Healthy Eating for Diabetes

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1 Healthy Eating for Diabetes What is diabetes and why is it important to manage it? Diabetes occurs when there is too much glucose in the blood. Learning how to manage your diabetes will help you feel better and help to prevent health complications caused by high blood glucose levels. Healthy eating and knowing how food affects your blood glucose levels plays an essential role in you managing your diabetes. To help manage your diabetes Know the foods that contain carbohydrate Eat regular meals, do not miss meals. Include carbohydrates at most meals. Discuss this with an Accredited Practising Dietitian. Limit foods/drinks high in sugar such as lollies, chocolates, cakes, biscuits. soft drink, cordial and juices If you are overweight, try to lose some weight Reduce fat intake by choosing low fat or reduced fat products and by limiting deep fried and battered foods, pastries, cakes, biscuits and take-away food. If you drink alcohol, limit yourself to 2 standard drinks a day. Being physically active can make it easier to manage your weight and your diabetes. Find an activity that you enjoy and aim for 30 minutes of physical activity each day. Always check with your doctor before starting any physical activity. What is carbohydrate? Carbohydrate is one of the building blocks of food. Foods that contain carbohydrate are the best source of energy for the body. When carbohydrates are digested, they break down to form glucose in the bloodstream. Glucose is then moved out of the blood stream by the hormone insulin so that it can be used for energy by the body. How does carbohydrate affect my blood glucose levels? It is the carbohydrate in food that directly affects blood glucose levels (BGLs). Eating regular meals and spreading carbohydrate through the day can help you manage your diabetes, appetite, and weight. Too much carbohydrate at one time will increase your BGLs. If you take insulin or some other diabetes medications and you don t eat enough carbohydrate or miss a meal, your blood glucose can go too low (hypoglycaemia or hypo).

2 Carbohydrate Foods Better choices are usually foods that have a low in glycaemic index, are low in fat, and high in dietary fibre. Speak to your Dietitian about how much carbohydrate you will need each day. 1 serve = 15 g carbohydrate

3 What is the Glycaemic Index (GI)? GI is a measure of how carbohydrate foods effect the blood glucose levels. Low GI foods are broken down slowly by the body and have less effect on the blood glucose levels. Examples of low GI foods include lentils and legumes, pasta, low fat milk and yoghurt and some fruits. The GI symbol appears on products that have been recently tested to determine their GI (for example, some breads, cereals and grains). Not all carbohydrate foods have been tested to determine their GI. Including low GI foods may help to control your blood glucose levels. When choosing carbohydrate foods it is important to consider not only the GI but how healthy the food is and how much you are going to eat. If you want to know more about the GI speak with a dietitian. Can I use sugar? Small amounts of sugar are acceptable, but too much sugar or sweet foods are not recommended as part of a healthy eating pattern. Small amounts of sugar, jam, and honey have little effect on blood glucose levels. A scrape of jam on grain bread, or a teaspoon of sugar on porridge is suitable. Avoid drinks that are high in sugar such as soft drink and cordial. These put too much sugar into your body at once. Your blood glucose levels rise because there is too much sugar for your insulin to deal with. What about alternative sweeteners? If you prefer, products with alternative sweeteners may be used in small amounts to add variety and enjoyment. There are two groups of alternative sweeteners: non-nutritive sweeteners (also known as artificial or intense sweeteners) and nutritive sweeteners. Non-nutritive sweeteners are essentially kilojoule-free and therefore have no effect on blood glucose levels or weight gain. These include o aspartame (951) (Nutrasweet, Equal ) o sucralose (955) (Splenda ) o acesulphame potassium (950) o saccharin o cyclamate o stevia They are used in some diet yoghurts, light cordials, soft drinks and sugar substitutes like Equal and Splenda.

4 Nutritive sweeteners Nutritive sweeteners are not kilojoule-free and have different effects on blood glucose levels. Some alternative sweeteners have a laxative effect and can cause diarrhoea. These include Fructose Sorbitol Xylitol LoGiCane All sweeteners available in Australia have been thoroughly tested and are considered safe to use. Discuss your use of sweeteners with your dietitian if you are concerned. What about fat? Unlike carbohydrate, the fat in food does not directly affect your blood glucose levels. However, too much fat can contribute to weight gain, making diabetes more difficult to mange. Different types of fats have different effects on the blood cholesterol levels and the risk of heart disease. Use polyunsaturated or monounsaturated margarine spreads instead of butter or dairy blends. Use a variety of oils for cooking canola, sunflower, soybean, olive and peanut oils are better choices compared with coconut oil or palm oil. If using salad dressings and mayonnaise choice those made from canola, sunflower, soybean and olive oils. Consider using reduced fat versions. Choose low fat or reduced fat milk, yoghurt and cheese, or soy products with added calcium. Try to limit ice-cream and cream. Choose lean meat. Trim any fat off the meat and take the skin off the chicken. Try to avoid fatty meats including sausages and processed meats such as salami. Have 2 to 3 serves of fish every week. The fish may be fresh, frozen or canned. Good choices include tuna, salmon, sardines, mackerel, and mullet. Limit high fat take-away foods and treats to once per week. These include pastries, pies, pizza, hamburgers, potato chips, cakes, chocolate, and cream biscuits. If you eat nuts, choose raw or unsalted nuts and limit to 30g (small handful) per day. Nuts maybe a suitable substitute for other snacks-discuss with your dietitian.

5 Eat more fibre Foods that are less processed are usually higher in fibre and have more vitamins and minerals. These are good choices for everyone, especially if you have diabetes. Eat wholegrain breads, cereals, pasta and rice. Eat plenty of vegetables. Aim for at least 5 serves per day. Vegetables as part of your meal can fill you up and help control your weight. Eat 2-3 pieces of fruit each day. Drink at least 2 litres of water every day, and more if it is hot. You can get constipated if you eat a lot of fibre and do not drink enough fluid. Can I drink alcohol? All alcoholic drinks are high in energy and can lead to weight gain. Alcohol can also increase the risk of developing heart disease by raising blood fats and blood pressure. Alcohol can increase the risk of hypoglycaemia if you are using insulin and some types of diabetes tablets. Your dietitian and diabetes educator can give you tips to avoid hypoglycaemia. The recommended maximum amount of daily alcohol intake for adults is 2 standard drinks a day for men and women. Have at least 2 alcohol free days a week. One standard drink is equal to: 285 ml regular beer, (1 stubbie/can= 1.4 standard drinks) 1 stubbie/can midstrength beeer 100 ml wine (the size of wine glasses varies) 60 ml fortified wine 30 ml spirit (= 1 nip) If you drink alcohol: Measure out a standard drink so you know what it looks like. Make sure you eat before drinking alcohol. Include carbohydrate foods e.g. potato, rice, pasta and bread. Better choices are wine, low-alcohol beers or spirits mixed with diet mixers. Dilute alcohol where possible. For example, make a beer shandy by mixing beer with low-joule (diet) lemonade, or dilute wine with soda water. Ask your doctor if you need to adjust your insulin dose.

6 Sample Meal Plan Breakfast 1 cup cooked oats ( ½ cup raw oats) or ½- 1 cup high fibre cereal with low fat milk or 2 slices of multigrain bread with baked beans, tomato, mushrooms, jam, or honey and 1 piece of fruit water Lunch 2 slices of multigrain bread or 1 roll with salad and lean meat, tuna, salmon, chicken, or low fat cheese plus 1 piece of fruit or 1 tub of low fat yoghurt water Dinner g of lean meat, chicken (no skin), or fish with 1 cup of pasta or 2/3 cup rice or sweet potato + corn, or potato + corn and plenty of other vegetables (all types of salad vegetables are good - beans, broccoli, cabbage, carrots, cauliflower, peas, silverbeet, spinach, and zucchini) and ½ cup of tinned fruit or ½ cup of low fat yoghurt or ½ cup custard water Snack Ideas: Discuss with your Dietitian first. Not everyone needs to include snacks. Fruit Low fat/ diet yoghurt ( g) 2 Oatmeal biscuits 2-3 Grainy Crackers with cottage cheese and tomato 1 thin slice of fruit bread Raw, unsalted nuts (5-6)

7 Individual Meal Plan To be completed by an Accredited Practising Dietitian Breakfast Morning snack Lunch Afternoon snack Dinner Supper Things I can do to help manage my diabetes: The information contained in this handout is intended as a guide only. An Accredited Practising Dietitian can provide you with expert nutrition advice to suit your needs. A list of dietitians in your area can be found on the Dietitians Association of Australia website (http://www.daa.asn.au/). References: Diabetes Australia (2006). Heart disease and diabetes. Diabetes Australia. (2007). Talking diabetes No. 15: Food choices for people with diabetes. Diabetes Australia. (2008). The glycaemic index. Heart Foundation. (2004). Dietary fats and heart disease.

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