Diabetes Superfoods

I knew the word ‘super’ would get your attention! Information on ’superfoods’ is clogging our news and social media feeds, however most of the time these foods carry an expensive price tag without the benefit. When you’re managing diabetes there is no need to purchase exotic fruits, juices that hail from the tropics or green powders; but focus on your everyday foods that have actual proven benefits when it comes to your entire health.

Everyone with diabetes will eat different amounts of carbohydrate with some opting for the lower range to manage their blood glucose levels. Im not going to talk about carb quantity today, but instead highlight some nourishing foods that will really enhance the quality of your diet. At the end of the day, whether you going lower or higher, carb quality and the overall nutrient density of your eating pattern are key aspects to staying well. 

Let's take a look at some of these quality foods. 

Salmon and other oily fish

Salmon plus other types of oily fish like sardines, mackerel and (the dark part of) tuna contain lots of omega-3 fats. These fats improve blood flow and reduce inflammation, triglyceride levels and blood pressure – all factors associated with diabetes. They also pack quality protein to help you feel satisfied between meals and assist with muscle maintenance. Aim for 2-3 serves (150g being a serve) of oily fish a week.

Non-starchy vegetables

Green leaves and vegetables with red and orange hues will provide beta-carotenes to improve your eye health. However, filling up on all non-starchy vegetables (despite the colour or type) will also give your diet a nutrient boost and make sure the protein and carbohydrate parts of your dish don’t take the full limelight.

Nuts

Nuts are packed with healthy fats, potassium, vitamin E (an antioxidant), zinc, magnesium, B vitamins, plant sterols and fibre. Together, these nutrients make nuts the perfect diabetes defender by improving insulin sensitivity and heart health. When included as a part of a meal, nuts will lower the overall glycemic index (GI) and make you feel full for longer. Enjoy a small handful of any nut each day – just hold the salt.

Legumes 

Whether canned or dried, legumes such as lentils, kidney beans and chickpeas really are natures own ‘super food.’ These little delights boast a variety of vitamins and minerals and are a great source of protein, healthy fats and low GI carbohydrates (like really low...the carb takes a while to break down to glucose). It is recommended to enjoy these little gems at least 2-3 times a week. Some people managing their diabetes with meal time insulin may find it challenging to match their dose with the carb content of legumes - chat to your CDE or dietitian about managing this. 

Pearl barley

Pearl barley is a highly nutritious, nutty textured grain that can be used in soups and stews and as an alternative for rice. Not only is it packed with the goodness of minerals such as selenium, magnesium and phosphorus, it has a low GI. Barley also contains beta glucans that can help to lower blood cholesterol levels. Include small portions of barley in your main meals when searching for the perfect low GI carbohydrate component. Remember, count the carbs. 

Rolled oats

Traditional rolled oats (not the instant quick oats) also have a low GI and contain beta-glucans. Oats also contain magnesium, which helps the body use glucose and secrete insulin properly.

Quinoa

This ancient little pseudo-grain (it’s technically a seed) has become a staple in many households. Its popularity soared just a couple of years ago because it contains all 9 essential amino acids making it a “complete” protein. It is also gluten free and has a low GI making it an ideal choice, especially for people who have both coeliac disease and diabetes.

Berries

It doesn’t have to be the expensive, exotic type (think gogi and acai); enjoy every day berries like strawberries, blueberries and raspberries. A study published in the Journal of Nutrition found that the flavonoids (plant compounds) found in berries and other red and blue coloured fruits and vegetables may lower levels of insulin resistance and inflammation (remember, people with type 1 diabetes can still get insulin resistance). Although it is not known exactly how many berries are needed to have these effects, berries make the perfect addition to meals and snacks without overdoing the carbohydrate load.

Milk and yoghurt

Milk and yoghurt offers health benefits beyond bone health. A regular consumption can improve heart health, reduce fat mass and increase lean muscle mass. These benefits may be due to the type of fatty acids present, how the calcium binds to this fat, and the presence of additional nutrients. Milk and yoghurt also have a satiating (feeling of fullness) quality due to its low GI and protein content, meaning you are less likely to reach for energy dense, nutrient poor snack foods when you include milk and yoghurt in your diet. Again, count the carbohydrate (lactose) when consuming milk and yoghurt. 

Of course your shopping list and pantry will include more foods that are healthy for you. But hopefully this article has highlighted some diabetes defenders that you can put back in your diet to enhance the overall quality.

Going against the grain...

A recent scientific review looking at dietary patterns and chronic disease risk showed that plant-based foods were more protective against chronic disease risk compared to animal-based foods. Amongst plant foods, grain-based foods such as oats and barley seemed to have a small edge, even over our fruits and vegetables. So much for the recent trend to go ‘against the grain.’ People with diabetes just always need to consider the amount on their plate,  and the impact that the entire meal has on blood glucose levels. You can still follow a lower carb diet (if that's the way you like it) and include some quality grains such as oats, barley and quinoa.

Preventing type 2 diabetes - The Mediterranean way

A snap from my time in Greece in 2014

As we discussed here yesterday, living a healthy lifestyle and maintaining your healthiest weight can prevent or delay the onset of type 2 diabetes. This is great news right!

The problem is, with the co-existence of the weight loss industry promoting every fad under the sun, and an obesogenic environment placing convenient food options at an arms reach, the meaning of living a healthy lifestyle is often blurred. As a dietitian helping people to eat for health, I do not recommend ‘diets’ or restrictive eating behaviours. Instead, I help people find their own healthy balance that eventually becomes a lifestyle that they can sustain and enjoy. I also consider the evidence around different eating patterns and how they help different population groups. I try and integrate this evidence wherever possible and appropriate. If we look at an eating pattern that is leading the way to help lower diabetes incidence, manage a healthy weight and reduce cardiovascular disease, there is no doubt that the Mediterranean way is winning.

So lets take a look at some key components of the Mediterranean eating pattern and enjoy some pic's from our recent trip to Italy and Greece.

A photo taken while completing 'The Walk of the Gods,' on the Amalfi Coast, Italy in 2014 - Just STUNNING!

An Extra Drizzle of Olive Oil Please

Sorry coconut oil lovers but when we look at the evidence, nobody can argue that olive oil is winning the race for the healthiest daily oil to use. NOBODY. 

The Mediterranean way is not consistent with the outdated approach of low fat eating, as it boasts a good intake of foods rich in healthy fats such as nuts, oily fish and an extra drizzle of olive oil with most meals. These fats are protective against cardiovascular disease, a strong risk factor for type 2 diabetes. Meals higher in healthy fats can also keep us feeling full and satisfied, helping to manage food portion sizes and reduce that urge for nutritionally poor snacks between meals. 

Hold the Red Meat

Red meat appears on plates just every 'now and then' in the Mediterranean region. Instead of red meat, the predominant protein sources are legumes, eggs, fish, shellfish, white meats such as chicken and turkey and a bit of yoghurt and cheese each day. Replacing red meat with these alternatives (majority of the time) may help to lower the unhealthy, saturated fat in your diet and prevent type 2 diabetes.

Lots of legumes

Legumes are a main feature in the Mediterranean diet. Whether canned or dried, legumes such as lentils, kidney beans and chickpeas really are natures own ‘super food’ as these little beans are loaded with various nutrients such as protein, protective fibre, healthy fats and low glycemic index (GI) carbohydrates. Even better, all of these nutrients are delivered at a low cost and can be served as a source of protein in replace of meat. It is recommended to enjoy these little gems at least 2-3 times a week.

Fill up on vegetables

Every healthy way of eating includes plenty of vegetables, including the Mediterranean way, which is a very plant-based way of eating. Filling up on non-starchy vegetables with most meals (not just dinner) will only provide you with the goodness of fibre, vitamins and minerals without the extra energy you may not require. Starchy carbohydrates such as potato, sweet potato and corn are also important, however if your energy requirements do not call for a large serve just allocate these vegetable to one quarter of your plate, just enough to keep you satisfied.

Nuts About nuts

The Mediterranean’s are just nuts about nuts and so are we. If you attempt to follow a ‘low fat’ diet you would automatically put the nuts back on the shelf after carefully reviewing the nutrition information panel. This is because nuts possess a large amount of fat. But this fat is GOOD and can keep our blood vessels healthy. Furthermore, nuts are jam packed with nutrients such as vitamin E (an antioxidant), zinc, B vitamins and fibre just to name a few. Although they are high in fat, there is evidence to show that enjoying a small handful a day (about 30-40 grams) can assist with weight loss, potentially due to the ability of nuts to keep us satisfied in a small dose. Any tree nut is a healthy choice, so whether is it macadamias, pistachio’s, almonds or cashews, just hold the salt, and you have yourself a perfect healthy snack.

Just like every healthy way of eating, the Med's way is about the whole eating pattern and lifestyle and not just about one food group or nutrient in particular (e.g. quitting sugar). This way of life also involves sharing and celebrating food with loved ones. So take a leaf out of the med’s book and sit down with your loved ones and share some of these beautiful foods - and enjoy every moment. 

Here are some snaps from my holiday in Italy and Greece last year - these give some beautiful insight into the Mediterranean way.

Delicious sardines, lightly fried in olive oil and drizzled with lemon 

Fried zucchini with a garlicy yoghurt sauce

Traditional Greek salad drizzled with olive oil

Santorini fava - made with yellow split peas (legumes)

A picture says a thousand words...

Amazing mussels and squid matched with a Greek salad - loaded with healthy fats and full of goodness

Grow your own and eat fresh and seasonal 

Berries at the Venice Farmers Markets

Exercise is a key component of the Meds way and a key factor in reducing your risk of type 2 diabetes

diabetes - not just 'a touch of sugar'

I have worked in diabetes for just over 5 years now.  Although 280 Australians develop diabetes everyday (BTW, this is MASSIVE), I feel that the general knowledge of diabetes in the community is pretty poor. Never have I come across a condition that comes with so much stigma and so many myths. I get it, I totally do...diabetes is one complex condition that often gets over simplified. What people often don't realise is: 

• Pre-diabetes and type 2 diabetes aren't as innocent as 'a touch of sugar.'
• Nobody has 'mild diabetes.' 
• There is no 'good' or 'bad' type of diabetes. 
• You don't have to be overweight to get type 2 diabetes.
• You don't have to be old to get type 2 diabetes.
• Many people are at risk of type 2 diabetes and don't realise it. 
• You can get type 1 diabetes at any age. 
• Eating sugar doesn't cause diabetes.
• Diabetes is a challenging condition to manage and requires 24/7 attention - it is hard work!

So being National Diabetes Week, I think its a good idea to take some time out to really understand what diabetes is. It may help you understand what a person with diabetes may be going through each day or teach you the differences between type 1 and type 2 diabetes.  It may also help you learn if you are unexpectedly at risk of type 2 diabetes. This post will form part of a series of posts over this important week. 

First of all..

To understand what diabetes is, it's good to get a handle on the role of insulin and what happens in a person WITHOUT diabetes.

Glucose (AKA sugar) is the main source of energy  that our body uses to function. The cells throughout our body get glucose from the digestion of all carbohydrate foods (not just table sugar), or from stores in our liver that are released when needed (for example, when blood glucose levels drop between meals or overnight, or in response to hormones such as adrenaline, growth hormone and cortisol, which may be released during exercise or when stressed, sick or excited).

Important point no. 1 - its not just food that affects blood glucose levels. 

When blood glucose levels rise, insulin allows glucose to move from the blood stream into the cells in our muscles and tissues. Here, glucose can be used to make energy.

To put it simply, insulin is like a key that unlocks our cell doors to allow glucose to move into the cells and be used as energy. 

Our body always needs a certain amount of glucose in our blood stream, and for most people, the body does a pretty good job of maintaining this. Without diabetes:

• The pancreas (an organ found next to your stomach)  produces insulin all day in response to blood glucose levels rising above the usual range, and
• the liver supplies glucose whenever blood glucose levels start to drop below the desired range.

What is diabetes...

Diabetes occurs when the body does not produce any, or enough insulin, or when the insulin being produced does not work effectively.

Without insulin, glucose builds up in the blood stream. 

Too much glucose in the blood stream over time can lead to small and large blood vessel damage, leading to diabetes-related complications. This is why one of the main aims of diabetes management is too keep blood glucose levels as close to a persons target range as possible. This can be a very challenging task due to the many factors that affect blood glucose levels - remember, its not just affected by food! 

The difference between type 1 and type 2

Some of you may be aware that the two main types of diabetes include type 1 and type 2 diabetes.

Type 1 diabetes is an autoimmune condition. This means that the bodies own immune system has attacked the insulin producing cells of the pancreas, therefore the pancreas can no longer produce insulin. Although for many people there is a strong genetic link to type 1 diabetes, we are not sure why this auto-immune reaction occurs. Type 1 diabetes is often diagnosed in childhood or adolescence, but it can occur at any age. It is not linked to lifestyle factors and cannot be prevented. 

Important point no. 2 - type 1 diabetes cannot be prevented.

Type 1 diabetes is managed by administering insulin regularly throughout the day - remember, without diabetes our body will produce insulin all day in response to fluctuating blood glucose levels. A person with type 1 diabetes has to mimic this natural process manually, using multiple injections of insulin or via an insulin pump that delivers a constant supply of insulin over the day. This helps to keep blood glucose levels as close to a target range as possible.  Doses of insulin will constantly need to be reviewed and changed throughout a persons life with type 1 diabetes, as doses will be affected by numerous factors such as growth, weight changes, hormonal changes, physical activity levels and food intake.

Managing type 1 diabetes is a balancing act of eating well for health, moving regularly, monitoring blood glucose levels and titrating insulin doses according to what is happening in their life that day. It’s a big job!

Type 2 diabetes occurs when the body does not produce enough insulin or when the bodies cells are resistant to the insulin being produced - you may have heard the term 'insulin resistance' before. People are often told that they have 'mild' diabetes when being diagnosed with type 2, but it is just as serious as type 1 diabetes and can lead to the same complications if ignored or not managed well. 

Important point no. 3 - all diabetes is serious with the risk of developing complications if ignored or not managed. 

Type 2 diabetes may be managed using dietary and physical activity interventions alone, however many people require oral medications and/or insulin in order to manage blood glucose levels effectively.  Because type 2 diabetes is what we call a progressive condition, many people will need medications or insulin to help manage blood glucose levels as their body slowly stops producing as much as it used to. 

Are you at risk of type 2...

Type 2 diabetes is much more complex than people believe. People diagnosed with the condition do not always fit the stereotype of someone who is carrying extra weight, who may not lead the healthiest of lifestyles. This is because it can result from a combination of genetics and risk factors that cannot be changed. These risk factors include, having a family history of type 2, having a history of gestational diabetes (diabetes during pregnancy), increasing age, coming from an Aboriginal, Torres Straight Islander, Asian (including Indian) or Middle Eastern background and having a history of cardiovascular disease. Although there is a genetic link and these non-modifiable risk factors, the risk for type 2 diabetes is greatly increased when associated with lifestyle factors such as:

• Low levels of physical activity.
• Carrying extra weight (especially around in abdominal area). 
• Smoking.
• High blood pressure.
• High cholesterol. 

This means that type 2 diabetes may be prevented or its onset delayed with a healthy lifestyle.

Important point no. 4 - you may be at risk of type 2 diabetes and not even know it.

This information shows how its important it is to identify if you are at risk of type 2 diabetes and the steps you can take in order to reduce this risk. To learn more about your risk complete this free online tool TODAY http://www.ausdrisk.com.au

Stay tuned for more posts this week about preventing and managing diabetes.