Q: I've recently been diagnosed with diabetes and am overwhelmed by all of the conflicting information about how to eat to best manage this condition.  Should I follow a diet that is high in fiber or with a low glycemic index?

A: There is no one diet or meal plan that works for everyone with diabetes. The important thing is to follow a meal plan that is tailored to personal preferences and lifestyle and helps achieve goals for blood glucose, cholesterol and triglycerides levels, blood pressure, and weight management--making consulting with a registered dietitian critical.   Research does show that for most people with diabetes, the first tool for managing blood glucose is some type of carbohydrate counting. Balancing total carbohydrate intake with physical activity and diabetes pills or insulin (if needed) is key to managing blood glucose levels. Glycemic index is an emerging system that is being explored to help people further refine carbohydrate counting.

The glycemic index (GI) ranks food based on their immediate effect on blood glucose levels. Carbohydrate foods that breakdown quickly during digestion have a high GI. Their blood sugar response is fast and high. Carbohydrates that breakdown slowly, releasing glucose gradually into the blood stream, have a low GI. GI is affected by many things, including the nutrients in a food, how the food is prepared, and the amount of food that you eat.
Low GI foods include most fruits and green vegetables, 100% stone-ground whole wheat or pumpernickel bread, rolled oats, oat bran, pasta, barley, sweet potato, corn, yam, lima/butter beans, peas, legumes and lentils.

Examples of foods with a medium GI include rye bread and brown or wild rice. High GI foods include white bread or bagel, corn flakes, puffed rice, white rice, potato, pretzels, rice cakes, popcorn, and saltine crackers. Notice that foods higher in fiber tend to have lower GI. So, within your carbohydrate allowance, choose foods higher in fiber.  

Dr. Cathy Kapica is Vice President of Global Health and Wellness at Ketchum Communications.  With over 20 years experience in health and nutrition, she counsels clients on strategies and tactics to incorporate wellness into their business plans. She is also Adjunct Professor of Nutrition at Tufts University. As a nutrition scientist with a doctorate in public health, she has had a distinguished career in nutrition and health promotion. 

As the former Global Director of Nutrition for the McDonald’s Corporation, Dr. Kapica led the nutrition effort for McDonald’s worldwide. She worked closely with a multidisciplinary team, including menu management, product development, supply chain, marketing and communications to develop and promote their health and wellness initiative --Balanced, Active Lifestyles--in the 118 countries where McDonald’s restaurants serve over 50 million customers everyday. She led the Food and Menu Committee of the Global Advisory Council on Balanced Active Lifestyles, an advisory board of 16 distinguished scientists from around the world.

Prior to joining McDonald’s, Dr. Kapica served as Senior Scientist and Director of Nutrition Education at the Quaker Oats Company where she educated consumers, health professionals and the media on the health benefits of oats.

Dr. Kapica is a graduate of Loyola University, Rush University and the University of Illinois, all in Chicago.