Download Diet and Diabetes

Diet and Diabetes
Nutrition tips to support the management of Diabetes at breakfast
Throughout 2015, Pick n Pay is publishing a series
of leaflets to support people with Diabetes.
This supplement is filled with nutritional advice and helpful shopping tips
to make navigating Pick n Pay’s breakfast aisles for Diabetes-friendly
foods a little bit easier. Be sure to look out for our dinner supplement,
which will be published later this year.
This information is not intended
for use as a substitute for
professional medical advice,
diagnosis or treatment. Please visit
your healthcare professional for
advice specific to your individual
requirements.
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What is Diabetes?
During digestion, the carbohydrates or starchy foods you eat are broken down
into glucose, a type of sugar. This glucose is absorbed into your bloodstream, and
becomes known as your blood sugar or blood glucose. Your pancreas then releases
the hormone insulin into the blood, which transports the glucose from the blood to
the body cells, to be used for energy. The insulin helps to regulate your blood
glucose levels.
Diabetes is caused when there is too little or no insulin, or the insulin cannot be used
properly by the body. This means that the body cannot control blood glucose levels
normally, or use the energy from foods effectively. Instead of feeding the cells with
energy, the glucose accumulates in the blood, causing blood glucose levels to rise
and, over time, causing damage to the kidneys, eyes, nerves and heart.
Know your types
There are several ‘types’ of Diabetes: Type 1 Diabetes,
Type 2 Diabetes and Gestational Diabetes.
Type 1 Diabetes
Type 2 Diabetes
Accounting for 5 – 10% of Diabetes
cases, Type 1 Diabetes is an
autoimmune disease ‘caused’ by the
inability of the pancreas to make insulin.
A combination of daily insulin, a careful
eating plan and physical activity is
required for its management.
Gestational Diabetes
Accounting for 90 – 95% of cases, Type 2 Diabetes is a metabolic disorder in
which the pancreatic cells do not produce enough insulin, or the body doesn’t
respond to insulin normally. Occurring most often in people who are overweight,
this type of Diabetes can often be managed through food choices, weight control
and physical activity alone. Glucose-lowering medication may help the body to
produce more insulin, or better use the insulin the body makes. Insulin injections
may be needed too.
Resulting from changes in hormone levels, Gestational Diabetes occurs in about 4% of pregnancies and,
although it usually disappears after delivery, requires careful control and monitoring during pregnancy.
You’ve been diagnosed – Now what?
%
20.7
In South Africa, 20.7%
of people have a family
history of high blood sugar
%
18
Around 18%
of people are
Pre-Diabetic
Please consult with a registered dietitian to obtain a meal plan specific to your individual requirements.
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9.5
%
The good news is that by taking responsibility for your health and wellbeing,
Diabetes can be managed. The first step is to develop a treatment plan with
your lifestyle in mind. Whether you choose to do this with the help of a doctor,
Diabetes educator or Dietitian, your treatment plan needs to take four key
factors into account: medication, nutrition, monitoring and exercise.
9.5% of people have
been diagnosed
with Diabetes
Eating for Diabetes
Did you know that a diabetic diet isn’t just for people with the
condition? In fact, dietary guidelines recommended for people
with Diabetes are the same as those recommended for the healthy
population. So rather than preparing separate meals for yourself,
encourage your family to adopt these healthy habits.
Timing is everything
Eat three regular meals per day to help control your blood glucose,
energy and hunger levels.
Size matters
It is best to consult with a registered dietitian to learn what portion size
is the right fit for you and your health. To find a registered dietitian in
your area, visit www.adsa.org.za
You are what you eat
The nutritional quality of the carbohydrates, proteins and fats you eat
has a direct impact on your blood sugar and your ability to control it.
Use this leaflet for tips on how to spot foods of higher nutritional quality.
To build a balanced breakfast meal, choose one food
from each of the following food groups to build your plate:
•
•
•
•
Food examples of each group
Group 1 High-fibre carbohydrates
1/4 High-fibre carbohydrates
1/4 Lean proteins
1/2 Vegetables and fruit
Small amount of
healthy fats
• Oat bran
• Bran cereal
• Low GI, low fat muesli
• Wholegrain bread
Group 2 Lean proteins
1. High-fibre
carbohydrates
3. Vegetables
and fruit
2. Lean proteins
4. Healthy fats
•
•
•
•
Low fat milk
Low fat yoghurt
Baked beans
Egg
Group 3 Vegetables and fruit
• Raw vegetables
• Raw fruit
• Dried fruit (in small servings)
Group 4 Healthy fats
•
•
•
•
•
•
•
Seeds
Nuts
Avocado
Peanut butter
Humus
Olive oil
Canola oil
Please consult with a registered dietitian to obtain a meal plan specific to your individual requirements.
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Don’t skip brekkies
Leanne Tee
Pick n Pay Registered Dietitian
[email protected]
After 8–12 hours without a meal or snack, breakfast is your body’s first chance to refuel its energy levels and replenish its
blood glucose stores. Eating a balanced meal with the right mix of carbohydrates, proteins, healthy fats and vegetables or fruit
helps to provide a sustained release of energy, keep your blood sugar levels stable and delay hunger symptoms for several
hours. Plus, research has shown that breakfast eaters tend to have improved nutrient intake, a healthier body weight and
improved ability to concentrate. So, if you’re not eating breakfast regularly, consider this your wake-up call.
Please consult with a registered dietitian to obtain a meal plan specific to your individual requirements.
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Diabetes and breakfast
PRICES VALID 16 - 29 MARCH 2015
19
80
Parmalat Low Fat
or Fabulite Fat Free
Yoghurt Assorted
1kg Each
49
90
Vital Original
Muesli 1kg
18
90
Clover The One 1%
Low Fat Fresh Milk
2 Litre
99
90
Douwe Egberts
Pure Decaff Instant
Coffee 200g
1190839_275 x 210_5
10
50
PnP Light Hummus
120g
SAVE 7.90
SAVE 5.60
22
24
R
90
Ryvita Assorted
250g Each
Bakers Provita
Assorted 500g Each
19
95
PnP Golden
Delicious
Apples
1.5kg
SAVE R8
27
R
PnP Mozzarella
Cheese 300g
24
90
PnP Bran Flakes
500g
20
90
Jungle Oats 1kg
29
95
10
85
PnP Ripe & Ready
Avocados 2s
SAVE R5
17
R
PnP Cottage Cheese
Assorted 250g Each
Sasko Low GI
True Whole Wheat
Brown Loaf 800g
28
90
PnP Large All Grain Eggs
18s
11
95
Albany Superior
Low GI Seeded
Brown Bread
700g
Products advertised in this catalogue serve as a guideline only. Please consult with your health practitioner.
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69
28
90
90
PnP Canola Oil
PnP Extra Virgin
2 Litre
Olive Oil 1 Litre
34
19
90
Colman’s Olive Oil
Spray and Cook 300ml
24
10
R
90
R
PnP Raw Cashew Nuts or
Raw Almonds 100g Each
PnP Dried Mango
Sulphur Free 100g
59
PnP Sunflower Seeds
100g
90
18
90
Twinings Green Tea
Assorted 25s Each
89
90
Black Cat Peanut
Butter Assorted 400g
Each
7
90
Dürsots Bean-a-Betic
410g
Douwe Egberts
Instant Coffee
Assorted 200g
(Excluding Decaf)
Glen Rooibos Tagless
14
Each
Teabags Pouch 80s
90
Nomu Skinny Hot
39
Chocolate 200g
90
Nestlé Pure Life Still
Mineral Water
6 x 750ml Sport Bottle
39
R
PnP Soda Water
9
2 Litre
50
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FREE
+
192 99
75
R
R
Diabion 100mg
MNI AntaGolin
Capsules 30s
R
PEDI-Relax Diabetic’s
279
45
Galvus Met 50/850mg
Tablets 60s
27945
Diaglucide 80mg
Tablets 60s
50
70
Diaglucide MR 60mg
Tablets 30s
5815
Schedule 3 prices advertised are for cash-only purchases
Doctor’s script required for scheduled prescription medication.
SAVE R10
149 149
R
Foot Care Cream100ml Each
60s
Galvus Met
50/1000mg Tablets 60s
SAVE 8.90
SAVE 7.50
SAVE R14
SAVE 20.90
Foodstate Sugar Balance
Formula 60s
Solal Glucose Regulating &
Diabetes Formula Capsules 90s
Probetix Capsules
60s
Solal Naturally Sweet
250g
Diabesol Softgel
Capsules 60s
95
Homemed Glucocheck Strips
50s with Free Meter
SAVE 25.20
225
R
SAVE 13.80
159
R
SAVE 10.60
70
R
SAVE 18.50
57
R
Pick n Pay cares about you and our environment, and that is why
we now have a safe and convenient way for you to dispose of your
diabetic related medical waste. Ask your pharmacist for more details.
Bedworth Park: Tel: 016 985 1279, Boksburg: Tel: 011 826 2981, Brackenfell: Tel: 021 981 3276, Brentwood: Tel: 011 568 0173, Centurion: Tel: 012 621 7025, Claremont: Tel: 021 674 5867, Durban North: Tel: 031 564 2300,
Faerie Glen: Tel: 012 991 3207, George: Tel: 044 871 1523, Greenstone: Tel: 011 452 1473, Helikon Park: Tel: 011 693 5374, Hurlingham: Tel: 011 998 3330, Key West: Tel: 011 273 0716, Lonehill: Tel: 011 465 2899,
Mall of the North: Tel: 015 265 1478, Middelburg: Tel: 013 244 1088, Montana: Tel: 012 543 6200, Newcastle: Tel: 034 326 1028, Norwood: Tel: 011 483 3390, Ottery: Tel: 021 703 0291, Pavillion: Tel: 031 265 8478,
Plattekloof: Tel: 021 558 0219, Promenade: Tel: 021 376 0488, Somerset Mall: Tel: 021 851 8256, South Coast: Tel: 031 904 7737, Southgate: Tel: 011 941 2452, Soweto: Tel: 011 938 4518, Steeledale: Tel: 011 613 5935,
Tableview: Tel: 021 521 5840, The Falls: Tel: 011 958 1113 and Woodmead: Tel: 011 656 9570.
PRICES VALID 16 - 29 MARCH 2015 AT PICK N PAY SUPERMARKETS AND HYPERMARKETS
Excluding Express, Franschhoek Daily, Pick n Pay Local stores.
Visit www.picknpay.co.za, or call 0800 11 22 88. Cellphone rates apply. Promotional stocks are limited. Prices include VAT. smart shopper terms and conditions apply. No traders. E&OE.
1188613_275
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Interpreting food labels
B
A
C
One of the best ways to determine whether a product is suitable
for someone with Diabetes, is to learn to interpret food labels.
Once you understand what to look out for on food labels, you
will begin to navigate the store aisles with ease, while choosing
suitable products for your needs. In South Africa, the way
manufacturers label nutritional information on food packages has
been standardised, which means that no matter which food you are
looking at, the same method of interpreting labels always applies.
A The information per 100g allows you to compare how much of each
nutrient is found in different products. This means that you can choose the
higher fibre, lower sugar and lower sodium products by comparing their
nutrition tables.
B The recommended serving size indicates how much of that product
you should eat at one time, while the information per serving indicates how
much of the various nutrients you will get from one serving of that food.
C This is a measure of the amount of energy a food provides. Taking in
more energy than your body needs or uses will result in weight gain, so it is
important to balance your extra energy intake with regular physical activity.
D People with Diabetes are permitted to have some sugar, provided it is
consumed in a small serving, in the context of a balanced meal. Eating
too much sugar in one go can have an impact on your blood sugar levels,
so aim for products with a lower sugar content wherever you can.
D
E
F
G
H
E Eating too much fat can cause excess energy intake and weight gain,
so it is best to choose lower fat products wherever possible.
F A high intake of saturated fat has been linked to increased risk for heart
disease. Choose products lower in saturated fats as a general rule of thumb.
G The higher the fibre content, the better! Fibre is important for digestive
health and helps promote a more gradual impact on your blood sugar levels.
Our Department of Health stipulates that a food must contain at least 6g
fibre per 100g in order to be classified as high in fibre, or at least 3g per
100g to be a source of fibre.
H A high sodium intake is linked to increased blood pressure. Ensure that
your total sodium intake from processed foods and added salt is not more
than 2000mg per day.
Breads
Top tips for healthier choices when shopping by category
• Choose breads which claim to be ‘whole-wheat’ or ‘wholegrain’
• Opt for breads which are low GI
• Your breads should be high in fibre (>6g per 100g)
• Examples: Heavy breads such as health breads and seed loaves, pumpernickel bread, rye breads, low GI breads
Breakfast cereals
• Choose high-fibre options (>6g per 100g)
• Compare and choose options with lower sugar levels
• Choose cereals with lower sodium levels
• Examples: oats, rolled oats, oat bran, wholegrain breakfast
cereals like bran flakes, shredded bran, low GI low fat muesli
Crackers
• Choose crackers which claim to be ‘whole-wheat’ or ‘wholegrain’
• Your crackers should be high in fibre (>6g per 100g)
• Aim to choose the crackers lower in total fat and sodium
• Examples: Provita, Ryvita, Finn Crisp
Cheeses
• Choose fat-free or low fat cheeses
• For hard cheeses, aim for a fat content of less than 13g per 100g
• Restrict your intake of hard cheeses to twice a week
• Examples to choose from: Low fat or fat-free cottage cheeses, Ricotta cheese, low fat feta or reduced fat cheeses
Milk and yoghurt
• Choose lower fat dairy products
• Be aware that sweetened yoghurts may contain added sugar
Choose plain or artificially sweetened yoghurt more often
• Examples: Skim or low fat milk in liquid or powder form, low fat buttermilk, plain low fat yoghurt, artificially sweetened fruit and flavoured yoghurts
Please consult with a registered dietitian to obtain a meal plan specific to your individual requirements.
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Building your cooked breakfast
Use your plate model to build a balanced cooked breakfast that is:
1/4 High-fibre carbohydrate
• Swap your chips for a slice of whole-wheat toast.
• Use whole-wheat flour instead of white flour when making home-made baked
goods like crumpets.
1/4 Lean protein
• Prepare your eggs without adding additional fat to them by boiling, poaching,
microwave scrambling or cooking an omelette without cheese.
• Try poached haddock, grilled kippers or fresh salmon instead of bacon.
• Choose baked beans as your protein serving over processed meats such as sausages and bacon, which tend to be high in fat and salt.
1/2 Veg
• Add volume to your plate with grilled vegetables such as tomatoes,
mushrooms and onions.
• Feel like an omelette? Include mainly grilled vegetables for a filling, healthy choice.
• Remember to use fat sparingly when preparing your veggie sides.
Small amount of healthy Fats
• Use fat sparingly in your cooking by aiming to use only 1 teaspoon
of fat per person sharing the meal.
• Use oils such as olive, canola and sunflower oils in place of brick
margarine, butter and other solid fats.
• Look out for canola, olive or vegetable oil sprays,
which allow you to use less oil in your frying pan.
High-fibre
carbohydrates
Vegetables
and fruit
Healthy
fats
Lean proteins
Did you know?
Research has shown that replacing saturated
and trans fat with poly- and monounsaturated fats
helps to protect against heart disease.
Beans are legumes, which are a source of protein
and fibre – good for people with Diabetes as they
help control your blood glucose levels. Just be sure
to eat beans in the serving size appropriate to your
meal plan as they do contain some carbohydrates.
Please consult with a registered dietitian to obtain a meal plan specific to your individual requirements.
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Quench your thirst
Choosing hot and cold beverages
When it comes to Diabetes, food often takes centre stage.
However, it is important to remember that what you drink has
as much of an effect on your waistline as it does on your blood
glucose. Water is the most readily available and healthy beverage,
which is why it should make up most of your daily fluid intake.
Craving a little liquid variety?
Here’s what you can sip on:
Need to drink more water?
Here’s how…
• Take water breaks instead of coffee breaks throughout your day.
• Keep a bottle of chilled water on your desk at work.
• Choose water over other beverages when buying from a vending machine or convenience store and opt for sparkling water
at special occasions.
• Have a glass of water with all your meals and snacks
(this will also help to fill you up to prevent overeating).
• Flavour your water with a squeeze of lemon or lime juice
for a light, refreshing drink.
• Make your own flavour-infused water at home by simply putting water in the fridge with cucumbers, strawberries or fresh mint
for a refreshing low-calorie drink.
• Up to 3 cups of caffeinated tea or coffee per day, using low fat milk
and an artificial sweetener if required.
• Unsweetened rooibos, black, green and herbal teas.
• Most diet drinks (like diet soda or diet tea) have zero grams of carbohydrate per serving, so they will not raise blood glucose on
their own. If drinking diet-fruit squashes and artificially
sweetened diet cold drinks, have no more than 3 – 4 cans per week.
• Cocoa powder can be used to make a hot chocolate drink
with boiling water, some skim milk and a little artificial sweetener.
And what you shouldn’t
Avoid sugary drinks like regular fizzy drinks, fruit punch, fruit drinks,
energy drinks, sweet tea, and sugar-sweetened smoothies. These will
have an impact on your blood glucose levels and can provide several
hundred calories in just one serving.
The benefits of exercise
Regular activity is as key a part of managing Diabetes as proper meal planning,
regular monitoring and taking medication as prescribed. When you are active,
your cells become more sensitive to insulin, which means that your body can
work more efficiently. During exercise your cells also remove glucose from
the blood using a mechanism totally separate from insulin. So, not only does
exercising consistently lower blood glucose, it also improves your blood
glucose control overall.
Top tip:
Get moving and get the most out of your exercise routine by
incorporating strength training (to build muscle and body structure),
cardiovascular training (to improve heart health) and flexibility
training (to ensure supple limbs and range of movement).
Is there such a thing as a bad egg?
Eggs are relatively high in cholesterol, yet there is now enough evidence to
suggest that we can eat an egg a day without a detrimental effect on our
blood cholesterol levels.
The South African food-based dietary guidelines allow
for 4 eggs per week and here’s why:
• Eggs are a source of protein and several essential nutrients.
• Although eggs are relatively high in cholesterol - 210mg per large egg (50g) they have a low saturated fat content.
• Many of the studies linking eggs to high blood cholesterol levels and poor heart health are now criticized and considered to be weak.
• New evidence suggests that eating eggs is associated with satiety
(feeling fuller for longer), good weight management and better diet quality.
So, if you enjoy eggs, go ahead, include them in your diet.
Just remember:
• Prepare your eggs with no extra fat by boiling, poaching or scrambling them.
• Limit your egg intake to 1 egg per day. And, if you have raised blood cholesterol levels, limit your intake of animal fats and increase your
vegetable, fruit and fibre intake.
• Egg whites contain no cholestrol. So, if a recipe calls for a few eggs, moderate your cholestrol intake by using two egg whites in place of one whole egg.
Please consult with a registered dietitian to obtain a meal plan specific to your individual requirements.
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Pick n Pay health hotline
Did you know that Pick n Pay has a registered Dietitian to provide free food and nutrition-related advice to
the public? Whether you’re looking for advice on managing your condition, weight loss, healthy eating tips
for kids, managing food allergies, interpreting food labels or just have a food-related question you’ve always
wanted answered, our registered Dietitian is just a phone call away.
Contact Leanne via the Health Hotline 0800 11 22 88 or email her directly on
[email protected] to start your nutrition conversation.
References and useful links:
• Duyff RL (2012). American Dietetic Association Complete Food and Nutrition Guide, 4th Ed. John Wiley & Sons Inc, USA.
• Catsicas R (2009). The Complete Nutritional Solution to Diabetes. Struik Lifestyle, South Africa.
• Shisana O, et al. (2013). South African National Health and Nutrition Examination Survey (SANHANES-1). Cape Town: HSRC Press.
• Diabetes South Africa: www.diabetessa.co.za/Content.aspx?ContentID=1&CatID=1
• American Diabetes Association: www.diabetes.org/?loc=bb
• Association for Dietetics in South Africa: www.adsa.org.za
• Pick n Pay Nutrition and Wellness: www.picknpay.co.za/health-corner-articles
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