Is tofu good for diabetes?

Soy and Diabetes

According to the American Diabetes Association, “Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life.”

“Diabetes now affects nearly 24 million people in the United States,” according to a new Centers for Disease Control and Prevention (CDC) study. “This means that nearly one in twelve individuals in the U.S. has diabetes.” Diabetes is also a major risk factor of heart and kidney disease.

Soyfoods Are Part of Diabetes Treatment

Physicians recommend several ways to treat the symptoms of diabetes and help decrease your chances of developing diabetes. Proper exercise, weight loss, and a diabetes diet can help manage your diabetes. Soyfoods can help!

Healthy Weight Loss with Soy

Soyfoods contain soy protein, a complete source of protein with all the essential amino acids of animal protein, but with less fat, saturated fat, and no cholesterol. An evidence based review shows that soy protein is equal to other lean proteins in aiding weight loss and maintaining lean body mass. Cholesterol-free soyfoods are also a heart healthy choice!

Diabetes Diet with Soy

The Diabetes Food Pyramid recommends 2 to 3 servings a day of low-fat milk. For those who avoid dairy, soymilk is an excellent option for people with diabetes that need a lower calorie source of calcium and other important nutrients. The Diabetes Food Pyramid also recommends 4 to 6 oz. of meat or meat substitutes throughout the day. Tofu and soy meat alternatives are low-calorie tasty options for this group. Diabetes recipes can use a variety of soyfoods — including tofu, soy burgers, soy dairy-free alternatives, edamame, and soy nut butter — to help maintain a nutritious diet and decrease diabetes complications.

Kidney and Heart Disease

People with type 2 diabetes often also suffer from kidney and heart disease. Diabetes patients often have albuminuria. This occurs when the body releases more than normal amounts of a protein called albumin in the urine. Isolated soy protein reduced albumin in the urine more than casein (dairy protein) in a Journal of Nutrition study. Isolated soy protein also helped increase HDL (“good” cholesterol). With the ability of soy protein to lower “bad” cholesterol and albumin, soyfoods make a great choice to help prevent kidney and heart disease in diabetes patients.

Another study, available in Diabetes Care, looked at the impact of soy protein consumption on cardiovascular and kidney disease risk in diabetics with nephropathy, or damage to the nerves that run throughout the body, connecting the spinal cord to muscles, skin, blood vessels, and other organs. Over 4 years, the patients with type 2 diabetes and nephropathy who ate a diet that contained 8 grams of soy protein in addition to animal and vegetable proteins reduced their high cholesterols and glucose levels as well as protein urea and other symptoms of kidney disease, compared to a control group that consumed only animal and vegetable proteins with no added soy.

Eating soyfoods can help you manage your diabetes, gain health and lose weight!

Food Order Has Significant Impact on Glucose and Insulin Levels

Eating protein and vegetables before carbohydrates leads to lower post-meal glucose and insulin levels in obese patients with type 2 diabetes, Weill Cornell Medical College researchers found in a new study. This finding, published June 23 in the journal Diabetes Care, might impact the way clinicians advise diabetic patients and other high-risk individuals to eat, focusing not only on how much, but also on when carbohydrates are consumed.

]”We’re always looking for ways to help people with diabetes lower their blood sugar,” said senior author Dr. Louis Aronne, the Sanford I. Weill Professor of Metabolic Research and a professor of clinical medicine at Weill Cornell Medical College, who is the study’s principal investigator. “We rely on medicine, but diet is an important part of this process, too. Unfortunately, we’ve found that it’s difficult to get people to change their eating habits.

“Carbohydrates raise blood sugar, but if you tell someone not to eat them — or to drastically cut back — it’s hard for them to comply,” added Dr. Aronne, who is also director of the Comprehensive Weight Control Center at Weill Cornell. “This study points to an easier way that patients might lower their blood sugar and insulin levels.”

Patients with type 2 diabetes typically use a finger prick test to check their glucose levels throughout the day. Maintaining normal levels, specifically after meals, is of the utmost importance, because if a diabetics’ blood sugar level is consistently high or frequently spikes, they risk complications of their disease, including hardening of the arteries and eventually death from heart disease.

This study looked to validate and advance previous research that showed eating vegetables or protein before carbohydrates leads to lower post-meal glucose levels. This time, though, investigators looked at a whole, typically Western meal, with a good mix of vegetables, protein, carbohydrates and fat.

They worked with 11 patients, all of who had obesity and type 2 diabetes and take an oral drug that helps control glucose levels, called metformin. To see how food order impacted post-meal glucose levels, they had the patients eat a meal, consisting of carbohydrates (ciabatta bread and orange juice), protein, vegetables and fat (chicken breast, lettuce and tomato salad with low-fat dressing and steamed broccoli with butter) twice, on separate days a week apart.

Dr. Louis Aronne. Photo credit: Carlos Rene Perez

On the day of their first meal, researchers collected a fasting glucose level in the morning, 12 hours after the patients last ate. They were then instructed to eat their carbohydrates first, followed 15 minutes later by the protein, vegetables and fat. After they finished eating, researchers checked their post-meal glucose levels via blood test at 30, 60 and 120-minute intervals. A week later, researchers again checked patients’ fasting glucose levels, and then had them eat the same meal, but with the food order reversed: protein, vegetables and fat first, followed 15 minutes later by the carbohydrates. The same post-meal glucose levels were then collected.

The results showed that glucose levels were much lower at the 30, 60 and 120 minute checks — by about 29 percent, 37 percent and 17 percent, respectively — when vegetables and protein were eaten before the carbohydrates. Insulin was also significantly lower when protein and vegetables were eaten first. This finding confirms that the order in which we eat food matters, and points to a new way to effectively control post-meal glucose levels in diabetic patients.

“Based on this finding, instead of saying ‘don’t eat that’ to their patients, clinicians might instead say, ‘eat this before that,'” Dr. Aronne said. “While we need to do some follow-up work, based on this finding, patients with type 2 might be able to make a simple change to lower their blood sugar throughout the day, decrease how much insulin they need to take, and potentially have a long-lasting, positive impact on their health.”

Diabetes and Carbs

Planning what to eat and when to eat is very important—especially if you have diabetes. Counting carbohydrates, or carbs—adding up all the carbs in everything you eat and drink—can help people with diabetes manage their blood sugar levels.

What are carbs?

Along with proteins and fats, carbs are one of three main nutrients found in foods and drinks. The carbs you eat have a direct effect on your blood sugar.

How many carbs should I eat?

There’s no “one size fits all” answer—everyone is different because everyone’s body is different. On average, people with diabetes should get about 45% of their calories from carbs. A carb serving is measured as 15 grams per serving. That means most women need 3 to 4 carb servings (45–60 grams) per meal, while most men need about 4 to 5 carb servings (60–75 grams). However, these amounts depend on your age, weight, activity level, and diabetes medications. Make sure to work with a dietitian to set your own carb goal. If you use insulin, ask about options to match your insulin dose to the amount of food you eat at meals and snacks.

Why should I count carbs?

Carb counting can help keep your blood sugar levels close to your target range, which can help you:

  • Stay healthy longer.
  • Feel better and improve your quality of life.
  • Prevent or delay diabetes complications such as heart disease, stroke, kidney disease, blindness, nerve damage, and lower-limb amputation (surgery to remove a body part).

It may be helpful to count carbs in the foods you eat most often to help you understand how it works.

What foods have carbs?

Common foods with carbs:

  • Grains, such as bread, noodles, pasta, crackers, cereals, and rice.
  • Fruits, such as apples, bananas, berries, mangoes, melons, and oranges.
  • Dairy products, such as milk and yogurt.
  • Legumes, including dried beans, lentils, and peas.
  • Snack foods and sweets, such as cakes, cookies, candy, and other desserts.
  • Juices, soft drinks, fruit drinks, sports drinks, and energy drinks that contain sugar.
  • Starchy vegetables, such as potatoes, corn, and peas.

Non-starchy vegetables, such as asparagus, broccoli, carrots, celery, green beans, lettuce, and other salad greens, mushrooms, radishes, spinach, tomatoes, and zucchini, have fewer carbs than starchy vegetables.

Try to limit foods that have added sugars, like sweets and fruit drinks, or are made with refined carbs, such as white bread, white rice, and most pasta. Instead, choose carbs such as fruit, vegetables, whole grain bread, brown rice, and beans.

Foods with about 15 grams of carbs:

  • A small piece of fruit.
  • 1 slice of bread.
  • 1/2 cup cooked oatmeal.
  • 1/3 cup cooked pasta or rice.
  • 4 to 6 crackers.
  • 1/2 cup black beans or other starchy vegetable.
  • 1/4 large baked potato.
  • 2/3 cup nonfat yogurt.

Foods with few or no carbs:

  • Meat, fish, and poultry.
  • Some types of cheese (check nutrition labels on packaged cheese).
  • Nuts.
  • Oils and other fats.

For a more inclusive carb list, see the American Diabetes Association’s Carbohydrate Choice List.

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According to an article by the New York Times, most of us tend to gain only one to two pounds during the holiday season, even though many media outlets report much greater gains, ranging upwards from 5 to 7lbs. However, these couple of pounds can accumulate and lead to age-related weight gain over our lifetime. There is no doubt that the holidays is a high risk season for weight gain. High-carb holiday treats and overstuffed plates quickly lead to a bulging waistline. In addition to kicking-up your workout frequency, you can do more damage control by using a few simple tricks to lower the glycemic impact of your meal. Believe it or not, this is the secret to staying slim.

The term “glycemic” refers to the presence of sugar in the blood. The glycemic index is a measure of how quickly a food type raises blood sugars after consumption. High glycemic foods such as rice, pasta, bread, cookies and candy release glucose more rapidly into our blood stream. More sugar stimulates a greater surge of insulin, the only hormone that instructs our body to store energy as fat. An insulin surge increases our cravings for mid-afternoon sweets and can cause us to eat 60 to 70 percent more calories at the next meal. The good news is, by applying a few tips and tricks to your meal, you can reduce the overall impact it has on your blood sugar … and ultimately your waistline.

1. “Whey” less. Protein slows the release of sugar into our blood stream, which leads to less insulin release. So the trick to blunting the effect of your high-carb treats is bumping up your protein. For best results, eat equal amounts of protein and carbohydrates during meal times (like 20 to 25 grams of both protein and carb). Enjoying a protein shake for breakfast and a second as a mid afternoon snack can give you a quick source of nutrients without promoting weight gain. Here’s a simple recipe: blend one serving of whey protein isolate, half a cup of frozen berries, a tablespoon of almond butter, a tablespoon of ground flax or chia seeds and water. Another benefit of this drink is that protein tends to keep you full longer. And for better appetite control at meal times, try consuming your protein first, your veggies second and your starchy carbohydrates last.

2. Stay steady. Eat every three to four hours to maintain blood sugar levels, prevent overeating and avoid excessive cravings. Skipping meals, irregular meal times and excessive caloric restriction will only lead to increased risk of binging later in the day. Before attending your next holiday dinner or party, try to have a snack such as a handful of walnuts or a few olives. The healthy fats in these foods can help cut belly fat and reduce the tendency to overeat. Finally, travel with snacks such as a piece of string cheese, raw almonds or cashews, or a balanced protein bar like The Simply Bar.

3. Dress up your salad. Studies show that a few teaspoons of vinegar added to a meal lowers the glycemic index by 20 to 40 perecent. Vinegar (along with foods such as pickled cucumber) also help to lower the insulin response to a starchy meal, possibly by slowing the rate at which the meal leaves your stomach. Vinaigrette dressing (one tablespoon of vinegar and two teaspoons of extra virgin olive oil) works just as well. You can also use lemon juice if you prefer or try using a supplement of apple cider vinegar in capsule form.

4. Add a little roughage. Consuming more fibre is another secret weapon in your arsenal against holiday weight gain. Fibre causes our stomach to stretch and increases the amount of time it takes for food to pass through the digestive tract. Both of these lead to better appetite control and make us less likely to keep munching away. While most people take in 10 to 15g of fibre per day, the amount that is required for optimal weight management and bowel health is 25 to 35g. Like protein, fibre also slows the flow of sugar into our bloodstream, which causes less insulin release yet still provides us with a steady supply of energy. Fibre also aids the removal of toxic estrogen from the body. In men and women, too much estrogen, a condition called “estrogen dominance”, causes toxic fat gain, water retention, bloating and a host of other health issues. The easiest way to increase your fibre is to add ground chia or flax seeds to your meals and protein shakes.
5. Walk it off. Even a short stroll can be a simple and highly beneficial way to avoid cheating, falling off track with your diet and minimizing the harmful effects those high-carb foods on your body. Studies prove that walking after an unhealthy meal can curb the effects of metabolic stress by reducing the amounts of fatty acids, sugars and stress hormones that are released into the bloodstream and subsequently stored as fat.

6. Start the day off right. Your first meal often sets the pace for the rest of the day. Cereals which are marketed as “healthy choices” may contain more vitamins and minerals than other cereals, but they also contain a ton of hidden sugar. Choose thick, dehulled oat flakes to make your oatmeal – these have a lower glycemic index than rolled oats or one-minute oats. Top with berries, one of the lower GI fruits, rather than a banana, a fruit with a higher GI, and toss a few nuts or seeds over the oatmeal. Finally, sprinkle a little cinnamon over your oatmeal. Recent studies have found that compounds in cinnamon can lower insulin within just 30 days.

Natasha Turner, N.D. is a Toronto-based naturopathic doctor and founder of the Clear Medicine wellness boutique. She is also the author of the bestselling book The Hormone Diet.

How Soy Reduces Diabetes Risk

According to Kim, the study shows that “what we eat can have tremendous impact on health outcomes by interacting with certain genes. Recent research also suggests that diet can even change the copy number of a certain gene, leading to biological changes.”

Soy is the most common source of isoflavones in food. In experiments with mouse cells, Kim, a molecular nutrition researcher who studies how fat cells develop in the body, and colleagues, focused on daidzein, one of the two main isoflavones found in soy. Many epidemiological observations and human clinical studies have shown that adding soy to one’s diet is associated with lower diabetes risk and improved insulin sensitivity, as well as lower cardiovascular disease risk, Kim notes. However, until now the direct target tissue and molecular pathways by which soy exerts its anti-diabetic effects was not clearly understood.

Kim and colleagues at Southern Illinois University, with others at the universities of Tennessee and Florida, had earlier found that dietary isoflavones reduced the severity of diabetes in an animal model of the disease by increasing the activity of certain transcription regulators in the fat tissue. For the current study, they hypothesized that daidzein and its metabolite, equol, are part of this activation process.

They found that daidzein and equol enhanced adipocyte differentiation, or the formation of fat cells, through activation of a key transcription regulator, the same receptor that mediates the insulin-sensitizing effects of anti-diabetes drugs. Thus, daidzein and equol daidzein and equol seem to work in a similar manner as anti-diabetic drugs currently in the market. Their findings are reported in a September online version of the Journal of Nutritional Biochemistry.

“Our results suggest that soy isoflavones exert anti-diabetic effects by targeting fat cell-specific transcription factors and the downstream signaling molecules that are important for glucose uptake and thus insulin sensitivity,” Kim notes. “The new findings help us to understand the cellular mechanisms.” That is, how these biologically active compounds in soy interact to regulate and initiate metabolic and biological functions.

Results demonstrate that daidzein and equol enhance adipocyte differentiation by activating a specific receptor. The downstream responses include increased expression of three proteins, resulting in enhanced glucose uptake and insulin sensitivity.

“Although some details remain to be worked out, our data provide an additional molecular basis for the mechanism of insulin-sensitizing action by soy isoflavones,” says Kim. “These new findings help fill a critical gap between epidemiological observations and clinical studies on the anti-diabetic benefits of dietary soy.”

Future studies will extend the work to primary cultures of human cells through collaboration with researchers at Pioneer Valley Life Science Institute and Baystate Medical Center in Springfield. If replicated, studies can move on to further work in whole body systems.

Tofu is a high-protein soy product that is popular among vegans, vegetarians, and meat-eaters alike. But you may be wondering is tofu good for diabetes?

Will it influence your blood sugar? And what other health benefits does it provide, if any?

Keep reading for the answers…

What Is Tofu?

To make tofu, soy milk is shaped and condensed until it is firm enough to be eaten. Soft tofu, called silken tofu, has the consistency of gelatin and it can blend well into desserts, smoothies, and sauces to create a light, creamy texture.

As you might guess from the name, firm tofu is more firm and is commonly used as a meat substitute in soups, salads, stir-frys, and sandwiches.

Tofu doesn’t have much flavor on its own; instead it takes on the flavor of whatever seasonings or sauces you’re cooking in. This adaptability makes tofu easy to incorporate into recipes.

Tempeh, tofu’s distant cousin, is made directly from soybeans themselves rather than from soymilk. It is firmer, denser, and higher in protein than tofu is. It does have a stronger flavor than tofu, but like tofu, makes an acceptable vegetarian protein option for any savory dish.

Tofu Nutrition Facts

Since soy products are known for their high protein content, let’s verify that by looking at the nutrition facts for a few different kinds of tofu.

Unlike whole soybeans, tofu doesn’t carry much fiber but it does pack a lot of protein!

You can see that tempeh is especially high in protein, with close to 20 grams of protein per serving. Tempeh is also rich in fats, which aid in stabilizing your blood sugar levels and keeping you fuller for longer after a meal.

The tradeoff with tempeh is the amount of carbohydrates in each half cup serving. Unlike the silken and firm tofu, tempeh contains a higher dose of carbs (more than 7 g), so it’s wise to stick to the recommended serving size of a half cup at a time.

That being said, soy products like tofu and tempeh are much lower in carbs than other non-meat protein sources.

Comparing Vegetarian Protein sources

Aside from tree nuts, most vegetarian protein options fall into the category of beans and legumes, which are often high in carbs.

Just take a look at the differences in protein and carbs between these protein-dense plant foods:

Chickpeas, lentils, and kidney beans all carry close to 20 grams (or more) of carbohydrates in just a half cup serving.

And although these legumes tend to contain more fiber than tofu or tempeh do, they are still members of the “high carb” club and should only be eaten in small moderated portions.

Tofu on the other hand contains only 2.3 grams of total carbs but supplies almost 9 grams of protein to your meal, so don’t be afraid to incorporate it freely into your low carb diet.

Now that you understand the nutritional value of these foods, you might be wondering how soy products like tofu affect diabetics on a chemical level. Are they helpful, hurtful, or somewhere in between?

Research on Soy/Tofu and Type 2 Diabetes

It turns out that the phytoestrogens in soy (also called isoflavones) have many properties that can benefit diabetics…

A 2013 review found that genistein, the main isoflavone found in soy protein, was able to improve pancreatic beta-cell functioning, decreased beta-cell apoptosis (death), improved fasting blood glucose, reduced HbA1c, and improve glucose tolerance in diabetic animal models.

A 2010 review found an association between fermented soybean products (like Tempeh) and improved glucose tolerance and reduced insulin resistance. The authors suggested that the low incidence of type 2 diabetes in Asia may be due in part to a higher intake of fermented soy products when compared to Western countries.

In a 2015 clinical trial 68 women with gestational diabetes (high blood sugar that occurs during pregnancy) were assigned either a control diet (70% animal and 30% plant proteins) or a soy diet that consisted of the same amount of total protein (35% animal protein, 35% soy protein, 30% other plant proteins).

After 6 weeks, the soy diet resulted in decreased fasting blood glucose when compared to the control diet (-12.7 mg/dL vs. +1.4 mg/dL). The control diet also resulted in higher insulin levels, higher insulin resistance, and decreased insulin sensitivity, as well as a decreased total antioxidant capacity when compared to the soy diet.

Not only can soy consumption lead to improved blood sugar and insulin resistance, but soy isoflavones can also reduce inflammation and improve your endothelial (blood vessel) health.

A 2011 study examined the effect that 6 months of soy isoflavone supplementation had on 87 obese postmenopausal women. The subjects were assigned to either a diet with exercise alone or a diet and exercise plus a supplement (80 mg of soy isoflavone). The women taking the isoflavone supplement in addition to diet and exercise saw improvements in leptin (a hunger hormone) and TNF-alpha (an inflammation marker) as well as a significant increase in the beneficial hormone adiponectin.

A 2015 study found that adult subjects (over age 45) with features of metabolic syndrome experienced reduced arterial stiffness when given a whole food soy snack for four weeks, while the control snack did not produce such results.

Conclusion

Tofu is a suitable protein option for vegetarians, or a great vegetarian alternative if you want a break from eating meat.

Tofu is high in protein and low in carbohydrates, making it an ideal food for both cooking and snacking.

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