carb counting for diabetics
Whether you battle to lose weight, or struggle to gain it, maintaining a healthy weight is a constant battle for many people with diabetes. Joanne Lillie explains how to make lasting changes.
Putting on weight
Controlling blood sugar levels is the starting place for achieving your target weight with Type 1 diabetes, as high blood sugar levels will cause glucose to be lost in the urine and result in weight loss, says dietician Genevieve Jardine. Many people find that once their glucose levels are under control, weight management becomes much easier.
Top tips to build mass:
- Go for low GI: To balance your glucose levels, lower-GI carbs such as wholegrains, beans, sweet potatoes and some fruit (like plums and apricots) are great choices, as they are less likely to spike your blood glucose. Milk and yoghurt also have a low GI. Just remember that low GI food still has to be eaten in the right portion.
- Eat more often: Rather than three meals a day, eat six smaller meals a day. Check your blood sugar more often and inject accordingly if you decide to try eating this way. Don’t skip meals as you will miss opportunities to increase your calorie intake.
- Fat has more calories than carbohydrates or protein: fat contains 9 calories per gram, while carbs and proteins contain 4 calories. So it makes sense to eat more fat when you’re aiming to put on a few pounds. Just be aware that you need to choose healthy fats. Cook with more olive or canola oil, get plenty of nuts and seeds, and add avocado and olives to salads.
- As long as your kidneys are in good shape, you can add protein powder to yoghurt or smoothies. This helps you gain weight as lean muscle mass rather than fat.
A normal body mass index (BMI) is vital for people with diabetes. “As the BMI increases, the amount of insulin required to maintain a normal glucose level also increases because patients become more insulin resistant,” explains endocrinologist Dr Joel Dave. An elevated BMI is also associated with high blood pressure (hypertension) and high cholesterol (dyslipidemia).
Healthy eating, regular physical activity, and medicine (if prescribed), are the key elements of Type 2 diabetes management. For many people with diabetes, the most challenging part of the treatment plan is working out what to eat.
Top tips to lose mass:
- Aim to reduce your energy intake while sticking to a healthy eating pattern. This means getting all the nutrients you need, in as few calories as possible. How? By focusing on nutrient-dense foods such as green vegetables, some fruits (especially berries) and beans.
- Carbohydrates from vegetables, fruits, wholegrains, legumes and dairy products are better than from other sources, especially those with added fats, salt and sugar. The most carb-dense foods include those with refined white flour: breads, biscuits, pastries, cakes, as well as white rice and potatoes. Limit these as much as possible!
- A Mediterranean-style diet may boost weight loss and benefit blood sugar control and cardiovascular risk factors. This means:
- Eating mostly plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts
- Keeping carbohydrate levels as low as possible
- Using healthy fats, such as olive oil
- Using herbs and spices instead of salt to flavour foods
- Limiting red meat to no more than a few times a month
- Eating fish and poultry at least twice a week
Ask the expert: Genevieve Jardine, dietician
“Learn to respond to hunger and not appetite. Often a high carbohydrate diet makes people hungry whereas enough protein and healthy fats helps make people feel fuller for longer.”
I don’t know about you, but I love the idea of eating only what’s in season. Fresh fruit and vegetables are obviously at their most abundant when they’re in season, and I like to only eat what’s local and fresh (don’t we all?!) It’s not always that easy to know what’s in season, though, and what to look out for. That’s why I love this seasonality calendar we were sent – take a look below and download a PDF if you’d like to keep it.
Happy cooking – and eating!
Seasons change, and so should the fruits and veggies you put onto your plate. Eating seasonally is tastier, more cost effective and sustainable. Chef James Diack, one of South Africa’s pioneers of provenance, has taken the concept of seasonality even further by producing a Seasonality Calendar for South Africans as a guide on what to eat each season, and what they can expect to see on his plates during the months and weeks of the year based on the produce from Brightside Farm.
“Seasonality and sustainability are all about protection – protection of the environment, protection of our diners’ health and not least of all protection of animal health. All of our practices are geared toward these goals,” James says.
Download the calendar to keep on your fridge!
It might seem as though being a restaurant chef would be too tempting a job for a Type 1 diabetic, but 30-year-old Vanessa Marx has made an art out of making healthy food delicious – and accessible.
When did you find out you were diabetic?
I was about sixteen and in high school – seriously bad timing! I had all the usual symptoms. I was drinking about four litres of water a day and falling asleep during class because I was so exhausted. My mom eventually suspected diabetes and I had to be hospitalised. It was a traumatic experience. I’ve always loved food, and I remember lying in my hospital bed naming all the foods I could never eat again… It was a long list!
How has diabetes changed your daily life?
That’s a hard question, because it’s so much a part of my daily life. It can be difficult, sometimes, explaining to people who don’t have diabetes how you’re feeling. If I wake up with low blood sugar, for example, I’m exhausted before the day begins. People understand a throat infection, but they often don’t understand what waking up low feels like. As a head chef, I need to be alert every day, taking charge of the kitchen. There’s no room in a busy kitchen for feeling tired or unwell because of high blood sugar or needing time out to have something sweet because of low blood sugar.
Isn’t it difficult to be around food all day? How do you resist sweet treats?
It is quite tricky! Often just the act of making sweet treats for someone else satisfies the urge for me but other times I’m pretty tempted: what puts me off is that I know how I’ll feel later. I do believe in “everything in moderation”, so I allow myself a treat now and then. As long as it’s a once-off, and I’m not doing it every five minutes!
What advice would you offer to other diabetics?
Be disciplined! Pay attention to your diet: what you eat plays a huge role in how you feel. Also don’t feel like you’re on your own, don’t be afraid to ask for help – talk about your diabetes, and explain to those around you what it feels like. There’s still a stigma around diabetes, that it’s only people with weight problems who are diabetic. But the only way we’re going to change that is by talking about it.
What makes your life sweet?
My family and friends, and my work.
Get in touch with Vanessa: @vanessajaynem on Twitter and Instagram
Together with Pick n Pay, we’ve designed a cookbook specifically for people with diabetes who want ideas for every meal of the day. Breakfast, lunch, dinner, snacks and treats – there’s something for everyone!
Get nutritional advice on how to build balanced meals, and delicious recipes the whole family will enjoy – whether or not they have diabetes.
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:
- 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
- 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
- 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)
- Green pepper
- Baby marrow
- Bean sprouts
- Mixed vegetables
- Green beans
- 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
- 2 teaspoons low-fat margarine / mayonnaise / dressing
- 4 olives
- ¼ avocado
- 80ml low-fat gravy / sauce
- 1 teaspoon olive / canola oil
From our community blog:
Petunia has a question for us about lowering high blood sugar:
“I would like to know what can I do to bring down my sugar. I have Type 2 diabetes, I’m on Actraphane 30/70 and I don’t have a proper diabetes diet.”
What do you suggest?
The obvious ones that spring to mind are:
- Eat lots of fresh vegetables, wholegrains, lean protein and no refined carbohydrates.
- Steer clear of sweet treats.
- Drink lots of water.
- Exercise a little every day – even if it’s just a walk around the block.
- Lose weight if necessary.
What do you have to add? Let’s help Petunia out!
I am also Type 2 – I find the best thing is exercise. Sometimes you can’t avoid the carbs, but if you walk, run or cycle 30 min per day – you can reduce your sugar levels significantly.
Diabetes is not an easy quick fix ever. It is important to manage this condition in the best way always and this means getting a lot of HELP! I suggest you find a dietician or a diabetes educator in your area and schedule an appointment a soon as possible. In order to understand this condition it’s important to understand how food and your medication impact on your glucose levels. It becomes so easy with this help!
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.
- Half of South African adults are overweight or obese. What that means is increased risk of heart disease, Type 2 diabetes, certain cancers and premature death.
- Our eating habits have changed so much that South Africans now spend more money on beer than on vegetables and fruit combined. What?!
- 45% of South African women are obese, as opposed to only 15% men. In 2013, South African women were the most obese in sub-Saharan Africa. So South African women are the most at risk for obesity.
I asked why that was and apparently there are three reasons:
- Women who were nutritionally deprived as children are more likely to be obese as adults (men who were deprived as children are not).
- Women of higher adult socioeconomic status (which is income, education and occupation) are more likely to be obese, which is not true for men.
- And possibly: in South Africa, women’s perceptions of an ‘ideal’ female body are larger than men’s perceptions of the ‘ideal’ male body – it’s seen as a status symbol to be a heavier woman.
Are you a South African woman? I am… Let’s make sure we’re informed and don’t let obesity happen to us and our sisters, mothers, daughters, friends.
Vitality gathered data from half a million Discovery members to give us these results:
- Their weight status (BMI and waist circumference)
Cape Town scores highest, with 53.5% of Capetonians in a normal weight range. Cape Town also topped the healthy purchasing score (which shows a positive relation between what you buy and whether your weight is in range or not.)
Fruit and vegetables
Cape Town purchased the most portions of fruit and vegetables compared to other cities – see the ranking above. In general, though, South Africans are only eating 3 servings of fruit and vegetables a day, as opposed to the 5 servings we should be eating.
Durban purchased the least amount of salt in SA, with Cape Town purchasing the most. We are eating twice as much salt as we should be in a day: it should only be 5g (1 teaspoon).
Durban came out top of this test too, with the lowest average number of teaspoons of sugar purchased – Bloemfontein purchased the most sugar. And again, we’re eating twice as much sugar as we should be – a staggering 100g a day! (That’s 24 teaspoons – in the food and drink we consume.)
There are a number of factors that play into this, of course. The way we buy our food – the impulse buys, the treats, emotional eating. Fast food is also a huge problem, because it’s loaded with salt, sugar and bad fats. Cooking at home with whole foods (not convenience foods or ready-made meals) has been proven to have an enormous impact on health and weight.
So what should we be eating? Here are some excellent guidelines.
What do you think? This information made me take a closer look at how I shop and what we eat… Not even because I’m diabetic, but just because I want my family to be as healthy as we possibly can.
From Facebook (Diabetic South Africans):
How do you treat yourself when you feel like something sweet?
I only have a tiny taste, seems to work for me, but then I don’t really have a sweet tooth.
Very difficult question 🙁
Jungle Oats Light snack bar or Canderel sweets… Sweet enough and good.
Any sweet fruit that is in season! For now grapes and mangoes work for me.
Lehuma, fruits do contain a lot of sugar – especially grapes and mango. Remember to have small portions.
Yes I know, Sharon, hence I only eat them as a treat when I feel like something sweet!
Two blocks of Lindt 70% dark chocolate.
Wow! I thought I was the only one who had this craving for sweet things. I eat ice-cream once in a while. I was really feeling bad about it.
We chat to Ishay Govender, acclaimed foodie writer, about her love of cooking and how to make Indian food just as tasty – but a little healthier.
You have a family history of diabetes – have you been tested yourself?
I get my blood sugar and cholesterol tested once a year – every year. Because I’m aware that Type 2 diabetes is often a hereditary condition, I’m very conscious of my health and how food contributes to my wellbeing. In traditional homes there’s an emphasis on food and family as a way of expressing love, and I know I’ve inherited that from my mother and grandmother – sharing food with people is my way of expressing that love.
Have you made any changes to your diet because you know Type 2 diabetes runs in the family?
I’ve learnt to alter things slightly so that they’re healthier but still have lots of flavour. When we first found out that my mom was diabetic I did a lot of research, and made sure she went to a dietician and found out specifics of how to change her cooking style. That said, we grew up in a very healthy household so the changes weren’t too difficult.
What advice would you offer to people who are struggling to eat a healthy diet?
I think the most important thing is to accept and make peace with the fact that you have diabetes – it doesn’t make sense to fight it. Also, food should never be about restriction, it’s about enjoyment. Change the spotlight from focusing on what you can’t have to what you can enjoy. It’s a great time to explore flavours, textures and a sense of fun in the kitchen.
Have you learnt any ‘tricks’ to make traditional Indian food a little healthier?
A few! Here are the main ones:
- Cook with less oil – it is possible, especially if you use olive oil cooking spray.
- Don’t eat double starch (i.e. rice and potato curry, or curry and roti)
- Cook vegetables for a shorter period of time so that they keep some of their goodness – things like okra and butternut don’t have to be cooked to mush.
- Rethink vegetables – they don’t only have to be pickled or curried, they can be fresh with interesting dressings. I try to include half a salad in a meal, with a yoghurt dressing (plain low fat yoghurt with toasted cumin seeds, mint and lemon zest – delicious!)
- I only use baby potatoes with their skins on – they’re low GI and the skin has fibre.
- Brown rice is so much healthier than white rice – it’s full of fibre and has a lovely nutty flavour. You also need less rice because it fills you up more.
- Spices and herbs are a diabetic’s best friends! They add such flavour and zest, and you can experiment with different combinations to make a dish more interesting.
What makes your life sweet?
The pleasure of enjoying food and food travel with my husband. Cotton pyjamas and fresh linen. The knowledge that even someone with a ‘soft’ voice like mine, can make a difference using it.
Get in touch with Ishay: @IshayGovender on Twitter / Instagram / Vin
Ask the dietician: Genevieve Jardine
From the community: “Every year I hold a National Heritage Day feast for my friends and serve up all the South African classics: boerewors rolls, koeksisters, samoosas, shisa nyama and curry. This year I have a diabetic friend coming and don’t want him to feel left out. How do I make the feast more diabetes-friendly?” Nashikta Singh
National Heritage Day is about celebrating the mixed flavours of South Africa, and there’s no better way to do this than by showing off our traditional dishes. Coming together around the braai or dining room table lets us share our past and create our future.
Traditional South African dishes have a lot of flavour and nutrition. Many of the classic dishes are naturally diabetes-friendly, while others may require some simple changes.
Made with onions, tomatoes, carrots, chillis, garlic, cabbage and cauliflower. It is packed with nutrients, fibre and flavour.
Tip: Don’t use too much oil while making chakalaka.
Mielie meal is a starch, so it will affect blood sugar. For better blood glucose control, you can cook it the night before and then reheat it on the day. This lowers the GI (glycemic index) of the pap.
Tip: Mix pap with cooked beans to further reduce the GI.
Use lean cuts of meat and fill the pot with a wide variety of vegetables. This method of cooking keeps the nutrients locked in the sauce.
Tip: Add plenty of non-starchy vegetables like baby marrows and green beans.
Curry and bobotie
The beauty of Indian cooking is all the herbs and spices. Garlic, onion, fresh chilli, turmeric, coriander and clove are all great for your health. Try to use lean cuts of meat (extra lean mince) and serve with small portions of brown basmati rice and vegetables.
Tip: Bean or lentil curry make an excellent starch alternative.
Shisa nyama or braai
Traditionally, braai meat is fatty (brisket, boerewors, chicken wings) and served chargrilled. Try to use leaner cuts of meat like skinless chicken or sirloin, with different marinades to keep the meat tender. Don’t only think meat when it comes to a braai: mielies, butternut, sweet potatoes and madumbes are also delicious.
Some traditional foods, like lean biltong or air-fried samoosas, can be altered to make them healthier. But when it comes to things like vetkoek and koeksisters, there’s not much you can do!
I don’t know about you, but cooking dinner is one of the things I wish I could just wave a magic wand at.
Wouldn’t it be lovely if somebody else did it for you? But not in a take-out way: I’d love it if somebody else made the kind of delicious, fresh, healthy food I try to make every day.
That’s why I was so excited to find out about UCOOK – seasonally inspired recipes, with all the ingredients delivered to your door.
You choose three meals a week, and they deliver a box full of fresh vegetables, meat, spices and everything you need to whip up a fabulous meal – including these recipe cards, which detail exactly what you need to do and when. The menu changes dramatically every week, but always in three sections: Health Nut (which is mostly low carb), Easy Peasy (20 minutes to make) and Veg (all vegetarian).
I let my husband choose the meals so (surprise surprise!) we had a lot of meat – but it was absolutely fantastic meat, organic and ethical, from locally sourced farmers. The vegetables were also top class – fresh and abundant, and the recipes are interesting and unusual (but not so unusual that I couldn’t get my kids to eat them!)
This is the Middle Eastern lamb with rustic baba ganoush and tzatziki – amazing! It took all of half an hour to prep (a little longer to cook) and it’s the first time I’ve ever successfully cooked lamb at home.
So what did I love about UCOOK?
- Not having to think about what’s for dinner.
- Not having to shop for dinner.
- Having all the ingredients for a delicious meal without worrying I’d forgotten something.
- Having a recipe to follow that is guaranteed to turn out well!
- Fresh, fabulous flavours – not the same old meals.
Of course, all this comes at a price. There are no sneaky costs – shipping is free and you don’t have to subscribe, you can just pay week by week if you like the meals (which I like a lot, because who knows what the week after next might bring?) They claim it’s cheaper than buying groceries, but I think that depends how you shop. I’m a pretty frugal shopper and I don’t think it would be cheaper for us, but it would certainly be more exciting and possibly healthier, as it would force our whole family to try new flavours, vegetables and ideas for dinner.
If you’re looking to add a little spice to your meals, I’d highly recommend giving UCOOK a try…
Remember when low carb wasn’t as well known as it is today? We do! Here’s an article from Sweet Life magazine published a few years ago that explains all the ins and outs…
Professor Tim Noakes says that a low carb, high fat diet is the way to go. We gathered your questions and asked him how the low carb diet affects diabetics. Here’s what he had to say.
What exactly is this diet?
A low carbohydrate, moderate protein, high fat diet. This diet is most effective for people with diabetes – either Type 1 or Type 2, or pre-diabetes, like myself. It also helps treat obesity, but it’s obviously not the diet for everyone. The question is whether it’s for 10% of the population, or 90% of the population – I think it’s about 60% or more.
Low carb means no bread, pasta, cereals, grains, potatoes, rice, sweets and confectionery, baked goods. You have to be resolute – and the more severely affected you are, the more resolute you have to be. If you’re already diabetic, you have every reason not to eat these foods.
Can you explain what carbohydrate resistance is?
My opinion is different from the traditional teaching. Carbohydrate resistance is traditionally described as someone who is unable to take glucose out of the blood stream and store it in their muscle and liver. I disagree with this explanation: I think we’re all born with varying degrees of carbohydrate resistance, and the children who get really fat very young are the ones who are most carbohydrate resistant. The carbs they take in they simply store as fat. That’s the first group.
The second group are people who become pre-diabetic at 30 or 40, and then they become diabetic at 50. They are overweight, and that’s a marker of the high carbohydrate diet. They eat a high carb diet, they are carb resistant and it gets more and more severe until they become diabetic. I think it’s genetic, and the reason I think that is because in my case, although I’ve lost weight, I’m still carbohydrate resistant – I can’t go back to eating carbs.
What if you have high cholesterol? Isn’t it dangerous to eat so much fat?
Firstly, the theory that high cholesterol is a good predictor of heart disease is not true – it’s a relatively poor predictor. A far better predictor is your carbohydrate status. Everyone knows this – if you’re diabetic or pre-diabetic, your risk of heart disease is increased. Diabetes, hypertension and heart disease are linked, but most heart attacks occur in people with cholesterol below 5. It’s very frustrating, because the public has got the wrong idea.
A high fat diet corrects everything, in my opinion – your HDL goes shooting up, your triglycerides come shooting down and that HDL to triglyceride ratio improves dramatically: that’s one of the better predictors of heart attack risk. The LDL small particles are the killers, and on a high fat diet, those go down. Your total cholesterol can go up, but that’s because your HDL has gone up, and the large, safe LDL particles have gone up. So unless you measure all those variables: HDL and LDL and triglycerides and glucose tolerance, you can’t judge the effects of the diet.
What carbs do you eat?
The good carbs are veg – that’s it. Sweet potatoes (not regular potatoes), butternut, squash and then I also eat dairy: milk, cheese, yoghurt. I don’t eat any fruit except apples, but that’s because I severely restrict my carbs. You’re not cutting out nutrients if you eat nutrient-dense foods like liver, sardines, broccoli and eggs – those are the most nutrient-rich foods you can eat. You can get vitamin C from meat if it’s not over-cooked. The key is that you eat lots of fat, and you don’t avoid the fat. I eat lots of fish, like salmon and sardines. And you want to eat lots of organ meats – that means liver, pancreas, kidneys, and brains if you can get them, but particularly the liver. Liver is very nutritious.
Is this diet possible for people who don’t have a lot of money?
You don’t have to eat meat every day – you can eat sardines and kidneys, for example, which are both very cheap.
Could the positive effect of a low carb diet on insulin resistance be because of the weight loss and not because of the new diet?
No, absolutely not. Because it happens within one meal – your insulin requirements go down within one meal, because you’ve shut off the production of glucose by not eating carbohydrates.
What is wrong with the old fashioned idea of a balanced diet? Why does it have to be so extreme?
If you’re diabetic, you have a problem with metabolising carbohydrates. You have to understand that if you want to live a long life and have minimal complications, you want to minimise your carb intake. Start at 50g a day. What that looks like is two eggs for breakfast, with some fish – salmon or sardines, and some veg. And dairy: cheese or yoghurt. That will sustain you until early afternoon. For lunch, I think you should have salad and some more protein and fat – and exactly the same for dinner. Chicken, cheese, nuts, salad, tomatoes, broccoli. It’s an incredibly simple way to eat, but you don’t get bored.
Once you’re on this diet, you feel so good, and you get rid of all these aches and pains and minor illnesses: you won’t want to go back. If you do go back to eating carbs you’ll put on the weight again. It’s not a diet, it’s a lifelong eating plan. It’s not a quick fix.
I think the diabetics who live to 80, 90, 100 are the ones who eat this kind of diet.
A few weeks ago, I got a message from Jane Sandwood, a nutritionist who believes in intermittent fasting. I asked her to explain it for all of us – and to explain how it might be beneficial to those of us with diabetes.
Disclaimer: This is not dietary advice and you should not make any changes to your diet without consulting your doctor.
I’ve been a nutritionist for ten years, and I’ve learned two things. Firstly, dieting is not the solution to being out of shape or overweight, and secondly, everyone’s bodies are different. For example, a well-balanced, but restricted diet and exercise works for me, but my husband has found a fasting regime mixed with exercising on an empty stomach to be better for him.
I wanted to cover the topic of intermittent fasting and how it can help some people lose weight and actually boost their workouts, so I wrote a Guide to Intermittent Fasting. The guide covers what fasting is, how it compares to diets, who should not do it, and also the different kinds of fasting people can undertake.
Does intermittent fasting work for diabetics?
While genetics play a significant role in whether or not someone will become diabetic, for a lot of people, lifestyle choices and diet are the main contributing factors, especially in cases of Type 2 diabetes. The American Diabetes Association has stated that due to our increasingly sedentary lifestyles, we’re raising our risks of becoming diabetic even further.
Way back in 1916, Dr Eliot Joslin, working at Harvard University, wrote about the benefits of using intermittent fasting techniques to aid control of diabetes. The main health benefits are as follows:
- Lower blood sugar: Your body will use up the glucose in your system more effectively because you are fasting for between 12 and 16 hours.
- Increase in metabolism: This will then increase the number of calories you burn, resulting in a better metabolic rate.
- Increase in receptivity to insulin: As the glucose in your system is being used in a better, more efficient way, the insulin you do create will work better and do the job it’s supposed to, which is moving the sugar out of your body properly.
- Healthy weight loss: You may find that intermittent fasting results in slower, healthier weight loss of 1-2lbs per week, which is ideal.
If you’re planning to try intermittent fasting, please speak to your healthcare practitioner first. Read this guide to find out more about how intermittent fasting can aid your health.
In issue 10 of Sweet Life magazine, we give some great blood sugar testing tips… Here are some more tips to bear in mind from Diabetes Nurse Educator Kate Bristow:
- Your blood sugar test is your day to day monitor – use it to test and understand your diabetes and the way it affects your body. Different people react differently to foods, illness and stress. Testing helps you understand how you as an individual deal with different situations.
- When pricking your finger, the sides of the fingers towards the tip are less sensitive than the middle pad of the tip of the finger.
- If you are on a long acting and rapid acting insulin (i.e. 4 injections a day) it is better to adjust your rapid acting insulin that is given with meals, according to the carbohydrates on your plate. This is called carbohydrate counting and your dietician can teach you how to do it. It gives you better accuracy and less risk of lows and highs in your blood sugar provided you are doing it right.
- Diabetes Educators and some doctors can download blood sugar meters on to their computers giving an accurate pattern for interpretation. Of course this is only as good as the number of tests done. For example, if one is only testing at the same time every day we are not going to get as much information as someone who is testing before and 2 hours after every meal. Again your educator can help with a testing schedule which fits in with your lifestyle and is not too arduous.
Do you have any questions about blood sugar testing?