Healthy Eating with Diabetes

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1 What is Diabetes? Diabetes is a condition in which the body is unable to control the amount of sugar (glucose) in the blood. This happens because your body is not producing enough insulin or your body is not using the available insulin effectively. Insulin is needed to take sugar from the blood to other body tissues where it is used as energy. Diabetes is not caused by eating too much sugar Why is diet important? It is important to follow a healthy diet, whether your diabetes is controlled by diet only, tablets or insulin. A healthy diet will help control your blood sugar levels and weight, and will help protect you against developing long-term complications. Special diabetic foods are not required. A diabetic diet is not a special diet; it is a healthy way of eating which is suitable for everybody. Which foods affect blood sugar levels? Sugary foods (e.g. sugar, honey, coke, lemonade) Starchy carbohydrates (e.g. bread, potatoes, rice, pasta) Food containing natural sugars (e.g. fruit, fruit juice, milk, yoghurt) Sugary foods will make your blood sugar levels rise quickly and should therefore be avoided. Starchy carbohydrates are broken down more slowly, causing a slower rise in blood glucose levels, making it easier to control your diabetes. Foods containing sugar Cut down on these foods as much as possible: Sugar, jam, marmalade, honey, sweets, chocolate, mints Fizzy drinks, cordials, ordinary squash, glucose drinks e.g. Lucozade Foods with a lot of added sugar e.g. fruit tinned in syrup, sweet cakes, biscuits and puddings. Page 1 of 9

2 It is quite difficult to have an absolutely sugar-free diet and small amounts of sugar in prepared foods are not usually a problem. Many processed and tinned foods have some added sugar but provided sugar is not a major ingredient, these foods can be included in a healthy diet. It is not necessary, therefore, to avoid savoury foods which contain a small amount of sugar, e.g. baked beans, high fibre breakfast cereals. Other names for sugar When you read labels watch out for words like sucrose, glucose, dextrose, fructose and molasses. These are all different types of sugar. Honey and syrup are also forms of sugar and should be avoided. Sweeteners e.g. Splenda, Candarel, Sweetex, Hermasetas, can be used instead of sugar in drinks, cereal etc *Ask your dietitian or practice nurse for Diabetes Fact Sheet No. 4 for information and details of suitable sweeteners. Starchy carbohydrate foods It is usually important to include something from this list of foods at each meal. Higher fibre foods are preferable but not essential. Potatoes/sweet potatoes preferably boiled, baked in jackets or mashed rather than roast or chips. Bread - try to choose multigrain, wholemeal or high fibre white bread or granary, e.g. pitta, French bread, chapatti, naan, baguettes, roti, teacake and scones. Cereals - have high fibre cereals e.g. Shredded Wheat, porridge, muesli Branflakes,, Weetabix etc Pasta, rice & other grains preferably choose whole wheat varieties of spaghetti, macaroni, brown rice, couscous, maize and bulgar wheat. Biscuits & crackers plain types e.g. Digestives, Ryvitas, Rich Tea, fig rolls. Just one or two with a drink, if you have them at all. Flour use wholemeal flour in baking or try a mixture of wholemeal and white flour rather than white alone. Cassava, yam, plantain, maize etc Page 2 of 9

3 Milk and dairy foods Milk contains natural sugar called lactose. It is best to keep the amount of milk you use to ½ -1 pint a day. Choose semi-skimmed or skimmed. Yoghurt also contains lactose. Choose a low fat, reduced sugar or diet variety. Cheese will not put up your blood sugar but it can be high in fat. Have small amounts, or choose low fat cheeses such as Edam, Brie, cottage cheese, reduced fat cheese. Remember that milk and cheese are good sources of protein and calcium - for strong bones and teeth. Don t cut them out altogether. Fruit and vegetables Vegetables and salad at a meal should cover at least a third to half of your plate. They are a good source of fibre and vitamins and minerals. Aim for at least five portions of vegetables, salad and fruit a day. Remember that a lot of fruit will affect your blood sugar levels. Vegetables Green vegetables, root vegetables and salads can be eaten freely. Frozen vegetables can be just as nutritious as fresh. To retain the most nutrients, cook vegetables as quickly as possible and only use a small amount of water. Be careful about how much, and what type, of salad dressing you use and don t add butter to vegetables. Fruit Fruit and natural fruit juices can affect your blood sugar, so don t eat too much fruit all at once. It is better to have it as a snack or as a dessert after your meal. Eating fruit with or after a meal helps to slow down the absorption of natural sugars. Include the skins of the fruit where appropriate, as it is high in fibre. Fruit juice, even if labelled unsweetened, contains the natural sugar of the fruit in a concentrated form. So it is best to limit it to a small glass a day, at meal times. Page 3 of 9

4 One serving of fruit = 1 pear 1 apple 3-4 plums or prunes ½ grapefruit 1 orange 1 peach or nectarine 4 oz (110 g) tinned fruit in natural juice, or drain off syrup 4oz (110 g) stewed fruit without sugar 4 fl oz (100 mls) fruit juice 3-4 apricots, fresh or dried 1 small banana 1 slice ( gm) melon/cantaloupe 10 grapes 1 tablespoon dried fruit 2 small kiwi fruit Meat, fish and alternatives These foods provide protein, vitamins and minerals but some fat. Red meat, e.g. lamb, pork and beef is quite high in saturated fat and should be limited, especially if your cholesterol is high. The fat in oily fish is good for your heart. It is best to include protein at each meal. Tips on how to reduce the fat content of protein foods: Meat Choose leaner meat, if possible, and trim off any visible fat including skin on poultry. Grill or bake, rather than fry, and skim any excess fat from casseroles, stews or mince. Try substituting some meat in a casserole with pulses, (lentils, beans,) and vegetables. Avoid eating too much processed meat such as sausages, corned beef, pies, pasties and bacon. Page 4 of 9

5 Fish Oily fish, such as herring, mackerel, sardines, pilchards and salmon, contain omega 3 which may help to protect us from heart disease. White fish is also a good choice try to grill, poach, bake or steam rather than frying. Eggs Poach, scramble or boil instead of frying. People used to limit the number of eggs eaten but they are a good source of protein and do not need to be avoided even if you are worried about your cholesterol. Nuts, beans & lentils These are good alternatives for vegetarians but can be enjoyed by anyone. Nuts contain good fat so are suitable for snacks or nibbles, in small quantities. Milk, cheese, fromage frais & yoghurt These are also good sources of protein and could be used as an alternative to the above. Choose low fat options where possible (see page 2 for more details). Foods containing mostly fat It is important that your intake of fats and oil should be kept to a minimum. This is because it is healthier for your heart and helps control weight. Fats and Oils These include margarine, spreads and cooking oils. Try to choose those which contain mono-unsaturated or polyunsaturated fats. Some spreads are lower in fat than others but whichever you use spread it thinly. Page 5 of 9

6 These foods contain a lot of fat and should be avoided or included only occasionally: - Crisps, Bombay mix Chocolate especially milk and white varieties Cakes, including diabetic ones, sponge and suet puddings Ice-cream, even diabetic ice-cream Pastry, pies, Yorkshire puddings and dumplings Cream - use natural yoghurt or light crème fraiche instead Mayonnaise, salad cream, coleslaw - use fat free salad dressing or natural yoghurt Takeaways Lower fat products may still contain quite a lot of fat and they may not be low in sugar either. It is important to check the labels. *For more information on food labelling, ask your dietitian or practice nurse for Diabetic Fact Sheet No. 6. Diabetic foods Diabetic biscuits, cakes, sweets and ice cream are available but they tend to be high in fat, calories and salt and can also be expensive. Some of them also contain sweeteners like Sorbitol, Maltitol or Xylitol, which can act as a laxative they are, therefore, not recommended. It is better to have just a small amount of the ordinary product. Diabetic jam and marmalade may be made using fructose, (fruit sugar). This is suitable for people with Diabetes but will not help you lose weight so be careful how much you have. Ask your dietitian or practice nurse for Diabetes Fact Sheet No. 5 for more information on diabetic foods and drinks. Page 6 of 9

7 Watch your weight Losing weight can help improve your health in several ways. Research has suggested that a 10% decrease in body weight could: Improve blood pressure Lower cholesterol and triglyceride levels Improve blood sugar levels If you are overweight, losing weight will help to control your diabetes. You should aim to lose ½ -1 kg (1-2 lb) per week. But don t get discouraged if it is less than that. If you only lose 1lb a month, it will be nearly a stone in a year. Tips for losing weight Eat regular meals. If you eat big portions, reduce your portion sizes. Try eating from a smaller plate. Eat more slowly and chew well. Eat less fat and fatty foods. Remember fat has got twice as many calories as the same weight of protein or carbohydrate. Grill, microwave, bake or poach food instead of frying and don t add extra fat or oil when cooking. Eat as many vegetables, and as much salad and fruit as you can - at least 5 portions a day. Fruit is high in natural sugar so it may be better to limit it to 2 or 3 portions daily. Choose high fibre, multi-grain or wholemeal bread, pasta etc. Be careful not to eat too much of these foods. Try to include some protein at each meal it will help you feel less hungry. Protein is found in meat, fish, eggs, cheese, milk, yoghurt, lentils, nuts etc. Be careful with the size of meat and cheese portions, especially if they are high in fat. Remember, alcohol is high in calories so avoid it or cut down where possible. Regular exercise will help you lose weight. Aim for half an hour a day. If you take insulin, you may need to reduce your insulin dose when you change your diet or if you take more exercise. (Consult your doctor or diabetic nurse about this) Page 7 of 9

8 Suggested meal plan Breakfast High fibre breakfast cereal and milk Wholemeal bread, a little margarine, butter or low fat spread with boiled or poached egg. Mid-morning Tea or coffee Fruit or plain biscuit if necessary Main meal Lean meat or fish or egg or beans or cheese Plenty of vegetables or salad Jacket potato or brown rice or pasta Low sugar yoghurt or fresh fruit or low sugar milk pudding Mid-afternoon Tea or coffee Fruit or plain biscuit if necessary Light meal Cheese or egg or beans or fish or meat Wholemeal toast or bread or potato or rice Salad or vegetables if liked Low sugar yoghurt or fresh fruit or low sugar milk pudding Evening snack Slice of wholemeal toast or fruit or plain biscuit or a milky drink Remember it is important to drink enough fluid, especially water. Snacks Most people with Diabetes do not need to have snacks, unless using mixed insulin like Novomix. If you need a snack because you are hungry or use a lot of energy, try to keep to high fibre foods and, if possible, include some protein. Page 8 of 9

9 Alcohol Alcohol need not be avoided by people following a diabetic diet. Diabetes UK recommends the following guidelines for sensible intakes:- Men - 3 units/day Women - 2 units/day 1 unit of alcohol = ½ pint ordinary beer, lager or cider or 1 pub measure of spirits (25ml) or 1 small glass of wine (125ml) or 1 pub measure of sherry, aperitif or liqueur (50ml) Everyone should have at least 2-3 alcohol free days a week. Alcohol and low blood sugar People on insulin or tablets for diabetes may need to take an extra starchy carbohydrate snack if they drink alcohol, because alcohol lowers blood sugar and can cause a hypo. It is important that alcohol is taken with or after a meal. *Ask your dietitian or practice nurse for Diabetic Fact Sheet No. 3 for more information on alcohol. Further information In the UK, there is a charitable association known as Diabetes UK. Their aim is to improve the lives of people with diabetes providing support, up-to-date information on a range of issues, including recipe books and useful dietary information. Contact Address: Diabetes UK Macleod House 10 Parkway London NW1 7AA Telephone: Web Site Page 9 of 9