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Oats for d-health

June 9, 2014 by Sally Leave a Comment

Oats are an awesome topic for a d-blog as they bring together so many aspects of food in our lives with diabetes including the glycemic index of carbohydrates, the importance of whole grains in our diets, soluble and insoluble fibre, heart health and the chance to talk about more delicious recipes. Not to mention with winter on our doorstep, oats are a wonderful comfort food breakfast for the coming cold mornings – Yes! And this idea follows on well from a recent blog about healthy eating on a budget as oats are definitely a bargain food!

Of course, like with all foods that I talk about individually, I need to make clear that they should be consumed as part of a varied and balanced diet as is demonstrated in the Australian Dietary Guidelines.

I’ll also talk about oats and coeliac disease, since around 10% of us with type 1 get coeliac disease, and I know I was devastated to find out that oats were off my diet when I was diagnosed. Now they’re back, so I’ll speak more of that further down

Glycemic Index

Oats come in various states – groats (the whole oat, just with husk removed), steel cut (the next ‘least’ processed version), oat bran, rolled oats, traditional oats and quick oats – just to name a few. As we often discuss, the less processing that the grain goes through, the lower it’s glycemic index should be as our body has to do the processing itself to break the whole grains down into glucose that our bodies need for fuel. So, when you’re choosing oats try to avoid the ‘quick oats’ which have been chopped smaller for faster cooking, when whole oats actually don’t need much (if any) cooking anyway.

It is also interesting to note that oats are lower in carbohydrates than many other grains. According to Calorie King, they come in at only 58% carbohydrate compared with rice at 79%, wheat at 71%, and quinoa at 64%.

Our D-health

We’ve probably all heard of the cholesterol lowering and glucose ‘slowering’ (I know, I made it up, but you get what I mean lol) abilities of beta-glucans that are found in oats, but oats are packed with a huge range of nutrients that are essential for maintaining health including B-vitamins, minerals (including iron, magnesium, and zinc) plus a whole lot more as well both soluble and insoluble fibre to keep our gut healthy too.

They also contain a plant nutrient that is unique to oats called Avenanthrades which have been demonstrated by research to possess anti-histamine and anti-inflammatory properties, as well as being shown to reduce a process involved in atherosclerosis. All good evidence for us with diabetes to include them in our diet on a regular basis as part of our 3-6 grain serves per day where one serve is a quarter cup of raw oats (17g carb = 1 serve/exchange).

There’s a lot of evidence to demonstrate the heart health benefits of oats, and I’m sure there’ll be more to come!

Oats and coeliac disease

Coeliac Australia says on their website that “FSANZ defines wheat, rye, barley and oats as gluten containing grains, as all four grains have been shown to trigger a reaction in those with coeliac disease.

“Many gluten free or pure oat products are now being imported to Australia. It is important to note that this means that the product is only free of contamination from wheat, rye or barley crops during the harvesting, processing or packaging of the product. The product has not had the gluten extracted or been genetically modified to be gluten free.

“It is recommended by the Medical Advisory Committee (MAC) for Coeliac Australia that despite the extensive medical research done in relation to oats and coeliac disease, oats should be excluded from a gluten free diet until the research is more conclusive and definitive.”

However, if you’ve been strictly gluten free for over a year and have fully recovered any previous damage, then it’s possible to do an ‘oat challenge’ using uncontaminated oats including 50g oats a day for 3 months with a pre- and post- biopsy to determine if oats are likely to cause you villi damage/inflammation.

Having diabetes, my doctor encouraged me to do this to help with the inclusion of more low-GI grains in my diet, and I would encourage the same of other people with diabetes who miss oats in their diet.

Notice I said ‘uncontaminated’ oats? From a coeliac perspective it’s important with all ‘gluten free’ grains to ensure they’ve been processed/packaged in a gluten free facility. Two I know of here in Australia are Freedom Foods and Carman’s Fine Foods. If you know of any others, please comment in the space below, thanks

Recipes

The obvious way to eat oats is to include them in your breakfast as porridge, muesli or in a smoothie, but there are so many other delicious ways to use them.

One of my favourite snacks used to be this Lowan recipe for oatbran and apple muffins as they were so easy to make and turned out perfectly every time, remembering I’m not a baker lol With both oat bran and apple, the GI of these would definitely be low. I just used a little less sugar – if you like it sweet you could use some sweetener in place of some of the sugar. I also choose to use light olive oil rather than vegetable oil (from an inflammation perspective).

I also like the look of this oat crumble topped pears with yogurt recipe which is likely to have a low-GI, but go easy on the sugar/maple syrup. Perhaps try some Agave syrup with its low GI instead?

And as far as savoury goes, they’re ideal to add to casseroles and soups. And how delicious does this recipe for lamb rissoles with tabouli and hummus sound? Yummo!

This roasted pumpkin crumble also looks like a top low-GI idea, especially good for those vegetarians amongst us!

And if you’re after more info on oats, Accredited Practising Dietitian/Nutritionist Catherine Saxelby wrote a blog on oats with more detail on the types of oats and her own favourite recipes that you can read here. And here’s a website that has a listing of all the nutrients if you’re interested.

Please share your favourite oaty recipes in the comments below! 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.

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How to manage d-lunches ‘on the road’

June 2, 2014 by Sally 3 Comments

Delicious snacks can fit easily into Guideline 3 with a little help from your friends <3

Quite a few of our readers have indicated that they find having a nutritious lunch to suit their diabetes requirements in their busy lives a tricky thing to deal with. Hopefully this blog will help with some practical ideas that you can implement whether you’re a truck driver, a shop owner, a school teacher, an office worker or even a shift worker.

Of course if you have ideas of your own that work, we’d love to have you add them at the bottom of the blog to help others too.

Benefits of taking your own

Making and taking your own lunches is not only financially and nutritionally rewarding, it can actually save you time (spent going to buy your lunch that could be better spent enjoying some exercise) and the effort involved really isn’t much. Also it’s easier to know you’re eating well when you are in control of the ingredients and the portion size.

I timed myself making a cheese and mixed leaf salad from a frozen loaf of bread the other day. It took only 3 minutes, which included slicing the cheese, packing it in a sandwich box and putting away the mess. An apple was the perfect accompaniment to it

Other easy lunch ideas may include:

the leftovers from last night’s dinner
pre-made soups or vegetable and legume laden casseroles

frittata made with veggies and legumes

salad mixed with your choice of tinned fish, meat, or tinned legumes

wholegrain sandwich with cheese or another protein source (such as egg, a slice of meat, a tin of tuna) and mixed salad (such as cucumber, onion, tomato and mixed leaves)

What should your lunch consist of?

Carbohydrates: Our lunches need to contain a low-GI carb source to keep our blood glucose levels steady. Read more here for other benefits of low-GI carbohydrates. These might include wholegrain bread, breadroll or wrap, tinned legumes (baked beans or 4 bean mix are easy options), cooked Basmati rice or quinoa or Rice Plus for a bit of variety.

Protein: The protein element provides us with many essential nutrients as well as helping us to keep our hunger satisfied for longer. A previous blog on this topic will help you to know how much to aim for and the reasons for it. This might include left over cold meats from dinner, a tin of tuna/salmon, cheese (for your dairy benefit too) or vegetarian proteins such as nut butters, hummous or tofu.

Vegetables: Remembering that we’re aiming for 5-6 vegetable serves per day which is quite a lot to achieve in one sitting, getting a serve or two in with your lunch can benefit you in so many ways. Keeping a bag of mixed salad leaves handy with tomatoes, carrots and celery can make adding a serve to a sandwich, or using the salad as the basis for your meal a very easy job. This is where soups really shine too as vegetable-based soups tick nearly all the boxes for a perfect lunch, especially with the colder weather approach. Leftover roasted vegetables are an awesome and delicious option too.

Fruit: Having a piece of fruit with your lunch will provide you with more of those wonderful plant based nutrients to keep your brain and body functioning in top order. Remember that we’re aiming for two pieces a day, so if you struggle to reach that, lunchtime is good time to slip a piece in to your day.

Dairy: If you’re not meeting your dairy needs each day (see previous blog on dairy) then having a glass of milk (you can get individual sized UHT milks to save refrigeration) or a yogurt if you’re not already having cheese with your lunch, can be a top way to add this food group.

Food Safety is very important for lunches

Read the previous blog on Food Safety, and remember to pay particular attention to foods like dairy foods (yogurt, milk and cheese), meats, cooked grains (like rice, quinoa and pasta) and prepared salads.

Some ideas to help keep these foods safe include the use of:

insulated containers with ice bricks
a thermos to keep soups and casseroles hot
keeping a frozen water bottle in your lunchbox to minimise bacterial growth
tinned food that you can open when you’re ready to each (tuna, sweet corn, baked beans)

What if I get stuck with no other option than to buy lunch?

Sometimes, despite best efforts to be organised and take your own, there will be situations where you need to buy lunch. A great tip here is to find supermarkets or stores where possible in preference to takeaways, bakeries, service stations or pubs. It’s easy to find the makings of your homemade sandwich in a supermarket and you’ll still have the portion control and financial benefits of taking lunch from home. A grainy bread roll, some cold meat from the deli and a small bag of mixed leaves makes an easy sandwich.

And if there are no supermarkets or stores and you do need to visit a takeaway, bakery, service station or pub, they usually do have a healthier option such as a grainy sandwiches (you could ask for no or minimal spread) and healthy fillings. It’s really worth the effort to avoid those pies, chips, battered foods and high-GI carbs wherever you can.

Where can I find ideas to suit what I need?

Nutrition Australia has a helpful webpage with more ideas for healthy lunchboxes for busy adults that you may like to view, as does Taste.com.au and ninemsn.com.au.

Making an appointment with an Accredited Practising Dietitian for personalised advice about how you can find lunches to suit you that are healthy for your diabetes and convenient for your lifestyle is an awesome idea. You can find one near you by clicking here.

If you’re unable to arrange that for any reason, Diabetes Counselling Online can arrange for Australian’s to have a free e-consultation with a dietitian just by registering here.

As mentioned at the top, if you have lunch ideas that work for a busy person we would love to hear about them as a comment below the blog.

Hoping it’s helped you with some ideas to improve the quality of your work day lunch breaks. Sally

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Top Ten Tips for healthy d-eating on a budget

May 26, 2014 by Sally 2 Comments

I’ve had a few requests for some ideas about how to eat healthy on a budget, especially with the costs of living with diabetes becoming ever higher. I’ve done some looking around and there’s loads of help out there.

Today’s blog is based around a handout I provide to my clients, but rather than focussing on all the points on that handout I thought it would be most useful if I chose my top ten favourite tips and provide helpful ideas and explanations for them, and give you links to other places you can look for more if you’d like to.

Before starting it’s important to remember that we need to follow the Australian Dietary Guidelines to ensure we include all the nutrients we need for overall wellness. Each meal should be balanced and include low-GI carbs, lean proteins and generous serves of non-starchy vegetables. Snacks should be based around fruit, nuts and dairy produce.

You may remember that I posted a blog on meal planning a few months ago and this is an awesome way to start on your money saving adventure by planning your meals and snacks and sticking to your plan. And if you’re of the opinion that fresh foods are more expensive than processed ones, think again. Take a look at this resource prepared by the Dietitians Association of Australia on The Real Cost of Healthy Food.

Sally Top Ten Tips

1) Shop to a list and focus on the five food groups

If you have a thoughtful list and don’t buy anything that isn’t on that list, you’ll make a huge dent in your usual food spending.

The Australian Dietary Guidelines further explains: “Spend most of your money on the Five Food Groups. Think hard about why you are buying discretionary foods and how much you really need to buy. This is especially important if you are trying to lose weight, because if you don’t buy it and take it home, it’s much easier to stick to your goals. If you would really like to have a high kilojoule food, buy the smallest amount that will satisfy you, the best quality you can afford and eat it slowly, savouring it with all your senses.”

Using the supermarket brochures as a guide to help you build your list and planning to purchase the products on special. Ensure you buy the five food groups foods before putting any treats in your shopping basket.

2) Carry a calculator

If you’ve prepared your shopping list and you know what your budget for your shopping is, then adding it up on a calculator as you go will help you to stay on track. Keep track of the amounts on the side of the list. Only shop for any extras after you’ve reached the end of the necessary items and know that you have budget left over for them.

3) Choose water as your drink of choice

Only deviate from water by choosing milk as an alternative to make up your required dairy serves through the day. Read here for more info on the importance of dairy and how you can include more in your day. If cost is an issue here, choose to buy home brand skim milk powder and make your own as needed – certainly use the powder for cooking. Same goes for yogurt which is a pricey item – yogurt makers are a very cost effective way of including yogurt in your diet.

4) Buy what’s in season and what’s on special.

You can check which vegetables are in season each month on the General Australian Seasonal Produce Guide. Check the supermarket specials listing either online or via the home delivered paper leaflets while you’re making your shopping list.

5) Buy and use the frozen, tinned or dried home brand products

Dried products such as lentils, soup mix, other legumes and rolled oats are all awesome sources of low-GI carbohydrate and fibre to help with our glycemic control, and they’re so much cheaper than the tinned, or fancy alternatives. When the budget’s tight for meat products, you can use the legumes to reduce the amount of meat you need in a meal or even happily enjoy a vegetarian version. Here are some awesome recipe ideas to help with this idea.

And if you’ve exhausted the fresh fruits and vegetables in season, the frozen and some tinned varieties can be a great buy and help to avoid wastage. I always keep frozen peas, corn, spinach and berries at home, so we’re not caught short with no ‘fresh’ vegetables. The frozen and tinned ones are just as nutritious. You can’t go past tinned tomatoes to make so many meals much tastier!

6) Familiarise yourself with your local supermarket

Keep a note of when they discount items for quick sale and arrange your visits on those days, remembering to only shop to your list.

7) Watch for significant specials on bulk items

Products that won’t spoil such as tins of tomatoes, tuna/salmon and baked beans, blocks of cheese that can be hand grated then frozen for ease of use, dried items such as basmati rice and pasta, and skim milk powder can save you lots if you keep your eyes open and check the supermarket brochures that are delivered to your home.

8) Don’t shop when you’re hungry

You know you will buy much more sensibly if you shop after lunch or after a good breakfast, or even after dinner as you won’t be guided by your hunger.

9) Look out for healthy eating on a budget recipes

There are lots of these around. Most of them use products that you should have in your pantry or that are in season. Taste has an excellent healthy budget recipes collection, as does Kidspot.com.au and there are many other sites that you will find if you Google ‘budget recipes healthy’ or similar.

10) Make the most of your leftovers

If you can buy a whole chicken or a whole roasting piece of meat it’s likely to be much cheaper per 100g, and will mean that you’ll have lots left-over to make extra meals for lunch, dinner and even breakfast.

The BBC Good Food website has some great leftover recipe ideas, as does Taste.com.au and many others – just keep an eye out for the lower saturated fats, lower glycemic index carbohydrates and lower sodium recipes wherever you can.

There are loads of ideas out there to help you. Some other really helpful links are:

The Australian Dietary Guidelines Healthy Eating on Budget page
The Dietitians Association of Australia Healthy Eating on a Budget page
The Australian Healthy Food Guide has articles on Smart Swaps and How to cut your bill in half and still eat healthily that may be helpful.
Choice Healthy Eating on a Budget
The Healthy Kids Healthy Eating on Budget

Remember that we’re eating for wellness so spend a little extra time to be prepared with delicious and healthy food ready when you need it, to help you avoid spending more and buying rubbish that you’ll only regret later.

If you have tips to share on eating healthily on a tight budget we’d love to hear them so please add them to the comments below.

Bon Appetite! Sally

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The significance of d-routine for wellness

May 19, 2014 by Sally 7 Comments

I had a friend visit last weekend. She, like me, is aged in her mid-40s, is a working Mum and has type 1 diabetes. She was telling me that she had started to suffer with anxiety or panic attacks and that her doctor had put her on medication for it. Not surprisingly her diabetes control was also not in a good place. For me it was somewhat of a shock to hear this of my extremely capable friend, but also was easy to imagine how it could happen when we reflect on just how stressful and overfull our lives have become. It also reminded me of the importance of having a routine, especially for those of us with diabetes, so that we don’t ‘juggle out’ diabetes as a ball in our busy lives. Diabetes really needs to be a very high priority for both mental and physical wellness, and yet it so often drops to a low one, dragging the rest of lives down with it.

As you know, I’m an Accredited Practising Dietitian, and my speciality is food/lifestyle and wellbeing, rather than psychology. In my blog today I wanted to remind people with diabetes about how having a routine every day can get your day off to the right start as well as helping your diabetes to be better controlled across the day, leaving you to focus on those other priorities in your life.

For myself I have created a routine that allows me that great start to the day, knowing that if you start well there’s a greater chance of continuing along that good line. As a dietitian I also am very aware of the evidence that tells us how important food is for mental health, hence the Australian Dietary Guidelines recommendations for a variety of fresh foods from the five food groups so that we get the nutrients we need for energy and for wellbeing, both physical and mental. The first key point in the guidelines reads:

“Good nutrition contributes significantly to maintaining healthy weight, quality of life,

good physical and mental health throughout life, resistance to infection,

and to protection against chronic disease and premature death.”

Planning is an awesome strategy

My routine starts with ensuring I have enough time to fit it all in – Planning! Drawing on my blog from last week where I quoted Accredited Practising Dietitian Jemma O’Hanlon reminding us that “Failing to Plan = Planning to Fail”.

My thoughts for the next day start the night before, and I do that to ensure that I have a good eight hours sleep before the time I need to wake up, knowing that tiredness will not help me in *any* way. There is a lot of evidence around the importance of a good night’s sleep for wellbeing.

I consider what time I’ll need to leave home to be where I’m going that next day. I know that my ‘d-routine’ takes me an hour and a half to complete, so I set my alarm to wake me an hour and a half before I have to leave, and off to sleep I go. Most days I plan to leave by 8am, meaning a 6.30am start. You’ll need to see how long your d-routine takes to work out your own hours.

My morning routine includes (not in order of importance, but how they occur):

1) Testing my BGL and having my medications

2) Eating a low-GI, high fibre breakfast with a serve of dairy

3) Checking my emails/facebook

4) Going for a 40 min walk/jog/lunge

5) Showering and dressing

6) Planning my snacks and lunch for the day

All six points are important for the success of my day, diabetically, mentally and physically.

No.1 – Testing my BGL and having medications – this one is a no-brainer for me. If I don’t know where I’m starting from with my BGL, how on earth can I know or control where I’m going with it? Same with the meds, there’s just no option not to have them. I’m often surprised to hear that people don’t take the medications they’re prescribed, and that’s why these two are the first on my list.

No.2 – Eating a low-GI, high fibre breakfast with a serve of dairy – we all should know the benefits of low-GI carbs as explained in my earlier blog, but when you know that your brain needs glucose to function properly again it’s a no brainer. Even if I’m not hungry, I eat my low-GI breakfast with grains, dairy and nuts to keep me energised for the morning.

No.3 – Checking emails/facebook – As a person who thrives on being organised and needs to be for my business to function smoothly, I need to clear out my inbox each morning and deal with the quick responses, so I can know issues have been dealt with so they’re not on my conscience when my mind should be focussed elsewhere. If I had to leave one point out of my morning routine this would be it, but I can do it pretty quickly in most cases.

No.4 – Going for a 40 min walk/jog/lunge – I know that if I don’t fit this in to my morning routine I will regret it for many reasons! Exercise brings so many benefits to everyone, and especially to us with diabetes. There’s also good evidence to demonstrate that those with diabetes who exercise enjoy much greater glycemic control. Not only does it give me a chance to think through my day ahead so I’m better prepared, but my diabetes control is so much more stable on the days that I’ve exercised first which makes my day run more smoothly by minimising the highs and lows that happen if I’ve missed it. I also enjoy the sunshine on my skin that will make me vitamin D, and saying ‘good morning’ to other walkers. Definitely a bonus from a mental health viewpoint too! You can read more about exercise and diabetes here. I wouldn’t be without it!

No.5 – Showering and dressing – Everyone does this one, so nothing special with diabetes here lol

No. 6 – Planning my snacks and lunch for the day – For me I need to know that I can have healthy low-GI (and gluten free as I’m a coeliac too) options available when I need them, so if pushed the least I will do is make a sandwich and take an apple and some nuts. It really only takes a couple of minutes and is well worth the small effort.

You and Your Routine

Of course my routine will be different to your routine. The main point I’m trying to make is that if you can consider the important things to keep your diabetes on track, your mental health in as good a place as you can, and your physical wellbeing with the good food and exercise then the day in the your life should be easier to manage. Every day is a new day, and routine helps to keep you on track. Routines can change, and if you feel that yours needs an update, then now is a great time to do it!

Mental Health

In terms of mental health with diabetes, if you feel like you’re not coping then it’s advisable to speak to your doctor. Diabetes Counselling Online has recently published an e-book on Diabetes Burnout which may also be helpful, and we offer six free hours per year of e-counselling to Australians who have diabetes and their friends and family – just go here to register.

I would also recommend a visit to see a diabetes specialist Accredited Practising Dietitian, and an Exercise Physiologist to help you get your diet and exercise routines right for your wellbeing.

My friend and I are going to try a meditation class that we found locally too (hence the meditation pic at the top).

We’d love to hear how you try to keep your diabetes day together. Hoping you found this helpful.

Best wishes, Sally

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Heart week reminders for d-health

May 5, 2014 by Sally 5 Comments

This week 4-10 May 2014 is Heart Week. It’s about raising our awareness and understanding more about our heart health, what the risk factors are, and how you can recognise a heart attack or a stroke.

We know that people with diabetes are 3 to 4 times more likely to develop cardiovascular disease (including heart attack and stroke) than those who do not have diabetes. In addition, around 75% of all people with diabetes die from cardiovascular disease, including heart attack and stroke. So it’s definitely an issue worth paying attention to!

My blog today will take a look at what the Australian Heart Foundation suggests we consider about our heart health. I will also be reviewing some previous Diabetes Counselling Online blogs of mine that relate to this topic to help you to gain a better understanding of how diet and lifestyle can help you protect your own heart health.

Modifiable Risk Factors

Knowing our risk (or risk factors) is the first step we can take to help prevent a heart attack or stroke. The Australian Heart Foundation highlights risk factors for heart disease that you have the ability to change as:

Smoking
Poor diet
Physical inactivity
Being overweight
High cholesterol
High blood pressure

The Heart Foundation wisely advises that we should visit our doctor for a heart health check, and talk with our doctor about risk factors and how best to prevent having a heart attack or stroke. Seeing an Accredited Practising Dietitian for personalised advice about your eating habits and an Exercise Physiologist to find activities that suit you is also something you should discuss with your doctor.

You can also read this Heart Foundation warning signs fact sheet that will help you to recognise if you’re having a heart attack, remembering that the sooner you are treated, the more chance you have of survival.

Review of past relevant Diabetes Counselling Online heart health blogs

I encourage you to have a re-read of some of my favourite blogs which discuss the evidence behind limiting or increasing or exchanging certain foods, thereby improving your cardiovascular risk. They include:

Guideline 3 – this one takes a closer look at the Australian Dietary Guidelines third guideline which in itself is a great summary for this blog: “Limit intake of foods containing saturated fat, added salt, added sugars and alcohol”.

Salt – As salt, or sodium chloride, is strongly associated with heart disease, this blog offers some great tips on how you can reduce your sodium intake.

Fats and Sugars – also strongly associated with heart disease, this blog reinforces the importance of eating a balanced diet.

The Glycemic Index – talks through the evidence of a low-GI diet helping with cardiovascular health.

Dairy – quoting from evidence in the Australian Dietary Guidelines, this blog talks about how many serves you need each day to guard against coronary heart disease, stroke and hypertension.

Wholegrains – again discusses evidence from the Australian Dietary Guidelines and gives you some great ideas!

Legumes – must be close to the perfect food, with lots of evidence of their positive effects on reducing cardiovascular disease. We should be eating these most days of the week.

Eggs – which brings home that the ‘usual’ rules for heart disease should be stepped up a little when diabetes is in the mix, with evidence indicating no more than 3 eggs a week is prudent advice for people with diabetes.

Nuts – these tick so many of our healthy eating boxes with diabetes. Lots to learn in this one too!

I’ll leave you with a few extra tips from The Heart Foundation. They’ve put together a Recipe Finder that will help you to choose heart healthy recipes, as well as a link to some hard copy cook books that you can order online. Don’t forget to see your doctor to assess your own heart health risk.

Remember that Diabetes Counselling Online offers free e-counselling to all Australians who have diabetes. This includes up to 6 hours a year with our dietitians, diabetes educators and counsellors if you feel that you need or would like any support. This service is also available to overseas members for a small fee.

Thanks for taking the effort to improve your heart health – we love you for it!

Sally

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