Should you really be eating that?

Daniel Sher educates us and shares practical advice on how to make peace with the food police.


Who are the food police?

People who feel they have the right to comment on your dietary choices.

As a person living with diabetes, here are steps can you take to stop the food police from ruining your day.

Empathise

One way of coping with the food police is to put yourself in their shoes. Often, they truly are coming from a place of care and concern. Even if their response is inflammatory enough to make you want to pull your (or their) hair out.

Recognise that often, when someone asks, “Are you allowed to eat that?”, the subtext of their question is: “I’m really freaked out by the fact that you have this illness. So, I’m making these comments to help me feel in control”.

Diabetes is tough for us who live with it, but it’s also taxing for our loved ones. Recognise that food policing might simply be a family member’s coping strategy. Once you’ve made peace with this idea, you’ll be better placed to educate and set boundaries to stop food policing for good.

Educate

Often, the food police lack an understanding of what people with diabetes can and can’t eat. For example, you may be shocked to learn how many people think that managing diabetes is simply about avoiding sugar. If only it were that simple!

If you’re feeling in a good enough mood, you can use your loved one’s display of ignorance as an opportunity to help them learn more about a) what managing diabetes is really about; and b) what sort of responses are and aren’t helpful.

Ultimately, however, the food police often leave us feeling angry and hurt; and we’re usually not in the right sort of space to educate. This is perfectly okay. In such situations, it’s important to own your anger so that you can set healthy boundaries.

Own your anger

Many of my clients are surprised when I tell them that anger is a good thing. Specifically, anger is a healthy indicator that something is off in a relationship. It’s a catalyst for important interpersonal change. Your anger lets you know that a loved one has overstepped a boundary.

If you’re able to channel your anger into a healthy response (discussed below), you’ll be using your emotion to help you establish appropriate boundaries.

To do this, it’s important to own your anger: acknowledge and accept its presence. Allow yourself to feel it; but give yourself some time to calm down before you act on what you’re feeling!

Set boundaries

Your job, should you choose to accept it, is to set healthy boundaries. It’s possible to do this in a kind way, but you need to be firm and assertive at the same time.

This is where ‘owning your anger’ comes into play. Connect with whatever the food police make you feel – anger, sadness or frustration. Tell them frankly what you feel when they speak to you in this way. This will help them to understand that what they are doing is not helpful or appropriate. The phrases below may be helpful in such circumstances:

  • “I know you’re coming from a place of concern, but what you’re doing is not really helping.”
  • “My body, my health, my choices. Please respect that and ease off.”
  • “If you really want to support me, you’ll stop making me feel ashamed and guilty.”

As a friend or family member of a person living with diabetes, how can you avoid becoming a member of the food police?

Educate yourself

If you believe that the most important aspect of managing diabetes is avoiding sugar and carbohydrates at all costs, you should educate yourself before making potentially harmful comments.

This is a common trap that the food police frequently fall into. You see your loved one eating a delicious muffin and you make a critical comment based on the assumption that they’re mismanaging their condition.

A good place to start would be to read articles on www.diabetessa.org.za on managing diabetes. However, even if it turns out that your loved one is making a ‘wrong’ or ‘unhealthy’ choice, it’s important to make peace with the fact that, ultimately, it’s their choice to make. Not yours.

Control your urge to control

When we ask someone whether they should really be eating that slice of carrot cake, it’s usually coming from a place of genuine concern. However, it’s not having the intended effect, because it’s likely to infuriate and annoy, rather than encourage healthier food choices.

So, what’s the solution? We need to recognise the fact that our loved one having diabetes elicits, in us, an overwhelming sense of being out of control. By acknowledging this feeling, we see that it leads us to try to control our loved one’s behaviour by constantly monitoring and commenting on their choices.

We need to learn to start accepting the fact that much of life itself is uncontrollable. There are certain things, such as our loved one’s dietary choices, that we need to let go and allow. This doesn’t mean, however, that you can’t do anything to support your loved one in making healthy choices. Read on to learn how to do this in an appropriate manner.

Offer your support

How can you convert your desire to help into a response that is truly useful for your loved one? Stop speaking and start listening. Stop advising and start asking questions. Show your loved one that you are curious and that you care.

Instead of trying to tell them what they should be doing, ask them what you can do to support them. Make yourself available to understand; and be non-judgmentally curious about their difficulties and decisions.

Research shows that social support is incredibly important for us diabetes patients. In most cases, your loved one will benefit simply by knowing that you are there and that you care, in a respectful and non-intrusive manner. Sometimes, your loved one will ask you to back off. In such cases, it’s important to give them their space.

MEET OUR EXPERT


Daniel Sher is a registered clinical psychologist who has lived with Type 1 diabetes for over 28 years. He practices from Life Vincent Pallotti Hospital, in Cape Town, where he works with Type 1 and Type 2 diabetes to help his clients thrive. Visit www.danielshertherapy.com


Mindful eating


Ria Catsicas encourages you to reflect on your relationship with food and to practise mindful eating.


Reflection

Part of living well as a person with diabetes requires that you sometimes need to take time to reflect on the choices you make and how they impact on how healthy you live your life. 

The types of food you should eat is well documented in the media. What we often neglect to recognise and fail to communicate is the how, when and why we eat. These are equally crucial factors that need to be considered. They impact on the quantity of food you consume which affects your weight, blood sugar and blood fat levels.

Research has demonstrated that when mindful eating is practised, less food is consumed at a meal, satisfaction is experienced earlier during the eating process and as a result there is a feeling of content after the meal. Mindful eating assists you to change from being an impulsive eater to become an intuitive eater.

Observation 1: Control where and when you consume your food

It is essential that you ask yourself: where you eat and when you eat. You will identify eating patterns which may be as follows: eating too fast; eating second portions; sneaking food; and eating in places other than your dining room, such as in your car, in the supermarket, in front of the TV and in the kitchen while cooking. All these locations are inappropriate and impact your weight negatively.

Observation 2: After identifying the habits, identify the rewards you receive

You must ask why you keep practising these poor eating habits if you intuitively know they result in weight gain. The logical answer to the question, is that they benefit you in some way. In other words, you feel rewarded by practising the behaviour. As you cannot change what you don’t acknowledge, it is important to identify the reward.

What rewards do you receive? 

  • Pleasure of food: You place value on the pleasure the taste of unhealthy foods provides and get instant gratification. The challenge is to control the frequency and quantity of consumption of instant gratification foods. You need to gain control of this – the ‘pleasure seeking taste’ as it contributes to the deterioration of your health and life.
  • Physiological calm: Consuming pleasurable food releases a ‘high’ in our brain. This triggers a desire to consume more and this desire is difficult to control.
  • Emotional relief: The act of eating can provide us with relief of emotions we do not want to face or resolve, such as fear, anxiety, anger, aggravation, frustration or sadness. The problem is that eating provides only temporarily relief. Ultimately, the weight gain causes feelings of guilt and disappointment that can erode your self-esteem.
  • Irrational rewards: You use food as a reward of enduring a stressful day. A typical scenario is coming home after a stressful day and you start consuming salty snacks with your glass of wine, or rusks with your cup of coffee.
  • Being sociable: You might find yourself part of a circle of friends and family that often get together and enjoy large lavish meals. It is easy to start to copy their behaviour as you want to belong and be accepted in the group.
  • Safety: Being overweight becomes a convenient excuse of not acting to change your life. It can serve as an excuse to do the difficult risky things in life that need courage. How many times have you told yourself – as soon as I lose weight I will start socialising, or resign from a low-paying job and seek a better job?

The bottom line

There is nothing wrong with the rewards we receive from consuming food. We all want to belong, be accepted or need emotional relief and have some pleasures in life. The problem is when we use food to reward. Excessive consumptions of all types of food causes weight gain, which will result in both physiological and physical illness that will impact on the quality of your life.

Strategy of eating better

You need to start a process of replacing bad unhealthy eating habits with good healthy eating habits. Practising the following steps will assist in doing so:

STEP 1: Replace the unhealthy habits with competing activities

Identify the triggers that result in eating outside your normal meal times or snacking consistently. This can be the time of day (after dinner) and the environment (coming home).

Make a list of activities you can do to replace the act of eating. They need to be incompatible with eating. Example, you cannot eat a packet of crisps whilst you are walking the dogs.

Choose activities that can be done with little effort. Keep these activities on your phone, or at a place where you can access it easily. Example, when you feel aggravated or upset; instead of eating, phone a friend, browse Facebook, read, or watch a movie on TV, or play a game on your computer. This is an everyday exercise consistently replacing the act of eating with a competing activity. Soon you will have changed the habit of inappropriate eating.

STEP 2: Resolve impulsive eating

Luckily the impulse or urge to eat does not happen all the time. It happens at certain times of the day. Resolving impulse eating requires two strategies:

  1. Identify the triggers (internal and external) that create the desire to eat impulsively. The urge to eat can be triggered by external triggers, such as the sight or smell of food as you are shopping, walking past the nuts and dried fruit section. The trigger might also be internal, like coming home and you become stressed by your children, who turned the house upside down.
  2. Create a defence strategy to combat the urge to eat. It starts by changing your thoughts, then soon the urge to eat at that time disappears. Change the buying nuts action by buying water as you enter the shop; this will help you to be more disciplined towards what you add to your trolley. When coming home, you can decide to make yourself a cup of tea and quickly create a game for your children, such as whoever picks up most of the toys will win a price.

STEP 3: Change your eating style to mindful eating

How you eat plays a key role towards gaining unnecessary weight. The eating styles that need change are the following:

  • Gulping down your food.
  • Consuming excessive portions, or second portions, or your child’s leftovers.
  • Eating while standing, on the move, or in the car.
  • Cooking and eating at the same time.
  • Snacking while watching television, or eating in other rooms in your house other than the dining room.
  • Overeating at parties or social events.

Mindful eating is about becoming aware and obeying sensations, such as hunger, fullness, taste and satiety cues. To change your style to mindful eating, you need to practise the following skills:

  • Slowing down the pace of eating by chewing slowly. An effective way is to start a conversation that will force you to slow down.
  • Eating your main meal away from distracting activities, such as eating in front of the TV or whilst working on your computer. Mindful eating should take place at a beautifully laid table.
  • Becoming aware of your body’s hunger and fullness cues and using them to guide the decision to start and end the meal.
  • Choosing to eat food that is both pleasurable and nourishing, using all senses while enjoying the experiencing of eating.

STEP 4: Create rewards that work for you – see yourself where you want to be

The objective is that the behaviours you have chosen to replace eating should let you feel so good that you will find them more attractive than eating food.

Stop using the excuse ‘I love food.’ Most of us love food. The question is how do you manage food in your life to optimise your health and your life. Mismanaging food causes you to become overweight and depressed.

Ultimately, to make these new behaviours or rewards, you need to practise them for at least a month. Be patient, you might not feel immediately that they will work but just persevere. Soon you will feel more in control and happier.

Example 1: Instead of going straight home rather change your route home and go to the gym. This will eliminate the urge to snack, which normally occurs when you sit in front of the TV.

Example 2: You have the habit of eating leftover food, especially the food your children have left on their plates. You should rather keep these leftovers and pack them in your lunchbox for the next day.

Example 3: To get out of the office, you and your colleague use the excuse to visit the cafeteria, which normally results in purchasing a chocolate. You should now convinced her that you two should take a walk outside the building and spend 10 minutes a day in the garden, next to the fountain. You should now decide it is a 10-min break to soak up some sun for vitamin D, and maybe even develop a game of identifying images in the clouds.

The rewards need to leave you with a feeling of having fun, a sense of accomplishment, feeling of calm, relaxed and in control. So, you are no longer driven by the instant gratification, self-destructive habits impulses or urges.

STEP 5: Visualise yourself, and create concrete reminders to stay on track

Visualisation of yourself – where you ultimately want to be and how this will feel – will strengthen your motivation. Create an image of yourself looking and feeling extremely good. Be specific in terms of place, time, the clothes you’re wearing and the remarks of the people. It can also be an image or photo of you doing something exciting, such as competing in a cycling race or dancing at a party. Look at this image daily.

Because tempting food is everywhere around you and part of your daily lives, it helps to create concrete reminders to stay on track. This can be a photo of yourself on the fridge, or your dress or pair of jeans that you would like to fit in that you now hang outside your cupboard, as a reminder that you will fit into. It is only a matter of time.

The key to reducing unhealthy food consumption is to develop strategies that allows for the replacement of food as a reward. They should be new positive constructive habits that let you feel good about yourself and your appearance.

MEET OUR EXPERT

Ria Catsicas
Ria Catsicas is a dietitian in private practice and completed a master’s degree in nutrition. She has a special interest in the nutritional management of chronic diseases of lifestyle and authored a book The Nutritional Solution to Diabetes.

Eating on a time budget

We all need to eat, but sometimes our busy schedules don’t allow us to. Christine Manga shares tips on how to eat on a time budgetit all comes down to preparation.


Louis E Boone said, “I am definitely going to take a course in time management…just as soon as I can work it into my schedule.” Does this sound like something you might also say? We live in rushed times: sticking to work schedules and deadlines; chasing after children; and road travel as part of work. All of these factors impact what, when and, if at all, we are able to eat during the day. Then add diabetes to the mix.

Having diabetes is challenging, there are things which need to be managed: taking medication, exercising and eating properly. Adhering to these will help keep your diabetes under control. Eating a balanced diet throughout the day is vital, as it assists to stabilise blood glucose levels. This may prevent hunger pangs and cravings which can lead to binge eating in the evenings.

A regular complaint that I hear from people with diabetes is insufficient time to eat during the day. So how do you overcome this? Preparation!

Why prep?

Knowing what to eat will simplify this task. It is important that you get food from all the food groups; carbohydrates, protein, vegetables and fat. Low-GI (glycaemic index of <55) and intermediate-GI (56-69) foods are a good option. Low-GI foods are more slowly digested, metabolised and absorbed. They result in a slower and lower glucose rise than higher GI foods. This allows you to feel full for longer.

How to prep

Take time to prepare food that will be easy and convenient to eat between meetings, sitting at your desk and even on the road (subject to safety). This should help you from feeling the need to rush off to the vending machine or stopping for takeaways. Be aware when buying ‘diabetic’ products; even though these products may be sugar-free, they often contain more calories and/or fat than ‘regular’ food. They also often have a laxative effect and tend to be expensive.

Here are some simple foods that can be easily prepared and packed. They can be eaten separately or combined.

  • Cook extra dinner in the evening, leftovers can be used in salads or sandwiches for lunch.
  • Wash, cut and peel fruit and/or raw vegetables into bite size pieces/crudités.
  • Cut or grate a small amount of low-fat cheese. Alternatively, pack small individually wrapped cheese wedges, rounds or sticks that don’t need refrigeration.
  • Keep ‘Lite’ varieties of packet soup on hand, these are quick to prepare.
  • Pop your own popcorn at home, add spices or cinnamon. This is low-GI and high in fibre.
  • Buy or roast your own seed mix. Sunflower, pumpkin, flax and sesame seed. Keep handy in small amounts. These contain healthy fats.
  • Small pots of low-fat or fat-free yoghurt. Add fresh berries, some peanut butter, nuts or seeds.
  • Lean biltong, pre sliced for easy eating.
  • Pack a peeled boiled egg.
  • Make whole grain sandwiches or wraps with any of the following fillings (cut into small manageable portion sizes):
    • Cheese and tomato.
    • Cottage cheese and peppadew.
    • Egg and mayonnaise with peppers.
    • Grated carrot and sweetcorn.
    • Guacamole and beans.
    • Tuna mayonnaise, cucumber and diced tomato.
    • Leftover meat, chicken or fish.
  • These fillings could also be enjoyed with Provita biscuits.

All of the above options will be easy to eat if you’re rushed and not able to take a dedicated lunch break. Pack water that you have flavoured yourself by adding fruit or cucumber. If you prefer flavoured drinks, stick to the Lite, Light or Zero options. Avoid fruit juice as it is usually high in carbohydrates and has a high-GI.

The preparation time will be worth it. Put very aptly by Benjamin Franklin, “By failing to prepare, you are preparing to fail.”

MEET OUR EXPERT - Christine Manga

eating time budget
Christine Manga (Post Grad Dip Diabetes and Msc Diabetes) is a professional nurse and a diabetes nurse educator. She has worked with Dr Angela Murphy at CDE Centre, Sunward Park since 2012.

Healthy eating – a family affair

A healthy meal plan isn’t just for people with diabetes. In fact, the dietary guidelines recommended for people with diabetes are the same as those recommended for the rest of the population. That means your family doesn’t need to prepare separate meals for you at home – they can simply adopt your healthy habits. Follow these 10 tips to build a balanced and healthy meal plan for your whole family.

  1. Enjoy a variety of foods.

Not one food can deliver all the necessary nutrients for you and your family, so you should make sure that your family eats different types of food.

  1. Make starchy foods part of most meals.

A small portion of good quality carbohydrates helps to give the body energy. Choose high-fibre starchy foods – like high-fibre breakfast cereals, whole grain bread and wholewheat pasta – over more refined versions for sustained energy to help your family through the work or school day.

  1. Eat dried beans, split peas, lentils and soya regularly.

Beans and legumes are good sources of protein, fibre and B vitamins, and they also help to improve blood glucose control. Aim to include beans and legumes in your family’s menu at least twice a week.

  1. Eat plenty of vegetables and fruit every day.

Vegetables and fruit contain loads of different nutrients, like fibre, vitamins and minerals. Your family should eat at least five portions of vegetables and fruit daily to make sure they get a variety of nutrients needed for health.

  1. Have milk, maas or yoghurt every day.

Encourage your family to enjoy at least three servings of dairy foods per day to ensure they develop strong, healthy teeth and bones. Aim to choose versions with less added sugar where possible.

  1. Drink lots of clean safe water.

Water is the best way for your family to stay hydrated and should be their first choice when choosing a beverage. It is the cheapest yet best drink of all. Start your children on water when they are young and it will remain a good habit for the rest of their lives.

  1. Use salt and food high in salt sparingly.

Eating too much salt increases your risk of high blood pressure (hypertension) and health conditions in the long term. Let your family enjoy the natural taste of foods by not adding salt to meals and avoiding salty ingredients in your cooking, such as stock cubes and soup powders.

  1. Use sugar and food and drinks high in sugar sparingly.

Limit foods with added sugar, like cookies, sweets, chocolates and sugar-sweetened drinks. Keep sugary foods as ‘special occasion’ treats, and practice portion control when you do enjoy them.

  1. Fish, chicken, lean meat and eggs can be eaten daily.

Protein helps to provide the body with strength and structure, while repairing damage and promoting growth. Including protein in your meals also helps to improve blood glucose control. Oily fish is also a great source of omega-3 fatty acids which helps to protect against heart disease.

  1. Choose good quality fats.

Beware of eating excess saturated and trans fats. When you and your family use fats, choose unsaturated sources like olive and canola oil, oily fish, tub margarines, avocado, peanut butter and nuts.

Pick n Pay Health Hotline

Did you know that Pick n Pay employs a registered dietitian to provide free food and nutrition-related advice to the public? Whether looking for guidelines on managing your condition, weight loss tips, healthy eating tips for kids, how to manage food allergies, how to interpret food labels or any other food-related query you have always wanted answered, our registered dietitian is just a phone call away.

Contact the Pick n Pay Health Hotline on 0800 11 22 88 or email healthhotline@pnp.co.za to start your nutrition conversation.

MEET OUR EXPERT - Leanne Kiezer

Registered Dietitian BSc Diet, PgD Diet UKZN, MSc Nutrition NWU. Leanne joined Pick n Pay as the resident dietitian in May 2014. She is the voice behind the Pick n Pay Health Hotline, providing advice to customers on a range of nutrition and health-related topics. She also provides nutrition input as part of the Pick n Pay food development team, and ensures that all communication is in line with the most recent advances in nutrition science and research.