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Hello blog readers! Thank you for being here. Today, I am co-writing with my longtime friend and fellow dietitian (AND yoga teacher!) Letal Garber, MS, RD, LD, RYT. Like myself, she sees nutrition through a non-diet lens. Unlike myself, she is an expert in Diabetes (DM) management! So, we decided to join forces and explain how a non-diet, Intuitive Eating (IE) approach can absolutely be taken when it comes to managing Pre-Diabetes (Pre-DM) and DM.
But How Do They Go Together?
When you think about DM, you probably think of medications, testing blood sugars, and maybe even diet and exercise as possible ways to manage this condition. You probably don’t naturally think about listening to hunger cues, making peace with food or rejecting diet mentality (just a few of the principles of IE). That’s why we put our heads together — to explain why the two actually really can go hand-in-hand.
If you are just learning about IE or you need a refresher on what it is, here you are: IE is a flexible, free way of eating that is in alignment with your body’s hunger and fullness cues, as well as your true food preferences – there are no “good foods” and no “bad foods”. An IE approach to nutrition also includes body acceptance, non-punitive physical activity, separating food from morality, and tending to your mental and emotional well-being.
And Type-2 DM (T2DM) affects 34 million Americans, and many have Pre-DM, which is characterized by slightly elevated blood glucose (sugar) levels and can be reversible through lifestyle changes. DM (specifically T2DM) is a disorder of the breakdown of sugar in your body. For our bodies to function properly, we need insulin to be the gatekeeper to our cells and allow sugar to enter in. In T2DM, that process is faulty, and the blood gets saturated with sugar, which can be dangerous if not treated. The primary goal in management is to stabilize blood sugars to improve health outcomes.
Unfortunately, managing DM is not so cut and dry. There are multiple factors that may impact blood sugars including: food (timing of meals, composition of meals, distracted eating, skipping meals), exercise, weather, dehydration, anti-inflammatory meds such as steroids, stress, sleep, menstrual cycles in females, caffeine, smoking, and infection (even just a mild cold/cough). It can be exhausting and even unhealthy to try and control all of the factors mentioned above.
So, we’re walking you through each IE principle to show you how IE can help in Pre-DM or DM management:
Reject the diet mentality. Keto, low-carb, severe caloric restriction may all have a negative impact on weight and health status due to their restrictive nature. Yo-yo dieting (years and years of going on and off diet) is often the culprit to regained weight and feelings of failure for people. Carbohydrate counting may be beneficial for some T2DM clients, especially if they are on an insulin-to-carbohydrate dosing regimen. However, eating for nourishment versus to “get rid of Diabetes,” is a more helpful approach and more sustainable than going on another diet.
Honor your hunger. Skipping out on meals or carbs may sound like a smart way to control blood sugars. On the contrary, missing meals may recruit sugar release from the liver to compensate for lack of food, making the blood sugars go higher OR drop the blood sugars too low. Skipping meals during the day and snacking excessively at night is a way of ignoring hunger cues or not making food a priority and is often the reason for high blood sugars upon waking.
Make peace with food. There are messages we receive from social media, friends, family and colleagues that skew our perception of food and eating, but if you challenge the validity of these messages and whether or not they make your life better, you could get one step closer to making peace with food and eating. One such message in the T2DM world is that all carbs are bad! Carbs is an umbrella term for fruits, vegetables, grains, milk, yogurt, and snack foods and should make up at least 50% of our daily caloric intake.
Challenge the food police. Here’s a rule for you to follow: “all food fits.” Morality and eating should not be used in the same sentence. In fact, deeming an apple “good” or a slice of pizza “bad” is unwarranted and often perpetuates feelings of guilt and shame whenever you overeat the “bad” foods. Start asking yourself this question: “when did I start relating foods to self-worth?”
Respect your fullness. Trust that your body will tell you when you’ve had enough to eat. Intuitive and mindful eating go hand-in-hand, and mindfulness teaches us to be aware of what the present moment is telling us. Allow yourself to slow down and have an “intimate” moment with the meal in front of you and ask yourself throughout the meal “what is my fullness level?” You may be surprised to find that you get more satisfied than when you eat in a rush or distracted. At the same time, if you eat past fullness, give yourself grace and know that your body will simply take longer to get hungry again.
Discover the Satisfaction Factor. Eat what you actually want to eat! Once you are fulfilling your true food desires, you’ll notice that your body does not want too much or too little of anything – this goes for both donuts and broccoli. Allowing yourself to take pleasure in eating is a big piece of healing your relationship to food and to yourself – even with Pre-DM and DM. And when we do not allow eating more food than we would have if we had allowed ourselves to eat some of the truly preferred thing! This may create a rollercoaster ride with your blood sugars as a result!
Honor Your Feelings Without Using Food. This principle encourages you to address emotional distress without using food. While turning to food for comfort sometimes is okay, it becomes an issue when it is all the time and the only coping skill used to deal with stress and other unpleasant emotions that come along with being human. Stress causes cortisol (our stress hormone) to increase and our blood sugars to rise, which makes learning to cope and manage stress without using food important for managing Pre-DM and DM.
Respect Your Body. We all have a natural weight range that our bodies want to maintain, and this is rooted largely in genetics. Instead of fighting your body by dieting and weight cycling, which is unhealthy for anyone (and particularly someone with Pre-DM or DM), work on accepting your body where it is right now. Once a person is truly eating and moving intuitively, weight will settle in its natural place. And remember – it’s hard to take good care of something we hate or dislike.
Exercise – Feel the Difference. Physical activity is one of the best ways to naturally manage Pre-DM and DM! But the key is making sure you are moving your body in ways that are enjoyable to you, not to punish yourself or “earn” food. Intuitive movement is about enjoying movement that is fun and feels good. Do what you love often, and if you don’t know what that is, think back to when you were a kid and what you liked to do then. Try things out and be honest with yourself about whether or not it brings you joy!
Honor Your Health – Gentle Nutrition. One of the biggest misconceptions of intuitive eating may be that it leaves health out of the picture. But this principle actually highlights honoring health without rigidity and perfectionism, which is entirely possible when managing Pre-DM or DM. Shoot for a balance of food groups at meals and snacks, and specifically pair carbs with protein as much as possible to avoid large blood sugar swings.
That’s what we have for you guys today! Thanks for reading.
In true health,
Caroline & Letal
PS. If you are struggling with your relationship to food, your body or exercise, I would love to work with you. Please send me an e-mail at thewholeyogird@gmail.com and we can set up a free discovery call to see if we are a good fit!