HEALTHY EATING FOR TYPE 2 DIABETES

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1 HEALTHY EATING FOR TYPE 2 DIABETES Information Leaflet Your Health. Our Priority.

2 Page 2 of 11 Introduction This leaflet provides general guidance about food choices if you have Type 2 diabetes. Making sensible food choices and adapting your eating habits will help you manage your diabetes and help protect your long-term health. This leaflet will help you take steps to balance your diet, which should help you control your blood glucose levels, blood fats including cholesterol, and blood pressure. What is type 2 Diabetes? Diabetes is a condition where the amount of glucose (sugar) in the blood is too high. Glucose levels are controlled by a hormone called insulin. In people with diabetes either not enough insulin is produced (insulin insufficiency) or it does not work properly (insulin resistance). For some people both happen at the same time. Good blood glucose control is important in the management of diabetes. If diabetes is not well controlled there is an increased risk of heart attacks and stroke, kidney and eye diseases, and damage to the nervous system. Lifestyle is important and can improve diabetes control. Some people may also need medication. Key steps to eating well with Diabetes Eat regular meals Maintain a healthy weight Be aware of the type and amount of carbohydrate in your diet (Starchy foods and sugars) Cut down on the fat you eat Eat more fruit, vegetables and salad Protect your heart by eating oily fish and limiting salt Drink alcohol in moderation only Eat Regular Meals Eat three regular meals a day and avoid skipping meals. This will not only help control your appetite but will also help control your blood glucose levels. If you take some diabetes medication you may also need to include a small suppertime snack. Try to avoid going 4-5 hours between meals.

3 Page 3 of 11 Maintain a healthy weight Losing weight, if you are overweight, can improve your diabetes control. It can: Reduce insulin resistance Improve blood fats Reduce your cardiovascular risk Make exercise easier This is especially important if you carry the weight around your middle. Getting the portions on your plate right is important if you are trying to lose weight. Use the guide below to help you get the right balance. Proportions on your plate if you are trying to lose weight. Proportions on your plate for weight maintenance. Rice, Pasta, Potato + Bread Meat, Fish, Eggs, Beans, Cheese Vegetables + Salad Rice, Pasta, Potato + Bread Meat, Fish, Eggs, Beans, Cheese Vegetables + Salad What is carbohydrate? Carbohydrate can be classified into starchy carbohydrates and sugars. The type and amount of carbohydrate you eat is important to control your blood glucose levels. Starchy carbohydrates include foods like bread, pasta, chapattis, potatoes, yam, noodles, rice and cereals. These are digested more slowly than sugars so do not increase your blood sugars as much. Most of your carbohydrate should come from this group and you should include a starchy food with each of your meals. Sugars include table sugars (e.g. caster, white, brown). Sugars can also be found in fruit (fructose) and some dairy foods (lactose). They can often be identified on food labels as those ingredients ending with ose.

4 Page 4 of 11 Why is carbohydrate important? All carbohydrate is converted into glucose and will have an impact on blood glucose levels. As this is the case, some people with diabetes wonder if it is better not to have any carbohydrate in their diet to keep their glucose levels under control. This is not recommended as: Glucose from carbohydrate is essential to the body, especially the brain High fibre carbohydrates, such as wholegrain varieties and fruit also play an important role in the health of the gut Some carbohydrates may help you feel fuller for longer after eating How much do I need? The actual amount of carbohydrate that the body needs varies depending on your age, weight and activity levels but it should make up about half of what you eat and drink. For good health most of this should be starchy carbohydrate, fruit and some dairy foods, with no more than one fifth of your total carbohydrate to come from added sugar or table sugar. Glycaemic Index (GI) Some starchy carbohydrate is digested more slowly than others. Glycaemic Index is a measure of how quickly or slowly carbohydrate containing foods are digested and how much of an effect they will have on your blood sugar levels. Foods with a low glycaemic index are digested more slowly and have less of an impact on your blood sugar. With diabetes you should try and include some low GI foods on a regular basis. Try to include at least one at each meal. Starchy foods with a low glycaemic index include: Wholegrain bread such as stone ground, granary or multigrain Oats and oat based cereals such as porridge, unsweetened muesli Some breakfast cereals such as All Bran, Special K, Bran Flakes, Sultana Bran Basmati or easy cook rice Pasta and noodles (fresh or dried) New potatoes, sweet potatoes and yam Beans, lentils and other pulses Low GI can not be used in isolation as some foods that are low GI are high in fat and sugar such as chocolate. It would not be beneficial to include these foods on a regular basis The amount you eat is also important. A small amount of a high GI food can affect your blood sugar the same as a large amount of a low GI food. This is referred to as Glycaemic Load.

5 Page 5 of 11 How to reduce your sugar intake Sugar is digested quicker than starch but this does not mean you need to avoid all sugar. Small amounts of sugar do not affect your blood glucose levels very much. Some sugar can still be used in baking as part of a healthy diet. You do not need to buy specialist diabetic products as they are not recommended. Use sugar free, no added sugar drinks such as diet fizzy drinks, no added sugar squashes and cordials, flavoured waters with an artificial sweetener Sweeteners such as Canderel, Hermasetas, Sweetex and Splenda can be used to replace sugar in drinks, desserts and on cereals Choose sugar free desserts such as tinned fruit in natural juice, no added sugar custard, jelly or milk pudding Use less sugar in cooking and baking. Many recipes work well with less sugar Limit chocolate, biscuits and sweets to 1-2 pieces per day after food and go for plain varieties Limit sugary foods such as sweet biscuits and cakes Cut down on the fat you eat Both the amount and type of fat you eat is important Eat less fat overall, especially saturated fat Choose mono-unsaturated spreads and oils (e.g. rapeseed or olive oil) Keep meat portions small and lean or choose fish as a healthy alternative Trim the visible fat from meat before cooking. You can replace some of the meat with lentils or beans in dishes Limit pies, cakes, pastries, sausages, burgers and takeaways Choose low fat dairy products such as skimmed or semi skimmed milk, low calorie or diet yoghurts Use stronger low fat cheese. Grating cheese makes it go further Be mindful of creamy sauces and dressings. Use tomato-based sauces instead Grill, bake, poach, steam or boil foods rather than cooking in fat

6 Page 6 of 11 Eat more fruit, vegetables and salad They provide vitamins, minerals and fibre and will help to control your weight and blood pressure. Aim for a least five portions a day. A portion is 80g and that is the same as: A medium fruit e.g. an apple, banana, pear 2 satsumas, plums and apricots 3-4 dried apricots 1 tablespoon sultanas or raisin A small glass of fruit juice or smoothie 3 tablespoons of cooked vegetables A cereal bowl of mixed salad 7 cherry tomatoes A handful of grapes or cherries Ways to include fruit and vegetables in your diet: Choose fruit or chopped vegetables as a snack Add chopped fruit to cereals and desserts Have salad with your sandwich, pizza or pasta Add extra vegetables to casseroles, soups and stews Fruit does contain natural sugars so remember to spread your fruit intake throughout the day and have no more than 5 portions a day. Limit fruit juice to one small glass daily. Protect your heart by eating oily fish and limiting salt Oily fish Oily fish contains a type of fat, Omega 3, which helps protect against heart disease. Aim to include oily fish such as mackerel, salmon, sardines twice a week Limit salt to no more than 6g per day Eating less salt may help reduce your blood pressure. This can reduce your risk of a stroke or heart disease. Eat less processed foods as these are often high in salt Use herbs and spices instead of salt for flavour

7 Page 7 of 11 Drink Alcohol only in moderation Alcohol is high in calories and can affect a type of fat in your blood called triglycerides. Alcohol can also affect your blood sugars and should be drunk only in moderation. Drinking on an empty stomach can increase your risk of hypoglycaemia (low blood sugars) if you are on certain types of medication. What are the recommendations? Up to 2-3 units per day for a women Up to 3-4 units per day for a man Don t forget to have at least two alcohol free days a week What is one unit of alcohol? 25ml or a single measure of spirits Half a pint of standard strength (3.6% ABV) beer or lager 100mls of wine that is 12% ABV 165mls of 5% ABV beer, lager or cider Understanding food labels Knowing how to make sense of food labels can help you to make healthy choices. When looking at labels it is useful to consider: How much of the food will I eat? Some foods may be high in sugar but are only eaten in small amounts so will have little effect e.g. jam Is the information given per 100g or per portion? How much you eat is important. The amount may not seem high for 100g but what if the portion size is 300g? How can I use the ingredient list? Ingredients are always listed in order according to how much they include. The nearer the top of the list the more there is in the product.

8 Page 8 of 11 Label claims what do they mean? No Added Sugar: No extra sugar has been added but there may still be a lot of natural sugar in the product e.g. fresh fruit juice Low fat or low sugar: These products must contain less than 5% fat or sugar (e.g. < 5g/100g). Remember low fat products can still be high in sugar and vice versa Reduced fat or sugar: These should contain 25% less than the standard product. The total amount could still be high Traffic light labelling Traffic light coding on products can give you a starting point. This method is often used to show the amount of fat, saturated fat, sugar and salt in food. Red means high: Choose these foods less often Amber means medium: Okay to include some of the time but go for green where possible. Green means low: A healthier choice The table below is a useful guide for comparing food labels when you are out shopping

9 Page 9 of 11 Meal Plan Making the most of low GI foods Breakfast Try an oat based breakfast cereal e.g. porridge/unsweetened muesli A bran based cereal with sliced fruit added Wholegrain/granary bread Lunch Add baked beans to your jacket potato and serve with a large green salad Try a bean based or vegetable soup Eat a variety of bread containing grains or pumpernickel bread instead of white or wholemeal bread Evening meal Use new potatoes or sweet potato, instead of mashed potatoes Choose basmati or easy cook rice instead of long grain rice Include plenty of vegetables or salad with your meals Include more beans and lentils in your meal; try adding them to casseroles and curries Snacks Have a piece of fruit Low calorie/diet yoghurt Sugar free jelly Unsalted and unsweetened popcorn Go easy on low GI foods such as chocolate and nuts as these are high in fat and calories which can lead to weight gain. Save them for occasional treats Other sources of information: Diabetes UK Is a charity for people with diabetes and has further information about diabetes on their website. Alternatively you can ring them on: or British Dietetic Association This is the professional association for dietitians and has food fact sheets on a number of conditions including diabetes and also has information on glycaemic Index. You can find this information on their website:

10 Page 10 of 11 Contact us Please contact your Dietitian on the contact number below: Dietitians - Community Based Selbourne House Union Street Hyde SK14 1NG Tel: The service is available: Monday Friday 8:30am 4:30pm Dietitians -Tameside Hospital Based Tameside General Hospital Fountain Street Ashton-u-Lyne OL6 9RW Tel: Fax: The service is available: Monday Friday 8:30am 5:00pm Your Dietitian is:

11 Page 11 of 11 If you would like this leaflet in a different format, for example, in large print, or on audiotape, or for people with learning disabilities, please contact: Patient and Customer Services, Poplar Suite, Stepping Hill Hospital. Tel: Our smoke free policy Smoking is not allowed anywhere on our sites. Please read our leaflet 'Policy on Smoke Free NHS Premises' to find out more. Leaflet number TG60 Publication date April 2014 Review date April 2016 Department Nutrition and Dietetics Location Tameside and Glossop

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