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Nearly every diabetic eats fast food at one time or another. Here are 10 suggestions for keeping the ill effects of fast food at a minimum.

Five Rules for Making the Right Choices in Fast Food If You Have Diabetes

Diabetics are constantly admonished that fast food lacks the nutrients they need and is loaded with fats, carbohydrates, and salt they don't. But it's a simple fact of life that diabetics do eat at fast food establishments for reasons of time, scheduling, and cost. If you are diabetic and you are going to eat fast food, you can at least make choices that lead to healthier eating.

1. Tell the counter clerk you'll have extra onions with that.

Onions contain sulfur compounds that cause bad breath. However, these sulfur compounds also act in much the same way in the body as alpha-lipoic acid, increasing sensitivity to insulin and in some cases (if you are a newly diagnosed type 2 diabetic) stimulating the release of insulin from the pancreas to help keep blood sugar levels lower.

2. Drink caffeinated beverages before you eat.

If you consume caffeine, it may be helpful to have your coffee or tea before your meal rather than after your meal. That's because caffeine stimulates your brain, and helps you taste fat better. The more able you are to taste fat in food, the less food you need to eat before your brain registers the fact that your cravings have been satisfied.

3. Nibble on moist foods before your main meal.

Eating a salad or having a cup of soup before your main meal serves two important functions in appetite control. The moisture in your mouth makes it easier for you to taste all the flavors in your food. If the food is really awful, you will notice this before you eat a lot of it. If the food tastes great, you will enjoy your meal more.

The other way that moisture in your food helps you eat less is by filling your stomach. Drinking water doesn't work as well as eating salad or soup. That's because water (or tea or coffee or soda) doesn't require any additional digestion. It just passes straight on through to the small intestine for absorption into the bloodstream. The fibers in salad and the fine particles in a simmered soup, on the other hand, require extra time in the stomach for tiny particles to be broken up into nutrients your body can absorb. University of Pennsylvania nutritionist Dr. Barbara Rolls has conducted literally hundreds of experiments of the effects of moisture on meal size and found that having soup first can make the meal satisfying for 100 to 150 fewer calories.

4. Forget the common advice to add flaxseed or flaxseed oil to your fast foods.

A popular diet guru advises his devotees to carry little bottles of flaxseed oil with them when they eat out. Just add flaxseed oil, which really is rich in healthy omega-3 essential fatty acids, where the restaurant would give you a salad dressing or use mayonnaise.

Aside from making your fast food meal slow, there is a big problem with this health advice. The linoleic acid in flaxseed oil is great for your body, but it makes your taste buds insensitive to salt and fat. If you eat fast food as an occasional treat, flaxseed oil will ruin the experience for you. You will probably just want more later.

5. Consider some eat this-not that choices from the fast food menu.

Authors David Zinczenko and Matt Goulding are famous for their Eat This, Not That books that list numerous fast food choices that are about equally satisfying but that have vastly different impacts on diet. Some examples of their recommendations include:

  • Eat the much-maligned McDonald's Big Mac (450 calories, 22 grams of fat) rather than an Arby's Angus Deluxe (750 calories, 39 grams of fat).
  • At the ballpark, eat a hot dog (310 calories, 27 grams of fat) rather than an order of nachos (1,108 calories, 82 grams of fat).

Zinczenko and Goulding don't list carbohydrate grams, but about 50% of the extra calories in most of their food selections are due to the carbohydrates that can keep blood sugar levels elevated. Their books—or a quick search for the suggestions online—should be required reading for all diabetics who indulge in fast food.

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