Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Patient information leaflet Royal Surrey County Hospital NHS Foundation Trust Guide to healthy eating to improve raised blood sugars Nutrition & Dietetics Department What is this leaflet for? ■■ To learn more about raised blood sugars and your health ■■ To learn about healthy eating so you can make changes to your diet ■■ To help you improve your raised blood sugars and reduce risk of complications What are raised blood sugars (glucose)? There are different terms used to describe raised blood sugars including: ■■ Impaired fasting glycaemia (IFG) ■■ Impaired glucose tolerance (IGT) What is Impaired Fasting Glycaemia (IFG)? Impaired Fasting Glycaemia (IFG) is a condition in which the body is not able to utilise glucose for energy as well as it should in a fasted state. This means your blood glucose is higher than normal. It is diagnosed by a blood test called a fasting plasma glucose level. If your fasting plasma glucose measures between 6.0 – 6.9 mmol/l a diagnosis of IFG is made (normal range 3.6-5.9 mmol/l). What is Impaired Glucose Tolerance (IGT)? Impaired Glucose Tolerance (IGT) is a condition in which the body is not able to utilise glucose for energy as well as it should after a meal. It is similar to IFG but it is diagnosed by 2 separate blood tests. Blood test 1: This measures your fasting blood glucose levels (this may be within the normal range). You are then given a sugary drink by the nurse or doctor. Blood test 2: This test occurs 2 hours after Test 1. Your blood glucose level will be measured again. If the reading is between 7.8-11.1 mmol/l a diagnosis of IGT is made. 2 Does having IGT or IFG mean I have Diabetes? No, however people with IGT or IFG are more likely to develop diabetes in the future. Making healthy diet and lifestyle changes can help reduce risk of developing diabetes. Why do I need to manage my IGT/IFG? Managing your IGT/IFG may stop or slow down the progression of diabetes and help to reduce your risk of developing heart disease and stroke. What type of diet is best to manage raised blood glucose? There is no specific diet to manage raised blood glucose. The advice is to follow a healthy, balanced diet keeping high fat and high sugar foods in moderation. The aim is to make healthy changes for life and maintain a healthy body weight to help reduce your blood glucose levels. Why is it important to have a healthy diet? A good diet is important for good health. Eating a variety of foods can help you: ■■ Manage your weight. ■■ Improve your general wellbeing. ■■ Reduce the risk of conditions including heart disease, stroke, some cancers, diabetes and osteoporosis (thin bones). The tips in this leaflet are intended to help you make the right choices and ensure that you eat as healthily as possible. 3 What is a healthy balanced diet? A healthy balanced diet contains a variety of types of food. The Food Standards Agency Eatwell Plate is made up of five food groups. These include: ■■ fruits and vegetables ■■ starchy foods such as wholemeal bread and wholegrain cereals ■■ protein-rich foods such as meat, fish, eggs and lentils ■■ dairy foods ■■ food and drink high in fat and/or sugar It is important to eat a range of foods from each group in the proportions shown below. 4 What are the important tips for a healthy lifestyle? ■■ Eat at regular times. Try to include breakfast, lunch and an evening meal. ■■ Include starchy foods, particularly wholegrain varieties, at meals e.g. bread, rice, pasta, potatoes, porridge, plain wholegrain breakfast cereals. ■■ Have at least 5 portions of vegetables and/or fruit every day. Eat a variety of types and colours, but do not count potatoes. Fresh, frozen, dried, tinned and juices all count towards the 5 portions. 1 portion of vegetables = 3 heaped tablespoons, 1 portion of fruit = 1 handful. ■■ Eat moderate amounts of protein, such as meat, fish, eggs and pulses (beans and lentils). Choose lean cuts of meat, remove excess fat and avoid frying where possible. ■■ Oily fish, such as mackerel, herring, sardines, salmon or fresh tuna should be eaten at least once a week. Canned tuna is a good low fat fish but does not count as part of your oily fish intake. ■■ Aim for a pint of skimmed/semi skimmed milk each day, or use other dairy sources. A small pot of yoghurt or a small matchbox size piece of cheese contain the same amount of calcium as 1/3 pint of milk. ■■ Reduce your intake of fats, oils, and fatty food. Choose plant oils or spreads such as olive/rapeseed and use sparingly. Choose low fat options as much as possible. ■■ Limit foods high in sugar. Have fruit or low calorie puddings or low calorie snack items instead. ■■ Drink plenty of fluid. Aim for 8-10 cups per day (1 cup = 200ml). Include a variety of fluids e.g. water, low calorie squash, tea, coffee, but limit fruit juice to one small glass per day and avoid drinks containing added sugar. ■■ Excessive intake of alcohol should be avoided. Alcohol is high in calories and a reduction can help weight control. ■■ Increase your exercise or activity levels. Even small changes are beneficial, but a 30 minute walk at least 5 times a week is the minimum advised. 5 What are the best food choices most of the time? Instead of… Try these… White bread, sugar, coated breakfast cereals, croissants Granary or wholemeal bread, porridge, wholegrain breakfast cereals Sugar for sweetening drinks, fruit or custard Artificial sweetener e.g. Canderel®, Sweetex®, Hermesetas®, Splenda® Squashes and fizzy drinks Low calorie / diet versions with no added sugar Desserts & puddings, milk puddings, jellies, canned fruits in syrup Canned fruit in juice, low fat or diet yoghurts, fresh fruit or sugarfree jelly or low calorie instant whip or mousses Cakes, doughnuts, pastries, cream-filled or chocolate biscuits, crisps Fresh fruit, rice cakes, scones, teacakes or plain biscuits (Rich Tea, Garibaldi or low fat digestives) Jam, marmalade or honey Reduced sugar jam, Marmite® or peanut butter in small quantities Fried & fatty foods Use only small amounts of oil in cooking. Choose lean meats and remove any visible fat. Ready prepared meals should be the lower fat or lower calorie or “healthy” options. Butter, lard, ghee, hard margarine, coconut oil, palm oil Choose a low-fat spread labelled ‘high in monounsaturates’. Cook with olive or rapeseed oil. Use sparingly. Full-fat milk and cheese Semi-skimmed, 1% or skimmed milk. Limit cheese to small portions of low fat varieties at meal times only. 6 What can I eat for breakfast? ■■ High fibre cereal e.g. unsweetened muesli, Weetabix ®, Branflakes®, Shredded Wheat®, with milk and/or low fat yoghurt. ■■ Porridge ■■ Small glass of unsweetened fruit juice or piece of fruit (dried or fresh). Eaten on its own or added to cereal or porridge. ■■ Wholegrain bread or toast with a scraping of low fat spread and/or jam, marmalade, honey, marmite etc. ■■ Fruit salad with low fat or low calorie yoghurt. ■■ Boiled or poached egg and wholemeal/wholegrain toast. ■■ Lean grilled bacon, grilled tomatoes, baked beans or mushrooms on wholemeal/wholegrain toast. What can I eat for my main meal? Always serve dishes with vegetables or salad, and make sure that you include a serving of starchy foods, e. g. potatoes, rice, couscous or pasta. Your plate should contain foods in the proportions shown in the diagram Meat, fish or alternatives Salad or vegetables Starchy foods Meat dishes ■■ Vary your types of meat to reduce your intake of red and processed meats. ■■ Lean minced meat dishes e.g. cottage pie, spaghetti bolognaise, chilli con carne. ■■ Always choose lean cuts of meat, remove any remaining visible fat and cook without using excess oil. Examples: chicken casserole, stewed lean meat with vegetables, lamb curry, stir fry pork/chicken/beef with vegetables, grilled meats, gammon & pineapple, lean pork chop with apple sauce lean roast meats with gravy made without added fat. 7 ■■ Fish dishes ■■ ■■ ■■ ■■ ■■ Choose both oily fish & white fish. Try grilling or baking in the oven with lemon juice. Cook in a low fat sauce, e.g. tomato sauce. Fish pie, made without cream or cheese. Grilled or oven baked fish fingers or fish cakes. Avoid frying fish or serving with chips. Pasta dishes ■■ Use tomato sauce or low fat bolognaise sauce, rather than creamy or cheese varieties. Salads Try cold lean meat, fish (fresh or tinned) or eggs with a variety of salad ingredients. E.g. lettuce, tomato, cucumbers, mushrooms, peppers, sugar snap peas. ■■ Aim to include some starch with your salad, e.g. bread, new potatoes, couscous, rice or pasta. ■■ Limit mayonnaise, salad cream or dressing. Opt for low fat varieties. ■■ Vegetarian dishes ■■ Use a variety of pulses, Quorn® or soya products rather than cheese. What can I eat for a snack meal? Soups Home-made, tinned or packet soup. ■■ Try consommé or soups with lentils, vegetables & pulses. ■■ Avoid “cream of” soups. ■■ Sandwiches Use wholemeal or granary bread, rolls, baguettes or pitta bread. ■■ Choose fillings of lean meats, fish, salad, cottage cheese or egg. ■■ Avoid full fat cheese, pate and fillings mixed with mayonnaise. ■■ 8 Jacket potatoes Opt for a small jacket potato (size of your fist) filled with baked beans, tuna, reduced fat coleslaw, cottage cheese, ham and pineapple. ■■ Avoid full fat cheese and fillings mixed with mayonnaise, oil or cream. ■■ Toast Topped with baked beans, sardines/pilchards/mackerel, tinned tomatoes, scrambled egg. ■■ Avoid using butter, margarine or spread with moist toppings. ■■ Salads Made with cottage cheese, lean meat, fish or eggs. ■■ Avoid high fat foods such as quiche and pastry products. ■■ Limit the use of mayonnaise, salad cream and dressing. ■■ What can I eat for dessert? ■■ ■■ ■■ ■■ ■■ ■■ ■■ Fresh fruit. Stewed fruit, sweetened with artificial sweetener. Try topping with low fat yoghurt or fromage frais. Tinned fruit in natural juice. Natural or low-fat/low sugar yoghurt. Sugar-free jelly. Try adding tinned fruit. Sugar-free mousse (made with skimmed or semi-skimmed milk). Low fat/low sugar milk puddings. What should I choose when eating out? Restaurants Try light starters e.g. clear soup, melon, lean meat/fish or salad. Avoid cheese and the bread and butter. ■■ Try grilled meat or fish with salad for the main course. ■■ Ask for food to be served without extra butter, oil or rich sauces added. Ask for dressing, sauces or gravy to be served on the side and only use small amounts. ■■ 9 Avoid fried food where possible e.g. chips. ■■ Opt for tomato based sauces instead of creamy versions. ■■ Ask for low fat milk with coffee/tea. ■■ Takeaways Type Healthier options Limit these options Sandwich Shop Wholemeal/granary bread, roll, pitta or wrap with salad and: Tuna & sweetcorn, low fat cheese spread, smoked salmon, cottage cheese, lean meats, chicken, sardines Croissant, pies, pastries, doughnuts, Cornish pasties, sausage rolls, salad dressing, mayonnaise, salad cream, butter and spread Pizza Thin crust base with low fat toppings e.g. ham and pineapple, lean meat, extra tomatoes and vegetables Thick or stuffed crust, extra cheese, salami, pepperoni, garlic bread Burgers Chicken, fish or vegetable burgers, potato wedges, salad Quarter pounders, added extras such as bacon & cheese, chips, milkshakes, mayonnaise Chinese Stir fried dishes, boiled rice, chop suey dishes, beef in oyster sauce Fried rice, deep fried batters, duck, ribs, seaweed, spring rolls, sweet & sour dishes, prawn crackers Indian Balti & tandoori dishes, tikka dishes (not massala), boiled rice, chappati, tomato based curries Korma & other cream/ coconut based dishes, biryani, naan, pilau rice, samosas, bhajis, poppadoms Café Baked beans, tinned tomatoes, mushrooms, poached egg on wholemeal/granary toast, grilled bacon sandwich Pastry, sausage roll, quiche, fried bacon and eggs, sausages, pasty, chips, cream cakes or desserts Coffee shop drinks Americano with skimmed milk, expresso, “Skinny” latté, cappuccino All drinks made with full fat milk including cappuccino, latté, mocha, hot chocolate 10 Meals out with friends and family should be enjoyable and not a source of anxiety. The occasional indulgent meal can be allowed as a treat. If you eat out regularly try to make sensible choices and avoid eating too much. Takeaways can be very unhealthy options, so it is best to limit the use of these as much as possible. What does a typical menu look like? Always remember that snacks, puddings, cakes and biscuits should only ever be eaten in small quantities, even when choosing low-fat or lowsugar varieties. Breakfast:Porridge or wholegrain cereal or Wholemeal toast with low fat spread Fruit or small glass of fruit juice. Light Meal: Granary or Wholemeal bread or roll Mixed salad vegetables Lean meat, fish, beans, egg or low-fat cheese Fresh fruit or low fat/diet yoghurt. Main Meal: Potatoes, rice or pasta Large serving of vegetables or salad Lean meat, fish, pulses or vegetarian dish Fruit or low calorie dessert. Between Meals: Fruit or a plain biscuit if required Water, ‘no added sugar’ squash, tea, coffee. Further reading Diabetes UK www.diabetes.org British Heart Foundation http://www.bhf.uk/heart-health/prevention/healthy-eating.aspx Disclaimer If you have any questions about the information in this leaflet please contact the Department of Nutrition and Dietetics at the address overleaf. 11 Contact details Nutrition and Dietetics Department The Royal Surrey County Hospital Egerton Road Guildford GU2 7XX Telephone: 01483 464119 Royal Surrey County Hospital (RSCH) NHS Foundation Trust fully subscribes to the National Patient Safety Agency (NPSA) Being Open best practice framework, November 2010. PALS and Advocacy contact details Contact details of independent advocacy services can be provided by our Patient Advice and Liaison Service (PALS) who are located on the right hand side as you enter the main reception area. PALS are also your first point of contact for health related issues, questions or concerns surrounding RSCH patient services. Telephone: 01483 402757 Email: [email protected] Opening hours: 9 .00am–4.00pm, Monday to Friday If you would like information documents in large print, on tape or in another language or form please contact PALS. Review date: May 2018 Author: Rachel Bracegirdle/Antonia Heal Review author: Nicola Clarke PIN150515–202 © Royal Surrey County Hospital NHS Foundation Trust 2015 Cover image: morguefile.com