Rice has received some negative publicity lately regarding its effects on the development of diabetes. A large study, published this March in the British Medical Journal, found that regular eaters of white rice were significanty more likely to develop type-2 diabetes than people who rarely consume the food. The study found that the risk of developing diabetes was 55% higher for Asian populations and 12% higher for western populations in those who consume 3 to 4 servings of white rice a day compared to those who rarely consumed white rice.

There are many misconceptions regarding the causes of diabetes. One of these is that excessive sugar intake leads to the development of type-2 diabetes. The general scientific consensus is that sucrose (table sugar) itself doesn’t cause diabetes although products with added sugar are typically calorie dense and therefore may contribute to the development of obesity if consumed to excess. Therefore, providing that an individual is a healthy weight, moderate consumption of foods rich in sucrose, or any other sugars, is unlikely to increase that individuals risk of developing diabetes.

One of the most important aspects of managing diabetes is preventing postprandial hyperglycemia, which is an exaggerated blood sugar response following a meal. In general, the glycemic load (GL) gives a good idea of the glucose response that will occur after eating a given amount of a particular food. The GL is calculated by multiplying the glycemic index of a food by the amount of carbohydrate. So for example eating two large grapefruit (GI of 25 and 50g of carbs) would effect blood sugar levels in a similar way to eating one banana (GI of 50 and 25g of carbs).

The idea of complementary foods is a relatively new concept in diabetes management and it refers to certain foods, that when consumed in conjunction with a traditionally high GL meal, help reduce the exaggerated glucose response that would normally occur. Some of these complementary foods are discussed in detail below.

Vegetables are a vital component of a healthy diet and this is particularly true for diabetics. Most fruits and vegetables are high in fiber and nutrient dense but low in calories making them ideal for diabetics who often need to watch their calorie intake. The general rule of thumb for diabetics is that root vegetables should be eaten in moderation (no more than 1 serving a day), while green and red vegetables are great choices and should be consumed in high amounts, preferably 3-5 servings a day. There are exceptions to this rule that we will discuss in more detail below.

Root Vegetables & Tubers

Root vegetables and tubers are relatively concentrated sources of sugars and starches and tend to contain only small amounts of fiber. This can be problematic for diabetics because they can produce a large glycemic response in situations when they are not combined with high fiber foods.

A common question asked by diabetics is whether they should substitute honey for table sugar in their diet. This is generally motivated by the belief that a “natural” product like honey will be better for their health than a refined product such as table sugar.

In general, I am of the belief that better management of diabetes comes not from eating a single food or focusing on a particular food group, but instead from the combined effect of numerous lifestyle and dietary changes such as weight-loss, a higher intake of fruits, vegetables, and whole grains, and increased physical exercise.

Those who drink less than 0.5 litres of water a day are significantly more likely to develop hyperglycaemia (high blood sugar) according to the results of a French study published in the journal Diabetes Care last month.

The research, led by Ronan Roussel, Professor of Medicine at the Hospital Bichat in Paris, involved 3,615 adults who were followed for 9 years. Over the course of the study there were 565 new cases of hyperglycaemia which was defined as either a fasting glucose level over 6.1 mmol/L or the commencement of treatment for diabetes.

Two studies, both published in July of this year, have linked high consumption of heme iron (the form of iron found in animal products) with an increased risk of developing gestational diabetes.

The first study was conducted by researchers from the Center for Perinatal Studies at the Swedish Medical Center in Washington, USA, and involved the study of 3,158 pregnant women who were followed over the course of their pregnancy. During the study, 158 of the women developed gestational diabetes.

Pectin is a substance found in the cell walls of land-based plants. Pectin combines with water to produce a thick, gel like substance, making it useful as a setting agent in jams and marmalades. Pectin has gained some popularity as a health food due to its ability to lower cholesterol levels. Interestingly, pectin has also shown promise as a potential aid to diabetics as several scientific studies have found improvements in glucose control following pectin supplementation.

Despite being the most popular vegetable in the United States, potatoes have fallen out of favour somewhat with nutritionists over the last few decades due to a relatively low nutrient density and high levels of quickly absorbed carbohydrates. Many diabetics avoid potatoes altogether for fear of exacerbating their condition. Fortunately the news is not all bad when it comes to diabetes and potatoes and most diabetics can include a modest level of potatoes in their diet.

According to a study published in the journal Diabetes Care in 2003, cinnamon may be quite effective at reducing blood sugar levels in diabetic patients, reducing the need for diabetes medication.

The study, conducted by Pakistani and American researchers, involved 30 diabetic men and 30 diabetic women who were divided into six groups. The first three groups consumed 1, 3 or 6 grams of cinnamon per day in the form of a cinnamon supplement while the final three groups received placebos.

A Mediterranean style diet that is high in fruit, nuts, legumes, and whole grains may reduce an individuals risk of developing type-2 diabetes by more than 80% according to new research published in May this year.

The study, conducted by Spanish researchers and published in the British Medical Journal, followed 13,380 Spanish university graduates for an average of 4.4 years. The graduates adherence to a Mediterranean diet was calculated by giving each participant a score of zero or one for their consumption of nine components of a Mediterranean diet.

Evidence from several large studies suggests that vegetarians may be more than 50% less likely to develop type-2 diabetes compared to those who consume meat on a regular basis.

One of the largest studies on the link between a vegetarian diet and diabetes came from a study of 25,698 seventh day adventists in 1960 over a 21 year study period. The study was published in the American Journal of Public Health in 1985.

People who consume nuts at least five times a week may be almost half as likely to develop type-2 diabetes as infrequent nut eaters according to the results of a recent study.

The study was published in The Journal of the American Medical Association in November 2002 by American researchers at the Department of Nutrition at the Harvard School of Public Health. The authors analyzed data on 83,818 women which was collected from the Nurses Health Study (NHS) over a 16 year period from 1980 to 1996.

A recent study has found that eating dairy products such as cheese, milk, butter, and yogurt can reduce an individuals risk of developing type-2 diabetes by as much as 31%. The study, published in the journal Diabetes Care in 2006, involved following 37,183 healthy middle-aged women for an average of 10 years. The women were asked to complete questionnaires on how frequently they consumed 130 common food products.

Consumption of coffee may be associated with a reduction in type-2 diabetes risk according to a study published in the June 2006 edition of the journal Archives of Internal Medicine.

The researchers used data from the Iowa Women’s Health Study which was conducted between 1986 and 1997 and involved 28,812 post menopausal women.

Regular red and processed meat consumption of more than 5 servings a week is a significant risk factor for the development of type-2 diabetes according to several research studies.

One of the largest studies on the link between meat consumption and diabetes risk was published in the journal Diabetes Care in 2004. It involved the study of 37,309 initially healthy women aged over 45 who completed a food questionnaire in 1993 and were then followed for an average of 8.8 years.