Food - Prediabetes & Type 2 Diabetes

Food as fuel - and for a happy, well-balanced diet

The way we fuel our bodies is vitally important, whether or not we are facing up to diabetes or prediabetes. We've assembled plenty of tips and information to help you think about the best way to approach food and drink. A healthy, balanced diet is the key of course, and that means plenty of fruit, vegetables and wholegrain.

Sugar is a big issue these days - again not just for people concerned about diabetes and prediabetes - so we've assembled a special section with information tips and advice. And the importance of drink shouldn't be forgotten, so we we've put together a guide to healthy hydration.

For more information on nutrition and a well balance diet you can contact Mairi Huntly directly through her own website

The importance of a well balanced diet

food

Your approach to food and diet it vital. Get it right and maintain a healthy balanced diet, and you will be going a long way to prevent the onset of diabetes and prediabetes. And if you do live with diabetes or prediabetes, food and diet will play an important role when it comes to managing your condition.

Read more

More than that, the food you eat everyday will affect how you feel in yourself, and how much energy you can call upon. And balance is all-important. No single type of food on its own will contain the right mix of all the nutrients you need. To eat well, it is necessary to eat from all the major food groups.

eatwell plate

The UK's national food guide - the eatwell plate - defines the Government's advice on a healthy balanced diet. The size of the segments for each of the food groups is consistent with government recommendations for a diet that would provide all the nutrients required for a healthy adult or child over the age of five.

It shows how much of what you eat should come from each food group. This includes everything you eat during the day, including snacks. So, try to eat:

  • Plenty of fruit and vegetables
  • Plenty of rice, potatoes, pasta and other starchy foods. Choose wholegrain varieties whenever you can
  • Some milk and dairy foods
  • Some meat, fish, eggs, beans and other non-dairy sources of protein
  • Just a small amount of foods and drinks high in fat and/or sugar

For more information on a balanced diet visit www.nutritionist-resource.org.uk/articles/balanced-diet. You can also search for a nutritionist near you using their simply and easy website.

Sugar as a hot topic - and how best to approach it

sugar cubes

Sugar has been a hot topic recently. From Jamie Oliver urging the Government to impose a sugar tax on fizzy drinks to scientists warning that the recommended daily intake should be halved, the sweet stuff has hit the headlines on a regular basis.

Read more

Let's go behind the headlines and dig a little deeper. For a start, it's helpful to think about sugars by splitting them into two groups. The first is naturally occurring - such as lactose in milk. Then there is what is known as added sugar - such as table sugar and concentrated sources like fruit juice.

The latest advice from the World Health Organisation (WHO) says that only five percent of your daily calorie intake should be made up of added sugar. That adds up to about five or six teaspoons (25g) for women and seven or eight teaspoons (35g) for men. The fact that one can of fizzy drink contains about nine teaspoons shows how easy it is to break the recommended limits!

Here comes a little bit of science, because to know a bit more about sugar, you need to know about carbohydrates, which are classified in two groups: complex and simple.

Complex carbohydrates are made up of many simple sugars, which are joined together by chemical bonds. The more chains and branches of simple sugars, the more complex a carbohydrate is, and the longer it takes to be broken down by the body and the less impact it has on blood sugar levels.

Simple carbohydrates are either monosaccharides (one sugar molecule) such as glucose and fructose or disaccharides (two sugar molecules) like sucrose (glucose with fructose) and lactose (galactose with glucose).

Facts about glucose

Glucose is the main source of energy for your body - every cell uses it to work properly. The term blood sugar refers to glucose in the blood. Our body breaks carbohydrates down into units of glucose when we eat. As blood glucose levels increase, insulin is released by cells in the pancreas. Cells then take up glucose from the blood. As the cells absorb sugar, the levels drop.

The Glycaemic Index

The Glycaemic Index (GI) is a ranking of how quickly foods make blood sugar rise. High GI foods break down easily into glucose, which is the defining standard with a GI value of 100. Foods that are absorbed more quickly have a higher rating, and slowly absorbed foods a lower one. (Choosing slowly absorbed carbohydrates, instead of quickly absorbed carbohydrates, can reduce blood glucose levels for people with diabetes.)

It's good to cut down

As we mentioned above, there are naturally occurring sugars and added sugars that are found in fizzy drinks, juice drinks, chocolate, sweets, cakes and biscuits. These are the sugary foods that should be targeted when cutting down on sugar.

NHS Choices, the UK health website, has provided the following tips for cutting down on food and drink containing sugars for a healthy and well balanced diet:

Food Swaps

  • Instead of sugary fizzy drinks or sugary squash, go for water, lower fat milks, or sugar free, diet and no added sugar drinks. Remember that even unsweetened fruit juice is sugary, so limit the amount you have to no more than 150ml a day
  • If you prefer fizzy drinks, try diluting fruit juice with sparkling water
  • Swap cakes or biscuits for a currant bun, scone or some malt loaf with low-fat spread
  • If you take sugar in hot drinks or add sugar to your breakfast cereal, gradually reduce the amount until you can cut it out altogether
  • Rather than spreading jam, marmalade, syrup, treacle or honey on your toast, try a lower-fat spread, sliced banana or lower-fat cream cheese instead
  • Check nutrition labels to help you pick the foods with less added sugar, or go for the low-sugar version
  • Try halving the sugar you use in your recipes - it works for most things except jam, meringues and ice cream
  • Choose tins of fruit in juice rather than syrup
  • Choose wholegrain breakfast cereals, but not those coated with sugar or honey

Healthy drinking starts with water

water

A lot of column inches in newspapers, magazines and web pages are devoted to healthy eating. But often people overlook the importance of healthy hydration and drinking well as part of a balanced diet.

Read more

Water is essential for daily life, of course. But it is also a cost-effective and healthy choice when it comes to finding a partner to food or simply quenching your thirst. Apart from anything else it doesn't have a single calorie, and has no sugars that will damage your health.

So a good tip is to drink water whenever possible, and drink plenty of it. If you want to pep it up, go for sparkling water or maybe add a squeeze of fresh lemon or lime. No-added-sugar squash or adding a splash of fruit juice are also good ideas.

Fizzy drinks

As we've seen in the food section, fizzy drinks, squashes and juice drinks can contain lots of added sugar. Watch out for flavoured water, as some varieties have a lot of added sugar. So make sure you get into the habit of checking labels. Similarly be careful of "juice drinks", which may have less fruit and more added sugar than you expect.

Milk

Milk contains the sugar known as lactose. It has a GI value of 41, and therefore considered a low GI food. It is broken down slowly and helps increase the absorption of minerals such as calcium, magnesium and zinc.

Milk is a good source of calcium, which helps build and maintain healthy bones. It also has protein, vitamins and other minerals, and does not cause tooth decay.

For a healthier approach, choose semi-skimmed, 1% fat or skimmed milk. And remember that if you drink flavoured milk, milkshakes, condensed milk and so on that these will contain added sugar.

Juices and smoothies

Take a common sense approach to juices and smoothies. The fresh fruit and vegetables will of course have a good variety of nutrients that all contribute to a good and healthy diet. But don't forget that juice contains sugar - and too much of it can harm teeth.

Tea, coffee and caffeine in general

A balanced diet can contain tea and coffee. But remember that caffeine is a stimulant, and can temporarily make you feel more alert or less sleepy. Adding sugar, or flavoured syrups, will have its own implications to think about. And as we've already seen it’s good to cut down on sugar.

Don't forget too that energy drinks usual contain high levels of caffeine and are often high in sugar. Sports drinks can help give an energy boost when you need it, but when it comes to dietary matters they are no different from any other sugary soft drink.

Healthy drinking tips

  • Water is best! Add some flavour with a squeeze of lemon or lime, or a slice of fruit such as strawberry
  • Enjoy your tea, coffee and hot chocolate, but think about spooning in less sugar and use semi or skimmed milk
  • Look out for caffeine-free herbal drinks, which make an alternative hot treat
  • Fruit juices contain vitamins and minerals but don't forget about their sugar content
  • Milk is great way to hydrate after sport and exercise - and it's a healthy source of calcium, protein and carbohydrate. Choose the semi and skimmed varieties

Fuelling with Type 2 Diabetes

pasta

This article has been provided by Dalia Maori R.D
Dalia is a Registered Dietitian based in Cambridge. She is fully accredited by both the UK's Health Professions Council and the American Commission on Dietetic Registration. The RD credential is reserved only for those nutritionists who have completed rigorous clinical and academic training.

Read more

One of the most positive things a person with Type 2 diabetes can do is to become fitter (build more muscle tissue), lose weight (especially around the waistline) and eat foods which will regulate blood sugar levels.

Carbohydrates are an important food group when it comes to fuelling the body for exercise, but knowing the difference between healthy and less healthy carbohydrate sources is essential for general health and weight loss.

Healthy (or low glycaemic) carbohydrates release sugar into the blood more slowly than less healthy (high glycaemic) carbohydrates which can dump too much sugar into the blood at once - causing hyperglycaemia (high blood sugar).

People with Type 2 diabetes should be aware that some medications may cause hypoglycaemia when dietary and exercise changes are made: this doesn't mean you should avoid making healthier choices and moving more. Just speak to you doctor before you make any significant changes and track your blood glucose levels. If hypoglycaemia (low blood sugar) occurs, ask your doctor to lower your dose.

 

Healthy carbohydrate choices for type 2 diabetics:

1. Legumes - lentils and beans are outstanding sources of carbohydrate: they release sugar very slowly into the blood preventing the high blood sugar which results from fast releasing carbohydrates. Their fibre and protein help to keep a person full for longer and they are packed with vitamins, minerals and antioxidants for optimal health. They are also very cheap.

2. Quinoa - a nutrient dense seed which is lower in overall carbohydrate then other grains, yet it can be eaten like a grain. Easily prepared, its high fibre and protein keep a person full for longer.

3. Vegetables - non starchy vegetables should make up half of the meal plate of anyone seeking optimal health, including type 2 diabetics. Starchy vegetables such as peas and butternut squash are good replacements for the more starchy pasta or rice for type 2 diabetics. Essentially, if a meal plate is almost all plant based colour, things are going well. Avoid potatoes without the skin on - new potatoes are the best choice from the potato family.

Why? – Potatoes without skin lack nutrients and have a higher glycaemic index which effects how quickly the sugars are absorbed from the carbohydrates. Mash potato is the therefore to be avoided. There is only a low amount of fibre in it leading to a high glycaemic index and also when the potato is mashed the cell structure is broken down, leading to the sugar being released quicker into the blood stream. Cold new potatoes with the skin on are the best as fewer carbohydrates are absorbed.

4. Lower carbohydrate fruits are great dessert choices for people with type 2 diabetes. Berries, such as blackberries and blueberries, are wonderful examples.

5. When eating grains, make sure they are in their whole intact form. Choose jumbo oats over processed breakfast cereal, brown rice over white and eat wholemeal pasta al dente.

Why? – The benefits of wholemeal pasta cooked al dente are all to do with resistant starch. Resistant starch is starch that is not broken down in the small intestine and as such acts in a similar way to fibre (meaning it keeps you regular).  Two main benefits of eating resistant starch are improved insulin sensitivity (how well your body produces and absorbs insulin) and lower blood sugar levels.

6.  And remember, drink lots of water!

 

pasta

Less healthy carbohydrate choices for type 2 diabetics:

1. Anything white: white bread, pasta, rice, crackers - all of these release sugar into the blood too quickly to be healthy for a person. Not only that, they are more likely to lead to weight gain and do not satisfy the appetite enough, due to their low fibre and nutrient status.

2. Processed breakfast cereals: it doesn't matter how healthy they say they are on the label - they release sugar too fast into the blood and are not satisfying. Choose something natural like boiled eggs, vegetables and a heavily seeded wholegrain toast instead.

3. Juice - do not drink fruit juice ever.

Why? - A good summary of the high level of sugar that can be found in fruit juices is present in the fact that when type 1 diabetics have hypos (low blood sugar) one of the quickest ways (but not the best - pure glucose is better) to get sugar back into the blood stream is by drinking fruit juice. As such if you are diabetic and trying to manage your levels fruit juice can cause huge spikes in blood sugar which can exacerbate weight problems as the sugar can be stored as fat. 

4. Try to avoid higher sugar fruits such as tropical fruits or dried fruits - focusing on lower carbohydrate fruits such as peaches will help with blood sugar control as well as weight maintenance.

5. Biscuits and cakes should be avoided as much as possible - they contain fast releasing sugar from the flour and the pure sugar they contain. Try having a few squares of high cocoa content dark chocolate instead. Avoid chocolate labelled as 'diabetic' - the artificial sweeteners they contain can induce diarrhoea while their carbohydrate content can still be too high.

 

For more of Dalia’s work head to - www.daliamaorinutrition.com

Join our newsletter