Questions and answers about the best diabetes diet.
Ajita Ratanjee is a registered dietician on the Sweet Life Panel of Experts. She shares some of her diabetes dietary tips with us today.
Blood sugar control is of the utmost importance for a diabetic. To date, many diabetics have a challenge keeping their glucose levels controlled. A combination of the following 3 factors ensure good glucose control:
- Use of medication (oral meds or insulin injections)
Foods to avoid
Most diabetics I meet are familiar with the “AVOID” list of foods. These are the obvious sugars e.g. Sugar, sweets and chocolates, sugary cooldrinks, cakes, pastries, biscuits, ice-cream, puddings etc. If you’re a diabetic and continue consuming the above list, then you are literally accelerating the chances of complications of diabetes: nerve damage, blurred vision, kidney failure, sores on feet etc.
However there are many who are compliant with the “AVOID” list yet may still find that their blood sugar levels remain elevated. Many years of clinical experience working with diabetics has allowed me to create a shortlist of other foods that are most likely spiking your blood sugar and you’re not even aware they are the cause. They are “healthy” food choices; however they tend to spike blood sugar and are not the best choice for a diabetic.
Other foods that spike blood sugar
These foods should also be avoided:
- any 100% fruit juice,
- dried fruit,
- energy drinks,
- flavoured bottle water,
- energy bars,
- muesli (containing nuts and dried fruit),
- popcorn, and
100% Juices and dried fruits are a concentrated source of natural sugar resulting in blood sugar elevation. Most energy drinks are loaded with sugar and are not suitable for diabetics. Energy bars tend to be marketed as low-fat, however that is not the same as sugar free (at all!)
The important thing to remember is that a diabetic should be aware of all foods that elevate bloods sugar levels. Grains, fruit and vegetables are all healthy but they need to be eaten in the correct portions to keep sugar controlled. Protein helps to stabilize sugar and thus an extra serving of meat / fish / chicken / egg etc. will not elevate glucose as much as an additional slice of bread / rice / potato.
The magic diabetes diet lies in the correct proportion of carb to protein at meals and snacks, and the correct portions at every meal and snack.
Choosing the right food
Fatty fish are high in omega 3 – tuna, sardine, salmon and mackerel are high in essential fatty acid. These are protective towards cardiovascular health and have anti-inflammatory properties. Diabetics are at high risk of heart disease thus omega 3 supplements are highly recommended. Make sure that you use good quality omega 3 that is heavy metal free.
Alcohol is metabolized as a sugar so plan in your glass of wine (preferable red and dry) or whiskey.
My key message in a nutshell would be – it’s not just about “no sugar” but rather getting the carbohydrate and protein balance. Test your glucose regularly; at different times of the day. This enables you to monitor your control throughout the day. Test your sugar before a meal or 2 hours after a main meal. Keep a record of your blood sugar readings.
At Easy Health Wellness we assist our clients by teaching them how to exchange carbs and how to count carbs to ensure that they always are in balance at each meal and snack, and they can enjoy variety in their eating plans. We also stock a fabulous range of sugar-free products to support our diabetic’s client needs.
The diabetic way of eating is a very healthy way of eating. We can all do with avoiding the refined carbs and eating regularly.
Find out more at www.easyhealthwellness.com or call 012 997 2783.
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.
Neville Pillay is one of Durban’s favourite DJs and comedians… Who just happens to be a Type 2 diabetic. We speak to him about keeping up with the Morning Rush on Lotus FM, with diabetes.
How long have you been diabetic?
I was diagnosed well over 12 years ago, when I was 28 years old. But I remember my doctor telling me at 24 that I was at higher risk for diabetes because of my family history, and that I should change my diet… If only I had listened then!
Was your diagnosis a surprise?
To be perfectly honest, I knew all the symptoms – frequent urination, constant thirst, itchy skin, the sweats – but I chose to ignore them. By the time I was diagnosed I wasn’t surprised at all.
Are any of your family members diabetic?
My dad was and my mom is – she’s a Type 1 diabetic. You would think that would have made me more aware of diabetes, but the way we were brought up, we were ignorant about it – it was just something that my mom had. Type 2, or adult-onset diabetes, is also a very different condition to Type 1.
Do you ever talk about diabetes on air?
Absolutely: every chance I get to relate my story, I do. Many of my listeners on Lotus FM are affected by diabetes in one way or another, so it helps to be able to share our stories.
Do you ever tell jokes about diabetes in your comedy shows?
Oh yes, for sure. My comedy is based on my life, so of course I do! For example, I’ve got a lot of friends whose dads have passed away and left them things: cars and houses, even a Jaguar – all kinds of things. What did my dad leave me? Diabetes. I also like pointing out the irony of the fact that Indians came to South Africa as indentured labourers to cut sugar cane… And what disease do we all get? The sugars! Diabetes.
How do you balance a busy lifestyle with eating right and exercise?
It’s so difficult to do, so difficult. I’m not a pro at it and yes, I lapse every now and then. But for the most part I’m on point with eating well, staying away from sugary drinks and sweets and taking my medication. I’ve been a DJ since 1997 and I love it, but if you want any kind of stability or comfort zone, radio isn’t it. Every day is different and the landscape is constantly changing. So that’s an added challenge.
What do you think the biggest challenge of living with diabetes is?
To constantly monitor your blood sugar and make the right choices. The difficulty is in making those daily healthy choices, even when you’re around other people who can eat anything they like. That said, I know that there are terrible side effects, so it’s well worth making the effort. I was diabetic for a long time before I was diagnosed, and I know there have been some debilitating effects on my body, so I’m very careful to take good care now.
What advice would you offer to diabetics who are struggling?
Make one small change at a time and eventually you will have changed your lifestyle to effectively manage your condition.
What makes your life sweet
My girls, Jordan and Skylar, and my job. I love to entertain and it drives me daily.
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.
- 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.
- 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
- 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.
- 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!
- 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.
- 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.
- 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.
- 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!
- 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.
- 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.
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:
- 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
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!
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.
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|
From our community blog:
I wonder if anyone can advise me. I’m 27 (soon to be 28) and was diagnosed as a Type 2 diabetic in 2010. When I lived in South Africa, my average blood glucose would read between 5-7 and I would have occasional episodes of hypoglycemia.
Since I moved to South Korea, I have had the opposite problem. My reading first thing in the morning before breakfast is 10-14! I eat special K cereal with skimmed milk diluted with water for breakfast, a garden salad with no dressing for lunch and an average meal for dinner. I take Metformin 500 twice a day (I’ve been on that dose since I was diagnosed) and exercise regularly but I can’t seem to drop my blood glucose to within healthy levels.
I can’t really seek medical help because with my job, I can be deported if they find out I’m diabetic.
How can I get my blood sugar down?
Hi Kerissa, Just wondering if you eat snacks in between your meals as well? My dietician has me eat 7 times a day. Here are my thoughts:
- Find a doctor that specialises in diabetes, you might need your medication changed. I was been diagnosed in August 2012 with diabetes, my medicine has changed since and now I’m on both metformin and insulin.
- As far as I know, special K is a no-no for cereal. Rather eat oats with an apple.
Make a change in your breakfast and see if that helps. Then test 7 times through the day for 2 days and take that to your doctor’s appointment.
Hope you can get it under control. I battle sometimes too, you are not alone!
I’ve been a Type 1 diabetic for 11 years now, so I can give you some input. Good carbs as far as I know (low GI) are: oats not Oats So Easy, brown rice, sweet potato, rye bread, brown rice cakes. Healthy fats are good for your joints and lowering the GI of a meal or snack (fish oil/omega 3 oil, 30g of almonds, quarter avocado). Good proteins are handy for maintaining muscles. Don’t forget to drink sufficient amounts of water daily to stay hydrated.
We all know that a healthy diet is key to managing your diabetes. But should you also be taking a diabetic supplement? Andrea Kirk asks the experts.
Living with diabetes can be challenging, so when you hear about a natural supplement that works wonders, it’s easy to get excited. “A number of supplements have been said to play a role in improving insulin sensitivity, blood sugar control, and helping to prevent complications of diabetes,” says endocrinologist Dr Joel Dave. “Although there is some observational evidence to suggest that some of these may be beneficial, unfortunately there are no large, long-term, placebo-controlled studies that prove any supplement is effective when it comes to diabetes.”
Dietician Cheryl Meyer agrees: “In some cases benefits have been shown, but at this stage there is just not enough scientific evidence.” Both experts believe that a well balanced diet should provide all the essential minerals and vitamins you need.
“I don’t recommend routine supplementation,” says Dr Dave, “but if someone is deficient in a specific vitamin or mineral, then I would recommend they take a supplement of that particular vitamin or mineral.”
When a supplement may be necessary
If you are experiencing specific symptoms and suspect you are deficient in a vitamin or mineral, speak to your doctor about having a blood test. Your doctor will make a recommendation based on the test results and may prescribe a supplement. Keep in mind that the type and dosage your doctor prescribes may be different from what is found on the shelf. Stick to your prescription rather than self-medicating.
Be careful of drug interactions
Dietary supplements can have adverse interactions with prescription drugs, other herbal products or over-the-counter medications, warns Meyer. The effects range from mild to potentially life-threatening, so it is important to disclose everything you are taking to your doctor.
Never replace your conventional prescription
“Don’t replace a proven conventional medical treatment for diabetes with an unproven health product or practice. The consequences can be very serious,” says Meyer.
“I generally advise my patients to steer clear of supplements unless we know for sure that it’s necessary,” says Dr Dave. “Rather focus on sticking to a healthy diet and lifestyle, monitoring your blood glucose and taking the medication your doctor has prescribed.”
Supplements and their claimed benefits
Alpha-lipoic acid (ALA) is an antioxidant made by the body. It is found in every cell, where it helps turn glucose into energy. Several studies suggest ALA helps lower blood sugar levels. Its ability to kill free radicals may also help people with nerve damage, which is a common diabetes complication. For years, ALA has been used to treat diabetes-related nerve damange in Germany. However, most of the studies that found it helps were based on using intravenous ALA. It is not clear whether taking it orally will have the same effect.
Source: University of Maryland Medical Centre
Chromium is an essential mineral that plays a role in how insulin helps the body regulate blood sugar levels. For many years, researchers have studied the effects of chromium supplements on those with Type 2 diabetes. While some clinical studies found no benefit, others reported that chromium supplements may reduce blood sugar levels, as well as the amount of insulin people with diabetes need. Good food sources of chromium include whole grain breads and cereals, lean meats, cheese, some spices (like black pepper and thyme), and brewer’s yeast.
Source: University of Maryland Medical Centre
Fenugreek seeds may be helpful to people with diabetes because they contain fibre and other chemicals that are thought to slow digestion and the body’s absorption of carbohydrates and sugar. The seeds may also improve the way the body uses sugar and increase the amount of insulin released. An Iranian study found that a daily dose of fenugreek seeds soaked in hot water may be helpful in controlling Type 2 diabetes. Another study from the US suggests that eating baked goods, such as bread, made with fenugreek flour may help to reduce insulin resistance in people with Type 2 diabetes.
Several studies have shown that American ginseng lowered blood sugar levels in people with Type 2 diabetes. The effect was seen both on fasting blood sugar and on glucose levels after eating. One study found that people with Type 2 diabetes who took American ginseng before or together with a high sugar drink experienced less of an increase in blood glucose levels.
Source: Penn State Milton S. Hershey Medical Center
Magnesium deficiency has been associated with increased risk of Type 2 diabetes. Some studies suggest that supplementing may be beneficial, but other studies have shown no benefit. A healthy diet should provide all the magnesium you need, so have your doctor check for deficiency before you consider supplementing. Good food sources of magnesium include legumes, whole grains, broccoli, green leafy vegetables, dairy products, seeds and nuts.
Source: Oregan State University and WebMD
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.
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).
When you think of your diet as it relates to your diabetes, you probably think mostly about the foods you consume. However, did you know that staying hydrated is also a big concern if you have diabetes? In fact, polydipsia is the term given to excessive thirst that is a symptom of diabetes. According to the Mayo Clinic, dehydration occurs when the kidneys have trouble filtering and absorbing excess sugar. Those who suffer with diabetes insipidus are also at an increased risk for dehydration.
To ensure that you stay hydrated and reduce the risk of dehydration caused by diabetes, follow these three top strategies.
Keep a water bottle with you at all times
One of the easiest ways to stay hydrated is to keep a full water bottle with you at all times. This removes the need to purchase water outside of the home, makes it simple to have a constant supply of water, and serves as a constant reminder to drink water throughout your day. Since many public places are equipped with filtered water, you can prevent the onset of dehydration caused by diabetes with little effort and no expense.
Set reminders to get enough water
The importance of staying hydrated while managing your diabetes symptoms should not be overlooked. Dehydration is a serious condition which shouldn’t be treated lightly. If you are having a tough time remembering to drink water during the day (even while carrying a water bottle with you), set daily reminders for yourself on your phone or computer to make it a habit. Treat regular water drinking as if it were as essential as taking a medication on schedule.
Replace other beverages with water
Do you tend to drink beverages other than water throughout the day? Skip beverages that don’t provide adequate hydration. Instead, replace some of your carbonated beverages, coffee, and other drinks with a glass of water. Aim to drink at least eight 250ml glasses of water every day. Consuming a sufficient amount of water (rather than beverages that simply contain water) will help combat the risk of dehydration.
Make it simple to stay hydrated
Making it a habit to stay hydrated doesn’t have to disrupt your life. Begin working these simple steps into your life to limit your chances of developing dehydration as a result of diabetes. While it may take a few weeks (or more) to be sure that you are consuming the proper amount of water, you’ll eventually see how simple it is to stay hydrated throughout the day.
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.”
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.
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.
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.
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.
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.
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
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.
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.
- 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).
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.
All you need to know about what cholesterol is – and how to deal with high cholesterol.
- Cholesterol is a fatty substance that is naturally present in your blood and cells.
- It is measured in four parts: total cholesterol; LDL (low-density lipoprotein) which is the “bad cholesterol”; HDL (high-density lipoprotein) which is the “good cholesterol”; and triglycerides (a form of fat that the body makes from food sources, such as sugar and alcohol).
- Your body needs some cholesterol for healthy functioning. But many people have too much of the “bad” type and too little of the “good” type.
- In some cases, high cholesterol is inherited, but more often it is the result of an unhealthy lifestyle and too much saturated fat in your diet.
- Having high cholesterol does not cause any physical symptoms that you would be aware of. That’s why it’s often called a silent killer.
- Doctors advise that you have your cholesterol tested at least once a year. If you have diabetes, you’re aiming for an LDL reading of less than 2.8mmol/l.
- People with Type 1 or Type 2 diabetes are at higher risk for cardiovascular diseases such as heart attack and stroke. This risk increases if your LDL cholesterol is high.
- Many of the things that help to control your diabetes will also help to lower your cholesterol. Four lifestyle changes that can make a huge difference: lose weight; exercise more; avoid saturated fat; quit smoking.
- “Good” HDL cholesterol helps your body get rid of the “bad” LDL cholesterol. Include more healthy monounsaturated fats in your diet to assist this process. These include avocado oil, olive oil, peanut oil, avocados and most kinds of nuts.
- Keep in mind that these lifestyle changes aren’t always enough. Some people may need cholesterol-lowering medication too.
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.
From our community blog:
I am a Type 1 diabetic since 1991. I have had two children and desperately want a third, but cannot face another pregnancy like the second due to severe hypoglycaemia that kept occurring.
I want to get a pump – my doctor did initially suggest it and I have asked for a referral to a centre that deals with pumps. I also would like to know what the chance of getting a pump on medical aid is if it is recommended by a doctor and if the medical aid is paying for CDE at the moment?
I am trying to control my sugars now but even tracking them 6-8 times a day, taking multiple extra shots when needed and tracking my diet closely is not helping.
The CDE has 5 pump centers in Johannesburg. 011 7126000. They also have an amazing 5 day course called DINE. Speak to Michelle Daniels.
I hope this may be of some help in resolving your control problems. I used a pump for 10 years and found it to be helpful particularly as you can control the long acting (basal) insulin for your individual requirements. You programme the pump to dispense whatever you need for each hour of the 24 hour day which will be exclusive to your needs.
A phone call to your medical aid should be able to tell you if they will support the purchase fully or partially. I stopped using mine because my levy on the consumables was increasing beyond reason.
It needs time and expertise to learn how to use the pump. I know we are all different but I believe that with the proper advise and treatment you should be able to get control before getting a pump. It will help your new doctor (it seems you need one) if you keep a record of insulin taken, food consumed, and exercise taken.
I’m a chairman of a support group, find one of these as they can also be very helpful.