This bit is unavoidably scientific, but only briefly: science was never really my thing as I discovered two weeks into a Biology, Physics and Chemistry A Level course which left me running for the safety of maths and economics. Anyway, the science can basically be boiled down into three basic principles: eat as much fibre as possible; low GI foods are best and good fat intake should be monitored. And this is why.
Fibre is a type of carbohydrate, but as it is not broken down by the body, it doesn’t contain any calories or raise blood sugar levels. It also helps to keep you regular and makes you feel fuller for longer. The average daily recommended intake of fibre is 25-30g but studies have shown that people with diabetes who eat 50g per day are able to control their blood glucose levels far better than those who eat far less. Bearing in mind that the average British male consumes just under 15g per day (13g for the ladies) the chances are you are not eating anywhere near enough.
There are two types of fibre and both are important in a diabetic context. Insoluble fibre keeps your digestive system working well, whilst soluble fibre improves blood sugar levels and lowers cholesterol in the blood stream. As people with Type 2 diabetes are 2-4 times more likely to suffer from cardiovascular disease than non-diabetics (a risk that doubles again if you smoke) anything that soaks up the nasty fats has got to be a good thing.
Good sources of soluble fibre include oatmeal (porridge), legumes (dried beans and lentils); fruits (apples, oranges and bananas are all good) and root vegetables (such as carrots). Insoluble fibre is to be found in wholegrain bread and cereal, fruits and veggies. Once you’ve got used to checking packaging, it gets easier to monitor your intake. We have just had a lunch of two slices of wholemeal toast with seeds and half a tin of baked beans, and have each eaten over 15g of fibre. We also had two poached eggs each as we are greedy and were very hungry and wanted to up the protein content of the meal.
Glycaemic Index (GI)
The glycaemic index is a ranking of foods containing carbohydrates, based on their overall effect on blood glucose levels. Foods that are absorbed slowly, gradually releasing glucose into the bloodstream, have a low GI. These slow acting carbs reduce the peaks in blood glucose levels that follow a meal, producing a lower insulin response and putting less strain on your pancreas and liver. Low GI foods also leave you feeling fuller for longer and less likely to feel the urge to snack between meals, and are associated with improved levels of good cholesterol and a lower incidence of heart disease.
Wherever possible, grain based foods such as bread, pasta, rice and noodles should be wholegrain, unprocessed and high fibre. The fibre acts as a physical barrier, slowing down the process of carbohydrate absorption and is an easy one to check on the packet. You may be surprised to find that some wholemeal products have been so ruthlessly ground that they have no more fibre than their white counterparts.
The GI levels of rice vary significantly depending on the type. For instance, brown rice has a GI of 55 (which is classified as low, but only just) whilst sticky jasmine rice has a GI of 98 (which is really high). Potatoes are a weird one as the cooking process can dramatically influence the GI, as can the type of spud. Basic rules of thumb are: new potatoes are better than old and boiling is better than baking or roasting. And mashed potatoes are a bit of a no-no as they are so easily digested.
Saturated Fats and Bad Cholesterol
This bit is quite tricky, especially as the long established health advice that all saturated fat is bad is currently under scrutiny. However, there are some basics that are irrefutable. Fat is an essential part of a healthy diet, but it is very calorific so watch your intake. The brain is the fattest organ in the body, containing up to 60% of fat. Not all fats are good, however, and not all cholesterol is bad.
Healthy fats include monounsaturates and polyunsaturates and they reduce the bad (LDL) cholesterol in our blood and increase the good (HDL) stuff. Sources include nuts, seeds, lean meat, eggs, oily fish and oils made from olives, nuts or seeds.
Unhealthy fats include all trans fats (found in hydrogenated fat) and many saturated fats that contain a lot of LDL cholesterol which leads to a fatty build up in our blood vessels: a major cause of cardio-vascular disease. Sources include processed meats, pastry, many takeaways, deep fried food and packaged cakes and biscuits. Current thinking is that the saturated fats found in dairy products are good for you in moderation, be be mindful of the calories when tucking into the cheese board.
Basic rules of thumb to follow are as follows. Chuck out your deep fat fryer and takeaway menus. Use reduced fat milk, cheese and yoghurt (though in the latter case beware the industry’s tendency to compensate for a lower fat content by adding sugar). Use spreads and cooking oils made from olives, nuts and seeds. Consider alternative sources of protein to meat: either fish, legumes or Quorn (both of the latter have the added advantage of a high fibre content).