Ask the Dietician

“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.

 

Proudly South African portion sizes

Ask the dietician: Cheryl Meyer

From our community: “Can anyone tell me about madumbis for diabetics – good or bad for us, and how much can we eat?” Lynette Hitchcock.

Madumbis, amadumbe, African potato or taro – call them what you will, they are delicious! They have a rich, nutty, earthy flavour and a stickier texture than potatoes. Like potatoes, they fall into the carbohydrate group of foods and can be roasted, mashed or boiled.

The key to eating proudly South African carbohydrates like madumbis, roti, pap or samp in a healthy diabetic diet is portion control! Counting the carbs in your meals and being aware of the carbs you eat can help you match your medication or activity to the food you eat. This can lead to better blood sugar control.

Remember: Everyone needs a different amount of carbohydrate at each meal and/or snack – the amount that is best for you depends on your:

  • age
  • height
  • weight
  • physical activity
  • current blood sugar
  • blood sugar targets

Not sure how many carbs you should be eating? Ask your doctor or dietician for help.

A general guide:
  Carb limits for women Carb limits for men
Meal 30 – 60g 45 – 75g
Snack 15 – 30g 15 – 30g

What does this mean? A food that has 15g carbohydrate is called “one carb serving”. One slice of bread or a small piece of fruit each have around 15g carbohydrate, so they are equal to one carb serving.

One carb portions of Proudly South African foods:

1 carb serving 50g madumbi
1 small roti (35g)
⅓ cup pap (60g)
⅓ cup samp (75g)
½ cup sweet potato (100g)
1 medium mielie (140g )
½ cup rice (50g)
1 x 15cm tortilla or wrap (35g)
½ cup pasta (100g)
1 slice bread (30g)
1 small apple (115g)

As much as possible, try to stick to this portion size, with a serving of protein (meat, fish, chicken, eggs, beans) and half a plate of vegetables or salad.

How to cook amadumbe: Scrub them clean and steam or boil until soft. Drain and cool slightly before removing the skins. Serve dusted with black pepper, a dash of salt and a drizzle of olive oil. Yum!

Amadumbe in numbers:
100g portion boiled amadumbe has: *

  • 600 kJ
  • 5g plant protein
  • 1g fat
  • 5g of carbohydrate
  • 1g fibre

* According to The SA Food Tables

“Junk” food for diabetics

Ask the dietician: Genevieve Jardine

From our community: “My favourite food isn’t very good for me… I love braais and chips, hamburgers and hot dogs. Is there any way to make these delicious foods better for me? Help!” Thabo Duma.

All of us like a bit of pleasure in life, and nothing beats a treat now and again. The attraction of junk food lies in its “quick fix” ability to satisfy food cravings. Unfortunately, what makes junk food so delicious is also what makes it unhealthy. Junk food tends to be high in kilojoules, bad fats and refined carbohydrates. Because it tastes so good, it’s also hard to stop eating. You may get away with one biscuit, but 4 or 5 will cause a significant increase in blood sugar.

When relaxing with family and friends, you want to be able to enjoy holiday food: take-outs, braais and easy meals. There are definitely ways to enjoy these times without feeling left out – and without packing on the extra kilograms!

Healthy take-out

For take-out options, choose grilled chicken breast or beef hamburgers with salad (no chips!) Or try grilled chicken breast, spicy rice, coleslaw and green salad. Choose water or a diet fizzy drink to go with your meal, and obviously skip the dessert. Try to avoid food that’s high in fat and refined starch and sugar – pizza, deep fried chips and sugary drinks are all a bad idea.

Braai menu

Who said a braai couldn’t be healthy? Bring chicken or beef kebabs and braaied corn on the cob, with carrot salad and green salad on the side. These are a much better choice, and much lower in fat and carbs than boerewors and chops, garlic bread, pap and gravy or white bread rolls. And they’re delicious!

If you’re looking for delicious snacks, here are some yummy diabetic-friendly options:

Snack Portion Energy Carbohydrate (including sugar) Fat
Popcorn (lite) 2 cups popped 636kj 15g* 7g
Dried fruit 2-4 pieces 381kj 21g 0g
Low GI biscuit 1 biscuit (30g) 440kj 15.3g 5.8g
Lean biltong Handful (30g) 346kj 1g 2g

* Remember that one carbohydrate portion = 15g.

Compare those to regular snacks and you’ll see the difference:

Snack Portion Energy Carbohydrate (including sugar) Fat
Chocolate 1 bar (50g) 1120kj 30g 15g
Energy bar 1 bar (40g) 739kj 22g 7g
Biscuits (with icing) 2 biscuits (33g) 676kj 30g 7g
Sweets (boiled) 125g packet 316kj 18g 0g
Potato crisps 1 packet (30g) 766kj 24g 12g

 

The best diabetes-friendly drinks

Ask the dietician: Genevieve Jardine

From our community: “My daughter is on insulin injections and can’t inject for every cold drink she wants. Everybody says aspartame is bad for you, so what can she drink except water?” Di-ann Reid.

A lot of the excess sugar in our diet comes from drinks that are high in sucrose and fructose: regular fizzy drinks, energy drinks and also fruit juices. These not only have an effect on blood sugar, but also increase overall energy intake, which can lead to weight gain. That’s why these drinks aren’t a good idea for diabetics.

So what else can you drink?

Artificially sweetened diet drinks
These are pretty much kilojoule free and don’t raise blood sugar levels, but most of them contain aspartame – the topic of a lot of debate for many years. Although aspartame has been linked to increased risk of cancer, mood disorders and even diabetes, nothing has been proven and the FDA (Food and Drug Administration) has approved diet drinks with aspartame, with a limited daily intake. So it’s a good idea to reduce the number of artificially sweetened drinks you have, especially if you’re using other sweeteners in tea and coffee.

Fruit juices
These often confuse people with diabetes, because they say “no sugar added” on the label. Although there is no added sugar, fruit juices are high in fructose sugar that can push up blood glucose levels. They are a concentrated form of natural sugar from the fruit – you get all the sugar, but none of the fibre that’s good for you. A small glass of fruit juice can have twice as much sugar as a piece of fruit!

Tip: When looking at food labels, always check the total carbohydrate content (per serving size) and not just the sugar content.

Here are some ideas for drinks with and without artificial sweeteners:

One-a-day drinks – low carb, with artificial sweeteners

  • Diet fizzy drinks (Tab, Coke Light, Coke Zero, Sprite Zero, Fanta Zero etc.)
  • Diet cordials (Brookes Low-Cal etc.)
  • Light iced teas (Lipton Iced Tea Lite etc.)
  • Light flavoured mineral water (aQuelle Lite etc.)

Everyday drinks – low carb, no artificial sweeteners

  • Freshly squeezed lemon juice in ice-cold water.
  • Hot or cold flavoured herbal teas (no sugar added).
  • All unflavoured sparkling water.
  • Chopped up fruit pieces (like strawberries, lemon or orange) soaked in water for the fruity flavour without the sugar.

Treat drinks – medium carb

These drinks have 6 to 8g of carbohydrate per serving – half the amount of normal drinks!

  • 200ml tomato juice (low GI).
  • 150ml Lamberti’s low GI juice.
  • 100ml Energade Champ (low GI).

Quick diabetes-friendly food

Ask the dietician: Genevieve Jardine

From our community: “I find myself worrying about food a lot, as a diabetic… What are the essentials I should always have on hand for healthy lunches or quick food on the go?” Kriveshen Moodley.

Life is busy, with many demands that distract us from healthy eating. So how do we make good food choices? It starts with the right attitude and being prepared. As a diabetic, it’s important to remember that food is part of your treatment, so it needs to be a priority – but it doesn’t need to be hard.

Some helpful tips for simplifying food choices:

  • Plan meals for the week and do a big weekly shop.
  • Take a bag full of fresh food to work on Monday morning to use as lunch for the week.
  • Keep healthy snacks stashed in your car.
  • Have a back-up meal replacement drink for those times you don’t have time to eat.

Breakfast ideas:

Great tip: Wake up earlier so that you have time for breakfast at home – always a good idea!

  • Bake some diabetic-friendly muffins as a breakfast option.
  • A poached egg in the microwave (even at work) on a slice of low GI toast with a piece of fruit is a healthy choice.
  • Microwave oats (they’re low GI!) with a chopped apple or ¼ cup (30g) raw nuts and seeds to make a quick nutritious breakfast.

Lunch ideas:

  • 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).

Dinner ideas:

Great tip: Cook meals for the week or cook double portions and freeze the food so that you have meals ready when you don’t have time to cook.

  • Make simple meals that don’t need lots of attention: roast chicken or baked fish with roasted vegetables. A steaming net is a handy tool that fits into any pot and steams all your vegetables at one time.
  • Always have a stash of frozen vegetables in the freezer for when you run out of fresh vegetables. When life gets busy, the first food groups to suffer are vegetables and fruit.
  • Always have salad ingredients handy. Salad is a quick side dish that takes up room on the plate so you can’t fill it with more carbs!
  • An omelette filled with vegetables like tomatoes, onion, mushrooms and peppers is a quick and healthy meal.

Get more fantastic meal ideas here.

Fun festive food

Ask the dietician: Genevieve Jardine

From our community: “With Christmas coming up I know I’m going to want to eat what I shouldn’t… What are the ‘safe’ foods to snack on at parties?” Jabu Hlazo

The festive season is a great time of year when the hard work is over and it’s time for fun and feasting. The question is, how do you celebrate with everyone else, but still maintain healthy blood glucose levels? Here are some holiday points to ponder.

Watch your weight

Most people tend to gain about 2 to 5kg over the festive season only to make a New Year’s Resolution to lose it again. Prevention is better than cure, so make it your goal not to gain any weight this festive season.

Treat yourself

Using your bonus money to buy special treats is tempting – nothing says Christmas like mince pies or brandy pudding. This year, why not use your money to buy healthy treat alternatives: exotic fruit, nuts or delicious lean biltong. Better yet, spoil yourself with non-edible treats like a magazine, a new recipe book or a pair of running shoes.

Get active

Use your free time and the sunny weather to try a new activity. Play a game of tennis, hire a bike, do that hike you’ve always wanted to do. Take the focus off food and get adventurous. Touring a new city on foot or playing with the kids on the beach allows you to burn off kilojoules and improves your body’s ability to use insulin more affectively. The result? Better blood sugar control.

Re-gift the chocolates

It’s the season of giving and granny’s homemade biscuits or that box of chocolates can become very tempting. The truth is that you don’t have to eat the whole box in order to celebrate or appreciate the gift. This year, rather re-gift the biscuits and spoil someone else.

Plan ahead

During the festive season the social calendar fills up. Be wise and plan around your daily ‘eating commitments’. It is still important to eat regular meals (even while on holiday) and you may need to adjust meal sizes and snacks around social engagements. For example, if you know that you have a family braai in the afternoon, you may want to plan a light lunch with a healthy snack just before you leave to help stabilize blood sugar levels and avoid binging on snacks. When invited out, offer to contribute to the meal and bring your own healthy alternative. You will be amazed how grateful people are when you arrive with an extra plate of fresh veggies and dip, or a fresh green salad or diabetic-friendly dessert.

Watch the alcohol

Holiday celebrations often involve excessive drinking, which can send blood glucose levels soaring with an inevitable crash in the early hours of the morning. Be sensible and opt for alternatives like light beer or light wine, and watch how much you drink: the recommended amount is two alcoholic drinks per day for men and one per day for women. Never drink on an empty stomach and don’t drink and drive. There is more at stake than just your blood glucose levels.

Party tricks

If the festive season means endless office parties and end of year functions, don’t hesitate to find out more about the food. Chat to the person in charge of catering the office party to ensure there will be snacks like chicken pieces, fruit kebabs, diced vegetables and sandwiches, as well as diet drinks and light alcohol. For restaurant dining, phone ahead for the menu and decide what to order so you’re not tempted when you get there. If you choose wisely and stick to reasonable portions, you’ll get through the festive season just fine.

 

What is the ‘right’ kind of food for diabetics?

Ask the dietician: Genevieve Jardine

From our community: “Being newly diagnosed, I am learning about foods that I can and can’t use. I cannot find an article explaining what to look for. It’s all a bit confusing. Help would be greatly appreciated.” David Staff.

“Eat the right type of food, in the right amount, at the right time of the day”

It’s important to make dietary changes that are simple and progressive. First you need to learn what foods should be in your trolley, fridge and kitchen cupboards: that will make good eating decisions easier to choose.

I have one simple rule: eat food that is as close to its natural form as possible! This helps to reduce the amount of processed, high sugar, high-fat foods that cause problems with weight and blood sugar control. Try not to focus on what you can’t have (it is very depressing) and rather be adventurous in experimenting with healthy nutritious meals.

Once you know which foods are suitable, you need to get specific and work out how much to eat. Portion control is very important. The good news is that almost all foods are allowed in correct portions.

Here are some general rules:

Starch: Use low GI, high fibre starches. Reduce foods made with lots of white flour and sugar (doughnuts, biscuits, cakes ). For your main meal, the portion size of starch should be the size of your fist (approximately 2 portions of starch).

Protein: Opt for low-fat protein. Remove visible fat from meat and skin from chicken. For your main meal, the portion of protein should be the size of the palm of your hand and the same thickness as your baby finger (less at other meals)

Dairy: Choose low-fat or fat-free dairy. Try for 2 portions of dairy a day.

Vegetables: Choose a variety of colours and serve raw, steamed and roasted. Eat lots – double portions where possible!

Fruit: Try to eat a variety of fruits. The size should be that of a tennis ball and you should aim for 2 servings of fruit a day.

Fat: Try to reduce the use of fats in your cooking. Rather grill, bake, boil, steam, microwave or stir-fry your food. The portion of fat should equal the size of the tip of your thumb.

Specific portion sizes:

Starch:

  • ½ cup wholewheat cereal / muesli
  • ½ cup cooked, cooled and reheated mealie meal / oats porridge
  • 1 slice seed loaf
  • ½ wholegrain seed roll / low GI bread roll
  • 3 Provita / 2 Ryvita
  • ½ cup (2 Tbs) beans or whole corn
  • 1 small mealie on the cob
  • ½ cup cooked, cooled & then reheated samp
  • ½ cup pasta / long grain rice / wild rice
  • ⅓ cup white rice
  • ½ cup brown rice with added lentils
  • ½ medium sweet potato
  • 2 – 3 baby potatoes
  • ½ cup cooked lentils

Protein:

  • 1 egg
  • 30g grilled chicken / ostrich / extra lean mince / grilled beef or pork
  • ¼ cup tuna
  • 30g steamed / poached / grilled / baked fish
  • 2 tbs peanut butter
  • 50g raw soya
  • 90g tofu
  • ½ cup cooked lentils / beans

Dairy:

  • 1 cup low-fat / fat-free milk
  • 100ml low-fat / fat-free sweetened yoghurt
  • 30g low-fat cheese (Lichten Blanc, Dairybelle InShape, Elite Edam, Woolworths, Mozzarella)
  • 50g low-fat feta cheese (Pick n Pay Choice Danish Style / Traditional, Simonsberg)
  • 50g low-fat cottage cheese (Dairybelle, Lancewood, Parmalat, In Shape, Clover)

Vegetables:

  • Asparagus
  • Green pepper
  • Baby marrow
  • Lettuce
  • Bean sprouts
  • Mushrooms
  • Broccoli
  • Mixed vegetables
  • Butternut
  • Onion
  • Cabbage
  • Pumpkin
  • Carrots
  • Peas
  • Cauliflower
  • Radish
  • Celery
  • Spinach
  • Cucumber
  • Tomato
  • Green beans
  • Watercress

Fruit:

  • 1 medium apple / peach / pear / grapefruit / orange
  • 1 large naartjie
  • 3 small apricots
  • 10 – 12 grapes (only!)
  • 1 small to medium nectarine
  • 1 tablespoon dried fruit
  • ½ cup fruit salad

Fat:

  • 2 teaspoons low-fat margarine / mayonnaise / dressing
  • 4 olives
  • ¼ avocado
  • 80ml low-fat gravy / sauce
  • 1 teaspoon olive / canola oil

To snack or not to snack?

Ask the dietician: Genevieve Jardine

From our community: “My average blood sugar over the past few months was higher than it should have been, so I’m trying really hard not to eat the wrong foods. Any tips for healthy snacks?” Lynnae Daniel

Getting creative with your snacks can really help make your daily meal plan more exciting. We all get into a rut with our meal choices, and adding different (healthy) snacks can improve variety, colour, flavour and even add valuable nutrients to your daily intake.

Not every person with diabetes needs to snack. Some people are happy with three square meals a day, while others prefer small snacks throughout the day. Your unique eating style largely depends on your own natural eating patterns, medication, blood sugar control, and how active you are.

Remember: If you go for more than 4 or 5 hours between meals you may need to snack in order to prevent your blood sugar from dropping too low. But snacking on the wrong kind of food can cause blood sugar levels to rise and also cause unwanted weight gain.

So what does a healthy snack look like?

  • A snack should be between 300 to 600 kilojoules otherwise it is more like a meal.
  • Snacking is a good chance to increase your vegetable or fruit intake (remember, the aim is 5 servings of vegetables a day).
  • Plate your snack to help control portion size: don’t eat straight out of a bag, box or packet – or straight from the fridge!
  • Portion your snacks into snack-size packets, or buy suitable snack portions.

Ask yourself: are you actually hungry? Don’t snack because you’re bored, stressed or worried.

Healthy snack ideas:

  • One piece of fruit (carb 15g, fat 0g, 300kj)
  • 100ml low-fat flavoured yogurt (carb 16g, fat 2g, 400kj)
  • 2 cups popped popcorn sprinkled with fat-free parmesan cheese (carb 15g, fat 7g, 636kj)
  • 30g lean biltong (carb 0.7 g, fat 2g, 346kj)
  • 3 Provitas or 2 Ryvitas with cottage cheese, tomato and gherkin (carb 20g, fat 2g, 382kj)
  • ½ an apple with 20g sliced low-fat cheese (carb 8g, fat 5g, 430kj)
  • Raw veggies (carrot sticks, cucumber, baby tomatoes, gherkins, baby corn, snap peas) with cottage cheese, hummus or avocado dip (carb 8g, fat 7g, 540kj)
  • 30g nuts/seeds (carb 3g, fat 14g, 735kj)
    Tip: Nuts and seeds are high in fat and kilojoules. However, the type of fat is much healthier than that found in a chocolate bar.

Unhealthy snack choices:

  • 50g bar of chocolate (carb 30g, fat 12g and 1120kj)
  • 30g packet of potato crisps (carb 24g, fat 12g, 766kj)
  • 300ml bottle of drinking yoghurt (carb 45g, fat 5.6g, 1140kj)
  • 25g packet of sweets (carb 18g, fat 0g, 316kj)
    Tip: It might seem like this snack is within the recommended carb, fat and kilojoule allowance, but they are empty kilojoules with no fibre and very little vitamins and minerals.

Snacking for exercise:

Remember that exercise can also cause low blood glucose. It is important to check blood glucose before and after you exercise. People react differently to exercise depending on the type, duration and intensity: some people see a rapid drop and others an increase in blood sugar levels, so it is important to test and see what your individual response is.

As always, you should see a dietician to help you plan suitable snacks for different situations. Fresh snack ideas can bring a sense of fun into your daily eating plan.