The Three Biggest Diabetes Myths
Article by Laura Rockett, RNutr
Diabetes is a condition that causes our blood sugar levels to be too high and it most commonly tends to be either Type 1 Diabetes or Type 2 Diabetes (1). According to Diabetes UK, almost 5 million people in the UK have a diagnosis of diabetes and 90% of them live with Type 2 diabetes (2).
As an NHS Nutritionist who has supported hundreds of people newly diagnosed with Type 2 Diabetes to improve their health, I’ve heard almost all the diabetes-related myths and misconceptions around. So I’ve chosen the three most common myths to debunk with you today.
Myth #1: “Only people in larger bodies get diabetes”
While it is true that carrying extra weight and body fat can increase our risk of developing Type 2 Diabetes (3), not everybody living in a larger body will develop diabetes. This is because our body weight is only one of the many risk factors. In reality, people in all BMI categories (“overweight”, “obese”, “healthy” and “underweight”) can and do develop Type 2 Diabetes (4), which adds to the growing evidence that BMI is an unreliable sole indicator of someone’s actual health (5).
So what are those other risk factors? Surprisingly, many of these other risk factors are things that we have very little control over: getting older, having a family history of diabetes, being African-Caribbean, Black African, Chinese or South Asian, having Polycystic Ovarian Syndrome (PCOS), having diabetes in pregnancy, sitting a lot during a typical week (e.g. a desk job) or having chronic mental health conditions (such as depression and bipolar disorder) (6).
Therefore, regardless of your weight or BMI category, if you have a combination of these risk factors, it would be worth exploring if you’re entitled to a free NHS Health Check or completing the ‘Know Your Risk’ questionnaire on the Diabetes UK website.
Myth #2: “There’s Nothing Safe To Eat…There’s Sugar In Everything!”
It may seem like sugar is present in every item of food and drink you can think of, and that can be a very worrying belief for somebody living with Type 2 Diabetes. This can be especially confusing when you find out that sugar is (naturally) present in healthy, minimally-processed foods like milk and fruit.
So let’s clear up the confusion by looking at the three main food groups (proteins, fats and carbohydrates) and their impact on blood sugar levels.
Protein
First up, protein. Proteins are made up of amino acids, which are little protein building blocks that all join up. There is no glucose (a.k.a sugar) in a protein, therefore foods that are naturally high in protein (like meat, chicken, fish and some meat alternatives) cannot break down into sugar. Therefore, they do not raise your blood sugar levels when you eat them (7). In fact, including protein at every meal can help slow down the speed at which our blood sugars rise, which can also help you feel fuller for longer (8).
Fats
Next, fats. Fats naturally have tiny amounts of glucose in them due to the sugary ‘glycerol backbone’ in their chemical structure. However, this sugary part of the fat molecule is relatively small, which is one of the reasons why fats tend to have very minimal effects on blood sugars on a day-to-day basis (9). In fact, having some fat (such as nuts or seeds) with your carbohydrates (like your morning bowl of porridge) is beneficial as the presence of fat slows down the speed at which our blood sugars rise (10). It is still important, though, to choose healthier unsaturated fats (like olive oil, oily fish, and nuts) rather than saturated fats (such as butter, cream, and the fatty parts of meat and poultry), and to limit how much fat we eat, as too much of any fat in large quantities can worsen other areas of our health (such as cholesterol).
Carbohydrates
The final food group is carbohydrates. Carbohydrates DO lead to an increase in our blood sugar levels. This is because all carbohydrates (whether they are sugary foods like sweets and soft drinks or starchy foods like bread and potatoes) break down into glucose in our body. Yes, even wholegrain, higher-fibre foods like brown rice and porridge oats. In fact, most people are shocked to discover that these complex carbohydrates impact our blood sugar levels.
Now, many people interpret this to mean they should cut out starchy carbohydrates completely. Many are also, understandably confused because for decades, slimming groups and public health messages have said that a jacket potato of any size, for example, is a ‘healthy’ choice. In reality, it would be very unhealthy for someone living with (or without) diabetes to cut out all ‘carbs’, as starchy carbohydrates provide us with slow-release energy throughout the day, gut-healthy fibre as well as important minerals and B vitamins. But there are things we can do to reduce the impact of these foods on our blood sugar levels (as well as making our diets more balanced). First, choose brown, high-fibre, wholegrain versions over white versions (e.g. of rice and bread) as often as you can, to slow down the rise in our sugar levels. Second, consider reducing the amount of carbohydrates on your plate to a third or a quarter of the plate, and bulking up the plate with vegetables, to reduce the amount of food on your plate that will cause your blood sugars to rise. And third, try to include protein and fibre (and perhaps small amounts of unsaturated fats) at each meal to slow down the sugar release.
Myth #3: “I’m only allowed to eat ‘diabetic’ chocolate and biscuits now”
Unfortunately, this is a big myth. This myth also applies to other ‘diabetic’ foods, such as sweets, mints and cookies.
While these ‘diabetic’ or ‘sugar free’ versions of our favourite foods are indeed lower in sugar, they still contain just as much carbohydrate as the regular version (11). (Recall from Myth 2 that all carbohydrates raise our blood sugar levels, not just sugars). Not only do they raise our blood sugar levels, they’re also just as high in fat and calories as the regular version. Furthermore, many patients tell me that they end up eating more of them in one sitting as they think they’re healthier than the regular versions. Due to the artificial sweeteners used to replace the sugar in these products, many people report getting diarrhoea after eating (the packaging will state it may have a ‘laxative effect’).
So, Diabetes UK (12) and the NHS do not recommend the ‘sugar free’ or ‘diabetic’ versions of foods. Instead, they recommend we eat the regular version, in smaller amounts or less frequently, as part of our healthy, balanced diet.
Summary
Whatever body size you live in, if you have any of the diabetes risk factors, consider completing the Diabetes UK ‘Know Your Risk’ questionnaire and speak with a registered healthcare professional, such as your GP, for further support.
If you’re looking to reduce your risk of, or manage your, diabetes, consider reducing your portion size of starchy carbohydrates (like bread, pasta, rice and potatoes), and opt for slow-releasing carbohydrate such as wholewheat or wholegrain varieties, as well as trying to incorporate protein and vegetables at most meals.
Diabetic foods may not be any better for us than ordinary versions of our favourite foods, so save your pennies (and your toilet roll), and try to maintain a healthy, balanced and varied diet where moderation is key!
This blog was written by Laura Rockett, who is a Registered Nutritionist, Certified Intuitive Eating Counsellor and Diabetes Educator working in the NHS and with private clients. She has spent the last 7 years supporting people and families living with Type 2 Diabetes to manage their condition and improve their health. Laura works in a weight-inclusive manner, which means she helps people to improve their health, without them needing to change their weight. You can find her on Instagram at @nondietnutritionwithlaura
References:
https://www.nhs.uk/conditions/diabetes/
https://www.diabetes.org.uk/professionals/position-statements-reports/statistics
Ethnic Differences in the Prevalence of Diabetes in Underweight and Normal Weight Individuals: The CARRS and NHANES Studies: Diabetes Res Clin Pract. (2018) Dec; 146: 34–40.
Misclassification of cardiometabolic health when using body mass index categories in NHANES 2005–2012
A J Tomiyama, J M Hunger, J Nguyen-Cuu & C Wells (2016) International Journal of Obesity
https://www.diabetes.org.uk/preventing-type-2-diabetes/diabetes-risk-factors
An increase in dietary protein improves the blood glucose response in persons with type 2 diabetes. Mary C Gannon, Frank Q Nuttall, Asad Saeed, Kelly Jordan, Heidi Hoover. The American Journal of Clinical Nutrition, Volume 78, Issue 4, October 2003, Pages 734–741
Dietary protein and muscle in older persons. Douglas Paddon-Jones and Heather Leidy: Curr Opin Clin Nutr Metab Care. 2014 Jan; 17(1): 5–11.
Protein: metabolism and effect on blood glucose levels. Diabetes Educ, 1997 Nov-Dec;23(6):643-6, 648, 650-1
www.tesco.com Comparison of Skinny Cookie Sugar Free Chocolate Chip Cookies 200G and Maryland Chocolate Chip Cookies 200G
https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/chocolate-and-diabetes