Diabetes Diet Information

Q: Can I Still Have Some Sugar in my Diet?

A: Yes. The diabetes diet does not mean a ‘sugar free’ diet. Sugar can be eaten as part of a balanced, healthy diet without having a harmful effect on blood glucose control. However, you should still try to cut down on sugary foods and drinks since eating them has implications for tooth decay, weight control and the overall balance of your diet.

Blood glucose control depends on diabetes medication and lifestyle factors, such as how much activity you do as well as what you eat.

As we are all different in terms of our nutritional needs, the limits are different too. Lots of foods contain sugar – natural or added – and it is the overall food choices you make, rather than just one food, that will determine whether you are eating a healthy diet.

Tips to Cut Down on Sugar

• Choose sugar free or low sugar versions of soft drinks and sodas. Sugar in a liquid form is rapidly absorbed and raises blood glucose levels quickly.

• Try experimenting by using less sugar in cooking and baking.

• Look out for reduced sugar, low sugar and sugar free foods as they can help you to reduce the overall sugar content of your diet. Remember that the fat, calorie, fibre and salt content of the diet is important too.

• Although jelly/jam is a high sugar food you only have a teaspoon or two on a slice of bread so the amount of sugar per serving is small. You may like reduced sugar jams because of the flavour but remember they won’t keep as long.

• Savoury foods that contain sugar (like some sauces, soups and vegetables) can be eaten as usual.

• Choose the reduced sugar versions of foods you tend to eat larger portions of and which you may eat regularly as part of a healthy diet.

• Although you may worry about the sugar content of cakes, confectionery and cookies, fat content is an issue, too. Some varieties of biscuits are also lower in fat — so compare nutrition information per cookie to make a fair comparison.

• As an alternative to cake there are lower fat baked products available, such as teacakes, malt loaf, scones and muffins. However, a piece of fancy cake on a special occasion such as a birthday will not harm the balance of your diet.

• Cookies and cakes should not form a large part of your diet so those labelled reduced fat or reduced sugar will not offer a big reduction in the overall fat and sugar that you eat.

For patients who suffer from Type 1 diabetes, diet is an important element of their clinical care. All patients with Type 1 diabetes should have access to a qualified dietitian.

Q: When I was first diagnosed I was told I could only have two egg-sized potatoes at my main meal. Is this still true?

A: Starchy foods like potatoes, bread, cereals, rice and pasta should be the basis of all your meals. This is because these foods help you to keep your blood glucose levels steady. Try and choose wholemeal or wholewheat varieties where possible. Everyone with diabetes has individual dietary requirements, which is why it is important to get specific advice from a local dietitian. He or she will guide you on the amounts of different foods you should eat.

Q: Which fruits contain the most sugar?

A: People with diabetes can eat any kind of fruit, regardless of the sugar content. Everyone is encouraged to eat at least five portions of fruit and vegetables every day. Spreading the fruit you eat through the day will avoid a sudden rise in blood glucose levels. Although some fruits have a lower glycaemic index, which shows how foods affect blood glucose levels, the important thing is to increase the amount of fruit you eat, including a wide variety of different fruits.

Q: Is it true that I shouldn’t eat bananas or grapes?

A: No. All fruit and vegetables are extremely good for you. They are high in fibre, low in fat and packed with vitamins and minerals. Research has shown that eating more can reduce the risk of coronary heart disease, some cancers and some gut problems. You should aim to eat five portions of fruit and vegetables per day: for example, three portions of fruit and two portions of vegetables or vice versa. Eating more fruit and vegetables also helps to improve the overall balance of the diet. Fruit is the perfect snack.

One portion =

• one medium- sized fresh fruit (apple, pear, banana, etc)
• two small fruits (apricots, plums, kiwi fruit, etc)
• a cupful of berries or very small fruit (grapes, raspberries, etc)
• a bowlful of salad
• a large slice of a large fruit (melon, pineapple, etc)
• three serving spoons of tinned or stewed fruit
• half a serving spoon of dried fruit
• a small glass of unsweetened fruit juice
• three serving spoons of a small vegetable (sweetcorn, peas, etc)
• two serving spoons of green or root vegetables or pulses (beans, carrots, etc)

Q: Do I need to eat special diabetic foods?

A: There is no need for anyone with diabetes to eat special diabetic foods like cookies, chocolate, jelly/jam or sweets. Instead you can eat ordinary chocolate, biscuits and jams as part of an overall balanced diet. The diabetic foods often cost a lot more, and tend to be just as high in fat and calories as ordinary products. They usually contain a bulk sweetener, such as fructose or sorbitol, which can have a laxative effect and make blood glucose levels rise. Diabetic foods are unnecessary and offer no special benefit to people with diabetes.

Remember that all confectionery, cakes and cookies are high in fat and calories and need to be limited according to the individual.

NOTE: We recommend that people with diabetes should see a state-registered dietitian locally for more specific advice about their individual targets and requirements.

Q: Do I need to eat a special diet now that I have diabetes?

A: No. The diet for diabetes is a balanced healthy diet, the same kind that is recommended for the rest of the population — low in fat, sugar and salt, with plenty of fruit and vegetables and meals based on starchy foods, such as bread, potatoes, cereals, pasta and rice.

Q: I’ve been asked out for a meal as a birthday celebration. Should I go?

A: People with diabetes can often feel daunted at the thought of eating out, whether it be at a restaurant or family party. Eating out should be no problem if you remember these tips:

• If your diabetes is controlled by insulin and you are going to eat later than normal you can delay your insulin and just have a small snack when you would normally eat to prevent going hypoglycemic
• If your diabetes is treated by diet alone or with tablets the timing isn’t as crucial
• It may be difficult to judge when food will arrive in a restaurant so if you take insulin inject as the food arrives
• If you are going to a party your host may phone in panic, wondering what you can or can’t eat. Tell them not to go to any trouble and reassure them that you are no different to anybody else
• We all like to have the odd meal that is higher in fat and sugar when we eat out, but if you eat out regularly you will need to take more care and make healthier food choices
• If you are going to a party, don’t just assume that food will be served. Try to check beforehand and if so establish what time it will be served.

Q: Can I still fast during Ramadan if I have diabetes?

A: Most Muslims fast during the month of Ramadan and it is possible to manage your diabetes during the period of fasting. No food or drink is taken between sunrise or sunset. People who are ill, pregnant or have a chronic condition like diabetes can be exempt from fasting during Ramadan.

For those people with diabetes who are diet controlled, fasting does not necessarily present a problem. It is important to make sure that food is taken when the day’s fasting is finished and before the fast begins.

For those people who are on tablets for diabetes it would be best to talk to a doctor about whether to continue taking tablets during the fast. If continuing then the tablets should be taken at the end of the fast (ie in the evening in order to cover the period of eating).

People with diabetes who are on insulin therapy will probably need to speak to their healthcare team about adjusting their regime because of the risk of hypoglycaemia. If you are concerned about fasting it is important to discuss it with your diabetes doctor or nurse.

Q: I’ve been told that some fats are worse for you than others. Can you explain what the different types of fats are and which I need to avoid to stay healthy?

A: Everyone is encouraged to cut down on the amount of fat in their diets. This is because fatty foods contain a lot of calories, which can cause us to become overweight. Try to cut down on saturated fat in particular and replace it with monounsaturated fat. Eating too much saturated fat is related to heart disease. The different types of fat (saturated, polyunsaturated and monounsaturated) have different effects on cholesterol levels — saturated fats put your cholesterol level up, whereas polyunsaturated and monounsaturated fats actually help to lower cholesterol.

Saturated fats are usually found in fatty meat, full fat dairy products, butter and lard.

Monounsaturated fats are found in olive oil and canola/rapeseed oil products. There is also a wide range of margarine and low fat spreads based on monounsaturated fats.

Polyunsaturated fats include sunflower, corn oil and soya oil, some margarine and low fat spreads, and oily fish such as mackerel, pilchards or sardines.

Q: How can I cut down on fat in my diet?

A: Use less of your margarine or use a low fat spread instead. Avoid adding any extra fat or oil to foods when cooking. Broil, bake, microwave, steam or poach instead of frying. Limit the amount of cookies, cakes, pastries and potato chips that you eat — even the low fat ones. Use lower fat dairy products such as skimmed or semi-skimmed milk, cottage cheese, low fat hard cheeses and yogurt. Try to choose leaner cuts of meat or trim all the visible fat off before cooking.

Q: How can I cut down on salt without my food tasting bland?

A: Generally we all eat more salt than we need. This isn’t just the salt we add at the table or in cooking. There’s also the salt added to food by manufacturers, because of its preservative and flavour-enhancing properties. Although we all need to cut down on salt it is particularly important if you already have high blood pressure. We recommend that you reduce your intake of salt rather than replacing it with one of the low sodium alternatives available.

Clearly you can’t take the salt out of manufactured foods but where there is a choice opt for foods that have less salt added.

You may find it easier to get used to a less salty taste if you cut down gradually or enhance the flavour of foods with herbs and spices.

Points to Remember

What, when, and how much you eat all affect your blood glucose level. You can keep your blood glucose at a healthy level if you:

• Eat about the same amount of food each day.
• Eat at about the same times each day.
• Take your medicines at the same times each day.
• Exercise at the same times each day.

Every day, choose foods from these food groups: starches, vegetables, fruit, meat and meat substitutes, and milk and yogurt. How much of each depends on how many calories you need a day.

Limit the amounts of fats and sweets you eat each day.

How to Find More Diabetes Diet Information

Diabetes Teachers (nurses, dietitians, pharmacists, and other health professionals)

To find a diabetes teacher near you, call the American Association of Diabetes Educators toll-free at 1-800-TEAMUP4 (1-800-832-6874) or see www.diabeteseducator.org and click on \"Find a Diabetes Educator.\"

For UK Diabetic Help, see the British Diabetic Association website:
www.diabetes.org.uk/home.htm

Recognized Diabetes Education Programs
Teaching programs approved by the American Diabetes Association

To find a program near you, call toll-free 1-800-DIABETES (1-800-342-2383) or see www.diabetes.org and click on \"Diabetes Info.\"

Dietitians
To find a dietitian near you, call the American Dietetic Association\'s National Center for Nutrition and Dietetics toll-free at 1-800-366-1655 or see www.eatright.org and click on \"Find a Dietitian.\"

SOURCE: National Institute of Diabetes and Digestive and Kidney Diseases. U.S. Department of Health and Human Services, National Institutes of Health, 2002. Website: www.niddk.nih.gov/

Health Disclaimer - The diabetic diet information and advice offered above is intended as a general guide ONLY. If you have diabetes, please consult your doctor about the best way to handle your condition. Diabetes is a serious condition which requires personal, professional advice.