Aims of a healthy eating plan

A diet for someone with diabetes is not a 'special diet'. It is a normal, healthy, well balanced eating pattern. People with diabetes do not need meals prepared separately from the rest of the family and there is no need to buy special foods although you may find you purchase lower sugar or diet foods than previously. All members of the family will benefit from following the diet recommended for people with diabetes.

Following a balanced diet made up of suitable portions of a variety of nutritious foods is an important part of successful diabetes management.

If you have diabetes you should see a dietitian when you are diagnosed and at least once a year thereafter.

The dietitian will assess your diet and give individualized dietary advice. Seeing a dietitian regularly will help keep you motivated and ensure that your diet is appropriate for any treatment you are receiving.

Health goals

1. Maintain blood glucose level within normal limits (BSL 4 – 8mmol/L) by balancing food intake with physical activity and/or medication or insulin.
2. Achieve and/or maintain acceptable weight.
3. Maintain blood fats (cholesterol and triglycerides) within normal range.
4. Protect against or reduce high blood pressure levels (a low salt diet, regular exercise and achieving a healthy weight may help.
5. Improve your overall health by choosing a healthy and varied diet as recommended in the ‘Australian Guide to Healthy Eating’
6. Make sure you are eating the correct portions of food – just because something is “good for you” doesn’t mean you can eat as much as you like of it.
7. Make sure you spread your meals out evenly over the day. Aim for 3 evenly sized, evenly spaced meals.
8. Children and adolescents need special attention with regard to eating and diabetes. Advice and regular review from a dietitian experienced in diabetes and / or paediatrics is desirable to ensure relevant growth and development markers are met alongside maintaining optimal diabetes control.

Nutritional goals

Eat at least 3 meals a day, spread evenly throughout the day (do not skip any main meal). Choose healthy, low fat, high fibre meals.

Adapt your diet to suit your medical management and presence of complications where necessary – ask for a referral to a dietitian if you are unsure.

Sample meal plan (quantities may need to be adjusted according to individual requirements):

Snacks may be necessary if you are experiencing dips in blood glucose levels, are underweight or need to increase your energy intake for growth as in the case of most children. A dietitian can help you determine whether or not you need snacks and if so, which ones would be suitable choices. Examples of healthy snacks include 1 piece of fruit, one low fat yoghurt, a few multigrain crackers with low fat cheese, a slice of raisin toast or a small handful of raw, unsalted nuts.

Carbohydrate Counting

Knowing which foods contain carbohydrate and being able to estimate how much carbohydrate you are taking in at each meal can help with weight management as well blood glucose control. If you are using insulin, carbohydrate counting can help you match your insulin dosage to your food intake which may help keep your blood glucose levels within your target ranges – discuss this with your dietitian if you would like more information about it.

What foods are best to choose?

Breads, cereals, rice, pasta & legumes Choose multigrain or high fibre varieties. These foods are absorbed more slowly and are therefore less likely to cause a rapid rise in blood glucose levels. For example, Oat Brits, Weetbix, All Bran, Special K, Porridge, and Guardian are better choices than Coco Pops, Corn Flakes or Rice Bubbles

Fruit Choose 2-3 pieces of fruit a day, preferably fresh (A serve = the equivalent of one medium apple or orange, or half a cup chopped/tinned (juice drained) ,stewed or dried fruit. Choose `no added sugar' tinned fruit rather than tinned fruit with added sugar/syrup and drain the juice off Choose low joule cordial instead of fruit juices. Fruit juices are a concentrated natural source of sugar and contain very little fibre.

Vegetables Try to eat 5 serves of vegetables a day. (1 serve = half a cup of cooked vegetables or 1 cup of salad)

This diagram, from the Australian Guide to Healthy Eating, shows the foods we need to eat every day to stay healthy. There are 5 main groups of foods – breads and cereals; vegetables, fruit, dairy products and protein rich foods. Make sure you include something from each group every day. Your dietitian can help work how many serves you should be having from each group.

Minimize high sugar foods

It is not necessary to exclude sugar completely –a little sugar can be used to make other, healthy foods taste better. For example – you can sprinkle a little sugar on a bowl of porridge. .

It is however important not to eat too many high sugar foods as this can contribute to weight gain and high blood glucose levels.

Which foods are high in sugar?

• Sugar, honey, golden syrup, jams, toppings, sweetened breakfast cereals e.g. Coco Pops, Nutrigrain
• Chocolates, lollies, sweet & semi-sweet biscuits, cakes, jellies & pastries
• Canned fruit in syrup, fruit juices, soft drinks, cordials, ice-cream
• Dried fruit e.g.: raisins, currants, sultanas, apricots
• Flavoured milk, sweetened yoghurt, sweetened condensed milk, Milo, drinking chocolate, sweet wines and liqueurs

Artificial sweeteners Artificial sweeteners can be used in moderation. Excessive reliance on these products is not encouraged however they can be a useful addition to the diet, for example diet cordial and soft drinks

Weight control

If you are overweight, losing weight can improve your blood glucose levels. Excess weight can contribute toward insulin resistance. A weight loss of even 5 to 10 % can improve this. A low fat, low sugar diet accompanied by an increase in physical activity is recommended.

Reduce salt intake

A lower salt diet can help with blood pressure control, prevent fluid retention and prevent heart disease. To lower the salt content of your diet:

• Do not use salt at the table
• Try not to add salt in cooking
• Use salt reduced varieties of stocks, canned vegetables, sauces etc where possible
• Reduce your intake of salt or salty foods. These include salt, all varieties of vegetable salt, Worcestershire sauce, soy sauce, Vegemite, Marmite, Promite, Bonox, beef tea, Bovril, beef cubes, soup cubes, stock cubes, packet seasonings, soda water, mineral water, processed meats, pickles and sauces, and olives.
• Add flavour using herbs and spices, garlic, ginger, chilli etc.
• Try to eat as many fresh foods as possible – minimize your intake of convenience foods