diabetes community blog
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.
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.
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 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.
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!
We just got the following letter from HEALA and had to share it with you – Sweet Life has submitted comment, feel free to do the same!
ACT NOW TO TELL THE NATIONAL TREASURY AND PARLIAMENT TO PASS A STRONG SUGARY DRINKS TAX
BACKGROUND: WHY THIS MATTERS
In recognition of the negative health effects of sugary drinks, Minister of Finance Gordhan’s 2017 budget speech included a plan to tax sugary drinks—such as fizzy drinks and energy drinks—to help South Africans live longer and healthier lives. Tackling obesity-related diseases needs to be a national priority, and the proposed tax on sugary drinks is a first step in addressing this national epidemic. It’s important to raise as many voices as possible to strengthen and pass the tax.
Treasury and Parliament are acting NOW to further consider the proposed tax. The South African government has been under immense pressure from beverage companies and retail groups to weaken this important policy with exemptions, loopholes, and watered-down regulations—and they are having an impact! Even though there’s a proposed tax in the legislation, it’s critical to raise voices to encourage our leaders to strengthen and pass this life-saving measure!
That’s why Parliament and Treasury MUST hear from YOUR ORGANIZATION to make sure the final policy is strong and effective in reducing consumption of harmful sugary drinks among South Africans. They will accept comments on the proposal through 31 March.
Your organization has a unique voice and story to tell about why this policy is important to you. While it is critical to be active and engaged in speaking out on the necessity of a strong sugary drink tax, submitting public comments to Parliament and Treasury on the tax policy is especially impactful. Below are some key messages you can customize when submitting your comments, which are being accepted until Friday, 31 March 2017.
KEY MESSAGES: WHY WE NEED THE TAX
We support the National Treasury’s sugar drink tax and applaud them for their efforts to improve South Africans’ health; however, the tax can be strengthened to make it even more effective.
Sugary drinks are one of the most significant contributors to health problems such as diabetes, obesity, heart diseases, certain cancers, and dental caries in South Africa and globally. South Africans are among the top ten consumers of soft drinks in the world. In addition, South Africa is already ranked the most obese country in sub-Saharan Africa, and a recent study found that diabetes was the second leading cause of death among South Africans in 2015.
Sugary drink taxes work to reduce consumption, improve health, and save healthcare rands. Global experts—including the World Health Organization (WHO), World Cancer Research Fund, World Heart Federation, and International Diabetes Federation—recommend sugary drink taxes as a way to reduce sugar consumption. Evidence from Mexico and other jurisdictions that have passed taxes show declines in consumption that will work to decrease diabetes and other diseases without costing jobs.
The sugary beverage companies know that the tax will work to reduce consumption and make South Africans healthier. That is why they oppose it so vehemently. By passing a strong sugary drink tax, Treasury and Parliament can protect South Africa’s health and children rather than the special interests who target their unhealthy products to our most vulnerable consumers.
FOUR WAYS TO STRENGTHEN THE TAX
Tax all the sugar in all sugary drinks
The proposed tax design exempts a large portion of the sugar in sugary drinks—giving a “discount” on the first 4g of sugar per 100mL, no matter how unhealthy a beverage is. The discount reduces the health impact of the tax and is a giveaway to the beverage industry and manufacturers whose products have the highest and most harmful levels of sugars. There is no health justification for the exclusion, and no other country with a successful sugary drink tax has followed this structure. Treasury and Parliament need to remove the 4g discount and tax all the sugar in sugary drinks.
Increase the tax rate of concentrates
The current tax proposal includes a tax rate for concentrates (squashes or syrups) that is half the rate for ready-to-drink products. South Africans are drinking more and more concentrates than ever before; it is the fastest growing segment of the sugary drink market. Consumption in terms of kcal/capita increased from 16.5 percent in 2009 to 32.9 percent in 2016; by comparison, consumption of regular cola carbonates in 2016 was only 29.3 percent. To achieve its objective of improving health, the tax must encourage South Africans to consume beverages that are lower in sugar—instead of switching to cheap sugary concentrates. The tax rate for concentrates should be increased to align with the rate for ready-to-drink sugary beverages.
Tax all drinks with added sugar
The current proposal doesn’t include all sugary drinks. Fruit/vegetable juices and dairy-based drinks with added caloric sweeteners contain equal or higher levels of sugars, despite their illusion of health. Treasury needs to clarify their proposal so that all fruit and dairy-based drinks with added caloric sweeteners (whether using a fruit juice, concentrate-based sweetener, or any other caloric sweetener) are taxed.
Some revenue from the sugary drink tax should be used to promote health
While the sugary drink tax itself will be effective in improving health, it will be even more effective if some of the revenue is used to fund programs to promote healthy eating and improve health. It’s critical that the intent expressed in the budget speech to do this is carried out in practice. South Africans need to know that revenues will be used to benefit the health of the country. Revenue should be directed towards health promotion measures, such as increasing the number of community healthcare workers, funding nurses in schools, developing and implementing effective health and nutrition education campaigns, or improving water and sanitation infrastructure.
3 SIMPLE STEPS FOR SUBMITTING COMMENTS
- Introduce your comment by discussing why this is important to your organization; this is your chance to personalize your comments with your own experience
- Draft your comments on why the tax needs to be passed and strengthened, using some or all of the key messages in this document
- Email your comments by Friday, 31 March 2017 to: Ms Mmule Majola email@example.com and Ms Adele Collins at firstname.lastname@example.org
The South African government MUST put the health of South Africans before special interests who target vulnerable populations with their unhealthy products. Please make your voice heard today!
Healthy Living Alliance
I am a writer, copywriter and journalist; I have been running Humans of SA for 2 years – we also have a Facebook page. I wanted to create a space where I could share South African stories. My aim has always been to open windows into worlds we might know nothing about. I interviewed a lady recently who lost her father to diabetes.
She speaks about a lack of understanding in terms of care and treatment. I feel it is important to bring attention and help create more awareness by telling stories of people who are diabetic, of professions who can advice and help.
If you have a story you are happy to share, please get in touch by emailing me.
I’m Nicolene from Bloemfontein, I’m almost 19.
I was at the doctor today for my eyes. I have bleeding in the back of my eye. Just want some advice how can I make this better?
The doctor said less sugar and sugar controlled. Just want to know who also has or had bleeding in the back of their eye on this page and what did they do to make it better etc.
My name is Timothy from KZN, I have been diagnosed with Diabetes type 2 in 2013 but the problem is that I’m failing to accept that I’m living with this chronic condition for the rest of my life.
Can anyone advise me how to accept my condition please?
Have you always wanted to see your name in lights? We can’t help out with that, but we are looking for some more testimonials to add to our homepage… So we can put your name in Sweet Life lights!
Looking for inspiration? Here’s what some of our readers (and our editor!) have to say:
Either comment on this blog post or send us an email and we’ll publish your comments right away!
UPDATE FROM DIABETES SA:
It is with deep regret that we need to inform you, our wonderful supporters, that we have had to postpone our walk until November, when all Global Diabetes Walks take place Nationally. We did not manage to procure sufficient sponsorship to cover our expenses, and as a Non-Profit Organisation unfortunately we do not have the capacity to make up for the shortfall ourselves.
We will advise you of the date in November as soon as it has been confirmed with KZN Athletics and the City of Durban. We once again apologise for any inconvenience we may have caused you.
Did you miss out on the Durban Diabetes Walk last year? Never fear – it’s going to happen in March this year! Here’s all the info you need to get walking for diabetes awareness…
Event: SASA amaShuga Walk for Wellness
Date: Sunday 15th March 2015
Place: Amphitheatre on the Lower Marine Parade, Durban
Cost: R50 per person
Reason: The aim of the walk is to educate people about diabetes
Enquiries: Nerve Events – 0312012169 during office hours
Organisers Nerve Events and Diabetes SA are stepping out with the launch of the aptly named SASA amaShuga Walk for Wellness – an exciting re-invention of what used to be the Global Diabetes Walk Durban.
The SASA amaShuga Walk for Wellness will kick off on Sunday March 15th 2015 at 8am. It will start from the Amphitheatre on the Lower Marine Parade.
There will also be a wellness expo at the amphitheatre where free blood sugar & blood pressure checks will take place.
According to Jenny Russell from Diabetes SA, a Stats SA report issued on 4 Sept 2014 showed that diabetes is the second highest cause of death in eThekwini Metro and the third highest cause of death in KZN!
“The aim of the walk is to educate people about diabetes which is reaching epidemic proportions globally. South Africa is not immune. Obesity is an emerging health problem in KZN, particularly among women. Many women living in urban areas where there is high HIV prevalence perceive themselves to be thinner than their actual Body Mass index (BMI) suggests. This may be a barrier to weight management,” she says.
Pat Bonini of Nerve Events says that the walk will cover a distance of 5km. “We urge the public to support the event. You are also invited to bring your dogs along on a leash. The walk attracts up to 2000 people and we would like to up that figure. The Walk and Wellness Expo is also a major fundraising exercise for Diabetes SA Durban”.
Both the organisers and Diabetes South Africa would like to thank The South African Sugar Association (SASA) for supporting the amaShuga. “Local Wellness celebrity Lisa Raleigh will once again be the MC for the event and we are grateful for Lisa’s continued support for this event,” adds Bonini.
Entry fee for the event is R50 per person and details of the event can be found by searching for SASA amaShuga Walk for Wellness – Durban on Facebook, calling 0312012169 or emailing email@example.com
Let’s all walk for wellness!