diabetes meal plan

Understanding diabetes nutrition

Living with diabetes: Understanding diabetes nutrition

 

healthy diabetes nutrition

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

10 helpful tips for a healthy diabetes diet

 

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

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

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

Eating for diabetes

 

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

Building balanced meals

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

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

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

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

 

Photo by Anna Pelzer on Unsplash

The carbs-fat-protein debate

Ask the dietician: Genevieve Jardine

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

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

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

How do carbs work in the body?

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

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

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

Where do fat and protein fit in?

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

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

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

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

Making the right food choices (at work)

Ask the dietician: Cheryl Meyer

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

Step 1: Build your plate

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

Look out for:

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

Some good protein choices:

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

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

Avoid:

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

Step 2: Choose portions with caution

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

Step 3: Carefully consider your choice of drink:

Some good choices are:

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

Finding the right food for diabetics

Sometimes the biggest challenge to eating a healthy diet is finding the right ingredients: here’s how Annora Mostert, the founder and group owner of Anja’s Pantry, and Alliyah Geldenhuys, who just opened Anja’s Pantry Plumstead, did just that.

Do you have a special interest in diabetes?

“It soon became clear that people with diabetes have the biggest need for healthy low carbohydrate and sugar-free food,” explains Annora. “So we involved trained nutritionists to guide us in what the right type of products should be for diabetics, and started to change the content of our pantry.” The result? All the products in Anja’s Pantry stores are now diabetic friendly. Some of the store owners also have close family members with diabetes, so as a team they work together to stock the right kind of products.

Do you think awareness is growing around healthy food alternatives?

“Absolutely! Social media is the biggest contributor creating awareness, but the awareness is now affecting policies. The research is so clear and the problem is so great that the South African government has followed the UK government in introducing a sugar tax next year on foods to try to curb the high sugar content in processed foods,” says Annora. As a result, all their stores offer a wide range of food products that are sugar-free and low carb so that those who want to avoid sugar can still have a variety of foods to choose from. “Our range of food products is now over 200 items with more being added all the time. This becomes a mini grocery store for the large percentage of the population that are either diabetic or pre-diabetic, those who have allergies or those who just want to lose weight while enjoying their food.”

How did you choose the location of Anja’s Pantry Plumstead?

Anja’s Pantry in Plumstead is right next door to a number of fast food restaurants. “We chose the location on purpose,” explains Alliyah, the owner of the store. “We want to provide healthier options to those in Plumstead and surrounds. It’s often difficult to prepare home cooked meals and so called ‘proper food’ with the fast paced lifestyles that many of us lead today. We end up simply settling for the quickest and easiest option available, but often these are unhealthy food choices. With our easy to prepare premixes and pre-prepared items such as pizza bases and meals, we are hoping to make it much easier for those wanting to enjoy a more nutritionally sound meal.”

Do you think there’s a particular need for healthy alternatives in the Muslim community?

“Yes! Traditional Muslim food is well known for being loaded with unhealthy fats, excessive carbohydrates and sugars. Diseases such as diabetes, high blood pressure and cholesterol are rife within the Muslim community and have sadly become a way of life for many within the community. I think it’s possible to ‘eat yourself healthy’, and that if we can share this vision and all that it stands for it will change the lives of many and allow Muslims to re-think their food choices.”

Do you have any advice for those who are struggling with their diabetes?

“Living a sugar-free and low carb life shouldn’t be that difficult,” says Annora. “We know that it is more expensive since real food items aren’t mass produced and made with lots of chemicals, but it saves so much on unnecessary medical bills.” Alliyah agrees. “An important part of managing your condition is to eat healthy meals and steer clear of certain items. Always read labels and check the ingredients of items that you purchase, as product packaging can often be misleading!”

What makes your life sweet?

For Annora, it’s feeling healthy and eating without feeling guilty. For Alliyah: “My amazing family, who made the opening of this shop a reality. It would never have happened without their help, guidance and support.”

Get in touch with Anja’s Pantry: Anja’s Pantry – the Food Farmacy on Facebook, @Anjas_Pantry on Twitter or www.anjaspantry.co.za

Diabetes-friendly kids menu

Ask the dietician: Genevieve Jardine

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

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

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

Breakfast:

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

Lunchboxes:

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

Dinner:

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

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

Living the low carb life

When Vickie de Beer’s son Lucca was diagnosed with Type 1 diabetes, she started a journey that ended with her publishing an award-winning cookbook and lifestyle guide: The Low Carb Solution for Diabetics.

Looking back, what do you wish you’d known when Lucca was first diagnosed with Type 1 diabetes?

That insulin takes much longer to reach the blood stream than we were told. I had a lot of anxiety about Lucca going into a hypo after eating, and it was completely unnecessary. I also wish I knew what a huge impact carbohydrates had on his blood sugar! We did carb count and test and inject diligently, but there were always unexplained highs and lows that frustrated me and made Lucca feel awful.

What inspired you to write The Low Carb Solution for Diabetics?

We have always, from the first day, taken Lucca’s diabetes seriously. We did everything the doctors and dietician told us. We adapted our diet to eating only low GI foods and tested Lucca’s blood sugars diligently. Every time we went to the doctor they congratulated us on his great HbA1c result and said that we were doing everything possible for Lucca’s health.

The doctor always said that the next step would be to control the extreme fluctuations between high spikes and lows in Lucca’s blood sugar. I could never get clear information on how we were supposed do that though, apart from doing what we were already doing. About a year ago I met Prof Tim Noakes at the book launch of Real Meal Revolution. We significantly reduced our carbohydrate intake, but did not remove carbohydrate completely from our diet.

I didn’t understand how we could remove all the carbohydrates from Lucca’s diet as suggested by the LCHF (Low Carb High Fat) movement. We were taught that children needed carbohydrates for energy, growth and brain function and I also knew that Lucca needed to get insulin. If we took away the carbohydrates how would he get the insulin he needed? I still gave the children small amounts of Low GI carbs like brown rice and brown pasta with their evening meals. Lucca’s blood sugar did not improve significantly – I would say that we were on a moderate carb diet.

A few months ago I made contact with a group in the USA that follow a low carb high protein (not high fat) diet with great success in managing steady blood glucose levels in Type I diabetic children. This way of managing diabetes is based on a book: Dr Bernstein’s Diabetic Solution. Dr Bernstein has been a Type 1 diabetic for 69 years. After reading his book and studying various other low carb websites and books, we decided to change the way we eat.

Do you have any tips for people who feel overwhelmed at the thought of changing their way of eating?

Do it gradually. We started with breakfast (because the boys love bacon!) and then did dinners – lunchboxes were the last!

What advice would you offer to people living with diabetes who are struggling?

Diabetes is in the details. The best tool is to test constantly and diligently. The bottom line is that cutting carbs makes diabetes easier to manage. All the hundreds of reasons I used to give to explain Lucca’s unstable sugar – the heat, stress, tiredness – it was always the carbs!

What makes your life sweet?

Hugs from my boys! Playing board games with them (and winning), swimming and braaing with them, reading with them… The fact that Lucca’s blood sugar is under control has changed our lives. We had a lot of anxiety in our life beforehand. Although we still test and inject diligently, the anxiety is gone. I think we have finally taken control of diabetes, and diabetes has lost its control over us.

Get in touch with Vickie: @Vickiefantastic on Twitter

Top tips for a pregnancy diet

Ask the dietician: Cheryl Meyer

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

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

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

Foods to avoid:

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

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

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

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

A note on cravings:

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

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

Diabetes dietary tips

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:

  1. Use of medication (oral meds or insulin injections)
  2. Diet
  3. Exercise

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
  • rusks.

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.

“Cheat” treats


Ask the dietician: Genevieve Jardine

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

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

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

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

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

How to cheat:

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

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

10 FAQ about the diabetic diet

Ask the dietician: Cheryl Meyer

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

Proudly South African portion sizes

Ask the dietician: Cheryl Meyer

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

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

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

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

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

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

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

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

One carb portions of Proudly South African foods:

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

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

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

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

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

* According to The SA Food Tables

“Junk” food for diabetics

Ask the dietician: Genevieve Jardine

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

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

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

Healthy take-out

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

Braai menu

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

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

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

* Remember that one carbohydrate portion = 15g.

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

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

 

The best diabetes-friendly drinks

Ask the dietician: Genevieve Jardine

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

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

So what else can you drink?

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

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

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

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

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

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

Everyday drinks – low carb, no artificial sweeteners

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

Treat drinks – medium carb

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

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

Crazy blood sugar fluctuations?

From our community blog:

Good morning,

I am in urgent need of assistance to help me get my diabetes / blood sugar levels in control and I’m actually almost on the brink of losing it… I’m struggling with sky high sugar levels and very low sugar levels, but it’s never between 4 and 6, it’s either lower, very low, or very-very high! I don’t know what to do anymore…

Please give me some advice. I am 28 years old, and have been diabetic since I was 9 years old.

Please help!

– Vasti

Comments:

Do not give up. If you are in a position to visit a Provincial Hospital do so. I want you to see a doctor please, for expert advice, as you need to undergo tests.
Krish

Dear Vasti
Sorry to hear that you are struggling with your diabetes. It is difficult to know how to help unless I have some information about types, doses and frequency of injections as well as some glucose values. You need to test and establish a pattern as to when the problems occur and in relation to what. Blood sugars that swing up and down cause more problems than those that are more stable. I suggest you establish a testing profile and then post again.
Regards
Lyn

Hi Vasti,

I have been a diabetic for 9 years as well and I am also 28 years old. You need to take a look at your diet and your lifestyle. From your email you sound like you are under a lot of stress and that is not helping your diabetes. With your sugar levels being so out of control your moods get affected badly. So strange how sugar levels have this effect on us but very true. You need to eliminate as much stress from your life as you can. You can get back to where you need to be as long as you take the day by day steps.

Your eating is very very very important and if you can try to exercise you must. When I was first diagnosed mine used to sit in the 30′s NOT GOOD! But now I am between 5-8 most days. I know that there are days when it is hard to keep your sugar levels under control but YOU CAN DO IT!

Please let me know if I can help with anything!
Thanks
Angela

Maintaining a healthy weight with diabetes

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.


Losing weight

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.”

Fun festive food

Ask the dietician: Genevieve Jardine

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

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

Watch your weight

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

Treat yourself

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

Get active

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

Re-gift the chocolates

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

Plan ahead

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

Watch the alcohol

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

Party tricks

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

 

Photo by Brooke Lark on Unsplash

How to eat seasonally

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!

Download (PDF, 1.08MB)

Quick diabetes-friendly food

Ask the dietician: Genevieve Jardine

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

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

Some helpful tips for simplifying food choices:

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

Breakfast ideas:

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

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

Lunch ideas:

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

Dinner ideas:

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

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

Get more fantastic meal ideas here.