Q: I have been trying to follow the Food Pyramid for quite some time. Now I find out that my blood sugar is too high. I don't have diabetes yet, but I don't want to get it. My doctor says to eat less carbohydrate, but not to cut back too much. He suggested I eat less bread and desserts. What should my "new pyramid" be?
A: One of the main principles of reduced-carbohydrate diets is that each person must find the carbohydrate level that works for that individual. Some prediabetics find that monitoring their blood glucose, as diabetics do, is helpful in figuring out what eating patterns keep their blood sugar stable and as normal as possible. This can be tremendously helpful in figuring out how much sugar (carb) your body can tolerate.
Realizing that each person is different, here are some guidelines for a low-carbohydrate diet pyramid:
Vegetables -- For most people, vegetables make up the base of the pyramid, with more suggested servings than any other type of food. You will see some low-carb pyramids with protein foods at the base. But by volume, try eating lots of non-starchy vegetables -- at least three to five cups per day.
Protein Foods -- The next rung up is typically protein foods. The amount of suggested servings will vary. Many people find that protein helps keep them satisfied longer than other foods.
The next groups are in random order and can be "ranked" depending on the individual:
Low-Sugar Fruit -- Most people who cut carbs eat one to three servings of low-sugar fruit (such as berries) per day. Avoid fruit juice, which lacks the fiber and some of the nutrients of the whole fruit and raises blood sugar much more.
Nuts and Seeds -- Nuts and seeds have lots of nutrients and, in some ways can substitute for starchier foods. Nut flours can be used to make some baked goods, such as muffins. Among the seeds, flax seeds are especially healthful and low in carbohydrates; they can also be used in baking. The combination of fiber, protein, and healthy fat in nuts and seeds makes them satisfying, and they have many of the nutrients of the more starchy grains, such as wheat.
Fats -- Although reducing carbohydrates usually means increasing fats, it is a common misconception that low-carbohydrate diets are loaded with saturated fats. Monounsaturated fats, especially olive oil, should be emphasized as a source of fat. The essential fats in foods, such as omega-3s found in fatty fish, are even more important.
Dairy Products -- The amount of dairy you eat will partly be determined by your sensitivity to carbohydrates. Milk has quite a bit of sugar, but it is broken down more slowly than other sugars, so many people tolerate it well. Diary products in which the whey is removed (such as strained yogurt, cottage cheese, or other cheeses) have less sugar. If you don't eat a lot of dairy, make sure you are getting calcium in other ways.
Legumes -- Beans and other legumes, such as lentils and peas, have quite a lot of carbohydrate. But this is a type of carb that is either digested slowly or not digested in the small intestine at all (resistant starch). Therefore, in moderation, they are excellent choices for people who don't process sugar well.
Whole grains -- Whole grains (but not whole-grain flour), such as brown rice and barley, are tolerated by some people as a part of a moderately low-carbohydrate diet. Their starch is broken down into glucose more slowly than refined grains and flour. A serving of grains is about half a cup. Whole grain pasta should be cooked al dente (slightly firm), as the more you cook it, the faster it is broken down into glucose.
Sugary and starchy foods -- At the top of the pyramid for people who's bodies do not process sugars well are the foods which are rapidly converted into glucose.
- Foods made with a lot of sugar (candy, soft drinks, etc.)
- Foods made with a lot of flour (cakes, cookies, crackers, etc.)
- Fruit juices
- High-sugar fruits (dried and tropical fruits have the highest amount of sugar)
- Some high-sugar condiments, such as barbecue sauce, ketchup, and salad dressings (check labels)