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Diabetes and Fast-Food Choices

Healthy Food Choices on the Go

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Updated February 21, 2012

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. I can't. Some can eat smaller servings of just about anything. Some can't, like me. 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. I often carry around an apple and a bag of almonds in case I can't find anything diabetes-friendly.

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. I know it can be a pain, but 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. I personally use Calorie Counter by Fat Secret on my phone.

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. I often take off the cheese and give it to my dog, who is a frequent companion in the co-pilot seat.

  • 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? One of my favorite meals is a Panda Express bowl. I order a bowl of kung pao chicken 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, I have found that some restaurants have counts as high as 41 grams of carbs and 18 grams of sugar. If I find one that is very sweet, I sometimes rinse it off a little with water. I grab a bunch with chopsticks and rinse with water from my water bottle. I try to 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 me and many others, corn tortillas are not too evil.

If I eat carbs, I personally try to limit them to one, 15-gram serving per snack or two, 30-gram servings per meal. Of course, your carbohydrate prescription may be much higher or even lower than mine. Make sure and talk to a dietician about what would work best for you.

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

When I simply cannot find a meal that fits into the first two choice categories, then I resort to counting carbohydrates. Another option would be using exchange lists. This requires looking up nutritional information. I also look at the sugar and calories and try to keep them as low as possible. For meals, I personally aim for around 30 grams of carbs (or less) and less than 5 grams of sugar, and I try to keep meals under 500 calories. Work with a dietician to find out what works best for you, your diabetes management and your goals.

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