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1 Diabetes UK 10 Parkway London NW1 7AA Careline: Produced by and copyright with Dorset Dietitians Working Group July 2002 Version Issue Date Review Date Document Author 1 01/05/07 01/05/2010 Dorset Dietitians Working Group Contact: Telephone:

2 Sample Menu What you eat affects your diabetes. Eating a healthy diet will help to control your blood sugar and keep your weight at the desired level. In the long term it will keep you healthy and fit. The main points to remember: Eat regular meals and snacks as necessary Include some starchy foods at each meal Choose high fibre foods Eat plenty of fruit and vegetables every day Limit fatty foods Limit added sugar and sugary foods Limit salt Starchy foods These are important energy providing foods and should be included at each meal, such as bread, potatoes, pasta, rice and breakfast cereal. They provide you with B vitamins and iron and can be a good source of fibre. Aim to eat similar amounts from day to day as this will keep your blood sugar levels more stable, particularly if your activity levels are the same. Breakfast Oat based or wholegrain cereal with low fat milk. Wholegrain bread with low fat spread. Lunch Lean meat, poultry, fish, egg, cheese or pulses. Wholegrain bread, potatoes, pasta or rice. Large serving of vegetables or salad. Fruit or suitable dessert. Helpful Hints Evening Meal Lean meat, poultry, fish, egg, cheese or pulses. Wholegrain bread, potatoes, pasta or rice. Large serving of vegetables or salad. Fruit or suitable dessert. Snacks Water, tea and coffee without sugar and low calorie drinks can be taken freely throughout the day. The rate at which starchy foods are absorbed may vary. Slowly absorbed starchy foods can help to improve blood glucose levels. They have a low Glycaemic Index. Examples to choose from include: granary, rye and pitta breads, oat and oat based cereals, beans and pulses, pasta, noodles and basmati rice. For more information, discuss with your dietitian.

3 Shopping Ideas A healthy diet for diabetes is a healthy diet for most people, so shopping can be easy once you know what to look for! Look for the products that are: Reduced Fat/Low Fat Reduced Sugar/No Added Sugar Diet/Low Calorie High Fibre/Fibre Added Reduced Salt/No Added Salt I read the labels they all have sugar Many manufactured foods contain small amounts of added sugar. Cereal, tomato sauce and baked beans are good examples of this. If foods containing small amounts of sugar are eaten with foods or meals containing lots of fibre, they are generally suitable because fibre slows the absorption of sugar. The term of which sugars refers to all sugar in the product and will include natural sugar found in fruit and milk as well as any added sugar. It is the added sugar you should avoid, for example in foods such as doughnuts, ordinary fizzy drinks, sweets and chocolates. These are also high in calories. Nutrition information given per 100g or 100mls is useful to compare similar products like yoghurts or cereal. How to eat more fibre A high fibre diet is important for your diabetes. The soluble fibre found in pulses such as peas, beans, lentils and in vegetables, fruit and oats is particularly good at controlling your blood sugars, and can help to reduce your cholesterol level if it is too high. Enjoy different varieties of high fibre bread granary, mixed grain, high fibre white bread or wholemeal. Eat plenty of fruit and vegetables have at least 5 servings everyday. A serving is one of the following: A slice of a large fruit (e.g.melon) 1 whole fruit e.g. apple, banana A handful of smaller fruits such as grapes or cherries 1/3 of a large tin of fruit in natural juice 1 tablespoon dried fruit 2 tablespoons of vegetables A small bowl of salad Choose an oat based cereal or high fibre breakfast cereals like Weetabix, Shredded Wheat, Shreddies, Branflakes or porridge, or cereals with dried fruit such as no added sugar muesli or Sultana Bran. When eating more fibre it is important to drink more fluid. Try to drink at least 8-10 cups of fluid without sugar each day. Try to eat more pulses beans, kidney beans, butter beans, peas and lentils. Try the tinned or dried varieties added whole or mashed into soups, stews, mince, casseroles, chillis and salads. Bake potatoes in their jackets or boil in their skins. Include rice and pasta. Try brown or wholemeal varieties. Choose plain high fibre biscuits, and crackers such as Garibaldi, Fig Rolls, Digestives, Hob Nobs, Ryvita, wholemeal crackers and buns such as wholemeal scones, wholemeal currant buns, fruit bread and malt loaf.

4 Fat Fat is high in calories. Cutting down on your fat intake helps with weight control which in turn will help control your diabetes. Saturated fat is found naturally in meat and dairy foods. It can cause blood cholesterol levels to rise increasing the risk of heart disease. Polyunsaturated fat e.g. sunflower oil and monunsaturated fat e.g. olive oil are better choices but they still need to be used sparingly as they contain the same amount of calories (energy) as saturated fat How to limit the amount of fat you eat Grill, bake, microwave, stir fry, dry roast on a rack or casserole instead of frying. Try to cook without adding fat or oil. If you need to fry, choose an unsaturated fat such as olive, rapeseed, corn or sunflower oil. Use a nonstick pan and the minimum amount of oil. Use butter or margarine sparingly. Try a poly- or mono-unsaturated margarine or low/reduced fat such as Flora light, Olivio, Vitalite lite, Olivite or supermarket own brands. Use low fat milk, skimmed or semi-skimmed types. Use low fat natural yoghurt or fruit yoghurt with artificial sweetener e.g. Shape, Ski light, Muller light or supermarkets own healthy eating range with no added sugar. Cut back on high calorie snacks such as pastry, cakes, biscuits, pies, crisps and peanuts. Eat more boiled, baked jacket or mashed potato instead of chips and roast potatoes. Try sunflower low fat oven chips and low fat crisps instead of full fat varieties, but only use occasionally. Use oil free dressings or low fat varieties of mayonnaise and salad cream. Weight Management If you are overweight, losing weight will help improve your blood sugar control. To lose weight you need to take in less energy (calories) as food and burn up more energy by increasing your physical activity. Exercise Regular exercise will help control your blood sugar and weight and can also help to lower your cholesterol level. If you have not been active for some time, start gently and build up slowly. Five to ten minutes of moderate activity twice a day is a good start. Walking briskly for 30 minutes five times a week is recommended. 30 minutes spread over the day e.g. 3x10 minutes is equally beneficial. Choose activities that you can enjoy. You might consider walking, dancing, gardening, swimming or cycling. Even small changes can be beneficial, eg: walk short distances instead of using the car, use the stairs instead of the lift, or get off the bus one stop earlier. Check with your doctor before starting any exercise programme or if you have any particular health problems. If you cut down on starchy food or if you increase your activity you may need to adjust the medication which helps control your blood sugar. If you feel you need more information, ask for a referral to your local diabetes centre.

5 How to reduce sugar intake It is important to avoid large amounts of sugar and sugary foods but it is not necessary to avoid sugar altogether. As part of a high fibre meal an occasional small portion of a dessert containing sugar will not cause a quick rise in blood sugar. High sugar foods are often low in fibre and high in fat and calories, so do not help blood sugar control or weight maintenance. There are many lower sugar products which would be healthier choices. Have: Sugar-free sweetener e.g. Sweetex, Canderel, Canderel Spoonful, Hermesetas Low calorie, sugar-free or no added sugar squash and diet fizzy drinks. Instead of these: Sugar, glucose. Ordinary squash and fizzy drinks Ideas for desserts All varieties of fresh and tinned fruit in natural juice. Milk puddings and custard made without sugar or tinned low sugar varieties. Natural low fat or diet fruit yoghurts and fromage frais. Sugar-free dessert mixes e.g. no added sugar Angel Delight and Instant Whip, sugar-free jelly. Occasionally. Ice cream 1 scoop Sweeteners Sweeteners such as Canderel, Hermesetas, Sweetex have a role to play in the diet for diabetes but should be part of a varied diet. Some sweeteners should be added at the end of cooking as they are bitter after being at a high temperature. Always read the information on the label about using a sweetener. Diabetic Products There is no need to buy these foods. Fresh fruit, stewed fruit (no added sugar), tinned fruit in natural juice, sugar-free jelly and other low sugar desserts. Sugary puddings and desserts, tinned fruit in syrup and jelly. Fruit pie or crumble with custard. Home made recipes can be modified so less sugar and fat are added. Biscuits, cakes, sweets and chocolates containing fructose or sorbitol should be avoided as they are high in calories, expensive and may have a laxative effect. Small amounts of low sugar jam or marmalade or pure fruit spread. Plain biscuits e.g. Rich Tea, Garibaldi, Gingernut, Fig Rolls, Digestive, scones, fruit bread, muffins, crumpets or tea cakes. Crackers or crispbreads e.g. Ryvita, Krackerwheat. Jam, preserves, honey and marmalade Sweet, cream and chocolate biscuits and cakes. Suitable food choices are available at the supermarket. Fruit juice A small glass of unsweetened fruit juice may be taken as part of a high fibre meal once a day. It contains a lot of natural sugar which will cause a rise in blood sugar if it is used to quench your thirst between meals. Dried fruit, nuts or mixtures of them (occasionally) Glacé fruit, sweets and chocolates including diabetic types.

6 Alcohol Alcohol affects how you function so it is best taken in moderation and always with food. Research shows that a small amount of alcohol may be of some benefit in reducing the risk of heart disease for men over 40 and women past the menopause. Sensible limits recommended for alcohol intakes are: For women: no more than 2-3 units per day, For men: no more than 3-4 units for men per day, with at least 2 days in a week alcohol free 1 unit is : ½ pint of beer, lager or cider (3.5% alcohol content) 1 small glass of wine (9% alcohol content) 1 small measure of spirits (40% alcohol content) The numbers of units will appear on labels for example there are 4 units in a large (440ml) can of strong lager (8-9%). Be careful with special beers/lagers. Some low carbohydrate beers are high in alcohol and some low alcohol beers are high in sugar Remember to use sugar free/diet mixers (e.g. slimline tonic, diet lemonade) Salt Meat and alternatives Meat, poultry, fish, eggs, cheese and pulses provide protein which repairs damaged cells and keeps your body healthy. Aim for as little fat as possible to be provided by these foods and eat moderate portions only. Pulses are a good source of protein with very little fat. Choose lean meat and trim off fat before cooking. Remove skin from poultry. Try fresh, frozen or tinned fish. Eat more oily fish such as mackerel, salmon, herring, pilchards and sardines. These can protect against heart disease. Eggs can be boiled, scrambled or poached. Cut down on meat by adding more vegetables and pulses to stews and casseroles in place of some meat. Use lower fat cheeses such as Edam, Brie, Gouda, reduced fat cheddar, cottage cheese or low fat cheese spreads. Moderate your intake of high fat cheese such as Cheddar, Stilton and cream cheese. Remember to fill your plate with starchy food and vegetables and include only 2 small/medium portions of meat or alternative foods each day. Too much salt in your food may increase your blood pressure which can contribute to heart disease and stroke. A pinch of salt can be used in cooking but do not add any at the table. Alternative seasonings include: pepper, herbs (fresh or dried e.g. parsley, thyme, mint), spices (e.g. cumin, coriander), lemon juice, malt and wine vinegars, garlic, onions and mustard. Limit salty foods such as Oxo, Bovril, Marmite, sea salt, garlic salt, celery salt, crisps, salted peanuts and soy sauce. If you wish to use a salt substitute discuss this with your dietitian. Fruit and Vegetables 5 servings per day Protein Foods e.g. meat oily fish, eggs, beans Starchy foods e.g. bread, potatoes, rice, pasta

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