Category: AtoZ of Healthy Eating 2021

Weight loss

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More than 90% of patients with Type 2 diabetes are overweight or are obese (people with Type 1 are sometimes underweight). Weight gain and obesity worsen insulin resistance whereas weight loss slows the progression of diabetes complications.

Weight loss of 5-10% of baseline body weight is recommended as an initial goal of treatment, and this amount of weight loss is associated with a 0,6-1,0% reduction in HbA1c and numerous other health improvements, including reduced sleep apnoea, reduced need for diabetes medications, improved mobility and quality of life, fewer hospitalisations, and reduced healthcare costs. 

When ≥10% of body weight is lost and sustained, improvements in cardiovascular morbidity and mortality are also seen.

However, weight loss of as little as 2-5% produces a clinically meaningful reduction in fasting blood glucose.

The American Diabetes Association (ADA) recommends that patients with prediabetes lose 7% of baseline body weight to avoid developing diabetes.

A sustained 7% weight loss improves many other outcomes in patients with diabetes and overweight/obesity, including fitness, decreased waist circumference, reduced blood pressure, improved sexual functioning, and improved reported peripheral neuropathy symptoms.

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Vegetables

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Not only do vegetables add colour and texture to a plate, but they are highly nutritious and rich sources of vitamins and minerals. Vegetables are convenient and easily available, and there are many to choose from. They are high in fibre and low in calories. Fibre can help manage blood glucose and can help to make you feel full.

Evidence shows there are significant health benefits to getting at least five portions of a variety of vegetables and fruit every day. A portion is 80g.

Since fruit contains sugar, it’s advisable that if you have diabetes, you have no more than two fruits a day.

A study, in 2017, showed dramatic improvements in health when the intake of fruit and vegetables were increased. This study promoted a greater benefit when 10 portions of fruit and vegetables were eaten a day.

Compared with eating no fruit or veg a day, it showed:

  • 200g cut the risk of cardiovascular disease by 13% while 800g cut the risk by 28%.
  • 200g cut the risk of cancer by 4%, while 800g cut the risk by 13%.
  • 200g cut the risk of a premature death by 15%, while 800g cut the risk by 31%.

If 10 portions a day seem a bit hard to achieve, at least start with three a day and aim to increase to five portions a day. 

One of the many reasons most people avoid vegetables is because they feel they have little flavour. You want to avoid smothering your carefully prepared vegetables in sugary and salty condiments, like ketchup or soya sauce, or loads of white sauce and cheese. 

Make sure to add plenty of all-natural flavourings, including fresh garlic and ginger, miso paste, spices like smoked paprika, chilli and cumin, and herbs, such as basil, rosemary and sage.

The recommendation is to have five fruits and vegetables a day, but really three to five of these should be vegetable servings.

Most vegetables are low-GI and low in carbs, but use this list to keep the carbs low and to know what a vegetable serving is.

Vegetable Amount
Asparagus

Aubergine

Baby marrow

Beetroot, cooked, no vinegar or sugar

Broccoli

Brussel sprouts

Butternut

Cabbage

Carrot

Cauliflower

Celery

Cucumber

Dill gherkins, not sweet

Garden peas

Gem squash

Green beans

Green pepper

Kale

Lettuce

Mangetout

Mixed veg, frozen (cauliflower beans, carrots)

Mixed veg, frozen (Hawaiian stir-fry)

Mixed veg, frozen (peas, carrots, corn)

Mushrooms

Onion, medium

Peppadew

Pumpkin

Red pepper

Spinach

Sugar snap peas

Tomato, cherry

Tomato, medium

 3 spears

1 cup cubes/80g

75g

¼ cup/45g

¾ cup/60g

100ml/40g

50ml/40g

¾ cup/150g

14cm/50g

¾ cup/75g

3 stalks/125g

1 cup slices/125g

190g

50ml/15g

1

60g/20 beans

¾ medium/90g

¾ cup/40g

3 cups/135g

80g

60g

60g

40g

1 cup/85g

1/3 medium

4/25g

¾ cup cubes/75g

½ medium/75g

2 cups/85g

50g

3/110g

¾ medium/100g
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Tips for snacking

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Most people with diabetes may be able to tolerate 15g of carbohydrates for a snack. Having more carbohydrates between meals often will mean that your blood glucose is high before the next meal.  

If you typically have low blood glucose before meals or experience hypos during the day, you should have a carbohydrate snack of 15g between meals.

If you don’t have hypos nor drop blood glucose quickly between meals then you should stick to low carbohydrate snacks (less than 5g carbohydrates).

You may also need a carbohydrate snack if you have a very long gap between meals.

Use the food label to determine the amount of carbohydrates per portion. Choose natural foods as snacks as often as possible.

Snacks options containing 15g carbs

  • 1 small apple (6,5cm diameter)
  • 100g low-fat fruit yoghurt
  • 4 Salticrax crackers 
  • 40g peanuts and raisins
  • 2 cups popcorn
  • 1 large carrot (7,5cm long) and 2 tablespoons hummus
  • ½ avocado
  • 1 slice low-GI bread with butter or margarine or cheese

Snacks containing less than 5g of carbs

  • ½ cup berries
  • 100g double cream plain yoghurt
  • 1 Salticrax cracker
  • 40g peanuts
  • 2/3 cup popcorn
  • 1 stalk celery and 1 tablespoon hummus
  • Sugar-free jelly
  • Boiled egg
  • Biltong 
  • Cheese, cottage cheese, Laughing cow cheese wedge
  • Olives
  • ¼ avocado
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Supplements

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It’s always best to let the food you eat provide your vitamins and minerals by eating a variety of food. Supplements should never replace standard diabetes treatment. 

Just because a product is natural doesn’t mean it’s safe to use. Some of these products can interfere with other treatments and medications. A number of supplements have shown promise as diabetes treatments. These include the following:

Cinnamon

Chinese medicine has been using cinnamon for medicinal purposes for hundreds of years. It has been the subject of numerous studies to determine its effect on blood glucose levels. More studies are being done, but cinnamon is showing promise for helping to treat diabetes by lowering fasting blood glucose.

Chromium

Chromium is a trace element used in the metabolism of carbohydrates. The research is mixed. Low doses are safe for most people but high doses may cause kidney damage.

Vitamin B1

Vitamin B1 is also known as thiamine. Many people with diabetes are thiamine deficient. This may contribute to diabetes complications like heart disease and blood vessel damage. Since vitamin B1 is water soluble, it has some difficulty getting into the cells. Benfotiamine, a supplemental form of thiamine, penetrates the cell membranes more easily but the studies are mixed on whether it actually prevents diabetes complications.

Alpha-lipoic acid

Alpha-lipoic acid (ALA) is a potent antioxidant. Some studies suggest it may reduce oxidative stress and thereby decrease inflammation; lower fasting blood glucose; and decrease insulin resistance. ALA needs to be taken with caution, as it has the potential to lower blood glucose levels to dangerous levels.

Bitter melon

Bitter melon is used to treat diabetes-related conditions in countries like Asia, South America, and others. There is a lot of data on its effectiveness as a treatment for diabetes in animal and lab studies but human data is limited and of poor quality. 

Green tea

Green tea contains the antioxidants, polyphenols. The main antioxidant in green tea is known as epigallocatechin gallate (EGCG). Laboratory studies have suggested that EGCG may have numerous health benefits including decreasing the risk of cardiovascular disease; preventing diabetes, improving blood glucose control, and improved insulin action. Although studies on people with diabetes haven’t shown health benefits, green tea is generally considered safe.

Resveratrol

Resveratrol is a chemical found in wine and grapes. In animal models, it helps prevent high blood glucose, and reduce oxidative stress. However, human data is limited. It’s not certain whether supplementation helps with diabetes.

Magnesium

Magnesium is a nutrient that helps regulate blood pressure and also insulin sensitivity. Supplemental magnesium may improve insulin sensitivity in people with diabetes, and it also may help to prevent diabetes.

As you can see from this list, there are a number of natural supplements that can be used to manage diabetes. However, even for those on this list, it’s important that you talk to your doctor before adding any supplement or vitamin to your diabetes plan since they may still have a negative interaction with some of your medications.

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Sugar substitutes

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Sugar substitutes and sweeteners include naturally occurring sugars, artificial sweeteners, and sugar alcohols.
Just because a sugar is naturally occurring doesn’t make it a better choice in diabetes. Sucrose, which is mostly derived from sugar cane, is naturally occurring but can spike blood glucose dramatically.
Artificial sweeteners have been around for a long time and do get negative publicity even though they have consistently been deemed safe in moderation.
Although sugar alcohols have carbohydrates, they are not absorbed by the body. Since they do contain carbohydrates, they will contribute to the total carbohydrate on a food label but should not be considered in determining glycaemic tolerance. For most people, sugar alcohols in small amounts don’t affect blood glucose at all. This is why it’s essential to look at the nutrient table as well as the ingredients list on a food label.
Often people will ask if it’s better to have honey than table sugar and the short answer is no since both are medium GI. This is the same for brown sugar.
Low or zero GI sugars are the best choices.



Recipes

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You could successfully convert your favourite high sugar recipes by a little experimentation. Try the following substitutions. If you know the function of the ingredients in a recipe, you can get a good idea that the changes you make will work.

Sugar provides flavour, increases moisture, tenderness, browning in baked goods. It helps yeast products rise, and is a preservative in jams, jellies and pickles.

Although people with diabetes can have controlled amounts of sugar in a food, reducing the sugar, lowers the carbohydrate grams per serving. If the recipe can have more fibre added, the food item will have a lesser impact on blood glucose.

  • Reduce all added sugar by 1/3 in a recipe, such as cookies and pie fillings. This includes brown sugar, syrup, honey, etc.
  • Limit sugar to 1 tbsp. for each cup of flour in quick breads and muffins.
  • Cinnamon, nutmeg, or vanilla will enhance sweetening flavour.
  • Try using a non-nutritive sweetener. However, cakes and cookies may be a little dry, so leaving some sugar in the recipe will keep the item moist.
  • Try options like banana-, carrot-, cranberry-, zucchini- or pumpkin bread. The fruits and vegetables will add fibre and you can use whole-wheat, oats, legumes, barley or even a nut flour instead of regular flour.
  • Spray some  Spray & Cook on the top of the muffins or cookies to increase browning.

If you really want to lower the carbohydrate in your home dinner recipes, try substituting high carbohydrate ingredients with lower carb versions.

For diabetic friendly recipes visit Our Recipe Book



Protein

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Protein is one of the three major nutrients found in food. Just like a carbohydrate is made up of links of glucose, so protein is made up of links of amino acids.

Amino acids are important building blocks in making and repairing muscles, and developing bone, hormones, and enzymes.

Protein does not increase blood glucose levels since it doesn’t contain glucose. Although protein doesn’t require insulin to move out of the bloodstream and into the cells of the body, it can stimulate the production of insulin and in doing so may help to manage blood glucose.

On the other hand, a diet that contains too much animal protein may increase the risk of developing Type 2 diabetes. However, a diet with plenty of plant-based proteins may modestly decrease this risk.

Protein is an essential nutrient in meats, fish, and certain vegetables, such as nuts, beans, and legumes.

A person with diabetes should favour foods with lots of protein but little animal fat, such as fatty fish (salmon, mackerel, tuna, pilchards), poultry, beans, lentils, nuts and seeds, soya and tofu.

Try to add some protein to every meal.

DID YOU KNOW?

Studies have shown that replacing carbohydrate with protein and fat can improve blood glucose control as well as help with weight (perhaps because protein and fat keep you fuller for longer).

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Omega-3

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Omega-3 fatty acids are a group of polyunsaturated fatty acids that are important for many functions in the body. The omega-3 fatty acids, EPA and DHA, are found in seafood, such as fatty fish (salmon, tuna, and trout) and shellfish (crab, mussels, and oysters) while omega-3 fatty acid, ALA, is found in other foods, including some oils, nuts, and seeds. 

Diabetes is a disease of chronic inflammation. Omega-3 can be beneficial by reducing the production of substances released during the body’s inflammatory responses.

Type 1 diabetes is an autoimmune disease where the immune system mistakes healthy cells for foreign cells and starts attacking them. The immune system attacks the insulin-producing cells in the pancreas. Studies show that getting enough omega-3 during the first year of life is linked to a reduced risk of autoimmune diseases, including Type 1 diabetes.

Metabolic disease is frequently found in Type 2 diabetes and usually includes elevated blood pressure, increased visceral fat (waist fat), decreased good HDL cholesterol, increased triglycerides, and insulin resistance. Omega-3 has shown to reduce symptoms of metabolic disease.

Non-alcoholic fatty liver disease (NAFLD) is also commonly found in Type 2 diabetes and insulin resistance. Omega-3 fatty acids have shown to effectively reduce liver fat and inflammation in people with NAFLD.

The best way to ensure effective and efficient omega-3 intake is to eat fatty fish two times per week. Try new recipes to include pilchard, tuna, sardines, salmon, and trout.

If you can’t eat fish, then you may want to consider taking an omega-3 supplement.

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Nuts

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Nuts (tree nuts and peanuts) are nutrient dense foods. They are rich in heart-healthy, anti-inflammatory unsaturated fatty acids, fibre and antioxidants.

Studies have associated nut consumption with a reduced incidence of heart disease and gallstones in both genders and diabetes in women. Limited evidence also suggests beneficial effects on hypertension, cancer, and inflammation, and even visceral fat (the nasty fat around the waist).

Contrary to expectations, studies also suggest that regular nut consumption is unlikely to contribute to obesity and may even help in weight loss. Obviously, this is when nuts are eaten in moderation.

Nuts are a great low carbohydrate snack instead of a healthy fruit. An apple has 19g of carbohydrates and about 300 kilojoules, whereas 10 almonds have 2,4g of carbohydrates and 300 kilojoules.

DID YOU KNOW?

A cup of almonds has almost the same amount of calcium as a cup of milk.

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