Download Guide to healthy eating to improve raised blood sugars

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?
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To learn more about raised blood sugars and your health
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To learn about healthy eating so you can make changes to your diet
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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:
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Impaired fasting glycaemia (IFG)
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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.
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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:
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Manage your weight.
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Improve your general wellbeing.
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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.
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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:
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fruits and vegetables
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starchy foods such as wholemeal bread and wholegrain cereals
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protein-rich foods such as meat, fish, eggs and lentils
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dairy foods
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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.
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What are the important tips for a healthy lifestyle?
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Eat at regular times. Try to include breakfast, lunch and an evening
meal.
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Include starchy foods, particularly wholegrain varieties, at meals e.g.
bread, rice, pasta, potatoes, porridge, plain wholegrain breakfast
cereals.
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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.
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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.
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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.
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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.
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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.
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Limit foods high in sugar. Have fruit or low calorie puddings or low
calorie snack items instead.
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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.
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Excessive intake of alcohol should be avoided. Alcohol is high in
calories and a reduction can help weight control.
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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.
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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.
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What can I eat for breakfast?
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High fibre cereal e.g. unsweetened muesli, Weetabix ®, Branflakes®,
Shredded Wheat®, with milk and/or low fat yoghurt.
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Porridge
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Small glass of unsweetened fruit juice or piece of fruit (dried or fresh).
Eaten on its own or added to cereal or porridge.
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Wholegrain bread or toast with a scraping of low fat spread and/or
jam, marmalade, honey, marmite etc.
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Fruit salad with low fat or low calorie yoghurt.
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Boiled or poached egg and wholemeal/wholegrain toast.
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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
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Vary your types of meat to reduce your intake of red and processed
meats.
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Lean minced meat dishes e.g. cottage pie, spaghetti bolognaise,
chilli con carne.
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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.
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Fish dishes
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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
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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.
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Vegetarian dishes
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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.
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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.
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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.
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Toast
Topped with baked beans, sardines/pilchards/mackerel, tinned
tomatoes, scrambled egg.
■■ Avoid using butter, margarine or spread with moist toppings.
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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.
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What can I eat for dessert?
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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.
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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.
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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
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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.
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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