Diabetes and Fast-Food Choices

Healthy Food Choices on the Go

Updated August 31, 2017

Ideally, fast food is not the first choice for people with diabetes. However, in real life, we run around and get hungry away from our kitchens. We need to eat regularly to keep blood sugar levels stable and to avoid the bad choices that being ravenous can lead us to. If you remember these simple rules when you have diabetes, fast-food choices don’t have to throw you off the path of good management or be void of good nutrition. People with diabetes have many different diet philosophies, beliefs, and practices. There is no one-size-fits-all plan. Some people can have a considerable amount of carbs. Some can’t or don’t want to. Some can eat smaller servings of just about anything. Some can’t. If you take insulin or any medication that can make your blood sugar go too low, make sure to get enough carbs to counteract the medication so you don’t go too low.

You can make food choices according to “levels.” Try to stick to the top level as much as you can. Keep options from fast-food drive-through windows, convenience stores, and ready-made grocery items in mind.

Use these choices to tide you over until you can treat yourself with healthier food. If you make choices that are further down the choice list and that are not very heavy on nutrition, make sure to try to eat healthy foods the rest of the day if possible.

Try to avoid large servings, too many calories, fried foods and fatty or sweet sauces. Calories, fat, and carbs can hide in the sauces and toppings. Try to look up what you eat. Sometimes, restaurants have nutritional pamphlets you can have. You can look online, carry a food count book, or use a phone app that lets you look food up quickly and see entire menus.

First Level Choices

First level choices are dark leafy greens, non-starchy vegetables, low-glycemic fruit, lower-fat grilled proteins, legumes (beans), nuts (such as walnuts and almonds), seeds (such as sunflower seeds), good monounsaturated fats and sea vegetables.

I personally try to avoid wheat and fatty cheeses. I am intolerant to both, especially when they are served together. They upset my stomach. Many people with diabetes have this problem and may not be aware it is causing digestion problems.

Most of the time, eating at this level means there are no carbohydrates to count or at least not that many. Watch out for sauces and toppings. Remember that fruits, beans, and starchy vegetables contain carbs. Stay within your goals for carbs per meal.

First level choices could be:

  • Grilled chicken salad. This can be found at most fast-food restaurants. Remember to check the nutrition label on the dressing and other add-ins they may offer.
  • Salad with nuts or beans. Some fast-food restaurants carry these types of salads. Sometimes their “Southwestern” salads include a scoop of beans. Watch out for fried additions, cheese, and heavy dressing.
  • Apple with nuts. These can be found in grocery stores and some convenience stores. If you can tolerate cheese, a cheese stick goes well with an apple.
  • Beans with lettuce, salsa, and guacamole or sliced avocados. These are staples in most Mexican restaurants. It is even better if you can find boiled whole beans rather than refried beans.​
  • Stir-fry with vegetables and protein. Stir-fry from a drive-through? Order a Panda Express bowl and ask for it to be served over mixed vegetables instead of rice or noodles. It does have a semi-sweet and spicy sauce that has 13 grams of carbs and 5 grams of sugar per serving.
  • Seaweed salad and a protein. Many grocery stores carry seaweed salad near the deli counter with other Japanese sushi selections. Unfortunately, the nutrition label is often absent. On average 1 ounce of seaweed salad has about 5 grams of carbs and 4 grams of sugar. However, some restaurants have counts as high as 41 grams of carbs and 18 grams of sugar. Pair it with grilled meat, deli meat, a boiled egg, or whatever they might have on hand.
  • Skinless chicken and green beans. This combo can be found at Popeye’s Chicken and Biscuits and Kentucky Fried Chicken.

Second Level Choices

Second level choices would be the choices listed above plus whole grains or grains that are high-fiber, low-carb, and don’t make your blood sugar level rise very high. We are all different. For many, corn tortillas are not too evil.

Second level choices could be:

  • Beans (as above) with a corn tortilla or two. If you can find a place with whole-grain flour tortillas, those may be an even better choice.
  • Grilled tacos with corn tortillas. Do not get fried tortilla shells. The best protein choices would be grilled chicken or fish.
  • Grilled sandwich or wrap. Some fast-food restaurants offer whole grain buns or wraps with grilled meats. These restaurants include McDonald’s, Burger King, Arby’s, Sonic, Carl’s Jr., and Chic-fil-A. If you are trying to limit starchy carbs, take off half the bun and eat the meal as an open-face sandwich. Some places also serve meats in a lettuce wrap.
  • Pita sandwich. Jack in the Box has offered the chicken fajita pita with a whole grain pita for a long time, and it’s one of my favorites. It is a bit higher than what I would like for fat and sodium, but it can be made better by ordering it without the cheese. Regularly, the item has 326 calories, 10 grams of fat, 6 grams of saturated fat, 987 milligrams of sodium, 35 grams of carbs, 3 grams of sugar and 23 grams of protein. Go without cheese, and the sandwich is 234 calories, 3 grams of fat, 1 gram of saturated fat, 842 milligrams of sodium, 34 grams of carbs, 3 grams of sugar and 17 grams of protein.

Third Level Choices

If you simply cannot find a meal that fits into the first two choice categories, then you may have to count carbohydrates. Another option would be using exchange lists. This requires looking up nutritional information. Also look at the sugar and calories and try to keep them as low as possible. Work with a dietitian to find out what works best for you, your diabetes management, and your goals.



Cannabis and Cannabinoids

I want to begin by stating that I am definitely “PRO” Cannabis!!

I’m writing today to share information I discovered regarding a report that was issued by the National Academies of Sciences-Engineering and Medicine on January 12, 2017. Described as one of the most comprehensive studies of research since 1999, at which time the National Academies released the report “Marijuana and Medicine: Assessing the Science Base.”

Utilizing literature databases an extensive search to identify relevant reports and research materials that have been published since the 1999 report was executed, more than 10,000 scientific abstracts were considered. The Committee moved forward based on the abundance of information published addressing Cannabis, the task statement, and other specified study parameters.

The steps involved were determined at the onset by the committee to cover detailed examination of “Health Topics” which demonstrated the most pressing affect to Public Health.

Nearly 100 different research conclusions were organized into 5 categories of the use of Cannabis or Cannabinoid and Health. Ultimately four recommendations outlining research priorities to be included in a research agenda were determined.

  • Addressing current research gaps
  • Identify actionable strategies
  • Highlight potential to improve data collection and enhance surveillance capacity
  • Introduce strategies to plug away at the existing obstacles currently inhibiting Cannabis research

This reports release occurs during a critical period of time for the use and benefits of Cannabis.

I admit my use of cannabis has been a part of life for a long while. So some may say I’m biased, however I know from personal experience that cannabis enables me to be more productive and provides greater pain management than occurs when I take prescription meds by themselves.

I definitely support the Federal re-categorization of marijuana from having no medical value to a position of valued medical benefit. This action would thus encourage study of the benefits derived from consumption of this wonderful plant.

Do not however take my word for it, check it out for yourself and by all means read the full report at nationalacademies.org/CannabisHealthEffects


What’s the Best Yogurt for People With Diabetes?

Greek Yogurt: Nutrition Benefits for People With Diabetes

Yogurt, typically made from cow’s milk (however, nowadays there are many alternatives), is a source of carbohydrate which is also full of good bacteria, calcium, and protein. If you have diabetes, yogurt can be a smart food choice; however, the trick is to know which kind of yogurt to choose and which to skip out on.

What to Look for in a Yogurt

In the best kinds of yogurt, you get a good balance of protein and carbohydrate, along with calcium and healthy probiotics.

You also don’t get a lot of added sugar, additives, food coloring, or saturated fat. Choosing a low-fat  or non-fat yogurt version can help you to reduce your total calorie intake as well as keep your saturated fat (the type of fat that increase bad LDL cholesterol) low. In addition, since yogurt is a source of carbohydrate, you’ll want to choose a yogurt that is low in added sugars such as fruited yogurts or those yogurts with added granola, or other toppings that are rich in sugar. Therefore, it’s best to choose plain, low-fat yogurt. If you need to add sweetness, top your yogurt with some berries or peaches. Frozen varieties can make your yogurt seem “syrup-y”, too, for more fiber and less added sugar.

Greek Yogurt vs. Regular Yogurt

Greek yogurt is regular yogurt that’s been strained, removing some of the whey and leaving behind a thicker, more protein-rich yogurt. Greek yogurt is readily available in regular grocery stores; find it in the refrigerated dairy section.

Regular yogurt provides 5 grams of protein per 6-ounce serving, while Greek yogurt provides up to 20 grams, depending on the brand. Because it has more protein, Greek yogurt has about 1/3 the carbohydrate of regular yogurt.  And, because lactose is a source of carbohydrate in dairy products, this means that many people find Greek yogurt easier to digest than regular yogurt.

 On the other hand, Greek yogurt has less calcium than traditional yogurt, so keep that in mind if you’re eating yogurt for calcium.

For people with diabetes, plain, low-fat, or non-fat Greek yogurt is an exceptional meal and snack option due to the low carbohydrate and high protein content. Avoid those Greek yogurt varieties that have added syrups, fruit preserves, and sweeteners on the side.

How to Have Yogurt in Your Diabetes-Friendly Meal Plan

Yogurt for breakfast: For a great, filling, and nutrient dense breakfast, try 6 to 8 ounces of plain low-fat Greek yogurt topped with one serving of fresh or frozen seasonal fruit (like berries, sliced peaches, chunked apples, etc.) and top it with 1 tablespoon nuts, such as, chopped almonds for crunch, additional protein, and healthy fats. If you like, add a sugar-free sweetener, cinnamon or vanilla powder for added flavor.

Traditionally, Greek yogurt is sweetened with honey, which is a simple sugar that could add calories and spike your blood sugar. But, if you can spare the carbohydrates, then you could try a teaspoon of honey instead of a sugar-free sweetener. However, a better idea for people with diabetes whose meal plan calls for more carbohydrate would be to stick to the sugar-free sweeteners and then perhaps to add another serving of fruit or a slice of whole wheat toast instead of the simple sugar found in honey.

Fruit and whole grains has some fiber and protein which will increase your nutrition and help to achiever fullness. Adding a serving of fruit and a sugar-free sweetener, your yogurt containing breakfast would be around 24 grams of carbohydrate. With an additional serving of fruit or whole grain toast, the meal would contain 40 grams of carbohydrate.

Yogurt in dips: Plain low or non-fat Greek yogurt can also be used almost exclusively in place of sour cream in dips and recipes since the texture and flavor are so similar. You can also sub out some mayo in coleslaw recipes. Lastly, you can use Greek yogurt it in baked goods that call for sour cream, such as cookies, scones or cake.

Yogurt in smoothies: Add some low-fat Greek yogurt to your smoothies for added thickness, texture, and protein.

Should You Use Sugar Substitutes (aka Low-Calorie Sweeteners)? What Does the Research Say and What Does it Mean? By Barbie Cervoni, RD, CDE | Reviewed by a board-certified physician Updated January 10, 2017

It’s one of the most frequently asked questions when it comes to health, blood glucose (blood sugar), and weight control: should you use sugar substitutes, aka, artificial sweeteners, low-calorie sweeteners, or non-nutritive sweeteners? Are they safe? Can they help you lose weight or reduce your blood sugar?

There have been decades of research on the safety of low-calorie sweeteners (LCSs) and whether they can help people lose weight or more easily achieve glucose control.

The research has been mixed, some positive and some negative. The truth is that the equation for a healthy eating pattern is one that does not focus solely on any one food or food product. Moderation is key.

And when it comes to losing and controlling weight, reducing calories from sugar and refined carbohydrates can help people who have diabetes or are overweight to lose weight and reduce blood sugars. So if switching from using sugar or regularly sweetened beverages, such as soda, to packets of LCS or diet beverages helps you control your weight and improve your blood sugar, then you may want to consider them.

For those of you who are skeptics of LCS becoming educated on the subject and weighing the pros and cons can help you to make good choices. Being overweight and having uncontrolled diabetes is a threat to your health and it may be advantageous to use products that help you reach your goals.

Many studies suggest that people who use LCS are able to lose weight easier, maintain a healthier weight, and control blood sugar levels. Hope Warshaw, MMSc, RD, CDE, BC-ADM, weighs in as an expert on the topic.

Some studies suggest that LCS promote overeating and eventually weight gain whereas others show when LCS are used as part of a healthy eating and lifestyle plan and can help control weight. Where does the truth lie?

Before looking at individual studies, here’s the bottom line. In viewing the body of research on LCS and body weight, many health associations and experts agree with the conclusions from a Scientific Statement from the American Diabetes Association and American Heart Association:

LCS are not a magic bullet for weight loss, but can be one of many tools you can use as part of a complete weight control plan. LCS can help people lower their calorie intake if they don’t replace the saved calories with calories from other foods.

There have been some conflicting studies but even more so conflicting headlines. To the research on LCS and weight control: A number of the headlines about LCS, and more specifically diet beverages that contain one or more LCS, have emanated from so-called observational studies. These studies review vast amounts of data from studies, which observe a large group of people and follow myriad lifestyle factors.

These studies can make observations but can’t confirm cause and effect, for instance, that LCS and/or diet beverages cause weight gain. The reality is that many other factors in a person’s food choices and lifestyle can cause weight gain. In a 2013 analysis by Pereira of a number of these observational studies, he concluded that people at risk of weight gain, obesity, and type 2 diabetes (T2D) may be more likely to increase their intake of diet beverages in an attempt to reduce their risk of diabetes and weight-related diseases.

A few randomized controlled trials (RCT) have been completed, which show that LCS (particularly when diet beverages replace sugar-sweetened beverages (SSB)) can help people lose a small amount of weight. RCTs are considered the gold-standard type of study in which researchers compare a control against one or more study groups to determine the impact of some change.

Peters and fellow researchers conducted a 12-week weight control program in about 300 men and women. The study group was instructed to drink 24 ounces per day of diet beverages (any type) and the control was to drink 24 ounces of water per day only.

Results showed the diet beverage group lost an average of 13 pounds or 44 percent more than the control group subjects who lost an average of 9 pounds.

Another RCT by Tate and fellow researchers looked at over 300 overweight adults over six months. The diet beverage and water groups substituted at least 2 servings per day of their SSB for a diet beverage or water. After six months the diet beverage drinkers were more likely to reach a 5 percent weight loss than the water drinkers.

One other study from the well-known National Weight Control Registry a registry of more than 10,000 people who have lost at least 30 pounds and kept it off for at least one year, looked at the consumption of LCS sweetened beverages in over 400 hundred people for seven years. It found 53 percent of participants regularly drank diet beverages and 10 percent regularly used SSB. Nearly 80 percent of participants reported that diet beverages helped them control their calorie intake.

Last but not least, a meta-analysis (analysis of many studies) published in 2014 by Miller and Perez found that LCS reduced body weight compared to placebo and modestly, but significantly reduced body mass index, fat mass, and waist circumference. In an editorial accompanying this publication, James Hill, PhD, a well-respected obesity researcher stated, “It means that LCS seem to be doing exactly what they were designed to do: helping reduce total energy intake while providing the sweet taste we value…You can confidently use this tool [LCS] without worrying that you might be unintentionally hurting your weight-management efforts.” 

Does one type of low-calorie sweetener impact weight differently than another?

There is no research to show this. Today, diet drinks are most often sweetened with aspartame (canned and bottled drinks), aspartame and saccharin (fountain soft drinks), aspartame and acesulfame-K, or sucralose. One reason beverage manufacturers may use a blend of LCSs is to take advantage of the different taste profiles of the different LCS to improve overall taste of the product.

What does research conclude about LCS and cravings and increasing appetite for sugary foods and sweets?

This has been another area of contention regarding LCS. The notion seems to be that because LCS are sweeter than sugar they overstimulate sweet taste receptors and cause sweet cravings which lead people to overeat and gain weight.

Several studies refute this notion. For instance, Antenucci and Hayes recruited over 400 people for a series of taste tests. Participants drank between 12 and 15 separate samples containing calorie-containing sweeteners as well as various concentrations of several LCS. Study participants rated the perceived sweetness of each sample. The results showed that participants perceived the sweetness of LCS at lower concentrations than the calorie-containing sweeteners. The researchers concluded that the results don’t support the claim that LCS over-stimulate peoples’ sweet taste receptors.

In addition, three of the studies previously detailed include findings to help answer this question. Peters showed the hunger ratings at 12 weeks increased slightly in the water group and declined slightly in the diet beverage group which resulted in significantly less hunger. An additional analysis of the Tate study by Piernas showed that while both the water and diet beverage drinkers reduced total calories and added sugars intake, the diet beverage group reduced their consumption of desserts more. The researchers conjectured that perhaps diet drinks satisfy the desire for something sweet. The NWCR study showed that nearly 80 percent of participants said that diet beverages helped them control their calorie intake.

Bottom Line: Rather than increasing cravings, appetite, and hunger, in actuality LCS (either as a sugar substitute or food and beverage), may satisfy people’s cravings for sweets and tamp down their hunger.

Is it possible for low-calorie sweeteners to affect the gut microbiome in a manner that can cause rises in glucose levels?

The gut microbiome is the large variety of microorganisms that live in the digestive tracts (the intestines) of animals and humans. Research in this area is accumulating and increasing. The thinking is that maintaining a healthy gut microbiome can play a role in health, disease prevention and maintaining a healthy weight.

The study by Suez and fellow researchers published in Nature captured a lot of media attention and made several very broad brushstroke conclusions about the use of all LCS when, in reality, the majority of the sub-studies in the paper reported focused on saccharin and a number of them were conducted in mice. It’s important to note that, although LCS are in the same category, they are different in origin, composition and how they’re metabolized. This was a very complex paper with many sub-studies within. At this point some of the key study results have been challenged by respected experts. As is true with a lot of research, additional well-conducted studies will need to be done to further prove this relationship.

The findings in this study that aspartame and sucralose, the low-calorie sweeteners in greatest use, raise glucose levels don’t concur with the existing body of research. It’s worth noting that to be approved by FDA as a food additive and for use by people with diabetes (which they are), research submitted to the FDA for approval must include the studies about the impact of the LCS on glucose levels. Research submitted to FDA for approval as well as additional research in the ensuing years after approval doesn’t concur. Overall, studies, conducted over the past few decades, show that neither aspartame nor sucralose significantly change the gut microbiome or raise blood glucose levels.

Most of the animal and human sub-studies reported in the Nature study focused on the impact of saccharin on glucose control. Of interest to people with diabetes is that saccharin has been in use for more than 100 years and for many years was the only choice available. To date there are a few animal studies which indicate saccharin in high doses may change the gut microbiome. Data from human studies on this topic are insufficient and less clear.

Bottom Line: Further research is important, but a dramatic impact of even moderate saccharin use on the gut microbiome or glucose levels appears highly unlikely.

What are the recommendations about LCS from the American Diabetes Association (ADA) and other organizations?

In November 2013, the ADA published an update to their nutrition recommendations for adults with diabetes. In this position statement, which reviewed many nutrition related topics, the ADA statement reads: “Use of nonnutritive sweeteners [LCS] has the potential to reduce overall calorie and carbohydrate intake if substituted for caloric sweeteners without compensation by intake of additional calories from other sources.”

Regarding the impact of LCS on glucose levels, the ADA concluded in these nutrition recommendations that existing research shows that LCS don’t cause a glucose rise unless the LCS is consumed in a food or beverage with other calorie containing ingredients. For example, that would be a yogurt or hot cocoa sweetened with an LCS. In contrast, diet beverages generally contain no calories.

Bottom Line: LCS don’t cause a glucose rise unless the LCS is consumed in a food or beverage with other calorie containing ingredients.

How much LCS do people in general and people with diabetes specifically consume?

When it comes to “safe” amounts of LCS to consume research shows that people, on average, consume nowhere close to what is called the Acceptable Daily Intake (ADI). This includes people with diabetes, who may be the highest consumers of LCS. ADI is defined by FDA and other regulatory agencies around the world as the amount of an LCS that a person can consume every day of their life with no safety concerns. The ADI is based on the wide range of animal studies required for approval and is based on a one hundred fold safety factor from what’s called the highest no adverse effect level.

Let’s look at aspartame for an example. The FDA ADI for aspartame is 50 mg/kg of body weight/day. This amount would be equal to using 97 packets of an aspartame-containing LCS each day over a person’s lifetime. Yet the Estimated Daily Intake (EDI) for aspartame was found to be 6 percent of ADI in the general adult population. EDI is defined as an estimation of the amount of the ingredient consumed if it were substituted for sugar in 100 percent of all possible foods and beverages.

The FDA requires extensive research on LCS prior to allowing LCS on the market. Generally speaking, LCS are approved for use by the entire general population. This includes children, pregnant and breastfeeding woman and people with diabetes.

What is useful information for a person who is overweight and at risk for Type 2 diabetes (T2D) or someone with T2D regarding the most important actions they can take regarding their eating plan and long term health?

It’s clear from the research and the nutrition recommendations from the ADA that the most important actions a person at risk of T2D (prediabetes) or with T2D can do to prevent or slow the diagnosis (of prediabetes) or slow the progression of T2D at or just after diagnosis is to lose about 5 or 7 percent of initial body weight and keep off as much of that weight as possible—a tall task for sure!

This should be achieved by eating fewer calories, choosing healthy foods, and being physically active (this includes aerobic activity, resistance training and reducing sedentary behavior). In addition, it’s critical that people get and keep their glucose, blood pressure and blood lipids, under control initially and over time. Hitting these targets or those that you and your provider decide on can give you your best shot at staying healthy and minimizing complications over time. Today we know control of diabetes is more than just controlling blood glucose levels.

As for the use of LCS, whether to replace sugar in hot or cold beverages or in foods and beverage, my recommendation is to take advantage of these products to support your efforts to lose weight and keep those pounds off and to help you consume fewer grams of less healthy carbohydrates (fewer refined grains, sweets, and sugary foods) and added sugars, particularly from beverages.

Bottom Line: Go beyond the headlines! Be sure to read the details of any new study on LCS and fit the new findings from that study into the existing body of research. Keep in mind that LCS have been studied for decades and the ones that are approved for use in the U.S. and around the globe have gone through significant regulatory scrutiny prior to coming to market. Plus, review doesn’t end there. Regulatory agencies around the globe continue to review the research and their use over time.


Pereira MA. Diet Beverages and the risk of obesity, diabetes and CVD: A review of the evidence. Nutr Rev. 2013;71(7):433-440.

Peters JC, et al. The effects of water and non-nutritive sweetened beverages on weight loss during a 12-week weight loss treatment program. Obesity Journal. 2014;22(6):1415-21. (Link to article: http://anschutz.new-media-release.com/study/downloads/oby20737_NNS_study.pdf)

Tate D, et al. Replacing caloric beverages with water or diet beverages for weight loss in adults: the main result of the Choose Healthy Options Consciously Everyday (CHOICE) randomized control trial. American Journal of Clinical Nutrition. 2012;95:555-563. (Abstract)

Catenacci V, Pan Z, et al: Low/No Calorie Sweetened Beverage Consumption in National Weight Control Registry. Obesity. e-pub:  http://onlinelibrary.wiley.com/doi/10.1002/oby.20834/full

Miller PE, Perez V: Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies. American Journal of Clinical Nutrition. 2014.

Suez J, Korem T, et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature, 2014.

Should You Eat Cereal for Breakfast If You Have Diabetes?

| Reviewed by a board-certified physician


Tonic Photos Studios, LLC/Photographers Choice/Getty Images.

We’ve heard countless times that breakfast is the most important meal of the day—it can help jump start metabolism, prevent food cravings, and help people lose weight. The most common complaint of “non breakfast eaters” is that they don’t have time in the morning to eat and that they are looking for quick breakfast ideas. Therefore, people often ask me, “Can I eat cold cereal for breakfast?” While it’s probably better to eat something for breakfast than nothing at all, cold cereal is typically not the best choice for someone with diabetes who is trying to lose weight.

The reason is multifactorial.

First off, studies have shown that those persons with diabetes tend to have better blood sugars and weight control when starting the day with a higher fat, higher protein, lower carbohydrate breakfast. Protein and fat tend to be more satiating which can keep you feel full for longer, typically resulting in less overall calorie intake. In addition, blood sugars tend to rise higher after breakfast and many people are resistant to insulin in the morning which can also cause blood sugars to spike. Elevated blood sugars may cause additional carbohydrate cravings, which can lead to excess calorie and carbohydrate intake, often resulting in excess sugar in the blood.

Secondly, many people overeat cereal which can lead to excess calorie and carbohydrate intake. A single serving of cereal is about 3/4 cup. Three-fourths cup of cereal will generally cost you about 120 calories and 24 g of carbohydrate.

This amount of carbohydrates is equivalent to eating almost 2 slices of bread and this is without adding fruit or milk to your bowl. A typical cereal meal such as 3/4 cup with 1 banana and 1 cup of low-fat milk contains about 340 calories and 66 g of carbohydrate (about 4 slices of bread). Although the calories are not too high, the quantity of food is small and the carbohydrate content is high.

Most people with diabetes should eat about 30-45 g of carbohydrates for breakfast and many do best when eating less than 30 g for breakfast.

Thirdly, not all cereal is created equal. Processed, refined, high sugary cereals are rich in calories, carbohydrates and sugar. When choosing a cereal, it’s important to choose a cereal that is low in sugar and high in fiber. Aim to choose a cereal that has less than 6 g of sugar and at least 3 g of fiber. Choosing a whole grain cereal would be best. Studies have shown that eating a diet rich in whole grains can reduce the risk of heart disease.

But, I Thought Cereal Was Healthy?

As stated earlier, not all cereal is created equal. Some cereals are made with refined carbohydrates and contain added sugars. Other whole grain cereals are made with healthy ingredients such as whole grains and nuts, but can be rich in calories and fat for a small portion. Cereal can be a good choice if you choose wisely and keep your portions controlled. In fact, many cereals are also fortified with vitamins and minerals, which can help people meet their nutritional needs. From time to time, foods rich in carbohydrate do serve a purpose for those people with diabetes.

For example, a good time to eat cereal maybe before exercise. Physical activity helps to burn sugar (or glucose). If you are someone who takes an oral medication orinsulin that can cause your blood sugar to drop, you will need to eat carbohydrates pre workout to prevent low blood sugars during physical activity.

If You Enjoy Eating Cereal Try These Tips to Lower The Carbohydrate Content: 

  • Choose a hot cereal like oatmeal, quinoa or another whole grain blend and add chopped nuts or nut butter for added fiber, protein and healthy fat. For example: 1/2 cup cooked oatmeal with 3/4 cup blueberries, and 2 tablespoons chopped walnuts, topped with cinnamon.
  • If you are choosing a cold cereal:
    • Read the label and stick to one serving, measure it with a measuring cup and use a small bowl to make the portion appear larger
    • Choose a cereal that is a whole grain (the first ingredient should say whole)
    • Choose a cereal that has at least 3 g of fiber and no more than 6 g of sugar
    • Avoid adding dried fruit, sugar, or other calorie sweeteners, such as agave, honey, table sugar
    • Add one serving of high fiber fruit to increase fiber content such as: blueberries, raspberries, strawberries
    • Choose unsweetened almond milk for less carbohydrate than cow’s milk
    • Skip the milk altogether and make a yogurt parfait: using low-fat Greek yogurt which will boost protein content and reduce carbohydrate content

What are Some Good Brands: 

If you are someone with diabetes you can assess which cereals work best for you by testing your blood sugar before and 2 hours after you eat. If your blood sugar is at goal, then you’re on track. Many of my patients tell me that their blood sugars are best and they feel the most satisfied when the eat the following brands of cold cereal which are low in sugar and are a good source of fiber:

Cascadian Farm Organic Purely O’s®


Post Bran Flakes®


Quaker Crunchy Corn Bran®


Fiber One®

Barbara’s Bakery® Puffins (Cinnamon and Honey Rice)

Kashi® (certain varities), such as, Puffed Rice, GoLean

Kellogg’s® Special K High Protein

Kellogg’s ®All Bran

The Bottom Line:

The key is to stick to one serving and watch your add-on’s. Cereal isn’t a good choice for everyone but it maybe better than eating nothing-at-all and can add vitamins, minerals, and fiber to your diet as well as help to prevent low blood sugars. 


Rabinovitz, H. R., Boaz, M., Ganz, T., Jakubowicz, D., Matas, Z., Madar, Z. and Wainstein, J. (2013), Big breakfast rich in protein and fat improves glycemic control in type 2 diabetics. Obesity. doi: 10.1002/oby.20654

Lausch, Marnie. On the Cutting Edge Diabetes Care and Education. Carbohydrate, Insulin Pumps, and Continuous Glucose Monitoring Technology and Special Features to Manage Glycemia. 2014;V35;2,pp 7-11.