’s not. In the right amounts, calcium can block other substances in the digestive tract that may cause stones. Talk with a health care professional about how much calcium you should eat to help prevent getting more calcium oxalate stones and to support strong bones. It may be best to get calcium from low-oxalate, plant-based foods such as calcium-fortified juices, cereals, breads, some kinds of vegetables, and some types of beans. Ask a dietitian or other health care professional which foods are the best sources of calcium for you.
Reduce sodium
Your chance of developing kidney stones increases when you eat more sodium. Sodium is a part of salt. Sodium is in many canned, packaged, and fast foods. It is also in many condiments, seasonings, and meats.
Talk with a health care professional about how much sodium should be in what you eat. See tips to reduce your sodium intake.
Limit animal protein
Eating animal protein may increase your chances of developing kidney stones.
A health care professional may tell you to limit eating animal protein, including
Although you may need to limit how much animal protein you have each day, you still need to make sure you get enough protein. Consider replacing some of the meat and animal protein you would typically eat with some of these plant-based foods that are high in protein:
Talk with a health care professional about how much total protein you should eat and how much should come from animal or plant-based foods.
Get enough calcium from foods
Even though calcium sounds like it would be the cause of calcium stones, it’s not. In the right amounts, calcium can block other substances in the digestive tract that may lead to stones. Talk with a health care professional about how much calcium you should eat to help prevent getting more calcium phosphate stones and to support strong bones. It may be best to get calcium from plant-based foods such as calcium-fortified juices, cereals, breads, some kinds of vegetables, and some types of beans. Ask a dietitian or other health care professional which foods are the best sources of calcium for you.
Limit animal protein
Eating animal protein may increase your chances of developing kidney stones.
A health care professional may tell you to limit eating animal protein, including
Although you may need to limit how much animal protein you have each day, you still need to make sure you get enough protein. Consider replacing some of the meat and animal protein you would typically eat with some of these plant-based foods that are high in protein:
Talk with a health care professional about how much total protein you should eat and how much should come from animal or plant-based foods.
Losing weight if you are overweight is especially important for people who have had uric acid stones.
DASH stands for Dietary Approaches to Stop Hypertension. The DASH diet is a lifelong approach to healthy eating that's designed to help treat or prevent high blood pressure (hypertension). The DASH diet plan was developed to lower blood pressure without medication in research sponsored by the National Institutes of Health.
The DASH diet encourages you to reduce the sodium in your diet and eat a variety of foods rich in nutrients that help lower blood pressure, such as potassium, calcium and magnesium.
By following the DASH diet, you may be able to reduce your blood pressure by a few points in just two weeks. Over time, the top number of your blood pressure (systolic blood pressure) could drop by eight to 14 points, which can make a significant difference in your health risks.
Because the DASH diet is a healthy way of eating, it offers health benefits besides just lowering blood pressure. The DASH diet is also in line with dietary recommendations to prevent osteoporosis, cancer, heart disease, stroke and diabetes.
The DASH diet emphasizes vegetables, fruits and low-fat dairy foods — and moderate amounts of whole grains, fish, poultry and nuts.
In addition to the standard DASH diet, there is also a lower sodium version of the diet. You can choose the version of the diet that meets your health needs:
Both versions of the DASH diet aim to reduce the amount of sodium in your diet compared with what you might get in a typical American diet, which can amount to a whopping 3,400 mg of sodium a day or more.
The standard DASH diet meets the recommendation from the Dietary Guidelines for Americans to keep daily sodium intake to less than 2,300 mg a day.
The American Heart Association recommends 1,500 mg a day of sodium as an upper limit for all adults. If you aren't sure what sodium level is right for you, talk to your doctor.
Both versions of the DASH diet include lots of whole grains, fruits, vegetables and low-fat dairy products. The DASH diet also includes some fish, poultry and legumes, and encourages a small amount of nuts and seeds a few times a week.
You can eat red meat, sweets and fats in small amounts. The DASH diet is low in saturated fat, trans fat and total fat.
Here's a look at the recommended servings from each food group for the 2,000-calorie-a-day DASH diet.
Grains include bread, cereal, rice and pasta. Examples of one serving of grains include 1 slice whole-wheat bread, 1 ounce dry cereal, or 1/2 cup cooked cereal, rice or pasta.
Tomatoes, carrots, broccoli, sweet potatoes, greens and other vegetables are full of fiber, vitamins, and such minerals as potassium and magnesium. Examples of one serving include 1 cup raw leafy green vegetables or 1/2 cup cut-up raw or cooked vegetables.
Many fruits need little preparation to become a healthy part of a meal or snack. Like vegetables, they're packed with fiber, potassium and magnesium and are typically low in fat — coconuts are an exception.
Examples of one serving include one medium fruit, 1/2 cup fresh, frozen or canned fruit, or 4 ounces of juice.
Milk, yogurt, cheese and other dairy products are major sources of calcium, vitamin D and protein. But the key is to make sure that you choose dairy products that are low-fat or fat-free because otherwise they can be a major source of fat — and most of it is saturated.
Examples of one serving include 1 cup skim or 1 percent milk, 1 cup low-fat yogurt, or 1 1/2 ounces part-skim cheese.
Meat can be a rich source of protein, B vitamins, iron and zinc. Choose lean varieties and aim for no more than 6 one-ounce servings a day. Cutting back on your meat portion will allow room for more vegetables.
Examples of one serving include 1 egg or 1 ounce of cooked meat, poultry or fish.
Almonds, sunflower seeds, kidney beans, peas, lentils and other foods in this family are good sources of magnesium, potassium and protein.
They're also full of fiber and phytochemicals, which are plant compounds that may protect against some cancers and cardiovascular disease.
Serving sizes are small and are intended to be consumed only a few times a week because these foods are higher in calories.
Examples of one serving include 1/3 cup nuts, 2 tablespoons seeds or nut butter, or 1/2 cup cooked beans or peas.
Fat helps your body absorb essential vitamins and helps your body's immune system. But too much fat increases your risk of heart disease, diabetes and obesity.
The DASH diet strives for a healthy balance by limiting total fat to less than 30 percent of daily calories from fat, with a focus on the healthier monounsaturated fats.
Examples of one serving include 1 teaspoon soft margarine, 1 tablespoon mayonnaise or 2 tablespoons salad dressing.
You don't have to banish sweets entirely while following the DASH diet — just go easy on them. Examples of one serving include 1 tablespoon sugar, jelly or jam, 1/2 cup sorbet, or 1 cup lemonade.
Drinking too much alcohol can increase blood pressure. The Dietary Guidelines for Americans recommends that men limit alcohol to no more than two drinks a day and women to one or less.
The DASH diet doesn't address caffeine consumption. The influence of caffeine on blood pressure remains unclear. But caffeine can cause your blood pressure to rise at least temporarily.
If you already have high blood pressure or if you think caffeine is affecting your blood pressure, talk to your doctor about your caffeine consumption.
While the DASH diet is not a weight-loss program, you may indeed lose unwanted pounds because it can help guide you toward healthier food choices.
The DASH diet generally includes about 2,000 calories a day. If you're trying to lose weight, you may need to eat fewer calories. You may also need to adjust your serving goals based on your individual circumstances — something your health care team can help you decide.
The foods at the core of the DASH diet are naturally low in sodium. So just by following the DASH diet, you're likely to reduce your sodium intake. You also reduce sodium further by:
One teaspoon of table salt has 2,325 mg of sodium. When you read food labels, you may be surprised at just how much sodium some processed foods contain.
Even low-fat soups, canned vegetables, ready-to-eat cereals and sliced turkey from the local deli — foods you may have considered healthy — often have lots of sodium.
You may notice a difference in taste when you choose low-sodium food and beverages. If things seem too bland, gradually introduce low-sodium foods and cut back on table salt until you reach your sodium goal. That'll give your palate time to adjust.
Using salt-free seasoning blends or herbs and spices may also ease the transition. It can take several weeks for your taste buds to get used to less salty foods.
Try these strategies to get started on the DASH diet:
Remember, healthy eating isn't an all-or-nothing proposition. What's most important is that, on average, you eat healthier foods with plenty of variety — both to keep your diet nutritious and to avoid boredom or extremes. And with the DASH diet, you can have both.
Potassium is a mineral involved in how body muscles and nerves work and plays a role in keeping your heartbeat regular. When kidneys do not function properly, potassium builds up in the blood. This can cause changes in how the heart beats, possibly even leading to serious heart complications, including heart attack or arrest.
Potassium-rich foods to avoid:
How to reduce potassium Intake?
It is a mineral found in salt (sodium chloride), and is used in cooking and medicine. Lowering salt intake is important in certain medical conditions including high blood pressure, heart disease, chronic kidney disease and kidney stones.
Phosphorus and calcium are minerals that helps build strong bones. High phosphorus is a common finding in people with chronic kidney disease, and can cause bone disease. It can also build up in different parts of the body like arteries, muscles, eyes, and under the skin causing all sorts of complications.
A normal phosphorus level is between 2.5 and 4.5. To keep phosphorus from rising above that level you need to do the following steps:
When your body uses protein, it produces waste. Your kidneys remove this waste. Eating more protein than you need may make your kidneys work harder.
Eat small portions of protein foods.
Protein is found in foods from plants and animals. Most people eat both types of protein. Talk to your dietitian about how to choose the right combination of protein foods for you.
If you are on dialysis, you need to eat more protein, Renal dietitians encourage most people on hemodialysis to eat high-quality protein because it produces less waste for removal during dialysis. High-quality protein comes from meat, poultry, fish, and eggs. Avoid processed meats such as hot dogs and canned chili, which have high amounts of sodium and phosphorus.
Renal diet is a diet limited in a number of nutrients, like sodium, potassium and phosphorus. Dietary limitation of those nutrients depends on several factors including:
The following table provides a general guide. It places all these nutrients side by side for easy comparison. Grading level (low-high-very high) given to each nutient is based on several assumptions including:
apply to patients on dialysis.
These assumptions might not apply to individual patients. Every patient should seek medical and dietetary help for more specific advice.