Dispelling myths about diabetes and dieting: Is what you eat more important than how much you eat?

Part of managing your diabetes is making conscious, healthful food choices. You don't have to completely deprive yourself of scrumptious meals and snacks - balance is the key.

Kelly O'Connor, RD, LDN, CDE, a registered dietitian and diabetes educator at the Diabetes & Nutrition Center at Northwest Hospital, helps debunk some food myths in the first of a two-part blog series about dietary options for people with diabetes:

Myth: What you eat is more important than how much you eat.

Large portions of anything, even fruit, can potentially increase blood sugar levels. "Really, the amount of something makes a bigger impact on your blood sugar. I'm not advocating eating junk food in small portions. But the truth is that the size of the portion is what makes a big difference," O'Connor says.

Have a balance of lean protein, complex carbs, healthy fats and occasional treats to help manage weight and keep your blood sugar level in its target range. Less healthy foods like sweets, if you can limit it to one portion, can be worked into your meal plan, O'Connor says.

Myth: Fat intake doesn't matter if you have diabetes.

Although fat contained in typical foods and ingredients like sour cream, butter and mayonnaise doesn't affect your blood sugar, it does affect your cholesterol level, which in turn can affect your heart and body weight. This is of particular concern for people with diabetes because they are already at increased risk for a heart attack and stroke, O'Connor says.

"I used to work with a diabetes doctor who would tell patients, "˜You have diabetes. I am going to treat you as if you are someone who has already had a heart attack,'" O'Connor says.

People with diabetes must watch their fat intake carefully, she says. Healthy fats are best; avoid trans fat and consume minimal saturated fat.

Myth: You must eat an evening snack to have good blood sugars in the morning.

It is recommended in some cases (not as much now compared to previous years because newer diabetes medications do not cause hypoglycemia overnight), but generally people with diabetes don't have to munch down a late snack if they don't want to.

If you aren't hungry or you've had enough calories during the day, it's ok to skip it, O'Connor says. If you do decide to eat a late snack, do so an hour or two before bedtime. "There's no perfect evening snack. It's what works for you to have a good blood sugar level the next morning," O'Connor says. "Most of the time, what we recommend is a little bit of carbohydrate and a little bit of protein, like crackers and cheese or fruit and nuts, or maybe a yogurt or half of a sandwich."

Myth: If you have diabetes, you should never drink alcohol.

You should check with your doctor about drinking alcoholic beverages, as the label on most diabetes medications advises against alcohol intake. If your blood sugar levels are under control, one drink can be included in your meal plan on occasion, O'Connor says. You may need to eat something along with your drink to prevent low blood sugar. Be mindful of the type of drink, particularly if it's a mixed drink. "Just be very careful if you choose to drink alcohol. If it's straight alcohol, it can lower your blood sugar. If you're drinking a strawberry daiquiri, pina colada, cranberry juice and vodka, or rum and coke, all of those things are probably more apt to make your blood sugars go up, not because of the alcohol, but because of the mixers," O'Connor says.

In addition to the Diabetes & Nutrition Center at Northwest Hospital, LifeBridge Health offers a monthly diabetes support group led by certified educators from Sinai and Northwest hospitals, providing a welcoming environment for people living with the disease to share personal experiences and receive important information about topics related to diabetes management.

LifeBridge Health is one of the largest, most comprehensive providers of health services in Maryland. It comprises Sinai Hospital, Northwest Hospital, Carroll Hospital, Levindale Hebrew Geriatric Center and Hospital, and related subsidiaries and affiliates.