Has your doctor warned you that you're at risk of developing type 2 diabetes? If you're one of the rising tide of people with high but not yet diabetic blood sugar levels, there are measures you can take to dodge the disease. And if you already have diabetes, these same tactics can help you manage your condition and lead a full and rewarding life.

The Diabetes Prevention and Management Cookbook by Johanna Burkhard and Barbara Allan was published in co-operation with the Canadian Diabetes Association. It concentrates on the avoidance and management of the most prevalent kind of diabetes, type 2, but the authors note that the nutrition information and menus included can be adapted for people with type 1 and gestational diabetes as well.

Here's a look at the first three steps (we'll cover the next three and the last four in upcoming posts):

1. Eat three meals a day, spread four to six hours apart

Along with the expected advice to not skip breakfast and to include all the food groups in each meal, the authors emphasize the value of the family meal, explain the "second meal effect" (the benefits that carry over from one balanced meal to the next) and suggest that not everyone needs snacks.

Avoid snacking if you need only 1,600 to 1,700 calories a day (there's a chart), if you tend to snack on junk food, if you're not used to eating regularly, if you have trouble with portion size or if your daily routine simply makes eating frequently difficult. On the other hand, four or more meal breaks work if you need 1,800 or more calories in a day, if you get full easily or if you have a flexible schedule.

"Snacks help you stay fueled from meal to meal, especially that long stretch between lunch and dinner," say the authors. "Have a mid-afternoon snack so you don't come home ravenous."

2. Limit carbohydrate to 45 to 75 grams per meal

Along with the simple carbs found in table sugar, honey, fruit and sweets and the complex carbs in starchy foods such as bread, pasta, oatmeal and potatoes, fiber is also a complex carbohydrate. But unlike sugar and starch, which increase blood sugar levels and so must be monitored carefully, fiber doesn't break down into glucose, and may actually keep blood sugar levels from spiking. "And because fiber-rich foods are chewy, they slow down our rate of eating, helping us feel full after less food," the authors note.

They also come out in favour of artificial sweeteners, used within the recommended safety limits: "…sugar substitutes are safe in moderation — and they really do help reduce calories and carbs."

3. Choose low- and medium-GI foods most often

The speed at which blood sugar rises after eating carbohydrates is measured out of 100 on the glycemic index (GI). Since food labels in Canada and the U.S. aren't required to include GI numbers, the book provides a chart for some common foods. Low- (under 55) and medium-GI (56-69) foods have many benefits, according to the authors. They:

  • Reduce the risk of type 2 diabetes
  • Help manage diabetes
  • Help with weight control by keeping people full longer
  • Lower blood cholesterol levels
  • Reduce the risk of heart disease

To start a healthy meal, here's a recipe from the book for green bean and plum tomato salad:

Green bean and plum tomato salad (page 226)

Makes 6 servings

This vibrant, refreshing salad combines fresh plum tomatoes with tender green beans in a grainy mustard dressing.

  • 1 lb. (500 g) green beans, ends trimmed
  • 1 lb. (500 g) small plum (Roma) tomatoes (about 6 to 8)
  • 2 green onions, sliced
  • 1 small clove garlic, minced
  • 2 tbsp. (30 mL) extra virgin olive oil
  • 4 tsp. (20 mL) red wine vinegar
  • 1 tbsp. (15 mL) grainy or Dijon mustard
  • ½ tsp. (2 mL) granulated sugar
  • ¼ tsp. (1 mL) freshly ground black pepper
  • ¼ cup (60 mL) chopped fresh parsley or dill
  1. In a medium saucepan of boiling water, cook beans for 3 minutes or until crisp and bright green. Drain and rinse under cold water to chill; drain well. Wrap in a clean, dry towel to absorb excess moisture.
  2. Cut tomatoes in half lengthwise. Using a small spoon, scoop out center and seeds. Cut each piece lengthwise into quarters. Place in a serving bowl.
  3. Just before serving, combine beans, tomatoes and green onions.
  4. In a small bowl, whisk together garlic, oil, vinegar, mustard, sugar and pepper. Pour over salad and toss to coat. Sprinkle with parsley.

Tips: If preparing this dish ahead, keep the blanched green beans, tomatoes and dressing separate and toss just a few hours before serving to preserve the beans' vibrant green color. When tossed ahead, the beans turn an olive green when exposed to the acid-based dressing. The mustardy dressing is also wonderful with other favourite vegetable and bean salad mixtures.

Recipe excerpted from The Diabetes Prevention & Management Cookbook by Johanna Burkhard & Barbara Allan © 2013 robertrose.ca. Reprinted with publisher permission.