How to Count Carbs with Diabetes

In the United States, 30.3 million people have diabetes, and a further 84.1 million have prediabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Diabetes is an incurable yet manageable medical condition in which the body struggles to regulate blood sugar. This happens when the body cannot produce enough insulin, or when insulin does not work correctly.

Insulin is a hormone that the pancreas makes to help the body process glucose, which is the simplest form of sugar. The cells use glucose to create energy. When the cells cannot take in glucose, it remains in the bloodstream, which can lead to severe health problems.

People who have diabetes must be careful about the foods they eat. Consuming an excess of certain foods might lead to persistent high blood sugar. This can lead to severe complications, such as nerve damage, vision and hearing loss, and cardiovascular disease.

In this article, we explore carb counting as a technique to help people with diabetes manage their blood sugar levels.

Carbohydrates are complex sugars. Many people with diabetes need to count the number of carbohydrates in each serving of food to control their blood sugar levels. People refer to this as carb counting.

Carb counting involves more than resisting a chocolate or ice cream craving, as some seemingly healthful fruits and vegetables might also contain a high carbohydrate content that contributes to blood sugar spikes.

How carb counting works

The first step in carb counting is identifying which foods contain carbohydrates and how rapidly these carbohydrates will boost blood sugar levels.

People can use a system called the Glycemic Index (GI) to calculate this. Every food has a GI ranking, with higher scores demonstrating a food’s rapid effect on blood sugar.

Having diabetes often means that people struggle to regulate their blood sugar levels. So, it is also a good idea for people with diabetes to focus on their diet. Consuming low-GI foods can lead to a slower, more controllable increase in blood glucose levels.

Doctors and dietitians will help people with diabetes work out how many carbohydrates they should consume each day and suggest meal plans to help them maintain a healthful, nutritional balance.

Previously, doctors and dietitians suggested a typical range of carbohydrates that was a fit-all solution for everyone with diabetes.

Now, doctors and nutritionists work with individuals on a one-to-one basis to calculate the ideal daily caloric intake and carbohydrate percentages and servings each person needs.

These amounts will vary according to a range of factors, including the person’s weight, height, activity levels, and whether they are taking medications.

Aims of carb counting

Carb counting alone is not a substitute for managing diabetes using medical care and prescribed medications.

The goal of carb counting is to keep blood sugar levels steady for the following reasons:

  • maintaining overall health in those with diabetes
  • preventing the complications of excessively high or low blood sugar
  • improving energy levels

Getting started with carb counting

Carb counting may help many people with diabetes to maintain steady blood sugar levels. However, it is only one way to manage diabetes.

Before trying carb counting, people should always speak with a nutritionist, diabetes educator, or doctor to determine:

  • whether carb counting is appropriate
  • the recommended daily allowance for carbohydrates
  • which foods they recommend

Different people will require different amounts of carbohydrates depending on the type and severity of diabetes they have.

Speak to your doctor about the ideal calorie and carbohydrate intake.

Calculating carbs

When a person has to calculate how many carbs they can consume each day, it is vital to know which foods contain carbohydrates, how many they contain, and their caloric and GI value.

In general, 1 gram (g) of carbohydrate provides around 4 calories. This can help a person calculate how many calories a particular snack or meal is providing.

There is no single number of carbs that is safe for every person with diabetes. Doctors shape the target based on individual needs and disease progression.

It is essential for those with diabetes to understand the content of food nutrition labels. Some describe nutrient serving per half portion, so it is necessary to be sure of exactly how many carbs a meal provides.

When reading nutritional labels, take note of the total number of carbohydrates per serving and add these totals into the total daily carbohydrate allowance.

For example, there are approximately 15 g of carbohydrate in each serving of the following foods:

  • a slice of bread
  • one-third of a cup of pasta or rice
  • a small apple
  • one tablespoon of jelly
  • a half-cup of starchy vegetables, such as mashed potatoes.

However, non-starchy vegetables contain only 5 g of carbohydrate per serving. This means that a person with diabetes can safely eat three times more non-starchy vegetables than starchy vegetables.

Carb counting tips

Carb counting may be challenging at first because it forces people to think about meals differently, and people might take a while to get used to it.

Some tips can help make carb counting a little easier, such as:

  • Counting mixed foods by the cup: On average, a fist is the size of a 1-cup serving. For a mixed dish, this is an effective way to judge the carb totals based on cup size.
  • Count tablespoons: It is helpful to know the number of carbohydrates in a tablespoon of food. People can count level tablespoons to create a healthful plate.
  • Count carbs in pizza using the crust: If possible, choose a thin-crust pizza. This will save 5–10 g of carbohydrate per serving size when compared to a slice of regular or pan pizza.
  • Smoothies may not always be the best bet: On average, a 12-ounce (oz.) smoothie might contain more carbohydrates than a regular soda if it contains juice. Drink smoothies in moderation.

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11 Vitamin-Packed Superfoods for People With Type 2 Diabetes

What makes a food “super”? When it comes to type 2 diabetes, it’s not just about foods that pack lots of nutrients. For a diabetes-friendly diet, you also need foods that will help keep your blood sugar (glucose) levels in check. There is no one single best food for type 2 diabetes. Instead, the best diet for type 2 diabetes is one that is based on whole foods and is rich in fiber, protein, and a moderate amount of healthy carbohydrates.

It’s true that people with type 2 diabetes need to watch their carb intake, but they don’t have to follow a fad low-carb diet. On the contrary, says Leah Kaufman, RD, CDCES, of Leah Kaufman Nutrition in New York City, the best diet for people with type 2 diabetes is “a well-balanced diet that has a healthy amount of carbs, protein, healthy fats, and vegetables per meal.”

While changing your diet won’t cure diabetes, it can lower your risk for type 2 diabetes complications, such as heart disease and neuropathy (nerve damage). Prioritizing a healthy eating plan is even more crucial now, as the novel coronavirus rages on in the United States and beyond. That’s because people with diabetes are among the groups at a higher risk for complications from COVID-19, according to the Centers for Disease Control and Prevention. Keeping your blood glucose in check has never been more important, and food can play a big role in that effort. In fact, diet affects type 2 diabetes in several ways, including glucose regulation, heart health, weight maintenance, and mood.

How can you tell good food from a bad one when it comes to managing diabetes? “Look for items that contain healthy fats and are high in vitamins, minerals, and fiber,” says Sue McLaughlin, RD, CDCES, at Burgess Health Center in Onawa, Iowa. It’s also crucial to eat a wide variety of foods to make sure you’re getting a healthy mix of micronutrients, phytochemicals, and essential fatty acids.

Unsure where to start? Check out these 11 tips for adding more superfoods to your diabetes diet!

1. Swap Out Meat for Beans and Lentils for Less Fat and More Fiber


High in fiber and protein, beans are digested slowly in your body, making them great for managing blood glucose levels in a type 2 diabetes diet. Just ¼ cup of any type of beans will provide as much protein as 1 ounce (oz) of a meat protein equivalent, according to the U.S. Department of Agriculture (USDA).

No matter which type of bean you choose, you’ll also gain a significant amount of your daily fiber needs from a 1 cup serving. For example, according to the Mayo Clinic, 1 cup of baked beans offers 10 grams (g) of fiber, while 1 cup of black beans has 15 g. Women need an average of 21 to 25 g of fiber per day, while men need between 30 and 38 g. According to an article published in the January-February 2017 issue of the American Journal of Lifestyle Medicine, only about 5 percent of the U.S. population meets that threshold, and yet a high-fiber diet is associated with a reduced risk of various diseases, including type 2 diabetes, obesity, stroke, heart disease, and even some cancers. (Just be sure to increase your intake of fiber slowly, and drink plenty of water, to reduce diarrhea, per the Mayo Clinic.)

Other legumes offer similar health benefits that are key in managing diabetes. In a study published in the Archives of Internal Medicine, Canadian researchers found that eating beans, chickpeas, and lentils was associated with improved blood glucose control, reduced blood pressure, and lower cholesterol and triglyceride (fat found in the blood) levels in people with type 2 diabetes. Those qualities are important because people with diabetes are at a higher risk for heart problems than the general population, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

What’s more, beans are good sources of magnesium and potassium. Diabetes is associated with magnesium deficiency, notes an article published in August 2015 in the World Journal of Diabetes, and potassium plays a role in further boosting heart health because it helps regulate blood pressure, notes the National Institutes of Health (NIH).


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2. Eat Salmon for Omega-3 Fatty Acids

a salmon fillet with a sprig of rosemary

Many types of seafood are good for people with diabetes. According to the NIH, salmon, mackerel, tuna, sardines, and herring are rich in omega-3 fatty acids, which promote heart health by helping lower the blood fats called triglycerides. Just be sure to avoid or limit your consumption of fish with high levels of mercury, such as tilefish, swordfish, marlin, and king mackerel, as outlined by the Food and Drug Administration (FDA).

Eating fish twice a week, which is recommended by the American Heart Association, has other far-reaching benefits: A study published in the American Journal of Kidney Diseases found that fish may protect people with diabetes against kidney problems. Fish is considered a diabetes-friendly food as part of a healthy, well-balanced diet. Choose blackened or grilled fish over fried preparations.


3. Consider Tree Nuts for Other Sources of Healthy Fats

assorted nuts

Loaded with fiber and protein, nuts are filling and contain high levels of unsaturated fats, the kind that contribute to HDL, or “good” cholesterol, making them a boon to your heart health. But when it comes to stabilizing blood sugar, polyunsaturated fats in tree nuts — such as almonds, cashews, hazelnuts, pecans, walnuts, and pistachios — are especially beneficial. (As a side note, peanuts aren’t tree nuts; they’re legumes.)

In a review and meta-analysis published in July 2014 in BMJ Open, Canadian researchers looked at data from 12 clinical trials and found that eating two servings of tree nuts a day lowered and stabilized blood sugar levels in people with type 2 diabetes and unhealthy cholesterol levels (dyslipidemia), and stabilized metabolic syndrome.

“Plant-based healthy fats can improve lipid levels,” says Kaufman. She recommends adding foods rich in polyunsaturated fats to help reduce high cholesterol related to elevated blood glucose, but with a caveat. “Although healthy, these foods do have a higher amount of calories, so I would limit them to one serving per day,” Kaufman notes. The Cleveland Clinic defines one serving as 1 oz or 35 peanuts, 24 almonds, 14 walnut halves, or 18 cashews.

4. Grab a Handful of Fresh Blueberries for Disease-Fighting Antioxidants

While all berries contain high levels of antioxidants, vitamins, and fiber, blueberries may be one of the most beneficial for people who have, or at risk for, type 2 diabetes. “Antioxidants,” says Kaufman, “are a broad term used to describe a food that can help protect the body from damage. Antioxidants can be found in the vitamins of the actual food, or even the coloring.” In general, the deeper the color, the higher the antioxidant content.

In an article published in the British Medical Journal, researchers at the Harvard School of Public Health found that for every three servings of blueberries (as well as grapes and apples) eaten per week, people reduced their risk for type 2 diabetes by as much as 26 percent compared with those who ate less than one serving per month. The authors based their conclusions on longitudinal studies of previous clinical trials conducted between 1984 and 2008, 1986 and 2008, and 1991 and 2009.

Fiber-rich berries also have the added benefit of satisfying your sweet tooth without any added sugars. Swapping out cookies for blueberries and other antioxidant-rich fruits will reduce blood sugar while keeping sugar cravings at bay. “Patients with diabetes should generally stay away from refined sugars and processed carbs to improve glucose control,” Kaufman says.

5. Have a Side of Broccoli to Increase Your Intake of Vitamins A and C


A review of clinical studies published in the American Journal of Nutrition found that a diet rich in cruciferous vegetables like broccoli may help reduce the risk of cancer.

Loaded with antioxidants, broccoli is a good source of vitamin A and is high in vitamin C, two nutrients essential for anyone, regardless of a diabetes diagnosis. According to the USDA, 1 cup of cooked, previously frozen broccoli (without added fat) supplies 93.8 micrograms (mcg) of vitamin A, or about 10 percent of the daily value (DV), and 73.4 milligrams (mg) of vitamin C, or about 82 percent of the DV.

Plus, with 5.52 g of fiber (22 percent of the DV), broccoli is filling — which makes it a good choice for people who are trying to lose weight and control type 2 diabetes.

6. Indulge Your Potato Craving With Fiber-Rich Sweet Potatoes

Sweet Potatoes

When it comes to foods for type 2 diabetes, not all potatoes are created equal. To keep your blood sugar levels in check, it’s best to reach for sweet potatoes, which are high in fiber (eat the skin for more fiber), as well as a host of other vitamins. According to the USDA, one boiled medium-size sweet potato (with no fat added during cooking) offers 3.75 g of fiber, or 15 percent of the DV.

“I typically recommend about one-half a plate of nonstarchy vegetables per meal and one-quarter a plate of fiber-rich starchy vegetables, such as sweet potato with skin on, to increase overall fiber intake,” says Kaufman, though it’s important to work with your healthcare team to figure out how much starchy vegetables is right for you. Other starchy vegetables you can eat in moderation include peas and corn.

Another important consideration is the cooking process. When boiled, sweet potatoes are a low glycemic index (GI) food, meaning they won’t spike your blood sugar as much as regular potatoes, according to research published in the Journal of Nutrition and Metabolism. Baking, roasting, and frying are the worst ways to prepare sweet potatoes for people with type 2 diabetes, they found.


7. Incorporate Spinach and Kale Into Pastas and Salads

Spinach and Kale

According to a previous review, eating 1 ½ cup of dark leafy greens, including spinach and kale, each day can reduce the risk of type 2 diabetes by 14 percent. Though the reason is unclear, it may be that leafy greens have a protective effect because they contain antioxidants like vitamins A and C. A cup of fresh, cooked kale (without fat added) offers 879 mcg of vitamin A, or about 98 percent of the DV, and 52.9 mg of vitamin C, or about 58 percent of the DV, notes the USDA. Leafy greens are also low in calories and carbohydrates (the same serving of kale has 36 calories and only 7.3 g of carbs), which is ideal for folks with type 2 diabetes.

8. Savor Your Morning Bowl of Oatmeal for Blood Sugar Control


Eating whole-grain oats may help you hit your target A1C and boost heart health. A systematic review and meta-analysis published in December 2015 in the journal Nutrients found that people with type 2 diabetes who ate oatmeal for breakfast had better postprandial glucose readings and lipid profiles than people who ate control breakfasts. Postprandial glucose readings measure glucose levels two hours after eating, and lipid profiles can help indicate heart health. It’s no mystery why oats are great in a diabetes diet — they’re another good source of fiber. The USDA notes that a ½ cup of cooked oats provides 4 g, or 15 percent of the DV, of fiber.

For the healthiest options of oatmeal, choose steel-cut or old-fashioned oats with no added salt, sugar, or preservatives. For a creamier texture, cook them in low-fat milk. Add toppings like berries, seeds, and nuts for a flavorful, filling breakfast.


9. Slice Open a Tomato for Heart-Healthy Lycopene


Nothing beats biting into a ripe, juicy tomato — and luckily, folks with diabetes don’t have to give them up. In fact, tomatoes are ideal for a diabetes diet. “Foods such as blueberries and tomatoes with rich coloring can be higher in antioxidants and should be consumed regularly by those with diabetes,” says Kaufman.

This superfood may help lower blood pressure and LDL(“bad”) cholesterol, which may lessen the risk for heart disease. A report published in the British Journal of Nutrition from a 10-year study suggested that that lycopene, a key nutrient in tomatoes, may help reduce the risk of heart disease by 26 percent. Keep in mind that your body will be able to absorb more lycopene from cooked tomatoes than from raw ones.

10. Go Greek With Your Yogurt for More Protein and Other Nutrients

Greek yogurt with pomegranate seeds and kiwi

Creamy and delicious, yogurt is a rich source of calcium, protein, and magnesium. It can also deliver valuable probiotics, which, according to a study published in April 2014 in the American Journal of Clinical Nutrition, can help reduce the risk of weight gain and obesity, as well as cardiovascular disease.

Opt for Greek yogurt; it’s slightly higher in protein than regular yogurt, which helps keep you fuller longer. According to the USDA, 1 cup of nonfat plain Greek yogurt offers 23 g of protein, while the same serving of nonfat plain yogurt contains 14 g of protein.

Read nutrition labels carefully and avoid any Greek yogurt products that have added sugars. Your best bet is to select plain, fat-free versions and add some sweetness with berries.


11. Get Your Monounsaturated Fats With Heart-Healthy Avocados

Avocados for Healthy Fats

Known for their heart-healthy monounsaturated fats, avocados top the charts in terms of health benefits. According to a review published in the journal Critical Reviews of Food, Science, and Nutrition, avocados can help lower cholesterol, promote normal blood pressure, and reduce inflammation, thanks to their high fiber content, potassium, and lutein. One serving of avocado (a third of a medium-sized avocado, or 50 g) has 80 calories, 6 g of healthy fats, and a variety of vitamins and minerals, according to California Avocados.

5 Tips to Prevent Gum Disease If You Have Diabetes

brushing teeth when you have diabetes

Gum disease, also known as gingivitis, has been called the fifth complication of diabetes behind heart, nerve, kidney and eye disease. Gingivitis is simply the inflammation of the gums around your teeth caused by plaque buildup.

So, why are you more at risk for developing gingivitis if you have diabetes? Diabetes educator Sue Cotey, RN, sheds some light on this question.

Gum disease begins with bacteria build up on and around your teeth that extends into the gums. Cotey says there is no difference between the bacteria in the mouth of someone with diabetes compared with someone without diabetes. “The reason gum disease is worse if you have diabetes is because you have a greater inflammatory response to this bacteria,” she explains.

Why gum disease makes it more difficult to control blood sugars

If you develop gum disease and it’s left untreated, it can lead to something called periodontitis, or an erosion of your jaw bone. This, in turn, can lead to loose teeth and damage to the gums. People with uncontrolled diabetes tend to get periodontitis more often than the average person or those who keep their diabetes under control.

Some signs that you have gum disease include:

  • Red, swollen and/or bleeding gums.
  • Loose or sensitive teeth.
  • Persistently bad breath.

If you have diabetes and have moderately advanced periodontal disease, it can be more difficult for you to control your blood sugars. “You may need deep cleaning, antibiotics or even oral surgery depending how advanced the gum disease is,” Cotey says.

In her 25 years of being a diabetes educator, Cotey says she has seen firsthand the relationship between gum health and diabetes management. “I’ve witnessed on multiple occasions that when people with diabetes see the dentist and address any current issues related to gum disease or inflammation, their blood glucose levels respond almost immediately,” says Cotey.

5 tips to avoid gum disease

Follow these tips to steer clear of gum disease:

  • Avoid acidic drinks like soda, energy drinks and water with lemon. These can erode the enamel of your teeth, which can lead to decay.
  • Floss daily between each tooth, sliding up and down and back and forth gently to avoid bleeding.
  • Brush your teeth and gum line for two full minutes, two times each day. Use a soft bristle brush using gentle strokes and make sure you reach all of your teeth. The goal is to get rid of plaque buildup. To do this, vibrate your brush across the tooth surface, the gum line and your gums.
  • Remember to gently brush your tongue for a few seconds, too, to get rid of bacteria.
  • See your dentist at least once a year and report any of the signs mentioned above immediately.

Other oral concerns if you have diabetes

People with diabetes are also more likely to have a dry mouth due to elevated blood glucose or medications. To avoid dry mouth, Cotey recommends chewing sugar-free gum, using a mouth gel or eating some sugar-free candy to stimulate saliva production. “If these don’t help, talk to your dentist for recommendations,” she says.

And if you’re into having a super white smile, you’re in luck! Cotey says many over-the-counter teeth whiteners are mild enough to be used by people with diabetes too.​

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Can You Eat Dandelions?

Dandelions pop up overnight to blemish a perfect green lawn and crowd out the petunias in your flower garden. But instead of going to war with the ubiquitous yellow weeds, you might want to welcome them into your kitchen.

“Dandelions are herbs, and herbs have many health and nutritional benefits,” says registered dietitian Nancy Geib, RD, LDN.

Why should you add them to your diet? Let us count the ways.

Nutritional benefits of dandelions

Dandelions pack a whole lot of vitamins and minerals into a small plant. “They’re probably the most nutritionally dense green you can eat — outstripping even kale or spinach,” Geib says.

Dandelion greens, in particular, are a great source of vitamins and minerals such as:

  • Vitamins A, C and K.
  • Folate.
  • Calcium.
  • Potassium.

Health benefits of dandelions

Besides being chock-full of nutrients, dandelions contain compounds that may help prevent health problems. Unfortunately, scientists don’t focus a lot of attention on wild herbs and plants. More research is needed to confirm everything dandelions can do, Geib notes.

“Still, some research points to several benefits of dandelion,” she says.

Provide antioxidants

Dandelions contain several different types of antioxidants throughout the roots, leaves and flowers, Geib says. Antioxidants protect your body against free radicals — rogue molecules that can damage your body’s cells and make you age faster.

Reduce inflammation

Chronic inflammation in the body plays a role in a long list of serious health problems, including cancer and heart disease. One way to stay healthy is by eating foods that fight inflammation. Add dandelion to your anti-inflammatory diet: Lab studies have found that compounds in these plants can dial down inflammation.

Manage blood pressure

Dandelions are rich in potassium, which makes them a natural diuretic. In other words, they make you pee. Diuretics are often used to help control high blood pressure.

Control blood sugar

Dandelion has been used around the world as a natural way to control Type 2 diabetes. Researchers are still investigating that link, but studies in animals suggest that the compounds in dandelions might help reduce blood sugar levels in people with diabetes.

Lower cholesterol

Lowering cholesterol is a key step to reducing the risk of heart disease. Studies in animals have found that extracts from dandelion roots and leaves can naturally lower cholesterol levels.

How to eat dandelions

“The great thing about the dandelion is that every part of the plant is edible,” says Geib. She shares her tips for preparing this free-range herb:

  • Greens: Dandelion leaves are on the bitter side, but they have a spicy kick similar to arugula. Try tossing some fresh, washed leaves into a salad. To take the edge off the bitterness, you can also cook them, Geib says. Soak the leaves in cold, salted water for 10 or 15 minutes, then cook them in boiling water until tender (no more than five minutes). Finish by sautéing the boiled greens with some olive oil, onion or garlic. Top with Parmesan cheese.
  • Flowers: Dandelions’ sunny blossoms give color to a salad. Use them fresh or dried to make dandelion tea — or brew dandelion wine. You can try infusing them into oil or vinegar, too, Geib suggests. (Dandelion-infused oil can also be used to make a salve that’s great for muscle aches.)
  • Roots: Roasted dandelion roots are used in a tasty drink similar to coffee. You can find dandelion-based coffee substitutes at health food stores.

Dandelion supplements

Can you get the goodness of dandelion from supplements and extracts? Possibly, though the science isn’t clear, Geib says. And since there is not a lot of research on dandelion supplements, there aren’t clear dosage guidelines.

Most foods pack the biggest nutritional punch if you eat them fresh — and dandelion is probably no exception, she adds. But if you’re not a fan of their flavor (or the plants are out of season), talk to your doctor about whether dandelion supplements might be beneficial.

Make sure to chat with your healthcare provider if you take certain medications. Dandelion supplements may interact with some drugs, including:

  • Lithium.
  • Blood thinners.
  • Certain antibiotics.
  • Diuretics (aka water pills).
  • Some heart and blood pressure medications.

Should you add dandelions to your diet?

Dandelions have a lot going for them, but there are some things to know before serving them for dinner. You can pick the blossoms right from your yard, “but — if you’re harvesting wild dandelions — make sure you’re picking them from an area you know hasn’t been treated with pesticides or other chemicals,” Geib cautions.

You don’t need to eat them every day to reap the benefits (though you could if that’s your jam). Geib suggests approaching them like any other herb and adding them into the rotation as part of a varied and colorful diet.

“Dandelions are really wonderful for their nutrition and medicinal value,” Geib says. “Don’t be afraid to try something out of the box.”

How Healthy is Oatmeal for Breakfast, Really?

The Short Answer from a functional medicine specialist

Q: How healthy is oatmeal for breakfast?

A:  I prefer to start my day with protein and healthy fat. Here’s why.

A colleague at Harvard did an amazing study involving three groups of overweight kids. He gave them three different breakfasts that had the same number of calories: instant oatmeal, steel-cut oats and a veggie omelet with fruit.

Then he put them in a room with video games and said, “When you’re hungry, push the button.”

Those who ate the instant oatmeal ate 81 percent more food during the day, and those who ate the steel cut oats ate 51 percent more, than those who ate the omelet.

What was really interesting was that blood tests found higher levels of insulin, blood sugar and stress hormones (cortisone and adrenaline) in the kids who ate the oatmeal. Their whole biology was different. The calories from the oatmeal behaved very differently than the calories from the omelet.

This is what we pay attention to in functional medicine. We see food not just as energy, but as information and instructions for your hormones, your brain chemistry, your gut flora and your immune system.

And it doesn’t take decades to occur. It happens in real time.

—Mark Hyman, MD, Director, Center for Functional Medicine

The Best Foods to Help Relieve Your Joint Pain

The Best Food to Help Relieve Your Joint Pain

You may already be taking medicines — either prescription or over-the-counter — to relieve morning stiffness, inflammation and pain in your joints. But many studies show that certain foods, spices and supplements may help in addition to medicines.

We talked with registered dietitians Kylene Bogden MS, RDN, CSSD, LDN  and Liz DeJulius, RDN, LDN about which healthy foods may help ease your joint pain. Here’s their recommendations on what to eat.

The Mediterranean diet

Many studies have found that the Mediterranean diet has various health benefits, some of which seem to overlap those attributed to nonsteroidal anti-inflammatory drugs (NSAIDs).

A Mediterranean diet consists of a high level of low-glycemic fruit, vegetables and legumes; a high level of unsaturated fats, especially olive oil, complemented by a modest amount of alcohol, mainly in the form of wine; a moderate to high level of wild fish; and a low level of dairy products and red meat.

A 2015 Michigan study showed correlations between a whole-foods, plant-based diet and significantly improved self-assessed functional status and reduction in pain among adult patients with osteoarthritis, Ms. DeJulius says. A whole-foods, plant-based diet consisted of fruits, vegetables, legumes and grains and is free of refined foods, which follows the Mediterranean approach.

Fish oil

The beneficial effects of fish oils are attributed to their omega-3 fatty acid content. Studies of fish oil consumption show that it has anti-inflammatory benefits and is particularly helpful for joint pain.

Natural sources of fish oil include cold-water fish, such as wild salmon, trout and sardines. Vegan and vegetarian sources included flax seed, chia seeds and organic soybeans.

A 2008 Australian study is one of many that showed fish oil reduced joint pain, increased cardiovascular health and reduced the need for NSAIDs.

“Just one serving of cold-water fish twice a week is enough,” Ms. Bogden says. She recommends a high-quality daily fish oil supplement in addition to consuming natural dietary sources.

Cruciferous vegetables

“In addition to other vegetables, you should try to eat a half cup of a cruciferous vegetable every day, such as broccoli, cauliflower, Brussels sprouts or kale,” Ms. Bogden says. “These are all nutritional powerhouses, chock full of antioxidants, vitamins and fiber.”

In 2005, a team of researchers in Maryland studied the effects of sulphoraphane, an antioxidant compound found in cruciferous vegetables, and found that it blocks an enzyme that causes joint pain and inflammation. In addition to aiding arthritis patients, it may be helpful for athletes who put a lot of pressure on their joints.

Spices and herbs

Turmeric and ginger are spices noted for their anti-inflammatory benefit. Often used in Indian cuisine, turmeric also is used in traditional Asian medicine for its anti-inflammatory properties.

A 2006 Arizona study showed promising research linking turmeric to the prevention of rheumatoid arthritis and osteoporosis.

Add turmeric and ginger to smoothies, eggs, or sauces for an anti-inflammatory punch, Ms. DeJulius says.

Green tea

Green tea is one of the most widely consumed beverages in the world, and its effects on health is the subject of much research.

A 2008 study in Maryland showed that green tea induced changes in arthritis-related immune responses.

Long-term use of NSAIDs can have adverse effects and cause discomfort; the polyphenolic compounds from green tea possess anti-inflammatory properties and have been shown to be an effective complement to nutritional therapy.

Ms. DeJulius recommends choosing organic green tea to reduce exposure to pesticides.

Foods to avoid

Ms. Bogden recommends avoiding certain foods if you’re trying to lessen joint pain.

“Sugars and refined grains, including white rice, pasta and white bread, are the worst food culprits when it comes to reducing or relieving joint inflammation,” she says.

Ms. DeJulius recommends limiting daily added sugar to six teaspoons for women and nine teaspoons for men. When using sugar, choose natural sources like honey, maple syrup, and coconut sugar.

“Red meat such as beef, lamb, pork — anything from an animal with four legs — also will increase inflammation. Another big no-no, for many health reasons, is trans fat or partially hydrogenated oil,” she says.

Ms. DeJulius recommends avoiding omega-6 fatty acids. The American diet is generally higher in omega-6s due to the high consumption of processed foods. The extra consumption of omega-6s can promote inflammation. Sources include corn oil, safflower oil, sunflower oil, peanut oil, grapeseed oil and vegetable oil. Check the ingredients lists for condiments such as mayonnaise and salad dressing.

If you feel that you’ve cleaned up your diet and are still experiencing food-related joint pain, Ms. DeJulius recommends meeting with a registered dietitian who is proficient in identifying food sensitivities for a personalized approach.

Brown Rice or White Rice: Which Is Your Healthier Option?

Which is healthier: Brown rice or white rice? A nutritional tale of the tape provides a clear winner by knockout. “Hands down, brown rice brings more to the table,” says dietitian Beth Czerwony, MS, RD, CSOWM, LD.

But brown rice might not always be your best choice depending on some personal health factors. (Nothing is ever 100%, right?)

So let’s break it down with Czerwony in a little Rice 101.

Why rice is a big dietary deal

Approximately 20% of the world’s calorie intake is connected to the humble rice grain, making it one of the most important foods on the planet. More than 3.5 billion people rely on rice as a daily staple of their diet.

To feed that need, farmers grow more than 100,000 different varieties of rice in a rainbow of colors. Thankfully, though, your mealtime choice typically gets narrowed down to a pair of options: brown or white.

Out of the two, white rice is far and away the most common to find on your plate – largely due to ease of cooking, a longer pantry shelf life and a neutral flavor profile that meshes well with other ingredients.

Differences between brown rice and white rice

Whole grains such as rice can be broken down into three main parts – the germ, bran and endosperm. Each component packs different minerals, vitamins and proteins that offer you varying nutritional value.

Brown rice contains all three parts, making it a whole grain. White rice? Not so much, says Czerwony. Processing strips white rice of the germ and bran, leaving the starchy (and least nutritious) endosperm center.

Manufacturers do enrich white rice to replace some of what’s lost during processing. “Basically, they strip it down and try to redress it,” explains Czerwony. “But the final product still falls short of the nutritional level where it began.”

Benefits of brown rice

Don’t let the small size of a grain of rice fool you. Inside that little husk resides nutrients with the power to reduce your cholesterol levels and lower your risk of heart disease, stroke and diabetes.

Brown rice outpaces white rice in:

  • Dietary fiber.
  • Manganese.
  • Magnesium.
  • Niacin.
  • Phosporous.
  • Vitamins B1 (thiamin) and B6 (pyridoxine).

It’s a complex carbohydrate, too, which can help you manage your cholesterol and lose weight. “Brown rice will also keep you feeling full longer, which helps when you’re watching how much you eat,” says Czerwony.

There is one negative on the ledger for brown rice: arsenic. Brown rice contains elevated levels of the naturally occurring toxic element, which is present in many foods. It’s not enough to cause harm in a typical diet. Women who are pregnant, however, may want to limit consumption.

Is white rice bad for you?

The short answer is no… at least when eaten in moderation. “Is it the best food for you? No,” says Czerwony. “But it’s not going to hurt you.”

Enriched white rice serves as a good source of folic acid, which is recommended for pregnant women to help with the prenatal development of their child. It’s also recommended for mothers who breastfeed. (Arsenic is not as present in white rice after processing.)

White rice also may be preferable if you’re on a low-fiber diet or have a sensitive stomach.

But it’s not hard to find criticism of white rice – particularly regarding how it can make your blood sugar levels spike. Some researchers even equate a serving of white rice to eating pure table sugar.

Additionally, research shows that a diet heavy in white rice could increase your risk of developing diabetes. (Whole grain brown rice has the opposite effect.)

Get creative with your menu

If you just can’t decide between brown rice and white rice, pick them both. Czerwony says she often advises people to mix the varieties. Cooking times vary for brown rice and white rice, which will require some in-the-kitchen adjustments.

She also encourages people to explore potential rice substitutes, such as quinoa, barley and ancient grains. These also can be blended with rice or served on their own. Countless recipes can be found online.

“It’s important to know there’s not just one option or a simple choice between brown rice and white rice,” says Czerwony. “Take advantage of the variety.”

And that, she says, maybe the healthiest choice of all.

Types of coughs: What do they mean?

There are many ways to classify coughs. The simplest way to determine what is causing them and the best treatment is to pay attention to how they sound and how they affect the body.

In this article, we identify the different types of coughs, what causes them, how to treat them, and when to see a doctor.

Dry cough

a man with one of the Types of coughs

Dry coughs commonly follow on from respiratory illnesses, such as colds and the flu. These coughs develop when there is little or no mucus in the throat. A person may feel a tickling sensation in their throat and be unable to stop coughing.

In most cases, the cough goes away on its own. However, there are other causes that people can investigate if a cough becomes chronic:

  • Asthma: Other symptoms include a tight sensation of the chest, shortness of breath, and wheezing.
  • Gastroesophageal reflux disease (GERD): This is when stomach acid travels up towards the throat, which can trigger a cough.
  • Lung cancer: A cough that is related to lung cancer may coincide with blood in the mucus. It is rare that a cough is due to lung cancer, but if a person is concerned, they should see a doctor.


A person can ease the tickling sensation of a dry cough by drinking water, taking a cough drop, or using cough syrup.

Wet cough

People might describe a wet cough as a chesty cough. This cough occurs when a person coughs up mucus or phlegm. Wet coughs are typically due to an infection, such as the flu, the common cold, or a chest infection.

A person with a chest infection may cough up phlegm that contains small amounts of bright red blood. This blood comes from the lungs and is typically nothing to worry about.

If a person finds themselves coughing up blood that is dark and contains food, or what resembles coffee grounds, they should seek medical help.

Some wet coughs can be chronic and may be due to:

  • Bronchiectasis: A condition resulting from mucus pools in small pouches in the lungs that the body is unable to clear.
  • Pneumonia: This is when a bacterial infection causes the tissue on the lungs to become inflamed.
  • Nontuberculous mycobacteria infection: This is noncontagious and can be accompanied by tiredness, feeling unwell, and weight loss.
  • Chronic obstructive pulmonary disease (COPD): This is a type of lung disease where common symptoms may include shortness of breath and wheezing.


Staying hydrated can help a wet cough stay productive and ease the symptoms of a cold. Some people also find relief from over-the-counter (OTC) cough remedies, such as cough drops, chest rubs, and pain relievers.

If a bacterial infection is causing the cough, a person may need antibiotics.

Whooping cough

Pertussis, better known as whooping cough, is a highly contagious bacterial infection. Newborns and people who have not had a vaccination may develop this illness.

A person with whooping cough typically has mild cold or flu-like symptoms, followed by an aggressive and painful cough. People with weak immune systems, such as babies, may struggle to fight the infection or have trouble breathing.

Those with this infection are most likely to pass it on for roughly 2 weeks from when they begin coughing. The best protection against the illness is a whooping cough vaccination.


Taking antibiotics early can decrease the severity of whooping cough, so an unvaccinated person should see a doctor as soon as possible if symptoms develop.


A person may cough if they have a partially blocked airway, and the body tries to get rid of the object. Likewise, a person who eats something large or something that irritates their throat may cough.

It is advisable to call a doctor if coughing persists after a choking episode.

A person who is choking severely will not make a sound when they cough.

Someone who stops coughing and is having trouble breathing may be choking. A person with them should perform the Heimlich maneuver and call 911.

Chronic cough

A chronic cough is a cough that lasts longer than a typical illness, usually 8 weeks or more. These coughs sometimes signal an underlying disease. A person should see a doctor for appropriate diagnosis and treatment.

Some potential causes of a long-term cough include:

  • an untreated infection or a respiratory virus that lasts longer than usual
  • allergies
  • smoking
  • exposure to irritants such as mold or dust at home or work
  • pneumonia or another lung disease
  • throat or oral cancer
  • swallowing disorders caused by other conditions, including dementia

Coughing in children

Although children can develop the same coughs as adults, some children develop a cough that sounds like a seal barking.

A barking, painful cough usually means a child has croup. The flu or a cold virus typically causes croup, which is common among children younger than 5 years old.

A caregiver should seek emergency help if the child:

  • has trouble breathing
  • is turning blue
  • has severe chest pain
  • develops a fever above 104°F
  • develops a wheezing cough

The symptoms of croup are often worse at night, and treatment at home includes:

  • using a humidifier
  • drinking plenty of warm fluids
  • getting plenty of rest
  • taking OTC medication, such as acetaminophen

A caregiver should not give a child aspirin due to its connection to Reye’s syndrome. Children under 14 years old should not take OTC cough medication, as they can be harmful.

Croup usually lasts for 5–6 days, but the cough can continue for around 2 weeks.

When to see a doctor

Coughs are a common symptom, especially during cold, flu, and allergy season. Most coughs are not serious, but some can be.

Seeing a doctor is advisable if:

  • a person with a cough cannot breathe or catch their breath
  • a chronic cough lasts several weeks
  • a person with a chronic illness, such as COPD, does not get relief with their usual cough treatment
  • a person coughs up blood

Seek prompt emergency care if:

  • a cough gets worse over several days
  • a newborn baby develops a cough and shows signs of respiratory distress

Signs of respiratory distress include:

  • breathing very hard
  • gagging
  • turning blue
  • using the muscles of the ribs to breathe


Coughing can be scary and may trigger fears of choking, but if a person can cough, they are passing at least some air through their respiratory tract.

In most cases, a cough will clear on its own, although chronic coughs and coughs in young children and unwell seniors warrant prompt treatment.

If a cough sounds bad, it is very painful, or does not go away, people should see a doctor or other healthcare provider.

How to Restart Healthy Eating Habits

diet, healthy foods, health eating, nutrition, fruits, vegetables, healthy dieting

Midway through cleaning out your car after another on-the-go week, a growing pile of crumpled fast-food wrappers reveals a harsh reality: Your efforts to eat healthier definitely took a wrong turn.

It happens, says registered dietitian Kate Patton, MEd, RD, CSSD, LD. The key is what comes next. Here are some tips to get you back on track.

Don’t dwell on your dietary misstep

You’ve heard the phrase “don’t cry over spilled milk,” right? Well, don’t cry over a weekend binge of deep-fried chicken wings, either. There’s no benefit to heaping guilt on your plate for past chews.

Bad food days are part of life, whether it’s the result of scheduling pressures, stress eating during the pandemic or simply the lip-licking lure of decadent desserts.

Patton advocates an 80-20 rule for watching dietary intake: “If you’re eating what you should 80% of the time, you’re doing pretty well,” she says. “It’s OK if you have a cheat meal here and there. Just don’t let it get out of hand.”

Quickly re-establish healthy eating habits

Hit the reset button on healthy eating habits as soon as possible after a misstep to get yourself moving in the right direction, says Patton. Focus on keeping a one-day setback from ballooning into a one-week setback.

Consider planning out meals for the week ahead to restore your routine, and maybe add in a new recipe or food item to spice things up. Stock your fridge with nutrient-rich fruits and vegetables for when you crave a midday nibble.

Learn from your eating misadventures, too, Patton says. If life’s hectic pace continually leads to greasy drive-thru dinners, arrange alternatives such as nutritious meals packed in a car cooler or pre-made dishes that can be plated as soon as you get home.

Using a food tracking app or journal to better understand your eating routine could help pinpoint and address persistent stumbling blocks to your dietary goals. “It’s a great way to understand the ‘why’ behind your behaviors,” says Patton.

Give yourself time to chew

One of the easiest ways to climb back on the healthy eating wagon is to slow it down at mealtime. Gobbling down food often leads to overeating. “It takes 20 minutes for your stomach to tell your brain that it’s full,” says Patton. “Don’t get ahead of it.”

Patton recommends setting down your fork between bites to reduce the plate-to-mouth food transfer pace. Adding in sips of water applies the brakes, too, while also helping to fill you up and curb your appetite.

The tactic is especially effective at parties, where tackling a buffet can lead to mass consumption in a hurry. “Eating slower is one way to eat healthier,” says Patton. “It’s a good habit to build.”

View healthy eating as a long-term commitment

Building a healthy diet isn’t something that’s done or undone in a single day. Instead, it’s a process best measured over months and years. It’s more important to develop lasting routines then to fixate on a momentary stumble.

Keep that in mind before fretting over the dent you put in a just-opened bag of potato chips.

“As long as you understand the bigger goal, you’ll be fine,” says Patton. “Be in it for the long haul.

Is Yogurt Good for Diabetes?

One glance at the supermarket’s miles-long yogurt aisle tells you all you need to know about yogurt’s popularity. But has yogurt really earned its reputation as a healthy superfood?

It’s complicated. Yogurt is absolutely good for you, says registered dietitian Julia Zumpano, RD. But not all yogurt is created equal, and some choices are definitely better than others.

Tart, sweet, thick, thin: Here’s what you should know about yogurt’s good side and how to pick a winner.

Is yogurt healthy?

As far as nutrients go, yogurt has a lot going for it. It’s full of:

  • Protein: Greek yogurt has about twice as much protein as traditional yogurt.
  • Calcium: You need calcium for strong bones and teeth. Your muscles and nerves also rely on this mineral to function properly.
  • Probiotics: These beneficial bacteria are important for your health. The helpful microbes may improve gut health and boost immunity. But only yogurts stamped with the “Live & Active Cultures” seal contain probiotics, and the type and amount can vary by brand. So check before you buy.

Those nutrients are good for head-to-toe health. But there’s also research suggesting that yogurt is specifically good for heart health: Yogurt has been linked to healthy blood pressure and cholesterol levels. And some research shows that eating yogurt as part of a healthy diet can help prevent long-term weight gain, which is good for the heart.

Beware of sweetened yogurts

While yogurt has a lot going for it, not all yogurt is a healthy choice. Some flavored yogurts — even those made with real fruit — can be more like junk food in disguise.

That strawberry swirl fruit-on-the-bottom or chocolate chip crunch topping can pack a sugary punch. Some flavored yogurts contain more sugar in one serving than the daily recommended amount. (The American Heart Association recommends no more than 25 grams for women and 36 grams for men.)

What about sugar-free flavors? Unfortunately, artificial sweeteners may not be any healthier than real sugar. And eating super-sweet artificial sweeteners can set up your taste buds to crave more sweet stuff throughout the day.

Your best bet is to avoid flavored yogurt and reach for the plain variety. “Plain, nonfat yogurt is best,” says Zumpano. “Both original and Greek-style are excellent sources of protein, calcium and probiotics.”

Yogurt shopping 101: What to know before you buy

What should you know before you hit that overwhelming dairy aisle? Here’s a rundown of your yogurt options.

  • Greek-style yogurt: Greek yogurt is strained to create a rich, creamy texture — and has twice as much protein as regular yogurt. “For managing your weight, try Greek yogurt,” Zumpano says. “It has more protein, which can help you feel fuller longer.”
  • Traditional yogurt: Regular old yogurt is also a good source of protein and other nutrients, though it doesn’t pack quite the same protein punch as Greek yogurt. But some people prefer its milder taste and thinner texture, so it’s worth a try.
  • Flavored yogurt: Fruity picks and other flavored yogurts can contain a lot of sugar, but the amount varies by brand. If you can’t resist, try to pick a flavor with less than 120 calories per container and no more than 12-13 grams of sugar.
  • Whole-milk yogurt: This extra-creamy option is a good choice for growing babies, toddlers and children, who need the extra fat for growth and development. But it’s high in saturated fat, so it may not be the best pick for older kids and adults. If you’re looking for something a little creamier, choose a 2% milk fat instead of full fat.
  • Nondairy yogurts: Yogurts made from soy, almond or coconut milk are good options if you have a dairy sensitivity or eat a vegan diet. They can be a good source of protein and heart-healthy fats. But some are high in sugar, so read labels carefully. Coconut milk yogurt is also high in saturated fat, so watch your portions accordingly.

Dress your yogurt for success

Unsweetened yogurt gets two thumbs up from many dietitians. But some people are put off by its tart taste. If you’re still getting used to plain yogurt, try these tricks until your taste buds adapt:

  • Dress up plain yogurt with fresh or frozen fruit, vanilla extract or a sprinkle of cinnamon.
  • Swap in Greek yogurt to replace some of the sour cream or mayonnaise in dips, dressings and soups. You’ll get the benefits of yogurt and cut some saturated fats from your diet.
  • Add Greek yogurt to fruit smoothies for an extra boost of protein and creamy texture.

Once you start adding a dollop of yogurt here and there, you’ll discover all sorts of ways to enjoy this versatile food.