Dairy Archives - Diabetes Counselling Online

D-discussion on ‘That Sugar Film’

March 23, 2015 by Sally 2 Comments

Last week I attended the Newcastle premiere of ‘That Sugar Film’, with Damon Gameau as the star. I was there because I was invited to participate afterwards as the ‘nutrition expert’ in the 30 minute Q&A with the audience, numbering 640. I thought my experience worth talking about as, although the film is doing an awesome job at raising awareness of how much sugar is in the foods we eat, it’s really important that people understand that eating well is not all about fearing or avoiding one nutrient (in this case, sugar). I believe that achieving optimum health through eating a well balanced diet, consisting of a variety of real foods, mostly plants, is the most important message to take away from this experience, and I hope that is what I communicated to the audience as a panel member.

In ‘That Sugar Film’ Damon Gameau performs an experiment on just himself. Bearing in mind that we’re all different, and, importantly, that this wasn’t a clinical trial, Damon’s self experiment can form a good reminder to us on some key points of understanding about how added sugars in foods can play havoc with our wellbeing in various ways. Damon has written a blog himself explaining what ‘added sugars’ actually means. He explains, as I have previously done, how and why the term ‘added sugars’ does not include the naturally occurring sugars in fruits and dairy. Natural sugars such as these, and other carbohydrates, including whole grains and legumes, also provide essential nutrients for wellbeing. I encourage you to read his blog on this subject (link above) as it provides a well balanced view.

The Dietitians Association of Australia (DAA), of which I am a member, supports the recommendations of the Australian Dietary Guidelines (ADG) about limiting the intake of foods and drinks containing added sugars. Examples are: confectionery; sugar-sweetened soft drinks and cordials; fruit drinks; vitamin waters; energy drinks; and sports drinks. The DAA believes a healthy, balanced diet involves eating appropriate amounts of a wide variety of nutritious foods, while occasionally being able to enjoy small amounts of ‘discretionary choices’. It’s about taking a balanced approach that is sustainable over the long term.

On that note, remember my recent blog chatting about Dr Rosemary Stanton’s talk on ‘Why so many controversies?’ Here, Dr Stanton reminds us that junk food, containing free sugars, poor quality fats, and high levels of sodium, currently accounts for 36% of the energy intake of adults, and greater than 40% of children’s energy intake. Those are scary figures. Those figures are worth considering when choosing foods and drinks, as are the points about added sugars in ‘That Sugar Film’. Making healthy choices is really about being mindful of what is in the foods we’re eating, choosing to buy and eat fresh foods, learning to read labels, and remembering to eat with moderation.

For us with diabetes, I found this experience to be a really good reminder to be mindful in our food choices. We can consider if we could make a healthier choice where there are options. This is not always possible, so remembering that ‘a little of what you like does you good’, if you make the decision to eat something from our ‘discretionary’ list, then it’s not worth feeling guilty about. Enjoy that choice, try to make it a small amount, and eat slowly and mindfully.

Nourishment and Enjoyment

It is important to appreciate that we eat food for more reasons that just getting the nutrients we need for good health. Eating is also a social activity and most celebrations are based around eating (think weddings, funerals, get-togethers and more). It’s about learning the balance between nourishment and enjoyment.

As APD Dr Joanna McMillan reminds us, it’s important to take pleasure in what you’re eating because that’s the only way you’ll do it for the long term. This is such an important message for us all to remember, especially when we have diabetes because it really is every meal for the rest of our lives. As we often say, ‘it’s all about moderation’ and trying where possible to make healthier choices.

Accredited Nutritionist Catherine Saxelby also reinforces these ideas in her blog on this film where she says, “On a more serious note, I believe the film goes overboard on the need to quit sugar. Are we not capable of moderation? Does it have to be total exclusion?”

Nutrition is a developing science

There is a lot to learn about food and how it affects us. As the dietitian for Diabetes Counselling Online I’ve written over 60 blogs on diabetes and food for Diabetes Counselling Online in an effort to help people with any type of diabetes to get a clear understanding of the nutritional value and health benefits of the food and drinks we choose. There are many more more topics to cover.

I’m constantly reminding people to aim to choose ‘real foods’ from the 5 food groups in the Australian Dietary Guidelines. These guidelines (released in 2013) were developed by real experts who reviewed over 55,000 scientific journal articles. They then translated that evidence into meaningful dietary advice, while reflecting a commitment to best practice standards in health guideline development. This amazing work was done to help all Australians to make better decisions about the foods we choose, to minimise risk of many long term health conditions.

Nutrition science is constantly developing and there are still many discoveries to be made. This is why dietitians constantly study to keep up to date with the latest research so the advice we provide in our medical nutrition therapy is providing you with the safest and most practical advice available.

Some processed foods aren’t all bad

Another point worth making is that ‘That Sugar Film’ demonstrates the large amounts of sugars that can be found in processed foods. It tells us that if you took all the foods off a shelf in a supermarket that contained added sugar, there’d only be about 20% of the foods left there. So this is an exercise for us in learning to read labels, as well as us understanding how to make informed choices of the foods that are there.

Some of these processed foods that are referred to in the film are baked beans, containing the equiv of 1 tsp of sugar per serve. Using baked beans as an example, the beans themselves are highly nutritious and 1 tsp sugar is in the sauce, which also contains nutrients such as lycopene that we need to obtain from cooked tomatoes. That 1 teaspoon of sugar is not enough to spike your BGLs and baked beans do have a low glycemic index, so they’re a good option for us when we need a meal in a hurry.

There are also other processed foods such as tinned and frozen vegetables, some breakfast cereals, some grainy breads and dairy products that as a dietitian I regularly encourage people to use. If these products weren’t being recommended, then chances are that people might inadvertently choose something less nutritious in an effort to have a little less sugar. Learning to label read is so important here. Some of the healthier, lower GI breakfast cereals are really convenient options in our busy lives, as well as containing important nutrients that we need for wellbeing, despite containing some added sugars.

Have you seen it?

If you haven’t seen ‘That Sugar Film’ yet, I encourage a viewing as it will help you to reflect on your own intake of ‘added sugars’, and perhaps help you to understand more about yourself and the food you eat. Just remember to come back and re-read here, so you can refresh your memory about the points I have made in this blog so you’re seeing a balanced perspective.

In the words of Michael Pollan: “Eat food. Not too much. Mostly plants.” This is reinforced by the words of Associate Professor and APD Tim Crowe, “Because there are thousands of natural chemicals present in foods, there is no single food that should be called a ‘superfood’. Instead, think ‘superdiets’ that contain plenty of different plant-based foods as the best way to eat for good health.”

Please feel free to ask questions either in the space provided following this blog, or on our closed Facebook group ‘Diabetes and Food – let’s celebrate it!”. I believe food really should be celebrated, not feared.

Sally

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

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D-thoughts on snacking

January 26, 2015 by Sally Leave a Comment

Happy Australia Day! And what good timing for a blog on snacking! It must be the ‘most asked’ question I get as a dietitian: “What are the best snacks for people with diabetes?”

It’s not really a black and white question as the answer depends on your personal diabetes requirements, your personal tastes, your ability to be mindful in your choices and your knowledge of healthy eating in general. So this blog aims to help you to be mindful in making snacking decisions.

We encourage you to choose foods that are higher in nutrients to add to your overall wellbeing, rather than ‘discretionary choices’ which everybody, diabetic or not, is encouraged to limit. It’s especially the case for us with diabetes… but it doesn’t mean missing out on delicious flavours!

Priority One

Your first priority needs to be your overall diabetes goals. Are you getting all the nutrients from your diet that you need for wellbeing? Are you needing to watch your weight? Is matching your food intake to your body’s ability to process carbs an issue for you?

A perfect segue to our Australian Dietary Guidelines… Are you actually meeting the quantities recommended in the 5 main food groups across your day?

In an ideal world we would choose snacks that are included in the foods that we are recommended to enjoy each day. In these examples I’m referring to the ‘Healthy Eating for Adults’ brochure, but there’s also a Healthy Eating for Children brochure for those thinking about their children with diabetes. In both cases, the actual food group listings are on page 2.

Each of the food groups has snacking potential, so there’s always plenty to choose from.

In the ‘Vegetables and legumes/beans’ group you can always find a low-carb snack if that’s what you’re after. Whether it’s raw veg to nibble on, celery with nut butter, blanched asparagus spears when they’re in season, tasty tiny tomatoes that burst with flavour in your mouth, hummous dip with veggie sticks, or even leftover cold roasted non-starchies or ratatouille (recipe in the files section of the closed ‘Diabetes and Food – let’s celebrate it!’ Facebook group). There are always options in this group of foods if one of them will meet what you’re looking for…

Next group down and a great one for those wanting something to satisfy a sweetness craving is the ‘Fruit’ group. With diabetes we are recommended to aim for about 2 serves per day, eaten at different times. However, some fruits are really low in carbohydrate, so we can have more of these without upsetting our glycemic control. Some of those include berries, passionfruit and kiwifruit. But still watch your quantities. If you want to know how much fruit will contain 15g of carbohydrate, take a look at www.calorieking.com.au , search for the fruit you are looking at, and adjust quantities to get to the 1 carb serve number.

In the ‘Grain (cereal) foods’ group, it’s easy to calculate whether you’re going to meet your daily recommended amount. Often for people with diabetes this is a group that people actually tend to be low in. Instead of choosing a ‘discretionary item’, swapping in a low-GI high fibre grain snack such a piece of heavily grained toast with a topping to suit your taste can be a great option to satisfy your hunger and keep your BGLs stable. Or even a small bowl of your high-fibre cereal. Of course these options all contain carbs, but they are all much more nutritious than a cracker or sweet biscuit.

In the ‘Protein’ group, snacking options are easy to find, but it’s important to remember to try not to exceed the guidelines in terms of serve sizes and number of serves recommendations. This is because protein contains energy (or calories/kilojoules) that will cause weight gain if you have too much, although they shouldn’t upset your glycemic control. I recommend having a read of this blog on Protein : written earlier, if you’d like more info. The perfect snack from within this group for us with diabetes is really a handful of nuts, as the evidence behind inclusion of nuts in our diet is quite outstanding. Read more about nuts in this blog.

And last, but not least, is the ‘Dairy and/or alternatives’ group. I wrote a couple of blogs about dairy and diabetes as it’s such an important food group for us with diabetes. Here’s a link to the first one and the second one that contain more great ideas for snacking. My favourite snacking recommendations to help meet the nutritional guidelines are a low-fat yogurt (low sugar too if you’re watching your carb intake closely) or plain low-fat greek yogurt with berries mixed in. Or a low-fat milk based smoothie made on frozen berries, with a couple of teaspoons of chia seeds added for extra fibre. Even a cup of milk based coffee can do the trick… These should work well to satisfy hunger and provide you with the nutrients this group is known for.

Priority Two

Your second priority, also a very important one, is to ask yourself what do you actually feel like eating and why? Sometimes snacking can become a habit. People say “I have a sweet tooth and NEED a biscuit or cake”. (or whatever) This is important too, because if you deprive yourself of what you really want (or feel you need) all the time, then your craving will only grow bigger and you’ll end up overdoing it and regretting it later. Not a good thing, but happens all too often. If you can enjoy a small amount of what you feel you “need”, being mindful of enjoying every mouthful, savouring the textures and flavours that you’ve wanted so badly, then you’re in a better place to return to your ‘healthier’ options on a regular basis.

Do I really need to snack?

If you’re medicated for your diabetes, and are putting yourself at risk of a hypo if you don’t snack, then you should snack as you’ve been advised by your medical diabetes team. If in this case you’d rather not be snacking as you’re just not hungry, then you should talk to your d-team and arrange to have the medication adjusted so that you don’t need to snack.

For those of you where snacking has just become a habit, it’s worth thinking twice to see if you really are hungry before you just head for a snack. Is it out of habit or because you’re bored? Sometimes a drink of water will satisfy that ‘hunger’ feeling, which may actually be your body telling you that you’re dehydrated. If you’re bored, take the opportunity to go for a walk, call a friend, do something off your household chores list, read a book, or engage in your hobby.

If you are constantly actually hungry, it may be worth your while to visit an Accredited Practising Dietitian to see how your meal plan can be adjusted to help avoid that happening. Being hungry is not good or necessary for you to manage your diabetes and weight well.

More ideas?

In the Diabetes Counselling Online closed Facebook groups ‘Diabetes and Food – let’s celebrate it!’ and ‘Diabetes Weight Matters’ we’ve asked the members what their favourite snacks are and have created a document up in the files section of the groups. I think I still need to finalise the weight matters file, but it’ll be there soon. These are member ideas, not necessarily dietitian approved, so please use this blog as a thought process in helping to make your snacking decisions right for you.

Also in the current issue (February 2015) of the Australian Healthy Food Guide they’re running a feature relevant to this blog that you may find helpful. It’s entitled “Your Treat Foods Toolkit” and explains “why those ‘naughty’ treat foods are discretionary, and how they can fit into a healthy diet.” It’s written by an Accredited Practicing Dietitian, Brooke Longfield and can be found on page 34. Although not related specifically to diabetes, you’ll find it helpful for portion sizes and understanding more about ‘discretionary’ foods.

Happy snacking! Sally

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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.

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.

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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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Dairy & Diabetes Part 2 – milk comparisons and more ideas

February 10, 2014 by Sally Leave a Comment

Hoping that after last week’s blog on dairy foods, you found some inspiration to meet your dietary targets for dairy and alternatives, especially knowing how good it is for glycemic control. This past week has also brought more evidence to light about the health benefits of consuming dairy, all the more reason to make it a focus in your own eating regime.

As promised, this week we’ll take a closer look at the nutritional differences between dairy and its alternatives and a few practical examples of how to incorporate more into your diet if you’re not meeting the guidelines.

So starting with the nutritional differences, I decided to make you a table based on various milks/milk alternatives. I searched CalorieKing.com.au and found what 250ml of each drink contained. Where there’s a dash (-) there was no data available.

Type of drink (250ml)	Energy (kJ)	Carb (g)	Protein (g)	Total Fat (g)	Calcium (mg)	Sodium (mg)	Fibre (g)
Lactose free, skim	360	12	8.5	0.3	305	88	–
Cow’s full fat	738	15.8	8.8	8.8	270	113	–
Cow’s skim	375	12.5	9	0.3	300	125	0
Almond, unsweetened	178	1	1.5	3.5	187.5	100	0.8
Soy milk, lite	398	7.5	7.5	3.8	300	225	1.3
Soy milk, regular	550	8	8	7.5	300	225	1.3

So when you’re considering what type of milk or milk alternative you should be having, not only does your decision depend on your intolerances but you also should think about the energy balance in your diet as well as calcium (aim for the 300mg mark per 250ml/1200mg per 100ml), sodium and even fibre!

When it comes to the carbs, remember that we encourage low-GI carbs with each meal and with snacks for many reasons (see benefits of low-GI blog for more info) including our glycemic control. So dairy carbs are good carbs for us with diabetes. Avoiding them won’t do you any favours.

Taking a further look at energy, you can see that those containing higher levels of fat are much higher in energy so if you’re watching your weight it makes sense to choose the lower fat varieties. The cow’s full fat has twice as much energy/kilojoules as the skim version, and a little less calcium.

For calcium, most of us as adults need between 1000mg and 1300mg per day, as outlined on page 154 of the National Health and Medical Research Council document of Nutrient Reference Values for Australia and New Zealand.

It’s also clear that the soy milks stand up well against the cow’s milk options, but have a third less carbohydrate and close to double the sodium in comparison.

(If you click on the image, it will show you an enlarged version).

In terms of meeting those 2.5-4 serves of dairy each day as outlined in the Australian Dietary Guidelines for Adults, breakfast is excellent place to start. As we also have diabetes to consider, we need to think through how many carb serves we’re having when we have a serve of dairy meaning sometimes a full serve will need to be halved. I’ve tried to explain this in more details with the examples provided.

If you’re making a smoothie with frozen berries, ¼ cup of raw oats and 500ml skim milk, that gives you two dairy serves first up, and three good quality carb serves to get you up and running in the morning as well as many other nutritional benefits.

Making a milk based coffee is also a good start. 250ml milk with strong coffee added will make you feel like you’re in a cafe having a latte and gives you a carb serve. Have that with your low-GI breakfast cereal served with milk and you’re already 1.5 serves on your way.

Not that I’m encouraging coffee, but if you’re out and about a milk-based drink such as a latte is good option for morning or afternoon tea – just don’t be tempted by other goodies in the place you buy it Of course, just a glass of cold milk is a perfect option too!

A tub of yogurt also makes an awesome low-GI snack, whether its morning tea, afternoon tea or dessert/supper. A quick look at CalorieKing.com.au tells me that a 100g tub of a low-fat fruit flavoured yogurt is about one carb serve (about 15g carb) and equates to half a serve of dairy. There’s no harm in having two of these across your day either if you enjoy them.

When it comes to cheese we should be careful from a heart health point of view, but if you can aim to choose a low-sodium and low-fat variety, a couple of slices will provide you with the equivalent of a serve of dairy – great for a sandwich. And of course, there’s no need to think about carbs with this one! You could use the equivalent of grated in your main meal or through a salad to add some oompff to your veggies.

And to finish off your day with a good low-GI pre-bed snack dairy is the perfect option. A warm glass of milk should help to get you nodding off and help to keep your blood sugars stable through the night.

Watch out for icecream though as although it’s a dairy source there’s only 100mg of calcium (1/3 of a serve) in half a cup of icecream (about 2 carb serves).

How do You ensure an adequate dairy intake?

Sally

Sally is the Social Media Dietitian with Diabetes Counselling Online, owner of her private practice (Marchini Nutrition), has had type 1 diabetes for close to 40 years and coeliac disease for many years too.

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