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Diet and Weight - the basics explained

• Introduction
• How important is diet ?
• How does eating affect my blood sugar ?
• How much food should I eat?
• Is it better to eat special Diabetic foods?
• What makes a healthy diet?
• Are there any foods I can’t eat?
• Can I eat lots of fruit?
• What is the Glycaemic Index?
• What are Exchanges?
• Over-the-counter foods
• Can I eat a snack?
• How can I cut down on my fat intake?

 

Introduction

Type 2 Diabetes can often be well controlled initially by diet alone.  Achieving and maintaining appropriate body weight is an important part of this process.  We recommend that all our patients with Type 2 diabetes see a dietician at the time of diagnosis and have ongoing review of diet if necessary.

How important is diet?

It is estimated that at least 80% of people newly diagnosed with Type 2 Diabetes are overweight.  Dietary advice is essential if weight loss is to be achieved.  Control of blood sugar is not the only goal in managing your Diabetes, as weight control in the long-term will protect you against cardiovascular disease.

How does eating affect my blood sugar?

Your blood sugar concentrations are influenced by the food you eat, what type, how much and how often.  In order to keep your blood glucose well controlled, it is important that you attempt as far as possible to eat the same amount of food at roughly the same time.  Try not to skip meals.  Ideally, your daily routine should not vary greatly in terms of your level of activity (exercise).

How much food should I eat?

The amount of food you eat should ideally be determined by your age, sex, current body weight and level of activity.  The following table should serve as a rough guide.

Is it better to eat special Diabetic foods?

There is no such thing as a Diabetic diet.  A healthy diet is what is recommended for all people, including those who do not have Diabetes.  Diabetic foods are artificially sweetened and have no other special properties.  Some of them, such as Diabetic chocolate, are in fact high in fat.  Diabetic cakes, jams and chocolates use sweetening compounds such as fructose and sorbitol instead of sugar.  Diabetes UK has a leaflet on these so-called ‘special foods’.

What makes a healthy diet?

People with Diabetes should aim to eat a diet which is:

1. Low in fat (especially saturated fats)
2. Low in sugar
3. Low in salt

The main base of your meal should consist of starchy carbohydrate foods such as pasta, bread, rice, yams or chapatti.  You should also try to eat more fruit and vegetables (4-5 portions daily).

Are there any foods I can’t eat?

In a word, no.  It is the quantities that matter.  There is no need to avoid anything containing sugar, though you should try to eat as little as possible.  You may even eat cakes, biscuits and puddings, though in very tiny amounts.

Can I eat lots of fruit?

Eating fruit is okay in moderate amounts.  Large amounts of fruit and fruit juices can lead to problems with blood sugar as fruits contain a form of sugar known as fructose, which can become converted to glucose in the body.  It is recommended that you try to eat 5-8 portions of fruit and veg per day.  Fruits should be ideally eaten fresh.  If you prefer tinned fruit, this should be in natural juice and not in sugar syrup.  Avoid eating lots of sweet fruits such as grapes and mangos.  Dried fruits may be eaten with cereal to provide more fibre.

Aim for 5-8 portions of fruit and vegetables per day

What is the Glycaemic Index?

Different carbohydrates will influence your blood sugars in different ways.  Carbohydrates can be graded according to their ability to raise your blood glucose.  This is known as a Glycaemic Index.  The greater the number, the more quickly your blood sugar will rise.

What are Exchanges?

This is another way of grouping or grading foods into different categories.  The foods listed in each category will have roughly equivalent amounts of energy, carbohydrate, protein and fat.  You can swap between these various foods and still get the same nutritional value.  The concept of exchanges is a useful way of introducing variety into your diet.

Over-the-counter foods

Most packaged and ready-to-eat meals have nutritional information on the pack.  This information is useful to give you an idea of exchanges and the amount of fat and carbohydrate in different types of foods.

Can I eat a snack?

It's good to snack.  People with Diabetes are encouraged to eat a snack as it helps spread the intake through the day.  Choose low-fat snacks - for example, a piece of carrot, fresh fruit and low-fat yoghurt are ideal snacks.

How can I cut down on my fat intake?

Foods such as butter, margarine, chocolates, cheese and fried foods contains more fat. These foods have a high calorie content and lead to weight gain.

• Avoid frying foods – use alternative methods such as boiling, steaming, grilling or roasting
• Use low fat dairy products such as skimmed milk, low fat spreads and low fat cheese
• Trim off visible fat from meat, remove skin from poultry.
• Try to eat fish at least two to three times per week
• Reduce your intake of ice cream, chips, crisps, nuts and processed meat

Useful links:

The British Nutrition Foundation: www.nutrition.org.uk

Calorie Counter: www.caloriecounter.co.uk

Low-fat recipes: www.low-fat-recipes.com

 

Dr Nishan Wijenaike, Consultant Physician
West Suffolk Hospitals Diabetes Service
October 2002