Ask the Dietician

Managing gestational diabetes

gestational diabetes

The 12th to the 16th of February is Pregnancy Awareness Week, an excellent opportunity to discuss one of the most common forms of diabetes: gestational diabetes. It is estimated that between 3% and 20% of pregnant women develop gestational diabetes, depending on their risk factors. We asked Pick n Pay’s dietician Leanne Kiezer for some helpful tips on gestational diabetes.

All pregnant women should be screened for gestational diabetes between 24 to 28 weeks of pregnancy. Women who are at high risk for undiagnosed Type 2 diabetes should be screened earlier than 20 weeks of pregnancy. This information, compiled by Diabetes Canada, helps to clarify some of the common myths and misconceptions around gestational diabetes, as well as offering some tips for its management.

What is gestational diabetes?

Gestational diabetes is a type of diabetes that occurs during pregnancy. Your body cannot produce enough insulin to handle the effects of a growing baby and changing hormone levels. Insulin helps your body to control the level of glucose (sugar) in your blood. If your body cannot produce enough insulin, your blood sugar levels will rise.

The good news

  • Your baby will not be born with diabetes.
  • Gestational diabetes can be managed and you can expect to have a happy, healthy baby.

What does gestational diabetes mean for my baby?

If left undiagnosed or untreated, gestational diabetes can lead to high blood sugar levels. This increases the risk that your baby will weigh more than 4kg (9lbs) and will have a difficult delivery. Gestational diabetes can also increase the risk of your baby becoming overweight and developing Type 2 diabetes in the future. It is important to breastfeed immediately after delivery for at least four months, if you can, to help reduce the risk of obesity and diabetes for your baby.

What does gestational diabetes mean for me?

A diagnosis of gestational diabetes means you will be working closely with your health-care team to manage your blood sugar levels and keep them in the target range. This will help you avoid complications in labour and delivery. After your baby is born, blood sugar levels will usually return to normal. However, you are at greater risk for gestational diabetes in your next pregnancy and of developing Type 2 diabetes in the future. Achieving a healthy weight in the normal BMI range can help reduce this risk.

Risk factors for gestational diabetes

Being:

  • 35 years of age or older
  • From a high-risk group (African, Arab, Asian, Hispanic, Indigenous, or South Asian descent)

Using:

  • Corticosteroid medication

Having:

  • Being:
  • 35 years of age or older
  • From a high-risk group (African, Arab, Asian, Hispanic, Indigenous, or South Asian descent)
  • Using:
  • Corticosteroid medication
  • Having:
  • Given birth to a baby that weighed more than 4kg
  • Prediabetes
  • Gestational diabetes in a previous pregnancy
  • Obesity (BMI of 30kg/m2 or higher)
  • A parent, brother or sister with Type 2 diabetes
  • Polycystic ovary syndrome (PCOS) or acanthosis nigricans (darkened patches of skin)

How is gestational diabetes managed?

Choose a healthy diet
Ask your doctor to refer you to a registered dietitian to learn about healthy eating during pregnancy. Try eating low-glycemic index foods (e.g. whole grains, legumes), spread over three meals and two snacks to help manage your blood sugar.

Achieve a normal pregnancy weight gain
The amount of weight you gain will vary depending on your weight before your pregnancy. Weight loss is not recommended. Talk to your health-care provider about appropriate weight gain for you.

Be physically active
Regular physical activity can help control your blood sugar levels. It can also help you:

  1. Boost your energy
  2. Sleep better
  3. Reduce stress
  4. Reduce pregnancy discomfort
  5. Prepare for childbirth
  6. Get your body back faster after childbirth
    Talk to your health-care provider about the right type and amount of activity for you.

Check your blood sugar at home
Checking and tracking your blood sugar with a blood glucose meter will help you and your health-care team manage your gestational diabetes.

Take medication, if needed
Sometimes healthy eating and physical activity are not enough to manage blood sugar levels and your health-care provider may recommend insulin injections or pills for the duration of your pregnancy. Medication will help keep your blood sugar level within your target range. This will help to keep you and your baby in good health.

Your health-care team can answer your questions and support you through this important time in your life. Your team may include your doctor, nurse and dietitian, but remember: the most important member of your health-care team is you!

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? Contact Leanne via the Health Hotline on 0800 11 22 88 or email her directly on
healthhotline@pnp.co.za to start your nutrition conversation.

Photo by Ashton Mullins on Unsplash

Healthy eating resolutions

Now that the New Year is well and truly underway, what resolutions are you going to stick to when it comes to healthy eating? Pick n Pay’s dietician Leanne Kiezer suggests three simple resolutions – and gives examples on how to make them work.

1. Eat a healthy breakfast

Breakfast really is the most important meal of the day! Start your day with a satisfying breakfast that doesn’t spike your blood sugar, and you’re more likely to stay in range the whole day.

The perfect breakfast for a person with diabetes is made up of:

  • 1/4 plate high-fibre carbohydrates (unless you’re low carb)
  • 1/4 plate lean proteins
  • 1/2 plate vegetables and fruit
  • Small amount of healthy fats

Here’s a list of what you can choose from to build a healthy breakfast, and here are some healthy breakfast tips.

2. Pack lunch for work

We all know how tempting it can be to grab something unhealthy when we’re at work and hunger pangs strike… If you pack a lunch for work, you’re much less likely to snack on junk food, and more likely to stick to your healthy eating resolutions. Here are some tips on how to make the right food choices at work.

And here are some ideas for delicious lunchboxes!

  • A sandwich made with low GI bread filled with lean protein (cottage cheese / low-fat meat / tinned fish). Stuff with lettuce, tomato, cucumber and other salad.
  • Vegetable soup with 1 to 2 slices of low GI bread or a small wholewheat roll.
  • A picnic lunch with wholewheat crackers, hummus for a dip and cucumber chunks, carrots sticks, baby tomatoes or snap peas instead of a salad.
  • A salad made with lean protein (chicken or tuna) with very little dressing and no high fat toppings (croutons, bacon bits, cheese etc).

3. Fill half a plate with vegetables at dinner

Need a reminder on how to build balanced meals for healthy eating (don’t we all?!) The goal is to always fill half your dinner plate with vegetables or salad. That way, there’s less space for carbs! Also remember to have some healthy protein at every meal.

Here are some delicious diabetes-friendly dinner recipes to inspire you.

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? Contact Leanne via the Health Hotline on 0800 11 22 88 or email her directly on
healthhotline@pnp.co.za to start your nutrition conversation.

Photo by OLA Mishchenko on Unsplash

How to host a healthy festive meal

Eating over the festive season is part of the fun, but all your hard work to get in shape for summer shouldn’t be compensated by endless indulgent meals! This year, when you host family and friends, why not consider serving healthier versions of classic holiday dishes? Here are some ideas from Pick n Pay’s dietician Leanne Kiezer for how you can adapt your recipes so that they are more balanced, lower in fat and include plenty of vegetables and fruit.

For starters

  • Offer healthier snack options like lean biltong or chopped vegetable crudités with a reduced-fat hummus dip, or smoked salmon, cottage cheese and capers on cubes of low GI seed bread.

For mains

  • Choose a lean beef, pork or lamb roast, and bake or grill the meat on a rack so that the excess fat can drip off the meat.
  • Use a pastry brush to brush oil onto the meat, as pouring the oil causes you to use much more than you need.
  • Rather than a whole chicken with the skin intact, choose individual portions of skinless chicken breasts and thighs for roasting. Check out our Mediterranean-style Chicken Bake recipe – delicious.
  • Instead of bread crumbs, use rolled oats or crushed bran cereal for stuffing. Also add extra sautéed vegetables to your stuffing, like carrot, mushrooms, onion and celery.
  • If your holiday recipe calls for bacon, choose back bacon with its excess fat removed.
  • Choose one starch side dish like rice or sweet potatoes. If opting for rice, choose wild rice, brown rice or pearl barley which offers a source of fibre. If potatoes are your festive favourites, try our Grape, Goats Cheese and Red Onion Stuffed Sweet Potatoes rather than deep fried potatoes.
  • Make plenty of vegetable side dishes available (remember these should fill half your plate!), like this Ricotta, Walnut and Butternut Salad or Buttery Shredded Brussel Sprouts.
  • Use fat-free or low oil dressing and flavoured vinegars for salads, or make your own low-oil dressings at home.
  • For dips and sauces made from mayonnaise, rather use a mixture of low oil salad cream and plain low fat yoghurt.

For dessert

  • If your recipe calls for plain or cake flour, halve the amount and replace with wholewheat flour in baked goods.
  • Instead of cream, use low fat evaporated milk in recipes (although not suitable for whipping).
  • Substitute apple sauce for half of the shortening or oil in your recipe.
  • Use variations of plain yoghurt with fresh fruit slices for your desserts – the fruit adds natural sweetness to the recipe, so there is no need for added sugar.
  • Serve fruit canned in its own juices (with the juice drained), or fresh fruit with jelly and lite custard.

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? Contact Leanne via the Health Hotline on 0800 11 22 88 or email her directly on
healthhotline@pnp.co.za to start your nutrition conversation.

Photo by Lee Myungseong on Unsplash


Healthy festive season recipes

It’s mid-December, which means we’re all ready to kick back, relax and feast with our friends and family… But does December have to be decadent? Not with the right recipes! Leanne Kiezer, Pick n Pay’s dietician, has shared some delicious – and healthy – festive recipes with us. Here’s to happy holidays (and happy blood sugar!)

Mediterranean-style Chicken Bake

Mediterranean Chicken Bake

Serves 4
Ingredients

  • Non-stick cooking spray
  • 8 skinless chicken thighs, on the bone
  • Juice and zest of 1 lemon
  • Pinch of salt
  • 2 red onions, peeled and cut into crescents
  • 2 garlic cloves, sliced
  • 2.5 cups chicken stock
  • 1 cup wild rice
  • 250 g cocktail tomatoes
  • 10 Kalamata olives
  • 3 tbsp. oregano, chopped

Method

  • Preheat oven to 200 degrees
  • Grease a casserole dish with non-stick spray
  • Place chicken, lemon, salt, onion and garlic into the dish, and toss to combine
  • Roast for about 15 minutes
  • Add the remaining ingredients, and continue to roast for 25 minutes, or until cooked through
  • Scatter with oregano before serving

Grape, Goats Cheese and Red Onion Stuffed Sweet Potatoes

Stuffed sweet potatoes

Serves 4
Ingredients

  • 4 large sweet potatoes
  • 20 ml olive oil
  • Pinch of salt and pepper
  • 2 cups seedless red grapes
  • 1 sprig rosemary
  • 1 red onion, cut into wedges
  • 200g goats cheese

Method

  • Place sweet potatoes on a baking tray. Rub with oil, salt and pepper
  • Bake for 20 – 30 minutes until almost cooked through
  • Toss grapes, rosemary and onion on baking tray with sweet potatoes
  • Bake for 10 more minutes
  • Slit sweet potatoes down the middle and scoop out some flesh
  • Mash with half the goats cheese. Season, and spoon back into cavity
  • Top sweet potatoes with remaining goats cheese, grapes, onion and rosemary bits

Buttery Shredded Brussel Sprouts

Buttery shredded Brussel sprouts

Serves 4
Ingredients

  • 20ml canola oil
  • 300g Brussel sprouts, finely shredded
  • 5ml lemon zest
  • 50g pecan nuts, toasted
  • 100g Pecorino cheese, grated
  • Pinch of salt and pepper

Method

  • Heat oil in a large frying pan and fry Brussel sprouts until wilted
  • Toss through remaining ingredients and serve

Ricotta, Walnut and Butternut Salad

Serves 1
Salad ingredients

  • 150 g butternut cubes, roasted
  • 125 ml ricotta, crumbled
  • 30 g walnuts, toasted
  • 2 gem lettuce, shredded
  • 1 bulb fennel, finely sliced

Dressing ingredients

  • 5ml olive oil
  • 15ml balsamic vinegar

Method

  • Toss salad ingredients together
  • Whisk oil and vinegar together
  • Dress and season salad just before serving

Take a pic if you make any of these for your festive feast, and share it with us on Facebook! We’d love to see…


Easy tips for healthier eating

The festive season is nearly upon us! But never fear, we’ve asked Leanne Kiezer, the dietician at Pick n Pay, for some helpful tips for healthier eating during the holidays. It can be really tempting to throw good meal choices out the window when the temptations of the festive season roll round, but unfortunately your diabetes doesn’t take a holiday… Here are a few helpful suggestions for eating healthy without feeling like you’re missing out on all the treats!

Make healthier choices when eating out

 

Eating out does not have to sabotage your focus on healthy eating. Use these tips to keep you on track:

Build healthier meals

 

You can reduce the amount of fat, sugar and salt in a recipe without compromising on taste by using healthy substitutes:

Fat: For baked goods, use half the butter, margarine or oil suggested in the recipe and replace the other half with apple sauce or mashed banana.

Sugar: In most recipes, you can reduce sugar by a third to a half. Add spices like cinnamon, cloves, allspice and nutmeg or flavourings like vanilla and almond essence to enhance sweetness.

Sodium: Reduce salt by one-half in baked goods that don’t require yeast. For foods that do require yeast, don’t reduce the amount of salt as it is necessary for leavening.

Healthy substitutes

 

Healthy substitutes not only reduce the amount of fat, energy and sodium in your recipes, but can also boost the nutritional content.

Get more great advice on healthy eating by visiting Pick n Pay’s Health Corner, calling Leanne on 0800 11 22 88 or emailing healthhotline@pnp.co.za.

 

 

Diabetic-friendly foods with iron?

Brian has a question I haven’t heard before… Any advice?

I am a Type 2 diabetic and just recently I broke my hand in a freak accident.

To cut a long story short, the blood tests showed that I have a serious iron deficiency and I’m on a course of iron and Vitamin C supplements.

My question is: what foods contain iron that I can add to my diet?

Thanks!
– Brian

Understanding diabetes nutrition

Living with diabetes: Understanding diabetes nutrition

 

healthy diabetes nutrition

Did you know that the dietary guidelines recommended for people with diabetes are the same as those recommended for general health? That means you don’t need to prepare separate meals for yourself at home – your family can simply adopt your healthy habits!

10 helpful tips for a healthy diabetes diet

 

Follow these 10 tips each day to promote a balanced and healthy meal plan to help manage your blood glucose levels:

  1. Eat at least three balanced, regular meals each day, incorporating a variety of different foods.
  2. While your healthy meal plan does allow for a small amount of sugar found naturally in many foods, avoid excess sugar and refined carbohydrates, as these promote poor blood glucose control.
  3. Include small servings of high-fibre carbohydrate foods, such as oats, bran cereals, brown rice, sweet potato, baby potatoes, wholewheat pasta, seed loaf, beans and lentils.
  4. Aim to eat at least three servings of vegetables and two to three servings of fruit every day.
  5. Include a portion of lean protein into each of your meals to help improve blood glucose control.
  6. Lose weight, if necessary. A weight loss of as little as 5 to 10% of your body weight can dramatically improve your blood glucose control.
  7. Cut back on saturated fats, such as butter, chicken skin, high-fat dairy products, fat on meat
    and processed meats, like sausage and boerewors.
  8. Use healthier monounsaturated fats such as olive oil, canola oil, avocado, nuts and peanut butter.
  9. Eat fish, especially oily fish like sardines, pilchards, mackerel and salmon, at least twice a week.
  10. Use salt sparingly, as excessive salt intake can lead to high blood pressure and heart disease.

Not sure what meal plan to follow? You can consult with a registered dietitian to compile an individualised meal plan specific to your needs, taking into account your food preferences, level of physical activity and lifestyle.

Eating for diabetes

 

Here’s a helpful guideline to illustrate what a balanced meal should look like, and how to divide up your plate. Aim for 1/4 plate high-fibre carbohydrates, 1/4 plate good quality proteins and 1/2 plate vegetables. Eat fruit in moderation, small amounts of healthy fats and some dairy.

Building balanced meals

Looking for delicious diabetes-friendly recipe ideas? Check out our free Sweet Life Pick n Pay Diabetes Cookbook!

This information was brought to you by www.picknpay.co.za

Pick n Pay is committed to promoting health and wellbeing among South Africans and employs the services of a registered dietician to provide food and nutrition related advice to the public. For your nutrition and health related queries, contact healthhotline@pnp.co.za or toll free on 0800 11 22 88

For more fantastic information on diabetes and nutrition, visit Pick n Pay’s Health Corner.

 

Photo by Anna Pelzer on Unsplash

What is diabetes?

If you’re newly diagnosed or looking to explain diabetes to friends and family, it can be helpful to have a breakdown of what exactly diabetes is, and how it affects the body. Pick n Pay dietician, Leanne Kiezer, breaks it down for us.

Understanding diabetes

Want to know how diabetes works in the body? Here’s a simple explanation.

It all starts with food.  The carbohydrates you eat get broken down into glucose, a type of sugar. This glucose is absorbed into the bloodstream, and becomes known as blood glucose. The release of the hormone insulin from your pancreas allows the glucose to pass from your blood stream into your cells to produce energy for the body. In this way, the insulin helps to regulate your blood glucose levels and allows your body to use the energy from carbohydrates.

In people with diabetes, the body produces too little or no insulin or the body is not able to use its insulin properly. This means that the process of allowing glucose to pass from your bloodstream to your cells for energy is hindered. As a result, glucose accumulates in the blood, causing blood glucose levels to rise. Over time, high blood glucose levels can cause damage to kidneys, eyes, nerves and the heart.

The good news is that with the right treatment plan, diabetes can be managed, allowing you to live a long, healthy, active life. The first step is to develop a treatment plan with your lifestyle in mind. Consulting with a team of healthcare providers, such as a doctor, diabetes educator and dietitian will help you to master the four key areas for managing your health and diabetes: Exercise, Healthy Eating, Medication and Monitoring.

Pick n Pay dietician explains diabetesInformation provided by Pick n Pay dietician, Leanne Kiezer

Types of diabetes

There are three types of diabetes:

Type 1 Diabetes

Accounting for 5 – 10% of diabetes cases, this is an autoimmune condition, in which the body turns on itself and destroys the cells of the pancreas that produce insulin.  A combination of daily insulin and a carefully developed eating plan is required for its management.

Type 2 Diabetes

Accounting for 90 – 95% of cases, this is a complex and progressive disorder where a relative lack of insulin occurs together with resistance to insulin action. Occurring most often in people who are overweight, the first step to managing this type of diabetes is lifestyle change, through exercising, healthy eating and promotion of weight loss. As the condition progresses, oral tablets and insulin injections may be required.

Gestational diabetes (GDM)

GDM is a form of diabetes first diagnosed during pregnancy. GDM usually disappears after pregnancy, but women with GDM and their children are at an increased risk of developing Type 2 diabetes later in life.

Get screened

Early detection of diabetes is important, as the longer your body is exposed to high blood glucose levels, the more damage it could do. Some people with Type 2 diabetes have no outward signs associated with high blood glucose levels, so testing your blood glucose level is the only way to be sure. To screen for diabetes, a finger-prick blood test is used – go to your nearest clinic or pharmacy for this quick, painless test.

This information was brought to you by www.picknpay.co.za

Pick n Pay is committed to promoting health and wellbeing among South Africans and employs the services of a registered dietician to provide food and nutrition related advice to the public. For your nutrition and health related queries, contact healthhotline@pnp.co.za or toll free on 0800 11 22 88

For more fantastic information on diabetes and nutrition, visit Pick n Pay’s Health Corner.

Diabetes dinner recipes

Not sure what to make for dinner? Let us help! Check out our delicious free diabetes-friendly recipes to get ideas for dinner that are tasty, healthy and good for people with diabetes (and all those without diabetes!)

healthy diabetes dinner

You’ll find recipes for:

  • Spinach and Leek Pie
  • Grilled Boerie, Cauli Mash and Relish
  • Korean Beef Lettuce Wraps
  • Baba Ganoush with Tortilla Crisps
  • Guilt-free Baked Chicken
  • Hearty Beef and Bean Soup
  • Delicious Chicken Barley Salad

Download your diabetes-friendly recipes here.

All with nutritional information to ensure you know the carbohydrate count, protein and fibre in each dish.

Looking for a specific diabetes recipe? Let us know!

And don’t forget to check out our free diabetes cookbook, which you can read online or download and print out.

Here’s to healthy, delicious, diabetes-friendly meals!

 

The carbs-fat-protein debate

Ask the dietician: Genevieve Jardine

From the community: “I don’t understand the whole ‘low carbs high fat or high protein’ idea – how do carbs, fat and protein work together? Is there a happy middle ground, or does it need to be all or nothing?” Wessel Jones

To understand what all the fuss is about, we need to look at the history of diabetes treatment. Treating diabetes (both Type 1 and Type 2) by lowering carbohydrates (carbs) has come and gone out of fashion over the last century. This debate is not a new one and it is probably not going to go away.

Before the invention of insulin, the only way for a diabetic to survive was to cut out the foods (carbs) affecting blood glucose. With the advent of insulin, the focus switched from lowering carbs to lowering fat to help reduce heart disease. Fast forward a couple of decades and we can see that we have failed in reducing obesity, diabetes or heart disease. It’s not as simple as just diet: it’s about physical activity, stress, diet and environment.

How do carbs work in the body?

What is quite simple is that carbs cause blood sugar to rise and the more carbs you eat, the higher the blood sugar goes. If a person wants to control their blood sugar, it’s a very good idea to reduce carbs. The big question is: how low do you go? A “low carbohydrate diet” can have anything from 20g to 130g of carbohydrate per day.

Remember: One portion of carb (a medium apple, a slice of bread) = 15g carb

The amount of carbs depends on the individual, their control, their medication and their weight. There is a growing amount of scientific evidence that low carb diets improve glucose control and help with weight loss.

Where do fat and protein fit in?

When carbs are cut, the amount of protein or fat (or both) go up. And this is where the debate heats up. The concern is not the low carb, but the increase in saturated fat or fat in general. Remember that not all fat is the enemy and there are good fats that play a very important role in the body.

A benefit of protein and fat is that in the immediate, they do not cause the same spikes in blood sugar. When you lower carb intake you have an immediate blood sugar lowering effect. When this happens, and you have fewer spikes and dips in blood sugar, your appetite is better controlled. The fuller you feel, the less likely you are to snack and the fewer kilojoules you consume. The fewer kilojoules you consume, the more likely you are to lose weight.

The problem with the low carb approach is that, like everything else, it needs to be a lifestyle. When you add carbs back into your diet you will put on weight, especially if you have increased your fat and/or protein. You can’t have it all: full fat products and also carbs. The most important goal is to increase your vegetable intake and try to eat as close to nature as possible. Eat foods in their most original form.

When it comes to deciding on the right ratio of carbs : fat : protein, work with a dietician. It may take time to find your correct balance and you need to be monitored properly with blood tests and possible medication adjustments.

Making the right food choices (at work)

Ask the dietician: Cheryl Meyer

From our community: “I get invited to lots of business meetings and workshops that are catered… Needless to say, none of the catering is healthy! What do I choose or how do I deal with this situation?” Rene Prinsloo.
Many of us consume at least half of our meals and snacks during work hours, which makes our food choices in catered meetings and workshops very important. Here are three steps to consider:

Step 1: Build your plate

  1. Aim to fill half your plate with vegetables or salad. Look out for vegetable skewers, veggie sides, crudités (chopped raw veg), soup or salads.
  2. Next, add a healthy carbohydrate: either a wholegrain/high fibre starch or a piece of fruit.

Look out for:

  • Wholewheat bread
  • A seeded roll
  • Wholewheat pita
  • Wholewheat pasta/noodles
  • Wholewheat wrap
  • Brown or basmati rice
  • Fresh fruit
  1. For long-lasting brain and body power, add a source of protein.

Some good protein choices:

  • Lean cold meats
  • Grilled chicken
  • Mini meatballs
  • Legumes like beans or lentils
  • Fish like tuna, sardines or pilchards
  • Cottage cheese
  • Boiled eggs

Sauces like low-fat mayonnaise, sweet chilli sauce, hummus or guacamole are optional but not essential.

Avoid:

  • Deep-fried foods (like samoosas, spring rolls or vetkoek)
  • Sausage rolls and pies
  • Croissants, muffins or other pastries

Step 2: Choose portions with caution

  1. Be sure to start the day with a balanced breakfast and keep healthy snacks or a packed lunch on hand to avoid arriving at a meeting hungry.
  2. Use smaller plates and serving utensils to help manage how much you dish up.
  3. Sit far away from the food to avoid “picking”.
  4. Use the size of your hand to determine sensible and healthy portion sizes and curb overeating:
  • A fistful is equal to one cup and can be used to estimate the portion size for carbohydrates (starches and fruits).
  • The size of the palm of your hand can be used to estimate the portion size for protein. For a stew, curry or casserole this would be about half a cup.
  • The tip of the thumb is equivalent to one teaspoon and can be used to estimate the portion size for all oils, butter or mayonnaise.
  • The thumb can also be used to estimate the portion size for peanut butter or hard cheese.

Step 3: Carefully consider your choice of drink:

Some good choices are:

  • Still or sparkling water
  • Tea or coffee
  • Vegetable juice
  • Low-fat milk
  • Sugar-free fizzy drinks

Diabetes-friendly kids menu

Ask the dietician: Genevieve Jardine

From our community: As the mom of a diabetic child, I’m constantly wondering what to make her that is delicious but won’t spike her blood sugar. Could you give me some basic guidelines please?” Bernadette Simons.

As a mother of three (constantly hungry) young boys I am kept on my toes when it comes to healthy eating. Although my children are not diabetic, I practice “diabetes-friendly” eating in my household. The bottom line is that you want your children to eat real, whole foods. This means no foods that are manufactured, processed and refined: time for a cupboard clear-out!

For children with diabetes, you need to make meals novel, colourful and exciting, while reducing refined carbohydrates and harmful fats. It’s important to break away from the rut of cereal for breakfast, sandwich for lunch and one-pot meal for dinner. Parents need to constantly focus on increasing fresh foods and not wait for dinner to try and make up the daily vegetable intake…
Here are some menu options:

Breakfast:

  • Bring back eggs for breakfast! Make eggs more interesting and nutritious by adding vegetables and baking in a muffin tray as mini crustless quiches. Serve with chopped strawberries or other brightly coloured fruit.
  • Try making your own cereal out of nuts and seeds, coconut shavings and some rolled oats. This can be eaten with plain yoghurt or milk. Use vanilla, cinnamon and half a grated apple to sweeten it naturally.

Lunchboxes:

  • Move away from a daily sandwich for lunch. Try choosing other low GI starch like baby potatoes or corn on the cob.
  • Add some protein – chicken drumsticks, hard-boiled eggs, meatballs, homemade fish cakes or cheese. Remember protein makes you feel fuller for longer and doesn’t spike blood sugar levels.
  • Add a small amount of colourful fruit like a fruit kebab or fruit salad.
  • All lunchboxes should have vegetables! If your child doesn’t like salad, give some cucumber and carrot sticks, baby tomato kebabs or cucumber sandwiches (two slices of cucumber with cheese or cream cheese in the middle).

Dinner:

  • Most traditional South African dinners are one-pot meals like curry, stew, cottage pie or spaghetti bolognaise that are high in starch and low in vegetables. Try adding more vegetables to stew, curries and mince. Make the mashed potatoes with added cauliflower, add lentils to brown rice, and use baby marrow or aubergine instead of pasta.
  • Always serve dinner with vegetables on the side. Raw carrot sticks, sliced cucumber or snap peas are kid-friendly. Children need to get used to eating vegetables that are not hidden in food but out in plain sight!

Remember: Children learn eating habits from their parents so you need to set the example. Tastebuds are influenced early on by processed foods with hidden sugars and fats, so it’s up to you to encourage your kids to eat – and love – real food.

Top tips for a pregnancy diet

Ask the dietician: Cheryl Meyer

From the community: “Being both diabetic and pregnant makes it difficult to know what to eat – there are so many things I have to avoid! And I’ve been craving sweet things. Any advice?” Sameshnie Naidoo.

The diet for pregnant women with diabetes should be a healthy, well-balanced eating plan aimed at supporting the pregnancy and promoting blood sugar control. This is essential for the wellbeing of both mom and baby.

Of course, pregnancy and diabetes means that there are more foods on the “Do Not Eat” list, as your normal diabetic diet has a new list of things to avoid. But bear in mind that it’s only for nine months, and that it’s for the best possible cause: your healthy child.

Foods to avoid:

Here’s a list of foods that you shouldn’t eat when you’re pregnant because they pose a potential food safety risk and might make you ill or harm your baby.

  • Soft cheeses e.g. brie, camembert, and blue-veined cheeses unless the label says they are made with pasteurised milk.
  • Processed cold meats or deli meats unless they are reheated until steaming hot.
  • Refrigerated paté or meat spreads (canned options can be eaten).
  • Refrigerated smoked seafood unless as an ingredient in a cooked dish e.g. a casserole.
  • Raw or partially cooked eggs and dishes that contain these e.g. homemade mayonnaise.
  • Raw or undercooked meat and poultry
  • Unpasteurised juice
  • Raw sprouts
  • Raw or undercooked fish or shellfish
  • The American Academy of Nutrition and Dietetics (AND) recommends pregnant women avoid fish high in mercury e.g. shark, swordfish, marlin. And limit intake of fish and shellfish lower in mercury e.g. prawns, canned light tuna and salmon, to 360g or less per week.

The good news? You don’t need to give up caffeine entirely. The AND recommends keeping your intake below 300mg/day, which is about one or two servings of coffee or tea. And of course rooibos is naturally caffeine free, so you can have as much as you like!

Being both diabetic and pregnant can feel restrictive from a diet point of view… When you’re lacking motivation, just remember that everything you eat your baby is eating too: so put down the junk food and pick up a carrot!

A note on cravings:

Whether it’s pickles and ice cream or other odd combinations, both cravings and food aversions are common during pregnancy. Although the exact cause is unknown, taste perceptions may change with hormonal changes. Cravings are generally harmless*, unless foods you crave replace more nutritious foods, or all you want is junk food. If broccoli loses its appeal, for example, substitute another vegetable that you enjoy and tolerate.

*Cravings for non-food substances like sand or chalk (a condition called pica) can be dangerous as they contain lead or other toxic substances. If you’re craving non-food items, consult your doctor.

The low carb diabetic pantry

Ask the dietician: Keri Strachan

We recently published an article called The basic diabetic pantry, which focuses on a dietary pattern rich in wholegrains / high fibre grains and starches, fruits, vegetables, legumes and nuts; moderate in alcohol consumption; and lower in refined grains, red/processed meats and sugar-sweetened beverages.

Some of our readers asked if we could provide the low carb alternative to the diabetic pantry, so here it is!

Low carb pantry guidelines

When you start a low carb lifestyle, you’ll be struck by how you no longer visit certain parts of the supermarket, only the areas of fresh produce, and limited packaged items. When buying real food there is no need for a label, but there are some that are still worth checking: this will help you to identify which brands are better than others to suit your needs.

Buy basic food ingredients and cook from scratch and you are unlikely to be fooled into hidden carbs sneaking in. Here’s a basic list of what to eat:

Protein

  • Meat (beef, pork, lamb)
  • Fish (especially omega-3 rich such as sardines, pilchards, salmon, fresh tuna, salmon, trout)
  • Free-range eggs
  • Cheese
  • Chicken

Vegetables and fruit

  • Low carb veggies, excluding butternut, all potatoes, peas and corn
  • Low carb nutrient dense fruit such as berries

Dairy

  • Full-cream milk
  • Full or double-cream plain yoghurt (but in limited amount due to natural carb content)

Nuts and seeds

  • Almonds
  • Macadamia nuts
  • Walnuts
  • Pecans
  • Sunflower seeds
  • Pumpkin seeds
  • Linseeds
  • Sesame seeds

Natural fats

  • Olive oil (not for cooking)
  • Olives
  • Avocado
  • Macadamia nut oil
  • Coconut oil and cream
  • Cream
  • Butter
  • Lard (no vegetable oils)

Other items:

  • Olives
  • Canned tomatoes
  • Tomato paste
  • Almond flour and coconut flour (but avoid replica foods too often, they are not as low carb as you think)
  • Stevia, erythritol (but try to avoid sweetness)
  • Cocoa
  • Coconut flakes/ desiccated coconut
  • Salt
  • Pure herbs and spices e.g. paprika, turmeric, cayenne pepper, cumin, rosemary, basil, thyme, parsley
  • Vinegar
  • Mayonnaise made from non-vegetable oil e.g. macadamia, avocado
  • Fresh herbs (rocket, basil, origanum)

Remember a few tips:

  • Do not snack!
  • Get enough fat to replace your carbs, and ensure that you last between meals without snacking
  • Avoid over-eating protein
  • Bulk meals with boldly colourful vegetables, herbs and spices
  • Drink mostly water, limit milk through hot drinks

 

Sundowner snacks

Ask the dietician: Genevieve Jardine

From the community: “My wife and I love having friends over for sundowners but never know what drinks to offer and what snacks to serve so that I can actually enjoy myself too. Any advice?” Riyaaz Benjamin.

Luckily, there is a way to enjoy (guilt-free) sundowners… It just takes a little planning. Let’s take a look at the when, what and where of it.

When?

The main problem with sundowners lies with the timing. As the name suggests, they usually occur long after lunch and just before supper. This means that you may arrive hungry and tired with low blood sugar levels: a recipe for overeating, drinking (sugary) alcohol on an empty stomach, and filling up on unhealthy snack food. After sundowners, you may then go for supper, which means even more food and alcohol.

The key? Sundowners are best handled when prepared. Make sure you have an afternoon snack just before arriving (preferably one that contains protein to help stabilise blood sugar levels). Upfront, decide to either have the snacks as a replacement dinner (only a good idea if there are healthy snack options) or hold back and leave room for a light supper.

What?

What is being dished up? The good news is that sundowner snacks are usually savoury and not sweet. The bad news is that savoury snacks – like chips and cream dip, sausage rolls and salty peanuts – are often high in starch and fat. Try to choose the healthiest options on the table, and don’t forget to dish up a plate rather than snacking so that you know exactly how much you’re eating.

Sundowners are also synonymous with cocktails (not the right choice of drink for anyone with diabetes!) When it comes to alcohol, good options are light beer, a wine spritzer made with Sprite Zero or soda water, or single spirit tots with diet mixers. Sparkling water with ice, lemon and cucumber is a refreshing drink if you’re not in the mood for alcohol.

Healthy snack ideas:

  • Lean proteins like nuts, lean biltong and grilled strips of chicken or beef.
  • Fresh vegetables like cucumber strips, baby carrots, baby tomatoes and celery sticks, served with a low-fat cottage cheese, avo or salsa dip.

Where?

The last thing to consider is where the sundowners are being held. If you’re hosting or going to a friend’s house, you can simply bring along what you would prefer to eat and drink. Restaurants can be more challenging, but easily overcome with a bit of forward planning. Call the restaurant beforehand and make sure that there are snacks or drinks on hand that you can enjoy. Most restaurants are more than willing to help – if not, at least you know and can plan for the evening.

Having diabetes doesn’t mean you can’t enjoy a cold drink and a delicious snack as the sun goes down, it just means you need to forward plan a little to enjoy it!

The basic diabetic pantry

Ask the dietician: Cheryl Meyer

From our community: “I’ve just been diagnosed and have no idea what to eat. Please help me! I just need some basic ideas of what to keep in my cupboard so I can make easy healthy meals…” John Tabenga.

Stocking your pantry is a fantastic place to start – healthy eating isn’t only about your kitchen, it begins when you wheel your trolley down the aisles of your local supermarket. Arming yourself with a well-planned grocery list will not only get you in and out of the shops quickly, it will also keep your healthy eating plan on track.

To help get you started I have put together a basic list to help you stock your fridge, freezer and pantry with healthy options:

Breakfast cereals

  • Oat bran
  • Rolled oats
  • Low GI muesli

Cooked starches

  • Baby potatoes
  • Sweet potatoes
  • Wholewheat pasta
  • Brown rice
  • Barley
  • Quinoa
  • Mealies
  • Corn: frozen, canned or fresh

Breads & crackers

  • Rye, wholewheat or low GI bread
  • Wholegrain crackers: Provitas, Ryvitas, Finn Crisp
  • Multigrain melba toast
  • Wholewheat wraps
  • Wholewheat pita bread

Legumes

  • Canned beans, lentils and chickpeas (drain and rinse well)
  • Dried beans, lentils and chickpeas

Dairy products

  • Low-fat milk
  • Low-fat yoghurt
  • Low-fat cottage cheese
  • Ricotta cheese
  • Hard cheeses: mozzarella or reduced fat cheddar

Tip: When choosing hard cheese, aim for less that 25g fat per 100g.

Meat, poultry, fish & eggs

  • Lean beef and pork, trimmed of fat
  • Chicken, trimmed of skin
  • Ostrich
  • Lean cold meats
  • Eggs
  • Fish rich in omega 3s: Fresh, frozen or tinned salmon, trout, tuna, pilchards, sardines, mackerel
  • Hake or kingklip fillets

Fats and oils

  • Olive / canola / avocado oil
  • Seeds
  • Unsalted nuts
  • Peanut butter
  • Avocado
  • Low oil dressings and mayonnaise (less than 5g fat per 100g)

Vegetables

  • Frozen vegetables: green beans, peas, carrots, cauliflower, broccoli.
  • Fresh vegetables
  • Tinned tomato
  • Tinned asparagus

Fruit

  • A variety of fresh fruit
  • Pre-cut frozen fruit
  • Canned fruit (in juice) for treats

Spreads

  • Hummus
  • Tzatziki
  • Olive oil

Snacks

  • Unsalted nuts
  • Lean or game biltong
  • Popcorn kernels to prepare homemade popcorn with a dash of oil and salt

Store cupboard basics

  • Non-stick cooking spray: Spray n Cook
  • Beef, chicken and vegetable stock powder
  • Lots of herbs and spices

Tip: Read food labels and compare different brands within each food category.

With these pantry essentials, you should be able to whip up all kinds of delicious diabetic-friendly meals… Check out our recipes here if you’re looking for inspiration!

 

“Cheat” treats


Ask the dietician: Genevieve Jardine

From our community: “I know that as a diabetic I should always try and be good, but sometimes it’s hard… What can I snack on without feeling too guilty about it (but that will also be a treat)?” Charne Smith.

A treat is something that tastes great, is normally high in fat and refined carbohydrate, and is eaten to either celebrate or make you feel better… But how do you have your treat and prevent it from totally messing up your blood sugar levels for the day?

Treats are not forbidden, but they should not be too often or too big. It all comes down to self-control and portion control. The occasional block or two of chocolate should not mean disaster for your blood sugar: it’s when you eat the whole slab that things spiral out of control. Everything in moderation is the key.

If you battle with cravings, you need to understand that the last bite never tastes as good as the first bite. The feel good rush you get from the first bite of a treat starts to fade as you continue eating, but your blood sugar levels start to increase.

What does this mean? You only need a small amount to feel like you’ve had a treat. You don’t need the whole slab, packet, bowl or slice…

How to cheat:

  • Split a dessert with your partner. It might drive them nuts, but it will keep your blood sugar and weight down. Better yet, plan ahead and choose a light main course so that you can have a small dessert on those special evenings out.
  • Choose biscuits and cakes that don’t have icing, or remove the icing and jam from cakes. Icing has twice the amount of sugar as the cake or biscuit.
  • Choose a dessert like apple crumble (without the ice-cream or cream) or two small scoops of ice-cream. Just remember to keep portions small.
  • Spoil yourself with some good diabetic-friendly ice-cream (low fat/low sugar), lite custard and diabetic friendly puddings.
  • Opt for small “bite” sized chocolates or chocolates with wafer inside (e.g. Kit Kat Fingers).
  • Dark chocolate with a high percentage of cocoa is better for you as it is higher in antioxidants. Dark chocolate is also bitter so people tend to eat less of it: usually a block or two is enough.
  • Salt and vinegar popcorn instead of crisps will keep your fat content low and help with salt cravings. When going to the movies, choose a small popcorn and a diet drink.

Remember: Spoiling yourself on the odd occasion is allowed. Always test your blood sugar levels to see how they react and you will learn to better control these situations.

10 FAQ about the diabetic diet

Ask the dietician: Cheryl Meyer

We asked our community what they most wanted to know about diabetes and food – here are 10 frequently asked questions, answered by our expert dietician.

  1. Must I cut sugar out of my diet completely?

Small amounts of sugar can be included in your diet, but too much sugar or sweet food is not recommended as part of a healthy eating pattern.

  1. What can I eat when I feel like chocolate?

Treats like chocolate can fit into a healthy diet, as long as you keep these points in mind:

  • Try to have treats with a meal, e.g. as a dessert.
  • Watch your portion size: choose a small portion or share.
  • Put a healthy twist on treats – check out these great recipes for ideas
  1. Do I have to buy special sugar replacements, or can I just use less sugar?

Small amounts of sugar, jam, and honey have little effect on blood glucose levels, so small amounts of sugar can be included in your diet, e.g. a scrape of jam on wholewheat bread.

  1. How important is fibre in a diabetic’s diet?

Fibre keeps your digestive tract working well, can help lower your cholesterol level and can improve blood glucose control if eaten in large amounts. Another benefit of fibre is that it adds bulk to help make you feel full. Given these benefits, fibre is important to include in a diabetic’s daily diet – and in the diets of those who don’t have diabetes!

  1. How many vegetables should I be eating in a day?

The amount of vegetables you need depends on your age, gender and level of physical activity. On average, an adult woman will need 2½ cups a day, while an adult man will need 3 cups, and children will need between 1 to 2 cups a day.

  1. How much protein do I need to balance out carbohydrate?

Protein should account for about 15 to 20% of the total calories you eat each day – roughly a fist-sized portion at each meal.

  1. Is too much fruit bad for diabetics? And grapefruit?

Fruit (any kind, grapefruit included) can be included as part of your diet, but controlling portion size is vital. Limit your portions to a fist-sized or tennis-ball sized portion at a time.

  1. How do I manage food for my diabetic child?

Provide structured, nutritious meals and snacks for your child and make healthy eating and lifestyle changes as a family (don’t single out one family member). Remember that they are a child first and a diabetic second. Work with your child’s diabetes health care team to help your little one grow up healthy and happy!

  1. My sugar is always high – am I eating wrong?

Diabetes is managed with diet, exercise, tablets and/or injections. Check in with your doctor to make sure your food choices, exercise levels and medication are on track to keep your sugar within your target range.

  1. How can a diabetic lose weight in a healthy way?

The best way to lose weight for good is to find an approach to eating that makes sense, doesn’t cut out whole food groups and has you eating regularly and feeling well.