If you’re new to the concept of Intuitive Eating, please check out my article, What is Intuitive Eating? before you read on.
When you are diagnosed with diabetes, you are often instructed to change your diet and start counting carbohydrates, calories, or macros.
While this approach may work for some people, what are you to do if you have a history of an eating disorder or have been on and off diets for most of your life?
If this describes you, the rigid and restrictive nature of a “diabetes diet” can lead to binge eating and yo-yo dieting, both of which can be harmful to your health – yikes!
What if there was another way?
Hi, I’m Kelly, Registered Dietitian, and Intuitive Eating expert. Would you believe me if I told you that your body contained the wisdom to help you control your blood sugars – and you could do it without counting and measuring your food? The fact is that there is research that shows that Intuitive Eating can help keep blood sugars in a healthy range in those with diabetes.
Let’s kick off this post with why your doctor might be recommending a “diabetes diet” and how we can do better: supporting your stable blood sugars AND avoiding a triggering, restrictive diet.
The rationale for the diabetes diet
The most common diet recommendation for diabetes is a diet that spreads out carbohydrates throughout the day to avoid overly high or low blood sugars.
When we eat or drink anything that contains calories – foods that contain protein, carbohydrates, and/or fat – our body breaks them down into small pieces that can be absorbed into our digestive tract.
Carbohydrates, whether they are complex (like from bread or pasta) or simple (like from candy or fruit) are broken down into simple sugars. Our body then secretes insulin which helps the sugars get into our cells – which is how our body uses the energy.
In type 1 diabetes, the pancreas stops making insulin entirely so people must take insulin.
In type 2 or gestational (pregnancy) diabetes, either the body makes less insulin or the insulin cannot work as well to move all of the glucose into your cells. Either way, the end result is extra glucose in your blood – elevated blood glucose.
For the purposes of this article, I will be focusing on the benefits of Intuitive Eating for type 2 and gestational diabetes. If you have been diagnosed with type 1 diabetes, and/or are taking insulin, I highly recommend that you work with a diabetes specialist to design a plan for you.
Now, our blood glucose levels experience normal fluctuations throughout the day: Levels increase after we eat a meal and decrease as our body uses the energy from the food we eat. But high levels of blood glucose for a long time cause the problems associated with diabetes: damage to the eyes, kidneys, nerves, and blood vessels.
So, treatment for diabetes aims to decrease blood glucose levels to a range where these negative effects are reduced.
Along with medications, there are diet recommendations: A typical diabetes diet aims to spread out carbohydrates throughout the day and limit them overall. So, common advice might be that you can have a certain amount of pasta, but that you would need to avoid other carbohydrate-containing foods in that meal. Many people mourn what they feel is a loss of their favorite foods and they feel like they are cheating when they eat pasta or desserts.
This conventional diabetes diet involves meal planning, measuring, and counting. And as I mentioned above, this strategy can work well for many people.
However, if this degree of planning and measuring isn’t sustainable, or makes you feel like you’re in the throes of a restrictive diet again, there is a different way.
Intuitive Eating with Diabetes
Due to the increased popularity and interest in Intuitive Eating, researchers have wanted to see if it could benefit people with diabetes too.
The good news is that studies* are showing that individuals with type 2 and gestational diabetes, who practice Intuitive Eating have the least likelihood of experiencing sustained high blood sugars.
For those of us who were trained using more conventional advice (like me!), this is interesting news! Especially since a conventional diabetes diet can feel like it has too many rules.
How does Intuitive Eating work for those with diabetes?
You might be wondering specifically how Intuitive Eating can help with blood glucose normalization in diabetes.
Enter the superpower of intuitive eaters: interoception.
Interoception is the ability to sense what is going on in your body: like how fast your heart is beating or how hungry you are. However, this skill can be refined so we have an even better understanding of our body.
Most of us don’t have the skills of interoception when we begin our Intuitive Eating journey. But through the practices of focusing on hunger, fullness, and satiety, and learning to trust our body’s signals, we strengthen our ability to feel what is happening in our bodies.
And this knowledge of interoception includes tracking your blood sugar too!
In one study, intuitive eaters could sense their bodies’ blood sugar levels (which the study researchers confirmed with a blood sugar measurement!).
Isn’t that cool?
The fact is that our bodies feel different when our blood glucose levels are high, low, or somewhere in the middle. And because Intuitive Eating trains us to be more aware of our bodies, we can eat in a way that supports healthy blood sugar – without measuring or counting.
How does this increased awareness help with diabetes?
Over time, people get to understand that low blood sugar might make them feel shaky, while high blood sugar might make them feel sluggish. Through experimentation, you can then learn to eat in a way that helps you feel satisfied AND energized.
The best news: you don’t need to cut out any foods. And: you don’t need to weigh or measure your food either!
Of course, developing this skill of interoception takes time and practice. However, in the end, it can help many people with diabetes have freedom and enjoyment around food while keeping their blood glucose levels in a healthy range!
In my practice, I help my clients improve their interoception while also helping them to eat a variety of foods without any restriction. When I start to teach my clients about gentle nutrition, I use my 3/2 rule. Well, it’s not really a rule but more of a suggestion!
With the 3/2 rule, I encourage my clients to include 3 or more food groups in each meal and 2 or more food groups in each snack. My clients report that they love using this strategy. They find their meals and snacks more satisfying, and it gently helps them try new foods.
If you’re curious about this approach, check out my article, How to Stop Obsessing Over Food: 3 Smart Nutrition Ideas.
That’s a wrap
If you’re struggling with a restrictive diet after your diabetes diagnosis, please know that there is another way! Through Intuitive Eating, you can learn to harness your own body’s signals and eat in a way that is both healthy and satisfying.
If you are curious about how Intuitive Eating might help you with diabetes, schedule your Take Action Call with me today. We can discuss what you’ve been doing so far and how Intuitive Eating can help you improve your health – without restriction! Just think how it will feel to manage your diabetes with confidence and freedom instead of restriction and guilt.
Sources:
Soares FLP, Ramos MH, Gramelisch M, de Paula Pego Silva R, da Silva Batista J, Cattafesta M, Salaroli LB. Intuitive eating is associated with glycemic control in type 2 diabetes. Eat Weight Disord. 2021 Mar;26(2):599-608. doi: 10.1007/s40519-020-00894-8. Epub 2020 Mar 30. PMID: 32232778.
Hayashi LC, Benasi G, St-Onge MP, Aggarwal B. Intuitive and mindful eating to improve physiological health parameters: a short narrative review of intervention studies. J Complement Integr Med. 2021 Dec 16:10.1515/jcim-2021-0294. doi: 10.1515/jcim-2021-0294. Epub ahead of print. PMID: 34913327; PMCID: PMC10098784.
Quansah DY, Gross J, Gilbert L, Helbling C, Horsch A, Puder JJ. Intuitive eating is associated with weight and glucose control during pregnancy and in the early postpartum period in women with gestational diabetes mellitus (GDM): A clinical cohort study. Eat Behav. 2019 Aug;34:101304. doi: 10.1016/j.eatbeh.2019.101304. Epub 2019 May 25. PMID: 31154153.
Quansah DY, Gilbert L, Gross J, Horsch A, Puder JJ. Intuitive eating is associated with improved health indicators at 1-year postpartum in women with gestational diabetes mellitus. J Health Psychol. 2021 Jul;26(8):1168-1184. doi: 10.1177/1359105319869814. Epub 2019 Aug 22. PMID: 31434517.
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