Health Archives - Page 9 of 11 - Diabetes Counselling Online

Eating well without counting calories

August 11, 2014 by Sally 2 Comments

Some of us really dislike counting calories. It’s great for those who do, and many I know use tools/apps such as MyFitnessPal and others with success, but it’s not for everyone. This raises the question, if you’re not counting calories how do you know how much to eat to lose or maintain your weight/wellbeing?

A good place to start is to have an understanding of the energy density in carbohydrates, proteins, fats and alcohols, these being the four ‘macronutrients’ that provide all our calories/energy in the food we eat. May I suggest a quick review of a previous blog called ‘Energy In/Energy Out – understanding how much you need and where you get it’. In a nutshell though, carbohydrates and proteins provide about the same amount of energy, and fats and alcohol are about double the energy density of carbohydrates and protein.

Another excellent thing to keep in mind is the Australian Dietary Guidelines that indicates how many serves of each of the five food groups each of us should be aiming to include in our daily food intake.

The reason for highlighting this suggestion is it is easy to think that because something is healthy that means we can eat as much of it as we like. We know that monounsaturated and omega-3 polyunsaturated oils, including avocados, nuts and seeds, are good choices for heart health (as outlined in the Blog 2 on fats – which are the best types for us to enjoy?). Often if people think they’ll lose weight by cutting out one macronutrient, it just doesn’t work in the long term as they tend to balance out the energy they need by including more of another.

For us with diabetes, often people think they should cut down on their carbs to help with their blood glucose control (which can be helpful – read more in the blog Discussion on low carb diets) but end up eating more fat or protein in their daily routine to make up for the energy they’re missing in the carbs they’ve cut.

So the idea to understand how to make your meal and snack choices contain the correct amounts of the ‘macronutrients’ to keep your energy balance as well as the foods from all 5 food groups to provide you the nutrition you need for wellbeing.

The key, as always with diabetes, is ‘balance’.

There are a number of plate diagrams around. The traditional idea of a medium sized plate divided into quarters, with one quarter being carb foods (preferably nutritious and low-GI), one quarter being lean protein and the other half being non-starchy vegetables, with a small amount of good fats too is an awesome idea to keep in your mind.

The Australian Dietary Guidelines also reminds us that “an allowance for unsaturated spreads and oils for cooking, or nuts and seeds can be included in the following quantities: 28-40g per day for men less than 70 years of age, and 14-20g per day for women and older men.”

Carbohydrate foods

Choices here can come from the vegetables, grains, dairy and fruit (although we tend to save dairy and fruit for snacks). You might choose sweet potato, Carisma potato or sweet corn if you were having a vegetable based meal, and around 2-3 carb serves of these would make up the quarter serve of your plate. If you were having rice, pasta or another grain food, again you’d aim for 2-3 carb serves on your plate.

It’s easy to think about carb serves as roughly a small fist size.

Protein foods

One serve of a protein food as outlined in the Australian Dietary Guidelines is enough to take that quarter allocation on your plate:

65g cooked lean red meats such as beef, lamb, veal, pork, goat or kangaroo (about 90-100g raw)
80g cooked lean poultry such as chicken or turkey (100g raw)
100g cooked fish fillet (about 115g raw) or one small can of fish
2 large (120g) eggs
1 cup (150g) cooked or canned legumes/beans such as lentils, chick peas or split peas (preferably with no added salt)
170g tofu
30g nuts, seeds, peanut or almond butter or tahini or other nut or seed paste (no added salt)

You can read more about protein in the blog Protein and diabetes – do you get the balance right?. And it can be easy to think about protein serves by aiming for a serve the size of the palm of your hand (no fingers or thumbs).

Non-starchy Vegetables

This section is half the plate, and is where many people struggle to eat enough. It should be made up of about 3 serves based on the Australian Dietary Guidelines, and doesn’t include the starchy veggies that sit in the carbohydrate quarter.

A standard serve of vegetables is about 75g or:

½ cup cooked green or orange vegetables (for example, broccoli, spinach, carrots or pumpkin)
½ cup cooked, dried or canned beans, peas or lentils
1 cup green leafy or raw salad vegetables
1 medium tomato

Some great ideas to make the non-starchy vegetables work for you might include roasting them or a vegetable stew or curry with a tomato base. And there’s always a hearty salad with perhaps some cheese from your daily dairy serves, or good old lightly steamed vegetables. You can also skewer them to be barbequed, and stir fry them – the options are almost never ending.

So don’t be held back by some maybe old-fashioned ideas about vegetables not being exciting. Give some new ideas a try and learn to embrace their wonderful nutritious and delicious qualities. And if at the end of a meal, or even in between meals, if you can discover some ideas for these non-starchy vegetables you’ll be happy to learn that they’re low in all the energy containing macronutrients so eat more of these to keep you satisfied.

How much weight is a good amount to lose?

This is really a topic for another whole blog, but just briefly I’ll take the opportunity to remind you that ‘going on a diet’ doesn’t work in the long term. Even if you lose weight in the short term, it will come back plus some – the evidence here is overwhelming. By following the Australian Dietary Guidelines suggested daily serves for your gender/age and participating in regular physical activity you are likely to lose about a kilo a month and it should be sustainable. There is certainly a lot to eat in there and I challenge anyone to still be hungry when consuming all that food! To maintain a healthy weight it’s recommended that you add in 2.5 serves from the food groups that you enjoy the most.

The main point is to avoid processed and take away foods as often as possible. Try to be organised and take your own meals and snacks with you to help avoid temptation.

My last key point is to remind you about the importance of seeing an Accredited Practising Dietitian to help you with a personalised consultation so you know you’re getting everything you need to be your best.

I hope you’ve found this useful in helping you to understand how much of the different foods you need to include in each of your meals, as well as the extras you have such as dairy, fruit and nut serves for your snacks if you need/want them.

Please let me know if you any questions. Wishing you all an awesome week. Sally

Sally is the Social Media Dietitian with Diabetes Counselling Online, owner of her private practice (Marchini Nutrition), and has had type 1 diabetes for close to 40 years and coeliac disease for many years too. You can access a list of all Sally’s Diabetes Counselling Online blogs here.

Please Share!

Exercise: Part 2… Where to Now

August 9, 2014 by Imagine_David Leave a Comment

‘Exercise’ or ‘physical activity’ or ‘movement’ is something Australians are doing less and less of.

As a person living with diabetes finding the time, the motivation, the energy are often barriers to getting started.

Lets take a look at some of the evidence around exercise.

Exercise Can be Fun. More importantly it is good for your entire health - physical and mental. — **Exercise Can be Fun. More importantly it is good for your entire health – physical and mental.**

The Transtheoretical Model

(TTM; Prochaska & DiClemente, 1983; Prochaska, DiClemente, & Norcross, 1992) is an integrative, biopsychosocial model to conceptualise the process of intentional behavioral change. Whereas other models of behavioral change focus exclusively on certain dimensions of change (e.g. theories focusing mainly on social or biological influences), the TTM seeks to include and integrate key constructs from other theories into a comprehensive theory of change that can be applied to a variety of behaviors, populations, and settings (e.g. treatment settings, prevention and policy-making settings, etc.). Dr. DiClemente published Addiction and Change: How Addictions Develop and Addicted People Recover (2003) which goes into more detail about the development of the model and how to appropriately use the model in both research and clinical work.

Stage of exercise behaviour and appropriate strategies
Stage	Definition	Appropriate Strategy
Pre-contemplation	Inactive & do not intend to become active in the next six months	Information on risks of inactivity, benefits of activity
Contemplation	Inactive, but thinking about becoming active in the next 6 months	Decision balance (weigh up pros and cons of becoming active).Discuss and overcome barriers.
Preparation	Made some attempts to become more active	Develop realistic activity goals.Establish support.
Action	Active, but only began in the last six months	Re-enforce successful attempts.Re-emphasise experienced benefits, overcome experience barriers.
Maintenance	Active for longer than 6 months	Relapse prevention.Alternative activities.

Pre-contemplation

“Individuals in the Pre-contemplation stage are not thinking about or intending to change a problem behavior (or initiate a healthy behaviour) in the near future (usually quantified as the next six months). Precontemplators are usually not armed with the facts about the risks associated with their behavior. Additionally, many individuals make unsuccessful change attempts, becoming discouraged and regressing back to the Precontemplation stage. The inclusion of the Precontemplation stage represents a significant contribution of the TTM, as individuals in this stage comprise a large proportion of individuals engaged in risky or unhealthy behaviors. In comparison to many traditional, action-oriented theories of behaviour change, which view individuals in this stage as resistant and unmotivated, the TTM can be useful in guiding treatment and prevention programs by meeting the needs of these individuals, rather than ignoring them.”

We all have limitations. Does your limitations act as a barrier to exercise? — **We all have limitations. Do your limitations act as a barrier to exercise?**

Information on risks of inactivity, benefits of activity

“The scientific evidence is clear-regular physical activity has powerful positive effects on both physical and psychological health. Conversely, physical inactivity has a high human cost in terms of health. It shortens years of life, decreases quality of life, and limits functional independence. These health effects arise from physical inactivity’s contribution to cardiovascular disease, obesity, diabetes, osteoporosis, mental health disorders, and some cancers (i.e., colon and breast)”. From The cost of being couch potato. Michigan Health & Hospitals [Mich Health Hosp] 2003 Jul-Aug; Vol. 39 (4), pp. 24-7.

Physical inactivity was directly responsible for 3% of disability adjusted life years lost in the UK in 2002. The burden of physical activity-related ill health in the UK. (Journal Of Epidemiology And Community Health [J Epidemiol Community Health] 2007 Apr; Vol. 61 (4), pp. 344-8)

Performing resistance exercise before aerobic exercise improves glycemic stability throughout exercise and reduces the duration and severity of post exercise hypoglycaemia for individuals with type 1 diabetes ( Effects of performing resistance exercise before versus after aerobic exercise on glycemia in type 1 diabetes. Diabetes Care (DIABETES CARE), 2012 Apr; 35 (4): 669-75.)

So, if we explore the evidence further we can determine that you, the person with diabetes, has significant benefits to gain from participating in some exercise.

For a person with diabetes exercise some of the benefits include:

Insulin to work better, which will improve your diabetes management
You control your weight
Lower your blood pressure
Reduce your risk of heart disease
Reduce stress.

Did you know that your body uses less energy when you are watching tv than when you are asleep?

**Talk to your health care team about other specific benefits for you.**

Remember: If your diabetes is not well managed, i.e your Blood Glucose Level is elevated to over 15mmols then it is best to avoid exercise until your blood glucose ton down below 14mmols. If you have type 1 diabetes check for ketones and follow your sick day plan. Exercise in these circumstances can actually elevate blood glucose and increase ketone production.

For gold standard advice on creating your exercise self care plan consult with an exercise physiologist.

So, having a little information here might you be able to move into the contemplation stage ……. sometime soon?

Kind Regards,

David

Diabetes Educator @ Diabetes Counselling Online

Please Share!

While we’re busy making other plans..

August 7, 2014 by helwild 2 Comments

A diagnosis of diabetes brings the ‘C’ word into everyday life: Control. We get bombarded with information, instructions, advice. We’re told to ‘test’, given pieces of paper to go to a clinic or hospital for a variety of even more ‘tests’. We’re monitored, measured, & judged. For some people, this becomes more important than anything else. They become hyper vigilant, testing, checking, measuring, exercising, dieting. Almost everyone diagnosed with diabetes begins their journey like this; driven by fear, anxiety, guilt, the notion of ‘control’ becomes all consuming. For some, this is relatively short lived, and things become all too hard. Those who ‘drop the ball’ early give up, bury their head in the sand, ignore advice, feel hopeless, helpless. Their diabetes remains ‘uncontrolled’. For others, the steady mantra of ‘control’ rules their lives. No matter what they achieve, no matter how ‘good’ their diabetic ‘control’ is, they strive to be ‘better’, to be ‘perfect’. To all intents and purposes, and according to most measures, their diabetes is ‘controlled’. Yet they still feel unsuccessful.

How do we find balance?

Ive been thinking a lot about this lately. Those who have a child diagnosed with diabetes come to this with a rather different perspective. For us, the worry, anxiety, need to achieve control are driven by the primal urge to protect our child. It can be harder for us to let go of the notion of ‘control’ than for the child themselves. After all, our main role in life is to care for our child, to make life the easiest, the best, it can be. We will access the best technology and resources available to us, whether thats a new insulin, a new way of measuring, a new test, an app, a new alarm or monitor, a hypo dog. It can be hard to relinquish that ‘control’ to our child. At what age do we ‘allow’ them to make their own decisions about management? For many of us, the decision is taken out of our hands. Our child will refuse to allow us to administer insulin, conduct tests, record results. They may lie to us, and we have the moral dilemma of respecting their autonomy, their right to privacy, and reconciling that with our parental role to manage their health. In some families, difficult topics are discussed. In others, they are not spoken of, they are ignored. Either way, the hard subjects, sex, death, religion, war, family secrets, unfairness, prejudice, injustice, and overnight hypos, all exist. Our children will learn about them. We do have the right to choose whether or not to speak of them.

We tend to judge ourselves very harshly around these changes in our ‘control’. Yet in the end, the vast majority of children with diabetes grow up to manage their diabetes well, to live good, productive lives, to participate fully in other aspects of life, work, socially, and also often with a strong social conscience, a sense of advocacy and participation in supporting others with diabetes. Through struggle & difficulty many are very compassionate human beings, people to be proud of. In managing our own diabetes, although some Health Care professionals may seem, or indeed be, somewhat judgemental, in the end we are all doing the best we can at the time. There may be ‘scope for improvement’, but judging and blaming have no part in our Mental Health, nor in our Physical Health. We need to find our motivation in self love and in our sense of our own worth. We deserve kindness, and the best we can do.

I think one of the key notions that helps to make this journey survivable is to accept that it is just that- a journey. We travel our road in life, and sure, for everyone, some more than others, there are rough patches, difficulties. The destination is known, we don’t know when, but we do know that ‘all things must pass’. Looking around us while were on that journey is what makes the difference. Taking that holiday in Japan, even though we can’t get an Insurance company to fully insure our insulin pump; walking to the shops in the sunshine, or the rain; playing with our child because it’s fun, not because the exercise will be good for his blood glucose control; taking time out from achieving, controlling, managing, to just simply be. This week I went back to my Yoga class. It’s been 5 years since I saw my teacher, Balbir. In that 5 years she has grown old, but she still has the mesmerising power to transport me during relaxation time to a place of calm and serenity; and the ability to lead me through physical practice which stretches and awakens my body to Life. Taking time to focus on the breath, on Balance, Serenity, and the practice of Mindfulness. Most of all, on Resilience. Building resilience in ourselves, and importantly in our children, helps us and them to live life fully: to achieve a level of mental health that will see our journey through life as a balanced one, a life to feel gratitude for, not a life of self doubt. Yesterday I saw an almond tree in full blossom. It was growing alongside a busy highway. Clearly it had stood there for decades before the road came along, before the construction that rose around it. Yet there it was, in full blossom, old, huge, bursting with optimism and life.

Life is what happens to you while you’re busy making other plans- remember to Notice your Life.

Its a Long Way to go, A Hard Row to Hoe

Helen Wilde

Helen has been the parent of someone with Type 1 diabetes since 1979. She has lived with the diagnosis of Type 2 diabetes herself since 2001. She is a Senior Counsellor with Diabetes Counselling Online. If you are struggling with Control or any aspect of your diabetes you may like to contact our team at

http://www.diabetescounselling.com.au/counselling-request/

carpe diem

Please Share!

Saucy tips to improve d-health

August 4, 2014 by Sally 2 Comments

Earlier this month we shared a thread in Diabetes and Food – let’s celebrate it! on what people’s favourite sauces were. There were some awesome ideas presented by our members on how to swap some of the more processed sauces for lower sodium/fat/sugar varieties and some great ideas for fresh, homemade options. I thought we’d look at some of these today, and how we could modify some recipes to make our own that would be kinder to our d-health.

Some of the sauces mentioned were Satay sauce, Bernaise sauce, salsa, curry sauces, tomato/bbq sauce, salad dressings, Worcestershire sauce, sweet chilli sauce, mustard pickles, and pestos.

It’s important that we remember that it’s okay to have small amounts of what we like if we really want them, but is better if we can find fresher, healthier alternatives or modify what we like to make the most of it while still considering our health.

Reminder on our targets

Primarily for heart health reasons, we need to look for less than 2g/100g saturated fat, less than 400mg/100g sodium, and we should minimise added sugars which may throw our BGL readings out of range.

Ideas for alternatives

When you consider the main reason we enjoy sauces with our food is to add flavour, then herbs (fresh and dried), spices, garlic, chilli, ginger, lemongrass, lemon/lime juice/zest and other fresh flavours can really lift your meal to a new level of enjoyment.

Sometimes thinking of alternatives to what you might normally use can prove inspirational and help you to enjoy the food even more knowing that you’re doing your insides a favour too!

One of our members who enjoys pickles and fruit chutney (high in sodium and added sugars) on her sandwiches and a store bought barbeque sauce (high in sodium, sugar and fat) or sweet chilli sauce (oh the sugar!) on her chicken or salmon suggested she would swap to “avocado on sandwiches and lemon juice on my chicken or salmon”. Such a simple idea and yet so delicious!

This website gives some great examples of various spices and what foods they go with to help you with some ideas, as well as how to best store them for freshness.

Another idea that emerged in our Facebook chat was that an easy alternative to lemon pepper (high in sodium) would be to grate and dry some lemon zest and mix it with freshly ground peppercorns. Wowser! and so easy

Salsas

Salsas are a mix of chopped fresh ingredients such as tomatoes, fruit, avocadoes, fresh herbs, garlic are so versatile that you can make up varieties depending on which fresh herbs you have available and what you’re adding it too.

Here are some recipe ideas for a tomato based salsa, a mango and capsicum salsa, an avocado salsa, and a spicy salsa, and there are plenty more where they came from! Don’t they look amazing!?!

Salad dressings

Store bought salad dressings can be a nightmare for heart health, and yet they’re such an easy thing to make yourself! At home we just use one third quality vinegar (white balsamic is my current favourite) or freshly squeezed lemon/lime juice to two thirds extra virgin olive oil. You can choose various oils (preferably those higher in monounsaturated fats) for variations on flavours. Sometimes a dash of sesame oil or other stronger flavoured oils can transform your salads.

And if you prefer the creamier salad dressings, just try some based on low-fat yogurt. This Australian Good Taste recipe sounds wonderful. As discussed further down too, if you *really love* your current processed creamy dressing, just mix it with half low-fat yogurt to make it a better option.

Here’s a link to some more awesome salad dressing recipes from Taste.com.au.

Pestos

It’s great to see that some of you have started experimenting with pestos as they’re so versatile and can really transform a boring meal into something very special. They can be used in pasta dishes, as a coating on meats, as a filling or stuffing in vegetables, and tossed through roasted vegetables make them irresistible, plus a whole lot more.

You just need a big bunch of soft-leafed herb (such as basil, coriander or parsley), a handful of nuts of your choice (pinenuts, walnuts and pecans work well), some quality extra virgin olive oil and extra flavours if you want them such as a quality parmesan cheese or fresh garlic. And if you have more than you need they freeze well for future use.

Here’s a link to some pesto recipes from Taste.com.au, remembering that you can control the sodium levels to suit your own health needs.

Modifying recipes

An awesome way to have the sauces you love but without the heart health issues is to make your own. We make our own barbeque sauce at home (and our own satay sauce) from recipes that we’ve found online and then modified to suit our heart healthy preferences.

For example in most recipes you can easily cut the ingredients that might be adding the salt and sugar in half quantities, and swap any saturated fats for monounsaturated fats.

Break it down

For our satay sauce we buy the Ayam brand of satay spices (which has a massive amount of sodium) and then break it down using low salt/sugar peanut butter and low-fat coconut flavoured Carnation milk to make it to our liking. It’s rather delicious too!

And if you fancy mayonnaise, try mixing 1 tablespoon mayo to 3 tablespoons low-fat natural yogurt which gives you the taste of mayo with less fat and more nutrients.

Add more goodness

Actually choosing your favourite sauce and ‘watering it down’ with other vegetables, herbs and liquids can also be a good option to retain the flavour you love while minimising the damage. A good example of this provided by a member of the ‘Diabetes and Food – let’s celebrate it!’ group was that of Patak’s curry sauces. She said, “I always add tons of stuff to them”. Some examples of good ‘stuff’ to add would be tinned tomatoes or passata for tomatoey ones, low-fat Carnation evaporated milk to creamy ones, or even low-sodium stock, as well as lots of extra fresh vegetables.

Healthier brands?

There are a few companies starting to offer better heart health choices in their sauces and spreads. Always remember to read the label and check for the less than 2g/100g saturated fat, less than 400mg/100g sodium and added sugars, but some good options might include the Walden Farms range of sauces (suggested by a member of the group, although I couldn’t see a nutrition information panel on their website to check the numbers) and the Fountain ‘No Added Sugar Smart’ sauces: Tomato and BBQ.

In summary, it’s okay to have small amounts of what we like if we really want them, but is better if we can find fresher, healthier alternatives or modify what we like to make the most of it while still considering our health. Hoping you found these ideas helpful.

We’d love you to share your own ideas below in the comments section to help others find healthier options for favourite sauces, dressings and the like. Thank You! Sally

Please Share!

Discussion on low carb diets

July 28, 2014 by Sally 8 Comments

Australian Guide to healthy eating poster

By popular demand through a thread in our Facebook group Diabetes and Food – let’s celebrate it!, this topic deserves a blog to help explain some of the ‘stuff we hear’ around carbohydrates and type 2 diabetes. I’d also encourage people with type 1 diabetes to read this though, because some of the points made are also relevant for us! Up front I will remind you that everyone has individual requirements and should see an Accredited Practising Dietitian for a personalised consultation, so this is a ‘general guide’ only.

Firstly we need to understand what ‘low’ means in such a context as in my experience as an Accredited Practising Dietitian, people tend to associate ‘low’ with ‘virtually no’ carbohydrate. We’ll also look at some of the evidence that shows that ‘low’ carb diets can help with glucose control in type 2s, and why when drugs (other than metformin or SGLT2-inhibitors) are introduced it’s important to ensure more (quality) carb intakes as advised by your health professionals. And lastly (but certainly not leastly) we’ll review how, based on the Australian Dietary Guidelines, it’s possible to have a nutritionally balanced diet while watching your carb intake.

What does ‘low’ carbohydrate mean?

If you ask some people what they think ‘low carb’ means, you may hear that it’s about cutting carbohydrates out as much as possible. Straight up as a dietitian my alarm bells ring as carbs feature in all five of the food groups that we need for nutrients to ensure our wellbeing: vegetables (starchy vegetables like potato, sweet potato and corn), fruit, dairy, protein (when the likes of legumes are included, and especially in vegetarian diets) and of course, the important grain/cereal foods.

The American Diabetes Association defines a low-carb diet as 130g of carb per day. Does that surprise you?? The ‘trick’ with low carb diets is therefore to know how to choose your carbs wisely so that you’re still meeting your nutrient requirements, and also to know what to replace that carb energy with (remembering that carbs, proteins and fats make up our daily energy intake) so you don’t get too hungry and be encouraged to ‘cheat’.

Remembering that there’s 15g of carbohydrate in an ‘exchange’ or ‘serve’ that gives us close to 9 carb serves across the day.

If you’re on medication that helps your body to produce more insulin, or you’re providing insulin yourself on a fixed dose then this idea is dangerous to your health so please speak to your health professionals before making any changes to your diet.

Some benefits of lower carbohydrate diets

Of course we know that all carbohydrates break down to glucose which is the fuel needed by our bodies, but in modern diets often too much (and poor quality) of this ‘fuel’ is provided which can cause stress to our organs and worsen our diabetes control. So understanding the benefits of a lower carbohydrate diet can help us to stick with it for longer and balance the rest of our diets more easily.

Some of those benefits may include:

Lower incidence of high blood glucose levels (hyperglycemia)
Lower amounts of medications need to control hyperglycemia
130g/day is a sustainable amount, meaning it’s easier to stick to in the longer term
Putting your pancreas under less stress to produce insulin, thereby helping it to keep working for longer
By ensuring your 130g/day is nutritious and low-GI carb you may also improve your blood fat levels (cholesterol/triglycerides) which will lower your risk of cardiovascular disease
It doesn’t necessarily lead to weight loss – that depends on your total energy intake.

How do you manage it best?

Again I will mention how important having a personalised consultation with your Accredited Practising Dietitian is because everyone is different in many ways. Here I will make suggestions that I hope will help to get your head around combining the idea of low carb into your daily routine while still meeting the nutritional requirements as outlined in the Australian Dietary Guidelines foundation diet (see page 2).

In a nutshell, it’s about only choosing your carb sources from the 5 food groups and balancing that out with quality proteins and healthy fats. I encourage you to re-read the previous blogs I’ve written on those topics as highlighted.

Remembering that 130g/day equates to close to 9 carb exchanges/serves, your day might start to look a bit like this:

Breakfast: ¼ cup of raw rolled oats (1 serve carb) served with 125ml light milk (half a serve), a small banana (85g – 1 carb serve) and a tablespoon of LSA mix (for extra fibre/protein) = 2.5 serves total

Morning Tea: A 100g tub of low-fat yogurt = 1 serve total

Lunch: A sandwich made on wholegrain bread (the grainer the better – 2 serves) made with a protein serve and as much non-starchy veg as you can handle, either on the sandwich or as a side, using half an avocado as the spread (for your good fats), and a piece of fruit such as an apple or pear (both good low-GI fruits – 1 serve) = 3 serves total

Afternoon Tea: A 30g handful of mixed unsalted nuts = not worth counting carb-wise

Dinner: Remembering the balanced plate being one quarter carb, one quarter protein and half non-starchy vegetables, this works with so many meals. Aim for your carb serve to = 2 serves total

Supper: You’ve still got half a carb serve up your sleeve. I would encourage something like half a slice of grainy toast with peanut butter on it to give you the energy to get you through the night, but half a serve of low-fat dairy would also work well, or even a couple of squares of dark chocolate if you fancied it = 0.5 serves total

In this example you can see that we’ve incorporated 9 carb serves/exchanges and yet have included quality carbs at every meal.

Some final tips

Remember to include protein and some non-starchy veg with every meal.
Rice and pasta can be problematic a serve size is so small. Something I recommend that works for many people is to include the carb serves in the form of legumes (lentils, chickpeas, kidney beans, etc) in the pasta sauce and use low-carb alternatives such as those made from konjac root, or make pasta/rice out of vegetables such as grated zucchini or carrot or cauliflower. I sometimes serve my pasta sauces on mashed cannellini beans and frozen spinach (warmed of course!) and find it’s very satisfying.
Don’t forget to exercise! If the point of minimising your carbs is to control your BGLs, then even as little as ten minutes exercise after meals can make a fantastic difference to your readings. Do some self-experimenting about how much your BGLs drop after say 10, 20 or 30 minutes walking after meals, and then if you want to include more quality carbohydrates in some meals, you’ll know how to manage better.

I hope this has proved useful for you, and that you have a better understanding of how a low-carb (130g/day) might help with your diabetes control. Of course please ask any questions below and I’ll be happy to address them for you.

Please Share!