Pasta is synonymous with comfort, which can be a dirty word when it comes to nutrition. And if you’re living with type 2 diabetes, it’s possible you’ve heard it’s a food you need to avoid.
But if you love pasta and are willing to make a handful of tweaks to the typical bowl, saying goodbye to this feel-good fare may not be necessary.
Though it’s higher in carbohydrates than some other foods, pasta can fit into a healthy meal plan for someone with diabetes, says Toby Smithson, RDN, a certified diabetes care and education specialist (CDCES) in Hilton Head, South Carolina, and author of Diabetes Meal Planning and Nutrition for Dummies.
Indeed, people with type 2 diabetes who ate a 50-gram (g) serving of pasta experienced lower spikes in blood sugar than they did after eating equal portions of white bread, potato, or rice, according to past clinical studies referenced in a study published in the April 2021 issue of BMJ Nutrition, Prevention & Health. You simply need to watch your portion sizes and prepare this dish mindfully, such as by limiting certain toppings and mix-ins (like cheese, meat, and sauce). Taking smart steps such as these can help keep your blood sugar, weight, and overall health and nutrition on track.
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Below, diabetes educators and registered dietitians share their go-to strategies for making pasta as diabetes-friendly as possible.
1. Choose Whole-Grain Pasta
One easy way to make your pasta dish more nutritious is to swap out traditional noodles for a higher-fiber variety. “Whole-grain pasta can be a great option because it offers more fiber, which can help blunt blood sugar spikes,” Smithson says.
Many typical white pasta noodles are fashioned with semolina flour, which is made by grinding a type of wheat known as durum, according to Bob’s Red Mill. While semolina can be a nutritious flour — especially when it’s enriched with vitamins and minerals — whole-grain pasta has a slight edge. “Nothing is removed in processing, so it has the highest nutrient value, including fiber,” says Sue-Ellen Anderson-Haynes, RDN, CDCES, a registered dietitian at Joslin Diabetes Center in Boston.
Two ounces (oz) of uncooked semolina spaghetti noodles (about 1 cup cooked) provides 200 calories, 42 g of carbs, and 3 g of fiber, making it a good source of the nutrient. But an equal serving of whole-grain spaghetti noodles contains 180 calories, 39 g of carbs, and 7 g of fiber, meaning it is an excellent source of fiber.
2. Make Veggies the Star of Your Bowl
To make your bowl more diabetes-friendly, just add color — from veggies, that is.
Specifically, centering your pasta dish on nonstarchy, naturally low-calorie vegetables increases the amount of food and adds vitamins and minerals, Smithson says.
“Nonstarchy vegetables are very high in fiber and have very little carbohydrate, which means less effect on blood sugar,” says Anderson-Haynes. She recommends filling roughly half of your plate or bowl with options like kale, collard greens, arugula, broccoli, asparagus, cucumber, spinach, carrots, or mushrooms.
3. Skip Creamy Sauce In Favor of an Oil- or Tomato-Based Sauce
Like other “white” foods to swap out of your diet (think: white bread, white rice, and yes, white pasta), ditch white sauce when preparing a more diabetes-friendly meal.
As Anderson-Haynes notes, traditional cream-based sauces tend to have more saturated fat and sodium than other options. “People with diabetes have a higher risk of heart disease, so it’s imperative to choose heart-healthy foods low in sodium and fat,” she says. According to the American Heart Association (AHA), foods high in saturated fat can raise cholesterol levels in the blood, which may increase your risk of heart disease and stroke. Meanwhile, getting excess sodium in your diet can increase the risk of high blood pressure — one of the major risk factors for heart disease, notes the AHA.
Smithson suggests choosing sauces with an olive oil and fresh garlic base, both of which offer potential heart-health benefits.
Olive oil, for example, contains a type of healthy fat known as monounsaturated fat. This type of fat may help lower cholesterol, a waxy substance that’s beneficial in small amounts, when traded in for less healthy fat sources like butter, according to the Academy of Nutrition and Dietetics.
These effects are supported by research. For example, a study of nearly 100,000 healthy men and women found an association between replacing 1 tablespoon (tbsp) of butter or margarine with an equal amount of olive oil and a 5 to 7 percent lower risk of heart disease after four years. While drawn from a large pool of participants, the study relied on self-reported questionnaires, which may leave room for error. The findings were published in the March 2020 issue of the journal Circulation.
Meanwhile, research suggests that allicin, a natural compound in garlic with antioxidant properties, may positively affect blood sugar levels. A review published in September 2017 in the journal Food & Nutrition Research found that a supplement form of the herb significantly reduced fasting blood glucose within one to two weeks. Researchers examined nine randomized controlled trials with a total of 768 people living with type 2 diabetes who took between 0.05 g and 1.5 g of garlic. Most trials included fewer than 80 participants and lasted only 12 weeks. That said, the research looked at the daily use of garlic supplements, finding improved blood sugar control in two weeks, as well as in 24 weeks in people with type 2 diabetes. Whether similar results apply to raw garlic eaten with the occasional bowl of pasta remains to be seen.
Remember: Olive oil provides healthy fats, but it’s still high in calories (124 calories per tbsp), so practice portion control. Use half a cup of olive oil and 4 to 5 garlic cloves per pound of cooked pasta, Smithson suggests. Portion the sauce equally among each serving of pasta (generally one-third of a cup of cooked noodles is 1 serving, according to Smithson).
Red pasta sauces like marinara or classic tomato are other great options, “as they are lower in overall fat and calories” than cream-based sauces, says Jana Mowrer, RDN, MPH, a CDCES based in Fresno, California. Just stick with a serving size that’s one-half to three-quarters of a cup, she adds.
When buying a packaged red sauce, choose a jar that contains no added sugar and, ideally, no more than 15 g of carbs and 140 milligrams (mg) of sodium per half-cup serving, Mowrer says.
4. Experiment With Veggie Noodles
If you can’t handle wheat, or you’d like to slash the carbs in your pasta dish even more, try crafting noodles out of vegetables. If you don’t have a spiralizer or mandoline — two kitchen tools used to spiralize produce by hand — you can use a vegetable peeler. Simply take the peeled veggie strips and place them in boiling water for 20 seconds, then transfer the noodles into a bowl of ice, Smithson says. “For ease of preparation, it’s fine to purchase spiralized veggie noodles,” she adds.
As long as they’re not made from squash or sweet potatoes, which are starchy, spirals made from vegetables will be the lowest-carbohydrate option, Smithson says. Plus, veggie noodles are typically lower in calories, while offering plenty of vitamins and minerals.
One cup of cooked zucchini spirals, for example, contains only 27 calories and 5 g of carbs, per the U.S. Department of Agriculture (USDA), whereas 1 cup of cooked whole-grain spaghetti noodles from Barilla brand contains 180 calories and 39 g of carbs.
That same portion of zucchini also offers 23.2 mg of vitamin C, making it an excellent source, and 476 mg of potassium, making it a good source.
Bell peppers, broccoli, carrots, and beets make for other good low-carb veggie noodle options.
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5. Practice Portion Control
Being mindful about portion sizes is key for enjoying pasta when you’re managing type 2 diabetes. “The goal is to keep blood sugar levels from spiking too high,” Mowrer says.
Food portions — especially at restaurants — are much larger today than they were 20 years ago, according to the Centers for Disease Control and Prevention (CDC). Multiple studies have found that people eat more food when they’re given bigger servings, and that they help themselves to more food when they have larger bowls and serving spoons, note the authors of a research article published in November 2014 in the journal Advances in Nutrition. With those expanding portion sizes comes more carbs and calories.
“It’s important when consuming pasta to include other food groups and practice portion control, aiming for about one-quarter carbs, one-half veggies, and one-quarter lean protein on your plate per meal,” Mowrer says. The CDC recommends using a 9-inch dish (about the length of a business envelope) to take the guesswork out of portion control. Some companies, like Livliga, sell plates and bowls that indicate the ideal amounts of certain foods to eat for a given meal.
The exact number of carbs to aim for depends on factors such as age, gender, activity level, and any medications you’re taking, says Mowrer. Generally, she recommends that people with diabetes aim for 30 to 60 g of carbs per meal. The American Diabetes Association (ADA) recommends working with your CDCES to figure out your carb goal.
6. Feature a Lean Protein
By combining a protein source with a carb-heavy dish like pasta, you can avoid a rapid blood sugar spike (and then a crash), Smithson says. That’s because protein is slower to digest than carbohydrates.
Plus, adding protein will make your pasta more satisfying, which may prevent you from overloading your plate with carbs, Anderson-Haynes says.
Opt for a lean protein source like skinless grilled chicken, ground turkey, or tofu. These foods tend to be lower in saturated fat and sodium than red meat or processed meats like bacon, according to the ADA.
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7. Go Easy on the Cheese
Pasta and cheese are a dynamic duo. And while people with diabetes don’t need to say goodbye to this yummy ingredient, moderation and choosing the right type are two keys to keeping your bowl healthy.
Executing portion control here may be an adjustment. Believe it or not, a single serving of cheese is only 1 oz, or roughly the length of your thumb from tip to base, according to the CDC. Try your best to opt for this thumb-sized serving, Mowrer advises.
As far as diabetes-friendly cheeses go, choose white ones like mozzarella or Parmesan, which are lower in fat and calories than other options. Mowrer suggests grating them to make the serving sizes go further. One ounce of low-fat, part-skim mozzarella, for example, has 70 calories and 4 g of fat (2.5 g saturated fat), according to the USDA.
Limit or avoid fattier cheeses such as ricotta. One ounce of full-fat ricotta from Hyvee brand has roughly 50 calories and 3.5 g of fat, including 2.25 g of saturated fat, per the USDA.
Reduced and nonfat cheeses can also be good options. A “light” version of ricotta, for example, offers 30 calories and only 1.5 g of fat (1 g of saturated fat).
