10 Ways to Keep Your Portions in Check if You Have Diabetes

Many people — with or without diabetes — have trouble estimating portion sizes. Weighing and measuring food can help. “We can’t be healthy if we eat everything put in front of us, and weighing and measuring teaches us appropriate portion sizes,” says Jill Weisenberger, RDN, CDE, a health and wellness coach in Newport News, Virginia. People with diabetes can eat roughly 30 to 45 grams (g) total carbs per meal for women and 45 to 60 g per meal for men, says Kimberlain.

So how do you know if you’re eating the right amount? “When I counsel patients, I show them common portion sizes and go through the equivalents for ‘counting carbs,’” Kimberlain explains. “For example, the following portions all contain 15 g of carbs: one (average) slice of bread, one-third cup of cooked rice; one-half cup of cooked legumes like lentils, black beans, or garbanzo beans; and one tennis-ball-size apple.”

Kimberlain encourages patients to go home and measure the foods themselves (with measuring cups and spoons) so they can see on their plates what these common portion sizes look like. But if you have type 1 diabetes or type 2 diabetes and are on insulin, you may want to use a scale, she adds. Some scales will tell you how many carbs the food has.

When eating out, you can estimate portions by comparing them with familiar objects — for example, 1 cup is about the size of a baseball, says Kimberlain, and one serving of meat, which is about 3 ounces (oz), should be the size of a deck of playing cards. A ½ cup is about the size of a tennis ball, which is equal to 1-oz equivalents, such as one serving of grains like cooked pasta, cooked rice, or cooked oatmeal.

It’s important to read food labels carefully when monitoring portion sizes. “The first thing to look at when reading a food label is the serving size,” says Kimberlain. “As food labels are currently written, they are not always just one serving. Therefore, if the serving size is more than one serving, you will need to calculate how much you’re eating. For example, if the serving size is 5 crackers, but you eat 10 crackers, you have to double all the information: 100 calories becomes 200 calories, 250 milligrams [mg] of sodium becomes 500 mg, etc.”

You also want to look at how much saturated fat you’re eating, says Kimberlain, as people with type 2 diabetes have an increased risk of getting heart disease. “For saturated fat, I teach people to look at the percentages,” she says. “Giving them the range of 5 percent to 20 percent allows them to know if the food is ‘high saturated fat’ or ‘low saturated fat.’ If an item has 5 percent, it’s a better choice.”

It’s also important to monitor your sodium intake. The American Heart Association recommends consuming no more than 2,300 mg a day and moving toward an ideal limit of no more than 1,500 mg per day for most adults, and this can be even more important for people with diabetes, Kimberlain notes. “Decreasing the amount of sodium in the diet can help many people lower their blood pressure. Lowering blood pressure also means decreasing risk for heart attack or stroke, both of which are common diabetes complications.”

People with diabetes also need to look at “total carbs,” says Kimberlain. “Sugar will be included in this category,” she explains. “Many people with diabetes might look just at the sugar category, but that doesn’t give the whole picture. For example, bread might have 1 g of sugar but 15 g of carbs. If you only looked at the sugar, you might opt to eat more, thinking that you’re not affecting your blood sugar levels when in fact you are.”

Common sense should tell you that all-you-can-eat buffets are tricky for everyone, but they’re especially risky if you have type 1 or type 2 diabetes. “They typically lead to overeating,” says Kimberlain, which can affect blood sugar and lead to dangerous weight gain for people with diabetes, she explains. Here are some of her tips for portion control at a buffet:

• Don’t starve yourself before going to the buffet, because you’ll be more likely to overeat.
• Get an overview — scope out what the buffet has before serving yourself. You may end up preferring healthier options.
• Take small portions.
• Watch the starches. This is more important for people with diabetes because starches directly affect your blood sugar. So be careful with grains like bread, rice, and pasta, but also be mindful of “starchy” vegetables like potatoes, corn, peas, and winter squash, which also affect your blood sugar.
• Try to eat slowly. This can help reduce your overall food intake.

Buying smaller plates or using a salad plate instead of a dinner plate are good options for people with diabetes because these are tangible portion control methods that are hard to circumvent, says Kimberlain. “There’s less room, and it’s more difficult to pile them a mountain high,” she explains. Kimberlain also suggests using the salad plate for your protein and carb (main dish), then using a regular dinner plate for a big salad or all the nonstarchy veggies you want.

Asking for a “doggie bag” or to-go container when dining out is a research-backed way to practice portion control. One study found that women who were offered the opportunity to take away leftovers ate substantially less in response to being served more food.

But don’t wait until the end of the meal to ask for a to-go container, says Kimberlain. Ask your server to package half your entrée before it makes it to the table, or cut it in half yourself before starting to eat to remove temptation. “By already minimizing what’s in front of you, you’re more likely to have a proper portion, versus portion distortion,” she explains. This also helps you avoid “cleaning your plate,” which is counterproductive when it comes to portion control, Kimberlain notes. “Sometimes when there is food in front of us we tend to continue munching when we’re not even hungry, or because we don’t want to waste food.”

Other ways to avoid overeating when dining out include ordering one entrée to share with a friend, or ordering an appetizer instead of an entrée, she adds.

Besides helping you monitor portion control, keeping a food log has another benefit for someone with diabetes: “By recording your intake and your blood glucose, you will learn how foods affect your blood glucose,” says Weisenberger. You’ll need to measure your blood glucose in pairs for this to work. “Measure just before eating and two hours after your first bite,” she explains. “If you do this often enough, you will know the best foods and portion sizes for you.” If you’re trying to lose weight, food journaling may also help you do that. One study found that the frequency of dietary self-monitoring is significantly related to weight loss.

How much is a portion, anyway? It’s hard to tell in this era of “supersized” foods. “The portions in restaurants are quite supersized in general — portion sizes have grown a lot in the last several decades,” says Kimberlain. “For example, today’s bagels or muffins are often at least two servings, yet we tend to eat the whole thing, thinking we’ve only had one serving.”

And while supersized portions are often offered at relatively low prices, don’t take the bait just because it’s a good deal for your wallet. “Supersized portions, for everyone, not just for people with diabetes, translate to a lot of calories consumed,” says Kimberlain. “Too many calories result in weight gain — a risk factor for both heart disease and diabetes. And if you already have diabetes, it puts you at risk for elevating your blood sugar.”

People with diabetes (and even those who don’t have diabetes) are much better off avoiding sugary drinks, including soda, juice, sports drinks, sugar-added coffee, alcoholic beverages (like sugary frozen drinks), sweet tea, lemonade, energy drinks, flavored waters, and sweetened nondairy milks, says Kimberlain. “You’re taxing your pancreas to secrete enough insulin in order to cover the circulating glucose that’s just been consumed,” she explains. “With a normally functioning pancreas, this doesn’t tend to be an issue, but if you have diabetes, you create a quick surge in blood sugar that stays elevated and is harder to lower,” partially because these drinks commonly lack additional nutrients and fiber, she notes. Even worse is when you pair sugary drinks with food, because now you’re consuming too many carbs all at once, she adds.

Healthier alternatives include water, infused water (cucumber melon, mint with lime), unsweetened tea, and sparkling water (there are sweetened sparkling waters, too, so choose carefully), says Kimberlain.

One study found that in addition to weight gain, higher consumption of sugar-sweetened beverages is associated with the development of metabolic syndrome and type 2 diabetes. Another study found that regular intake of sugar-sweetened beverages is associated with a greater increase in insulin resistance and a higher risk of developing prediabetes.

Think you have to give up snacks if you have diabetes? Quite the opposite. Snacks are important during the day to help with overall blood sugar control, says Kimberlain. But when you eat is as important as what you eat because you want to make sure you give your blood sugar enough time to come back down to normal before a meal. “Perpetual high blood sugar levels can lead to complications,” she explains.

Protein-only snacks can help you satisfy your hunger without spiking your blood sugar, says Kimberlain. “For example, if breakfast was at 7 a.m., lunch at noon, snack at 3:30 p.m., and then dinner at 7 p.m., but you found yourself hungry at 10 a.m., I might suggest having a protein-only snack, which wouldn’t elevate your blood sugar [two hours before lunch]. Examples of protein-only snacks include a hard-boiled egg, nonstarchy veggies with a plain Greek-yogurt-based dip, celery and peanut butter, a low-fat cheese stick, or avocado with tomato.”

But for your 3:30 p.m. snack, there’s enough space in between meals to allow for your blood sugar to return to normal levels, so some carbs are okay and may also prevent you from overeating at dinner, explains Kimberlain. “Examples here could be a half sandwich (on whole-grain bread), an apple (tennis-ball size) with peanut butter, cottage cheese and pineapple, cheese and whole-wheat crackers, plain yogurt with fruit mixed in, or a handful of mixed nuts with a fruit.”

Additional reporting by Jennifer D’Angelo Friedman.