By Lindsay Hodgson, Dietetic Intern at Hailey Crean Nutrition, LLC

What is Intuitive Eating?

Intuitive Eating is an individualized nutrition approach that emphasizes the connection between mind and body by using internal hunger and satiety cues to guide food choices (1). Rather than a diet plan, food rules, or weight loss, Intuitive Eating focuses on a positive mindset towards lifestyle behaviors and helps people cultivate a varied and flexible diet to support their health (1).

There are 10 principles that define Intuitive Eating (1). They are:

• Reject the Diet Mentality,
• Honor Your Hunger,
• Make Peace with Food,
• Challenge the Food Police,
• Discover the Satisfaction Factor,
• Feel Your Fullness, Cope with Your Emotions with Kindness,
• Respect Your Body,
• Movement- Feel the Difference and
• Honor Your Health with Gentle Nutrition 

Intuitive Eating now has over 125 studies to validate its many benefits(1).  Physical health outcomes associated with intuitive eating include lower blood triglycerides, higher HDL “good cholesterol” levels, and lower risk for cardiovascular disease(2).  Another review suggests relationships between Intuitive Eating and weight maintenance, improved blood pressure, and improved diet quality(3). Research has also noted mental health benefits such as less disordered eating, and increased body image satisfaction, emotional functioning, sense of optimism, and motivation to exercise(4). 

How does Intuitive Eating fit into diabetes management? 

At first it seems like managing blood sugars and eating intuitively cannot coexist. In diabetes, managing blood sugars involves external diet influences like counting carbohydrates to account for medications, eating or drinking when the blood sugar is low despite feeling full, constantly paying attention to diet, and more. 

In reality, there are numerous ways to integrate diabetes management and Intuitive Eating. Interestingly, a 2016 study of children and adolescents with type 1 diabetes found a correlation between higher Intuitive Eating scores and lower hemoglobin A1C values(5).  People with diabetes have a unique strength of being in-tune with their bodies because of the self-monitoring and mindfulness that comes with managing blood sugars, which can translate nicely into developing the habits of an intuitive eater. Below are a few important areas where Intuitive Eating principles and diabetes management may intersect. 

Permission and Food Police: Carbohydrates

People’s food attitudes and beliefs shape their behaviors and relationship to food. “Challenge the Food Police” means challenging the beliefs that foods are “good” versus “bad.” Understandably sugar and carbohydrates are often demonized in the diabetes world, while carbohydrates can seem scary and confusing especially after a diagnosis when learning to account for them in the diet. 

It is important to be aware that negative thoughts can lead to restricting those foods, which can promote a toxic cycle (1).  This may look like someone depriving themselves of carbohydrate-rich foods, experiencing strong cravings, overeating or feeling “out of control” around those foods, and then experiencing feelings of guilt or shame that lead to them restricting their carbohydrate intake again, and so on. In addition to the mental and emotional consequences, restriction of carbohydrates is problematic for the body because the body’s breakdown of carbohydrates, glucose, provides brain and blood cells their fuel (6).  In these ways, carbohydrate restriction can take a toll on someone’s well-being while complicating their diabetes management.

The principle, “Make Peace with Food” can help break or prevent this cycle, which means people consider the food beliefs they hold about carbohydrates and give themselves permission to eat them(1).  This can take some “trial and error” as people with diabetes cultivate a better understanding of how their blood sugars respond to various carbohydrate-containing foods, but helps establish trust and a stronger mind-body connection.  

Honor Your Health (and diabetes) with Gentle Nutrition

A person with diabetes might honor their health by making specific nutrition choices to support their blood sugars. For instance, they might choose a blood-sugar friendly food option versus a food craving, or eat with more structure instead of spontaneity on a day their levels have been trending high. When honoring health, the mindset and motivation come from a place of self-care and desire to nourish as opposed to self-discipline and rigidity.  

Strategies to use gentle nutrition with diabetes:

• Eat consistently throughout the day for reliable carbohydrate intake and to prevent low blood sugars
• Enjoy balanced meals with carbohydrates, fat, and protein 
• Experiment with fiber-rich sources of carbohydrates (i.e. whole grains, fruits, starchy vegetables, beans), which are absorbed more slowly into the bloodstream 
• Engage in enjoyable exercise to increase insulin sensitivity 

Intuitive Eating and Diabetes

Diabetes poses unique diet challenges, but food should still be a joyful part of life for people with diabetes. People with diabetes don’t need to restrict carbohydrates or have a strict diet plan. Luckily, it is absolutely possible to eat intuitively with diabetes, as people can prioritize different Intuitive Eating principles based on their needs on a given day. Intuitive Eating may take time, but over time is a health-promoting approach that offers individuals the opportunity to develop flexible and pleasurable eating patterns. 

Reference List: 

1. Tribole E, ​​Resch E. Intuitive Eating: A Revolutionary Anti-Diet Approach. 4th ed. St. Martin’s Publishing Group; 2020.  
2. Hawks S, Madanat H, Hawks J, Harris A. The Relationship between Intuitive Eating and Health Indicators among College Women. American Journal of Health Education. 2005;36(6):331-336. 
3. Van Dyke N, Drinkwater EJ. Relationships between intuitive eating and health indicators: literature review. Public Health Nutr. 2014 Aug;17(8):1757-66. doi: 10.1017/S1368980013002139. 
4. Bruce LJ, Ricciardelli LA. A systematic review of the psychosocial correlates of intuitive eating among adult women. Appetite. 2016;96:454-472. doi:10.1016/j.appet.2015.10.012
5. Wheeler BJ, Lawrence J, Chae M, et al. Intuitive eating is associated with glycemic control in adolescents with type I diabetes mellitus. Appetite. 2016;96:160-165. doi:10.1016/j.appet.2015.09.016
6. Mahan LK, Raymond JL, Franz MJ, Evert AB. Krause’s Food & the Nutrition Care Process. 14th Edition. St. Louis, MO: Elsevier; 2017.