Irish dietitian Orla Walsh: Top food tips for type 1 & 2 diabetics
Whether you have diabetes or not, eating well is essential. However, the foods you choose in your daily diet to help manage your condition will make a big difference. Our resident dietitian Orla Walsh shares her dos and don'ts for diabetic diets
If you were to line up 15 Irish people aged between 20 and 79 years, one of these people is likely to have diabetes. For a condition which is regarded as relatively preventable, this number is staggering. What's worse, this number is increasing. In fact, it's estimated that one-in-five people over the age of 45 years are at risk of developing type 2 diabetes within the next five years.
Weight loss is often necessary as the majority of those with type 2 diabetes are overweight and being overweight is one of the reasons why diabetes develops. To put this into perspective, the risk of having undiagnosed diabetes increases by 90pc for every 5kg/m2 increase in BMI (body mass index).
Nutrition can prevent, control and put you in remission from type 2 diabetes. Many of the healthy eating tips for those with type 2 diabetes are based around weight loss if overweight, controlling blood sugar levels and keeping the heart healthy. Here are some simple dos and don'ts.
■ Top tips for type 2 diabetics
1 Don't forget that total carbohydrate intake counts
All carbohydrate-rich foods cause your blood sugar (aka blood glucose) levels to rise, regardless of how healthy the source is. Some carbohydrates cause blood sugar levels to rise slowly while some cause it to rise quickly. Therefore all diabetics need to be aware of the quantity and quality of the carbohydrates they are eating. Plants contain carbohydrate, in varying degrees. It's important that you're carbohydrate-savvy and know your portions.
For example, fruit is a healthy food that is rich in vitamins, fibre and phytocompounds. Fruit also contains carbohydrate. Therefore if you are a diabetic, despite fruit being super healthy, eating lots of fruit in one sitting is not advisable.
2 Eat your fruit, don't drink it.
The carbohydrate within fruit is released into your blood stream slower than the carbohydrate within fruit juice as your body has to process the fruit before it can be absorbed. By 'process it' I mean it has to mechanically break down the likes of the crunchy apple into tiny pieces using your teeth and your stomach muscles. This gives digestive juices greater access to the food so that is can chemically break it down to be absorbed. When you drink juice no mechanical digestion is needed. The digestive juices can act fast and absorb it quickly, causing a quick rise in blood sugar levels. Sticking to the example of the apple, when you eat an apple, you often eat just one. When you drink apple juice, you often drink the juice of four. This is why it's best to eat your fruit rather than drink it.
3 Don't eat sweets often
Fruit is a healthy food that along with many important health-boosting nutrients provides carbohydrate in the form of simple sugar to your body. Due to the sugar content, those with diabetes need to be mindful of how much fruit they eat, and how much at any one time. However, they do not need to cut fruit out of their diet as fruit, as well as vegetables, protects the body from ill health. Sweets, on the other hand, provide sugar, but provide no beneficial nutrients to the body. Therefore if someone with diabetes were to seriously reduce the amount of sweets they ate, as well as things like biscuits, cakes and other so-called 'treats' their body would be a healthier place. So those with diabetes, just like the rest of us, shouldn't eat sweets often.
4 Don't forget to check for added sugars
Natural wholefoods have not been tampered with by man therefore they do not have sugar added to them.
Processed foods, on the other hand, can contain added sugars. In order to see how much sugar your food contains, look at the packet for the nutritional information. You'll see the sugar content listed as 'of which sugars'. Your aim is to eat foods with less than 5g of sugar per 100g. Some healthy foods are naturally higher in sugar. So be sure to look at the ingredients to see if your food naturally contains sugar or has sugar added to it. It's the added sugars that you're aiming to reduce. But be aware, sugar has many names, so look out for the words 'sugar', 'syrup', 'honey' and words ending in '-ose'.
5 Do Eat more fibre
It's a safe assumption that you're not eating enough fibre. We need 24g-35g of fibre every day and 80pc of Irish adults do not eat this amount. General guidance such as 'eat wholegrain carbohydrates' often doesn't increase your fibre intake enough. So how do you make real gains? Here are some simple every day ideas.
· Go from white bread to wholemeal bread and bump up your fibre intake by 2g. However, change your butter to peanut butter and your jam to mashed strawberries and you'll be eating 6g more fibre.
· Instead of getting mayo and lettuce in your lunchtime sandwich, get guacamole, peppers and cucumber for a 4g bump.
· Change from white rice to brown rice and you bump up your fibre by 2g. However, halve your rice portion and add in half a tin of chickpeas and you've bumped it up by 9g.
· Add some seeds to a yoghurt as a mid-morning snack and enjoy a handful of nuts at your mid-afternoon snack for a 5g boost.
6 Go Au Natural
A good rule of thumb is when you choose what carbohydrates to eat, pick those that look similar to how they looked when they grew out of the ground. They're often more nutritious and can be lower in carbs and cals. The humble spud is a perfect example. Six baby new potatoes (about 200g worth) is only 130kcal and 30g carbs. It's a portion of carbs that most people would be content with. To put it into perspective, pasta contains about 250 to 350kcal per standard portion (150-200g cooked) and contains about 50-70g carbs. It's not a case of never eating pasta again. It's more an encouragement to eat our carb-rich plants more often than processed carbohydrates.
7 Combine your food for better Glycaemic Load (GL)
The glycaemic load considers the amount a meal impacts your blood sugar levels. To help lower the GL of your meals in a diabetic-friendly manner lean protein and veg need to become your new best pals. At the very least, both lunch and dinner need to be based on these two. This doesn't mean living off boiled chicken and steamed broccoli.
There are many healthy protein sources and a lovely variety of vegetables that can become your staples. See chart.
8 Eat more heart-healthy foods like soy
Many soya foods are naturally low in saturated fat which may help maintain healthy cholesterol levels. They also have cholesterol-lowering and heart-healthy properties. Try including more servings of soy into your daily diet.
· One handful of soya nuts
(roasted Edamame beans).
· 100g soya mince or chunks (as served).
· 85g marinated tofu.
· 75g silken hard tofu.
· One glass soya alternative to milk.
· Soy yogurt.
· 3-4 tablespoons fresh or frozen
young soya beans (aka Edamame).
Controlling blood sugar levels and eating heart-healthy foods can reduce the complications that go hand in hand with uncontrolle diabetes and poor diet. These tips will help put you on the right path.
■ Type 1 Diabetes top tips
Although type 2 diabetes and type 1 diabetes share the same name, they are rather different. Type 1 diabetes is an autoimmune disease. It develops when the body's own immune system attacks the organ called the pancreas. It does not develop due to an unhealthy lifestyle. It often occurs in childhood or early adult life and always requires insulin to be injected into the body or an infusion through an insulin pump. Regular exercise and making dietary adjustments can help better control your type 1 diabetes. The dos and don'ts for type 2 diabetes still apply. However, there are a few more handy tips for those with type 1 diabetes.
1 Adjusting meals Instead of adjusting your meals to your insulin, aim to adjust your insulin to your meals. You do not have to eat the same meals day in day out.
2 Carbohydrates Know your carbohydrate to insulin ratios. When you know how much insulin to inject per 10g of carbohydrate, you remove the guessing.
3 Know your insulin Be aware that the amount of insulin you require per 10g of carbohydrate may be different depending on a lot of factors including time of day. Do note that things like infections, stress and pregnancy can change your typical ratio.
4 Learn to be carb savvy If you're not carb portion savvy or are not aware of your ratios, sign yourself up for a course to learn more, eg DAFNE, Berger, BRUCIE.
5 Do not compare yourself to the stats If your HbA1c is good and you're healthy, you may never have complications from your diabetes.
6 Reduce your risk of complications To further reduce the risk of complications from your diabetes, eat to protect these parts of your body.
a. Aim for over five different fruit and veg each day. They'll help protect your eyes and heart.
b. Eat oily fish twice a week to protect your heart, eyes and nerves. Oily fish is any fish that isn't naturally white, eg mackerel, salmon, sardines, fresh tuna.
c. Drink lots of water and reduce your salt intake to help keep your kidneys functioning as they should.
7 Don't smoke. Ever The impact smoking will have on your body will be greater than someone without type 1 diabetes.
8 Get checked for coeliac disease Get checked for coeliac disease with a simple blood test at your local GP. Coeliac disease is more common in those with type 1 diabetes. Some people with undiagnosed coeliac disease have no symptoms, so get checked regardless.
9 Monitor your thyroid function Keep monitoring your thyroid function during routine blood tests also. Similar to coeliac disease, issues with thyroid function are more common in those with type 1 diabetes.
10 Don't underestimate the power of exercise Different exercise types impact your blood sugar levels differently. Know your body and get to terms with how your body responds. Do mix up the types and forms of exercise. And remember, when exercising, always carry hypo treatment with you.
Health & Living