Dessert for Diabetics on a Paleo Diet

My gran is just about to start receiving “Meals on Wheels”, which is a great service. In principle. Vulnerable people (mainly the elderly) are provided with a cooked nutritious meal at lunchtime. For many recipients, this will be the main nutrition they get in that day, so it’s really important that the meal provides the nutrition they need. Especially for those with conditions like diabetes, you'd think?

Each day (it’s even available on Saturdays and Sundays) they offer a choice of a main course and a choice of dessert. The main course choices, as you might expect are a traditional meat based meal, or a vegetarian option. And the desserts? Yep, hot, cold or diabetic.

I was really shocked to see diabetic desserts – and even more surprised to see what they are. You’d maybe expect low-carb options, like a cheese board perhaps. But no, they’re traditional sweet desserts, such as cakes and pies.

Looking at the definition I found on the web of what the diabetic options should consist of, it’s clear the providers of nutrition are stuck with conventional wisdom. “Desserts for diabetics must be sweetened with artificial sweeteners or sweeteners combined with a minimal amount of sugar”.

How about making desserts sugar (and sweetener free) entirely – or even swapping the dessert out for a starter instead!? Where did the idea that all meals must be finished with a dessert come from anyway?

As meals on wheels only provides one meal a day, they have some helpful recommendations as to what diabetics should eat for the rest of their meals:

That's right – diabetics should get 6-11 servings of bread and grains a day! DIABETICS! Also, note the low-fat recommendations. Those diabetics have got to steer well clear of anything so much as resembling fat, and instead go for low-fat options, that have replaced the fat with carbohydrates. Oh, and fruit – go right ahead.

Rethinking Diabetic Nutrition: Beyond Outdated Guidelines

When it comes to supporting our elderly population, especially those managing diabetes, food should be medicine. Meals on Wheels is a brilliant initiative, but it urgently needs to modernise its approach to nutrition. The idea of serving sugar-free cakes and artificially sweetened pies as “diabetic-friendly” options might seem considerate on the surface, but it reflects a deeper problem – the reliance on outdated dietary guidelines that have long been challenged by more current nutritional research.

Why the Conventional Approach Falls Short

Traditional diabetic dietary guidelines are still rooted in the high-carbohydrate, low-fat philosophy that rose to prominence in the 1980s. While this was once believed to help manage blood glucose levels, we now know that excessive carbohydrate consumption – particularly refined grains and sugars – can cause significant blood sugar spikes, contributing to insulin resistance over time. This makes the recommendation of 6–11 servings of bread, rice, and cereal daily especially problematic for individuals with diabetes.

Even when desserts are labelled “diabetic-friendly”, they often include ultra-processed ingredients and sweeteners that may still cause a metabolic response. These sweeteners can also maintain a preference for sweet foods, making it harder to adopt healthier habits long term.

The Real Needs of Diabetics

What elderly diabetics truly need is stable blood sugar and real nourishment. That means meals built around whole, unprocessed foods, rich in nutrients, moderate in protein, and containing healthy fats to promote satiety and help regulate insulin levels. High-fibre vegetables should form the base of each meal, supported by quality protein sources like free-range chicken, grass-fed beef, or oily fish, and unrefined fats such as olive oil, avocado, and coconut.

The obsession with low-fat diets has done far more harm than good, especially in vulnerable populations. Fat is not the enemy – in fact, it’s crucial for hormone production, brain health, and absorbing fat-soluble vitamins like A, D, E, and K. Replacing fat with processed carbohydrates and sugar-free sweeteners only inflames the very issues it aims to mitigate.

What Should a Diabetic-Friendly Meal Look Like?

Here are a few practical examples of meals that could truly support diabetic health without relying on gimmicky desserts or misleading low-fat claims:

• Roast chicken with steamed broccoli and roasted pumpkin – add a drizzle of olive oil and sprinkle of sea salt for flavour and healthy fat.
• Grilled salmon with zucchini noodles and sautéed spinach – loaded with omega-3 fats and fibre.
• Beef and vegetable stew – slow cooked with root vegetables like swede and turnip instead of potato, which helps keep the glycaemic load low.
• Omelette with mushrooms, capsicum, and herbs – a brilliant source of protein and B vitamins, perfect for any time of day.

For dessert? Skip it. Instead, offer a nourishing starter like a cup of bone broth or a side salad with lemon dressing – something to stimulate digestion without a blood sugar spike.

The Role of Fibre and Fermented Foods

For elderly people in particular, digestive health is paramount. A fibre-rich diet can help regulate blood sugar, improve bowel function, and reduce inflammation. Fermented foods like sauerkraut, kimchi, or coconut yoghurt (unsweetened) can further enhance gut health and immunity — something that becomes increasingly important with age.

Rather than offering ultra-processed “low-fat” puddings, why not introduce small portions of these powerful foods into regular menus? They may not be traditional, but they align more closely with the metabolic needs of someone managing diabetes.

Rethinking the Role of Dessert Entirely

The notion that every meal must end with something sweet is entirely cultural. Many traditional societies across the world do not regularly include dessert in daily meals. Offering a choice of dessert to someone with type 2 diabetes – especially when it’s essentially a sugar-laden option masquerading as healthy – feels more like a marketing gimmick than a health strategy.

Instead, institutions like Meals on Wheels could be leading the way by breaking the dessert habit altogether. What if the optional extra were a nourishing mini snack pack for later in the day – like a boiled egg, some sliced cucumber with hummus, or even a homemade seed cracker with avocado?

Supporting Caregivers and Families

Of course, it’s not just the meal providers who need to adapt. Families and caregivers also need clear, updated resources on what a truly diabetic-supportive diet looks like. That includes guidance on the types of fats to encourage, how to reduce carbohydrate dependence, and how to replace processed foods with real, nutrient-dense options.

Empowering those around the elderly is just as important as changing what’s on the plate. A collaborative, evidence-based approach is what will ultimately lead to better health outcomes – not just for diabetics, but for all elderly Australians relying on community food services.

A Call to Action for Change

It’s time to move away from the outdated dietary guidelines that continue to dominate public health institutions and food services. We must stop equating “low-fat” with “healthy” and start embracing the real science of blood sugar regulation and metabolic wellness.

Meals on Wheels and similar services have an enormous opportunity to improve not only the health but also the dignity of their recipients. No more artificial sweeteners disguised as health food. No more sugar-free jelly with hidden thickeners. No more pretending that bread and margarine are essential daily staples for diabetics.

Instead, let’s push for whole food meals, full of colour and nutrients, that honour the complexity of diabetes and support longevity and quality of life.

What Do You Think?

I’d love to hear your thoughts on this. Are you or someone you know receiving Meals on Wheels or a similar service? What changes would you make if you could design a new menu from scratch – one that actually helps people thrive? Leave a comment below and be part of the conversation.