How to Have a Healthy Relationship With Food

People with diabetes have a notoriously complex relationship with food. Food and nutrition are a cornerstone of a healthy life with diabetes, and balancing it with insulin intake, exercise, sleep, and stress management can be a lot to handle. This article will outline strategies that you can implement to cultivate a healthier relationship with food. Warning: this article may contain triggers for people who struggle with disordered eating and/or body dysmorphia.

Having a healthy relationship with food takes time and is sometimes difficult to achieve for some people, especially if you live with diabetes. Studies show that people with diabetes are more than twice as likely to have an eating disorder.

The most common eating disorders are anorexia nervosa, bulimia, and binge-eating disorder, but people with diabetes may also suffer a unique disorder to their condition: diabulimia, where one withholds insulin (and eats as per usual), letting blood sugar levels skyrocket in order to lose weight rapidly.

Combine diabetes with any of these eating disorders is a recipe for disaster, and can quickly lead to serious complications and even death. So, how can you develop a healthy relationship with food, when so much of diabetes involves counting, tracking, measuring, and constantly thinking about everything we put into our mouths?

Learn to Follow Hunger Cues

Diabetes can warp one’s thinking about food. Often, people with diabetes respond more to their blood sugar levels than their hunger pangs. One will always eat when they’re low, for example, but if their blood sugar is high but they’re hungry, they will often wait until glucose reaches more normal levels before eating. This can be healthy from a blood sugar and HbA1c point of view but does not help establish a healthy relationship with food.

If your blood sugars are well-managed, learn to follow hunger cues in addition to blood sugar needs. Eat when you’re hungry and stop when you’re nearly full. It can be helpful to eat lower carbohydrate foods if you’re hungry but your blood sugar is high, but don’t punish yourself by skipping meals altogether.

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Practice Mindful Eating

People tend to multitask and do a million things at once, and in our fast-paced world, that can come to be expected. One thing that you should never multitask, however, is eating. Take the time to put your phone down, close your laptop, step away from the television, and really enjoy a meal without distraction. Take the time to smell your food, feel the texture, chew thoroughly, and really taste the flavors.

Practicing mindful eating helps prevent overeating, and the experience will leave you more sated. Slow down and really enjoy your meal. Practicing being in the moment and savoring your food, being thankful, and appreciating all of the work that went into growing, cultivating, and cooking a meal can help form a healthier relationship with food.

There Are No “Good” or “Bad” Foods

Understand that there are no “good” or “bad” foods. No food should be forbidden (unless, of course, you have a serious allergy or celiac disease). Labeling foods as “off-limits” puts them on a pedestal and makes people more likely to binge eat them later on.

At least one study confirmed this; a group of dieters and non-dieters were given a milkshake to drink and then were ushered into private rooms where they could eat an unlimited amount of cookies. Shockingly, non-dieters were much better at regulating their cookie intake and stopped eating when they felt satisfied, while the dieters ate significantly more cookies. Labeling the milkshake “bad”, the dieters felt that since the milkshake already “broke” the rules of their diet, they might as well overeat the cookies.

This is counterproductive, as having a treat every now and again will do nothing to “ruin” a diet, HbA1c, or your diabetes control. Treats and incorporating foods that you enjoy just for the sake of enjoying them are crucial to sound mental health and is a key to a healthy relationship with food.

Make space in your diet to incorporate treats, so you never feel deprived, and never label foods as “good” and “bad”. If you’re recovering from disordered eating, do not forbid entire food groups. For example saying, “I’ll never eat grains again” will make you much more likely to binge eat it and can cause your mental health to go into a tailspin.

Think in Terms of How You Can Nourish Your Body

People caught up in disordered eating often fixate on calories (and sometimes if you live with diabetes, severely restricting carbohydrates). Shift your thinking. Instead, ask yourself, “how can I best nourish my body today?” Make sure to include healthy fats, protein, and carbohydrates into your diet to fuel your activity and life.

Instead of exercising to “burn off” whatever it was that you ate that day, flip the narrative and ask yourself how can you best nourish yourself for the activity and day ahead? It can be helpful to look at specific vitamins and minerals as well.

This can also help incorporate new foods into your diet that you may have traditionally been hesitant to try. For example, if you have some ice cream after dinner, note the fact that it has both calcium and vitamin D in it. Bread, too, often has lots of fiber and thiamine (vitamin B1). See the good in all foods, and focus on the nutrients they provide. This will help heal your relationship with foods and incorporate new foods into your diet.

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Seek Professional Help

Managing a chronic disease that requires constant vigilance in your diet and the foods you consume can be exhausting, but you don’t have to go it alone. Ask your doctor for a referral and enlist help from a registered dietitian or nutritionist, who can help you craft a meal plan that will work for both your diabetes and non-diabetes related goals, and will also be specific to your activity level and lifestyle.

If you’re struggling with disordered eating and think you are developing an eating disorder, get help right away. Seeing a psychologist or diabetes therapist can also be beneficial for those struggling to heal their relationship with food.

Relationships with food, especially while living with diabetes, are personal, complex, and require regular work to keep healthy. By following these strategies, it’s possible to get to a place in which food no longer controls your thoughts, and instead, fuels your overall physical and emotional well-being.

A healthy relationship with food means balancing nutrition with your diabetes needs, not labeling foods as either “good” or “bad”, seeing the value in nutrition beyond calories and carbohydrates, and remembering that food doesn’t have power over you.

Taking the first steps to fix a bad relationship with food can be complicated, but is well worth the effort.


Emergency Changes to SNAP and WIC (Food Stamps) Adjust to Thousands of New Applicants During COVID-19

This content originally appeared on diaTribe. Republished with permission.

By Karena Yan

SNAP and WIC help connect millions of individuals and families to affordable, nutritious foods. Here are how these programs are evolving

Healthy food and nutrition are important not only for managing diabetes but also for the proper function of your immune system. The World Health Organization (WHO) recommends that people maintain a nutritious diet and limit their alcohol and sugary drink consumption to improve our bodies’ ability to fight off viruses like COVID-19.

At the Tufts’ Food and Nutrition Innovation Council (FNIC) Summit on April 16, experts in nutrition, healthcare, and policy gathered to discuss the implications of coronavirus on the affordability, accessibility, and sustainability of healthy food in our country. In addition to discussing the changes brought about by the pandemic, council members made food policy recommendations for the post-COVID future.

While coronavirus poses a challenge for the smooth operation of programs like the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), the USDA’S Food and Nutrition Service has implemented emergency changes to these programs to ensure access to healthy food for program recipients.

What are SNAP and WIC?

SNAP, previously referred to as food stamps, is a federal program that provides nutrition benefits for eligible, low-income individuals and families to support their ability to purchase healthy foods. These benefits are provided via an Electronic Benefits Transfer (EBT) card, which acts as a debit card at authorized retail food stores.

Similarly, WIC provides federal grants to low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk. WIC serves about half of all infants in the United States, and these grants supplement the purchase of foods, health care referrals, and nutrition education.

How has coronavirus impacted SNAP and WIC?

As unemployment has reached nearly unprecedented levels , enrollment for SNAP and WIC has seen a marked increase. In California, application volume to receive CalFresh, the state’s version of SNAP, has seen a 350 percent increase since the crisis began. More than 57 percent of these applicants reported that they lost a job within the previous 30 days, compared to 16 percent in January.


Image source: diaTribe

Moreover, panic buying and stockpiling during the epidemic have made the availability of SNAP- and WIC-eligible products scarcer. This is particularly true for WIC recipients, who may only use their funds on a limited list of products that have been selected as low-cost and nutritious. For those who do not receive WIC benefits, the National WIC Association asks shoppers that if they are choosing between two items, one of which is WIC-eligible, to avoid buying or hoarding WIC-eligible products, including infant formula.

What emergency changes have been implemented to support SNAP and WIC?

The USDA has implemented a 40 percent increase in overall SNAP benefits, which amounts to a $2 billion monthly allotment in addition to the usual $4.5 billion that goes toward monthly SNAP benefits. WIC has also received $500 million in additional funding to cover increases in program participation.

Additionally, while SNAP and WIC have some requirements that are challenging to meet during COVID-19, such as mandatory in-person visits to enroll or re-enroll in the programs, the USDA has offered many accommodations to these requirements. However, the USDA’s Food and Nutrition Service has offered many accommodations to these requirements, in addition to providing extra funding to both programs. Several of these program changes are highlighted below. To see the full list of changes, please see here.


  • Application Processing: State agencies can extend certification periods and temporarily waive periodic report form submissions for enrolled households. Additionally, in lieu of face-to-face interviews for enrollment, states are waiving the interview requirement or conducting interviews via telephone.
  • Pandemic EBT (P-EBT): States are now allowed to provide benefits (similar to SNAP or “food stamps”) to children who normally receive free or reduced-price school meals.
  • Able-bodied Adults without Dependents (ABAWDs) Time Limit Suspension: States may temporarily suspend the time limit associated with ABAWD work requirements, which ordinarily terminate an ABAWD’s SNAP benefits after three months of unemployment.


What happens after COVID-19 is over?

At the Tufts’ FNIC Summit, council members discussed the importance of maintaining some, or all, of these measures after the crisis. Requirements such as in-person visits and lengthy renewal processes pose barriers for SNAP/WIC recipients and risk delaying or inhibiting people’s ability to access these services, regardless of the circumstances. Moreover, given the sharp uptick in SNAP/WIC enrollments, the increased efficiency and accessibility of these programs will greatly benefit recipients long after the “end” of the coronavirus crisis.

Furthermore, council members hope even further adjustments to SNAP/WIC are made in the future. While these programs have been relatively effective in facilitating access to healthy foods for low-income individuals and families, the FNIC calls for greater emphasis on nutrition within the programs, such as by providing a subsidy for fruit and vegetable purchases or removing sugar-sweetened beverages from the list of eligible purchases.

Such incentives can provide vast benefits for both individual health and healthcare costs. For example, a 30 percent fruit and vegetable incentive for SNAP participants is estimated to save $6.77 billion in healthcare costs over a lifetime. Thus, while some headway has been made to these SNAP/WIC programs, advocates must pursue not only the permanence of these adjustments but also additional changes to the programs’ health and nutrition standards and practices.


Keeping Your Immune System Healthy

This content originally appeared on Beyond Type 1. Republished with permission.

By Mariana Gomez and T’ara Smith

Perhaps you’ve read about boosting your immune system to protect you from infections and other illnesses, including the Coronavirus. But, there aren’t any magic foods, supplements, or one-size-fits-all solutions to boosting your immune system because it’s a complex network of cells, organs, tissues, and proteins. Still, healthy living provides its benefits, including keeping our immune systems strong, and research is being conducted to study the effects of nutrition, exercise, mental health, and others on our immune response.

How Diabetes Impacts Your Immune System

Type 1 diabetes is an autoimmune disease. There is not enough evidence to identify the cause but we know that our immune system insulin-producing cells are destroyed. We now know that people with type 1 diabetes are more likely to have a co-occurring autoimmune disorder. The reason that co-occurring autoimmune disorders are so common isn’t yet known. We also know that hyperglycemia can affect our immune system’s response so it would represent a barrier for recovery and fighting virus and bacteria. This does not happen only in type 1 diabetes (T1D) but other types of diabetes as well.

People with type 2 diabetes should be aware of the impact the disease has on their immune system as well. Hyperglycemia in diabetes is a probable cause of the disruption of how the immune system functions. Humans also produce “natural killer” cells that are critical to human immunity. A study showed people with type 2 diabetes have lower counts of these cells compared to those without diabetes and with prediabetes. This makes it harder to defend the body against viruses, diseases, and diabetes-related complications.

Overall, people with diabetes are more susceptible to common infections such as the flu and pneumonia. To protect your immune system, stay up-to-date on your doctor’s visits, get vaccinated against the flu, and get screened for complications.

Essential Nutrients for a Strong Immune System

Another way you can protect your immune system is through nutrition. With a healthy diet, food can help protect you against illnesses and help improve recovery. Different foods contain different quantities and types of nutrients and micronutrients. Therefore it is important to include a variety of food groups in your diet. Vitamins A, B6, C, E, magnesium, and zinc play important roles in our immune function.

How Vitamins + Minerals Help Your Immune System

Vitamins and minerals are known as essential micronutrients. Even though they are needed for our health, our bodies can’t make them on our own or enough of essential micronutrients, therefore, they must be obtained through food. There are nearly 30 vitamins and minerals the human body can’t make on its own. A healthy diet will include different groups of foods that contain some of these nutrients.

Micronutrient malnutrition results in a lack of vitamins and trace minerals that can affect the response of our immune system to fight different health conditions. The NIH lists the recommended dietary allowances (RDA) for vitamins and minerals. While this provides general guidelines for different age groups, please talk to a nutritionist or your doctor about recommended intakes for you.

Vitamin A is an anti-inflammation vitamin that helps develop and regulate the immune system and protect against infections. This Vitamin can be found in sweet potatoes, carrots, broccoli, spinach, red bell peppers, apricots, eggs, and milk. While vitamin A is important, it is possible to consume too much of it. High intake of vitamin A from supplements and some medications can cause headaches, dizziness, coma, and death. According to the NIH, pregnant women shouldn’t consume high doses of vitamin A supplements.

Vitamin B6 helps improve immune response to the increase in the production of antibodies, a protective protein produced by the immune system to fight antigens in the body. Vitamin B6 is found in a variety of foods. Food sources of vitamin B6 include pork, fish, poultry, bread, eggs, cottage cheese, tofu, and wholegrain foods such as oatmeal and brown rice. Getting too much vitamin B6 from food is rare. However, from supplements, long-term use for a year or more can lead to nerve damage.

Vitamin C also known as ascorbic acid, helps your immune system by fighting free radicals that cause cancer and other diseases. It’s a popular nutrient to fight or treat the common cold. While focusing on vitamin C consumption may not prevent you from getting sick, it could decrease the length and severity of cold symptoms. It also helps by stimulating the formation of antibodies. This vitamin can be found in oranges, grapefruit, tangerines, red bell pepper, papaya, strawberries, tomato juice, among others. Too much vitamin C can cause diarrhea, nausea, and stomach cramps.

Vitamin E works as an antioxidant, which protects the cells from damage by free radicals and helps the body fight infections. This vitamin can be found in sunflower seeds, almonds, vegetable oils, hazelnuts, and spinach and other green leafy vegetables. There isn’t a risk of consuming too much vitamin E from foods. Precautions should be taken when taking supplements, which could interfere with other treatments such as chemotherapy or radiation therapy.

Magnesium is a nutrient that our body needs to regulate the function and work of our muscles and the nervous system. It is involved in the process of forming protein, bone mass and genetic material. It is found in legumes, nuts, seeds, whole grains, green leafy vegetables, milk, yogurt among others.

Zinc is found in cells throughout the body. It helps the immune system fight bacteria and viruses and is needed to produce proteins and DNA. During pregnancy, infancy, and childhood, the body requires zinc to grow. Zinc can be found in oysters, red meat, poultry, crab, lobster, cereals, beans, nuts, whole grains, and dairy products.

Drinks That Help Your Immune System

You can find or create your own drinks to help your immune system. Some beverages you may want to try at home that are high in important immune-friendly vitamins are:

*Juices may be high in carbs and sugar, so if you can, opt for unsweetened teas like green/chamomile teas, or whole fruits.”

Alcoholic beverages are generally fine to consume in moderation. Drinking too much alcohol can lead to a weaker immune system. Heavy drinkers are more likely to get pneumonia and drinking too much alcohol at once can slow your body’s ability to ward off infections.

Should You Use Supplements to Help Your Immune System?

Supplements are used in cases where diet is not able to sufficiently provide micronutrients. While supplements aren’t meant to replace a balanced diet, they’re used to help people with other health conditions and may be prone to nutrient deficiencies. Many vitamin and mineral supplements can be purchased over the counter. But, check with your physician or a registered dietitian nutritionist to see if you actually need them. If you’re taking other medications, talk to your doctor on how vitamin and mineral supplements can interfere with those drugs.

Other Things You Can Do to Stay Healthy

A healthy diet is definitely a big part of remaining healthy. Other things you can do on a regular basis to maintain your health is to practice good hygiene (i.e. washing your hands), see your healthcare provider routinely, keeping an emergency medical plan and your emergency contacts updated. Also, prioritize physical activity and refrain from smoking. From a mental and emotional health perspective, practice stress-relieving techniques and know the signs of diabetes burnout.


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