Amy Campbell is a registered dietitian and Certified Diabetes Educator who has been working in the field of diabetes for many years. She is the author of several books about diabetes, including 16 Myths of a Diabetic Diet and Staying Healthy with Diabetes: Nutrition and Meal Planning. In addition, Amy is a lecturer and frequent contributor to several diabetes-related websites.

Americans love their pasta. According to the website, Americans eat about 20 pounds of pasta every year. Not surprisingly perhaps, the United States is the second largest producer of pasta, churning out 4.4 billion pounds of pasta annually.

Pasta pitfalls

As delicious as pasta is, it has its drawbacks, particularly for people with diabetes. Most people choose white pasta over whole-grain pasta. White pasta is refined, meaning that the whole-grain component of the grain is removed, along with the fiber and some vitamins. Food manufacturers may or may not enrich, or add back, some of the nutrients lost during refining. Refined foods tend to have a higher glycemic index than unrefined foods. The glycemic index is a rating of how fast the body converts carbohydrate into blood sugar. Because refined foods fall short in fiber, they tend to be quickly digested and processed, leading to a faster rise in blood sugar levels. This occurrence, often combined with a larger-than-recommended portion size, can wreak havoc with diabetes control.

In addition, many pasta dishes are laden with calories. Drop by your local Olive Garden for some fettuccine Alfredo and you’ll pack away 1220 calories. Prefer the Macaroni Grill? Their lasagna will set you back 600 calories. Granted, many pasta dishes are made with fatty ingredients: olive oil, butter, cream, cheese and red meat are the top contenders, but even a pasta-with-pesto dish can tip the calorie scale.

Resistant starch

Just because you have diabetes doesn’t mean that you can no longer eat pasta. If you choose to avoid it, that’s fine. But, is there a way to enjoy a plate of pasta without limiting yourself to one-third of a cup (technically, a serving of pasta), or seeing your blood sugar skyrocket afterwards? Maybe!

Resistant starch is a type of starch that, well, “resists” digestion in the small intestine. There are different types of resistant starches, classified according to their structure or source. Examples of resistant starches include whole grains, legumes, raw potatoes, underripe bananas, and cooked and cooled potatoes, rice, and pasta! The net effects of resistant starches include increased satiety, less hunger, improved insulin sensitivity, and lower post-meal blood sugars.

Pasta as a resistant starch

Back to pasta, then. Eating a plateful of pasta isn’t going help your blood sugars any. But, eating a helping of cooked, then cooled pasta just may. When pasta, rice or potatoes are cooked and then cooled, the starch in those foods becomes resistant to the digestive enzymes that break down carbohydrate in the small intestine. While a dish of a cold pasta salad may be fine for warm weather, many people like their pasta served hot. Is there a way to enjoy hot pasta and keep that resistant starch benefit? Reheating pasta that has been cooked and then cooled might just do the trick.

Dr. Chris van Tulleken, a physician and research fellow at University College London Hospital and a presenter on the British program “Trust Me I’m a Doctor,” rounded up some volunteers who ate hot, cold or reheated pasta on different days, all on an empty stomach. Each day, the volunteers gave blood samples every 15 minutes for two hours to see how the pasta affected their blood sugars. As expected, the cold pasta led to a smaller rise in blood sugar than the hot pasta. But surprisingly, the reheated pasta led to an even smaller rise in blood glucose – the rise was 50% lower than the rise from the cold pasta.

Granted, this wasn’t a large scale, randomized controlled study. But the results are exciting and warrant further research.

Tips for eating pasta

Can you really eat a decent-sized portion of pasta and still maintain a healthy blood sugar level? It sure seems promising, based on Dr. Chris’s findings. Here are some tips to fit pasta into a diabetes eating plan:
• Choose whole-grain pasta whenever possible. Brand names include:

  • DeLallo
  • De Cecco
  • Barilla Whole Grain
  • DeBoles
  • Gia Russa

• Keep an eye on the portion of your pasta. One-third of a cup is hardly realistic for anyone, but 3 cups may be too much. Bulk up your plate by adding in a lot of vegetables.
• Include a lean protein source, such as chicken, lean beef, seafood, or beans.
• Add a healthy fat, like olive oil, walnut oil, nuts, or seeds.
• Skip the creamy, cheesy sauces and go for a marinara, or vegetable-based sauce.
• Try cooking your pasta, then cooling it, then reheating it to increase the amount of resistant starch.
• Experiment: check your blood sugars about two hours after eating the pasta meal and take note as to how things worked out. Remember that the 2-hour blood sugar goal for most people is less than 180 mg/dl.

To learn more about a healthy diabetes diet:

Mediterranean Diet Helps Control Diabetes
Diabetic Diet: 5 Reasons Fruit Is a Healthy Choice
The Best Diabetes Diets