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Yoghurt, probiotics and d-health

March 10, 2015 by Sally 2 Comments

With so much fascinating talk about gut microbiata (micro-organisms/bacteria) and health about, I thought it worth a fresh look at yoghurt as part of the dairy serves in our day as it is a great source of these microbiata in our diets. I’m also often asked about which are the best yoghurts from a fat and sugar perspective. Please consult your healthcare team before following the advice here, especially if you’re pregnant, breastfeeding or have a compromised immune system.

We’ll start with a review of why dairy is so important in our diets, then go on to look more closely at probiotics (live organisms/bacteria) and to look at some of the yoghurt choices available on the market, and what to look for when you’re making choices. We’ll finish with some ideas to help us to include more yoghurt in our day.

Last year I wrote a couple of blogs on ‘Dairy and Diabetes’ that I’d really like to remind everyone of, as they included some important messages for our diabetes health.

In the first one, ‘Dairy Foods – health benefits for us with diabetes’ we looked at the dairy and alternatives group in the Healthy Eating Guidelines for Adults brochure. We notice that different genders and ages have significantly different requirements in this important food group. We all need different amounts for different reasons, and for us with diabetes it’s a really important food group for many reasons. Not least, that dairy products have a low-glycemic index. There’s also a great amount of evidence relating to how meeting our dairy serves can contribute to improved wellbeing, with or without diabetes, so pop back and have a read of this one too.

We’re also reminded in the words of the Australian Dietary Guidelines that: “Milk, cheese and yoghurt have various health benefits and are a good source of many nutrients, including calcium, protein, iodine, vitamin A, vitamin D, riboflavin, vitamin B12 and zinc. These foods provide calcium in a readily absorbable and convenient form.”

The Guidelines also remind people with lactose intolerance in relation to yoghurt that: “lactose in yoghurt is already partially broken down by bacteria that thicken the yoghurt, so should be well tolerated”.

The second blog (link above) is about milk comparisons and more ideas for including more dairy in our diet.

Which leads us on nicely to more on yoghurts….

Probiotics – why are they important?

Yoghurt provides similar health benefits that milk does and can have the added benefits of good bacteria or probiotics (eg aBc – La-5 Lactobacillus acidophilus, BB-12 bifidobacterium, Lc-431 Lactobacillus Casei and LCG) which contribute to improved health. Health based on those good bacteria is currently attracting a lot of research into improved immunity, general wellbeing and to improve specific conditions such as Irritable Bowel Syndrome, NAFLD (very relevant for those with type 2 diabetes) and mental health among others. This article provides much more detail if you’d like to read more about probiotics and health/wellbeing.

However, not all yoghurts contain added probiotics, so it’s important to check the label for mention of them, otherwise you may not get the benefits you’re hoping for from them. It’s also worth noting that yoghurts containing probiotics will have a shorter shelf-life as the bacteria deteriorate fairly quickly, so don’t wait around until the yoghurt is on its ‘best by’ date if you’re hoping for the probiotic benefits.

Fat & Sugar in yogurts

With diabetes, and even just in general health, it’s important that we minimise added sugars and keep an eye on the saturated fats in our food products.

The Australian Dietary Guidelines recommends that we choose low-fat dairy products, which means we’re looking for less than 2g/100g saturated fat due to its link with heart health issues, inflammation and increased insulin resistance/decreased insulin production over time. This is particularly important for us with diabetes, and although adding fat to a carbohydrate will lower the glycemic index of the meal, it is just not worth taking the risk with saturated fats. It’s best to try to minimise them in our food choices.. The other aspects of the yoghurt (low GI quality carb and protein) will still help to lower the glycaemic index of the meal without the extra fat.

As to added sugar, we are always looking for as little as possible as an added ingredient. Lactose is a naturally occurring sugar with a low-GI that’s found in dairy foods, so just looking at the amount of sugar in the nutrition information panel may not help us to know whether it has added sugar. Check the ingredients listing first, looking for ‘added’ sources of sugar, like ‘sugar’, honey, palm sugar, maple syrup and other syrups. On the nutrition information panel, look for less than 10g/100g sugars to help watch the added sugars.

If you like the sweeter flavoured yogurts, try adding your own sweetness in the form of fruit, or even a small amount of added sugar, so at least you are in control of the extra sugars. Of course artificially sweetened yogurts are also readily available if you don’t mind the flavour.

Dietitian Connection recently published a comparison table of yoghurts by student dietitian Stacey Beech (thank you Stacey!) which includes information about all the macronutrients (fat, carbohydrate & protein) as well as fibre, calcium, sodium and probiotics. From this list I’ve picked a few ‘better’ examples of brands from that table to try, with a focus on the good bacteria, the low saturated fat, and low added added sugars. My top three favourites are:

The Nestle Ski Soleil (artificially sweetened) range
Vaalia Natural Probiotic Yoghurt (unflavoured)
Pauls All Naturally Tub Set Yoghurt 99.8% Fat Free (also unflavoured)
Jalna Low Fat plain yoghurt

There are other yoghurts on the market that may not have made Stacey’s list, so remember that you want the pack to tell you about the good bacteria (probiotics) it contains, look for less than 2g/100g saturated fat and less than 10g/100g sugar (preferably no added ‘sugar’). This Aldi one is a good example. It’s 2.7g/100g saturated fat, just over our target, but ticks all the other boxes so I’d say that it was worth a try too!

If you’re finding that plain yoghurt is a little bitter for your tastebuds, why not give the lactose free versions a try. These seem sweeter because the added lactase enzyme has split the lactose sugar into its parts, which changes the way it tastes, but with the same health benefits.

Some of the strained Greek yoghurts are also less tart because the whey has been strained off.

Of course you can always make your own, but watch the sugar and fat components in doing that

Multiple uses for yoghurt

For those of you who struggle to meet the recommended dairy serves in your day, yoghurt is an excellent option that can be included multiple times across the day. More than one serve a day is easy to achieve. It works:

At breakfast on top of cereal with fruit
As a snack or dessert choice
As a dressing on your salad (mixed with fresh herbs, lemon juice or vinegar and a teaspoon of grainy mustard)
In place of sour cream on your baked potato (helping to lower the overall GI of the potato)
In place of fats in baking recipes (read this blog by Joan Bailey to learn more)
As dip or accompaniment to Indian curries (example recipe)

How else do you include yoghurt in your day? We’d love to have your comments and suggestions! See the comments box below.

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 bread

February 9, 2015 by Sally 5 Comments

Bread has become a staple food in our modern diet but can be problematic for those of us with diabetes, especially if it has a high glycemic index, we eat too much of it, or it contains too much of nutrients such as sodium and saturated fat which can affect our heart health and longer term insulin resistance. Today’s blog aims to help to you make better choices by understanding where it fits in the Australian Dietary Guidelines and find a bread that you can enjoy while maximising your glycemic control.

And for those of us who avoid wheat/rye bread due to the gluten content (coeliac disease, wheat intolerance or a FODMAP intolerance) we can take a look at some of those options too.

Probably a good place to start is a look at where bread fits in the Australian Dietary Guidelines, then we’ll go on to a reminder on label reading, which will lead in nicely to a look at some of the better bread choices on the market for people with diabetes based on a comparison table put together by student dietitian Stacey Beech for Dietitian Connection.

Australian Dietary Guidelines

Of course bread fits into the grains and cereals food group in the Australian Dietary Guidelines, and we encourage breads that are full of whole grains which provide extra nutrients and fibre in the bread you’re choosing. This is beneficial for your general health, as well as your diabetes health. And the more whole grains there are, the lower the glycemic index will be to help you avoid those spikes which can be associated with breads for some people.

Click on the image if you need it to be larger

You can read more about grains in this blog on grains prepared earlier for Diabetes Counselling Online. And the recent blog on snacks highlights that a piece of grainy bread can work well as a snack (with a topping) if you haven’t used your suggested serves for the day.

Label reading on bread packs

It’s important not just to think about the amount of carbohydrate in the bread you’re choosing, because often if the carb is low they’ve had to manipulate fat and sodium to make up for it.

As with most products we should be aiming for lower total fat (breads are usually quite low at around 2-6g/100g), lower saturated fat (well under 2g/100g) and lower sodium (less than 400mg/100g). Fibre should be as high as possible, and protein can be higher too (to contribute to lowering the GI).

We discussed this comparison a while ago in the Diabetes and Food – let’s celebrate it! closed Facebook group and the main point made was that although the Helgas low carb seeded loaf is indeed lower in carb with 27.7g/100g compared with 44.5g/100g in the ‘usual’ one, there’s over 10% more energy (kilojoules) meaning it won’t help with weight management because the fat is 10.9g/100g in the low carb version, compared with 2.8 in the grainy one. If you’re not trying to lose weight then it’ll be fine, but it’s worth bearing this in mind as we know that extra body weight contributes to poorer glycemic control.

It’s also worth checking comparison tables (summary of one below) as I noticed there’s a bread called ‘Well Being Lower Carb Bread’ that actually has the same level of carbs as many of the wholegrain varieties – just a reminder to not always believe what it says on the pack!

Helgas low carb 5 seeds bread NIP — Helga’s low carb 5 seeds bread NIP

Helgas mixed grain bread NIP — Helga’s mixed grain bread NIP

Good bread options from the Dietitian Connection bread comparison table by Stacey Beech

This is a mini-table with content taken from Stacey’s more comprehensive table, to show you some of the better bread choices on the market. All values are per 100g.

By no means am I suggesting these are the best breads, but by showing you this comparison I hope to help you to recognise which breads will be better choices for you. I’ve only chosen the ‘mainline’ brands to compare. And I’ve only covered wheat breads here, where rye breads are also a good option.

Bread	Energy (kJ)	Protein (g)	Fat (total) (g)	Fat (sat) (g)	Carb (g)	Dietary Fibre (g)	Sodium (mg)
Burgen Wholegrain & Oats Bread	964	10.7	9.1	0.6	31.9	6.4	280
Helga’s Traditional Wholemeal Grain Bread	1010	9.9	4.0	<1.0	38.0	7.3	400
Coles Smart Buy Multigrain Sandwich	990	8.8	2.4	0.4	47.0	4.3	400
Well Being Lower Carb Bread	952	10.4	2.1	0.6	36.8	8.8	349
Tip Top 9 Grain Wholemeal	1040	12.4	6.4	0.7	30.6	8.7	370

And here are some of the gluten free comparisons if you have an interest here.

Bread	Energy (kJ)	Protein (g)	Fat (total) (g)	Fat (sat) (g)	Carb (g)	Dietary Fibre (g)	Sodium (mg)
Helga’s Sunflower and Red Quinoa GF Bread	1100	6.3	8.0	<1.0	40.1	4.2	400
Coles GF Chia & Seed Bread	1130	7.3	7.5	1.5	41.2	3.7	280
Country Life Gluten & Dairy Free Lower GI	1030	6.0	7.2	<1.0	37.2	4.2	400
Pure Bred Multigrain Farmhouse (added Iron)	717	5.1	2.3	0.3	32.6	9.7	534
Burgen GF Sunflower and Chia Bread	1190	7.0	9.7	1.4	39.7	4.2	400

I included a variety of breads here for you consider what type of bread will suit your personal needs, but of course you should consider how you personally enjoy the taste of the bread you’ve chosen. Trying a few different varieties is often a good idea in that respect to find what works for you, for taste, glycemic control and long term health.

Sourdough and Wraps

These types of breads can be beneficial for people with diabetes, especially for those who really don’t like the grainer options.

With sourdough it’s important to check that it is ‘real’ sourdough as the term ‘sourdough’ is often misused as a marketing word on some breads. If it’s real sourdough, then the glycemic index should be lower (due to the fermentation process involved).

Wraps

There are a few good wraps around, although there aren’t many actually listed in the Low GI Shoppers Guide 2014 with a low-GI. The only one I could spot was the Diego’s low-carb wraps which have 11.g carb per serve. But I’d be checking the fat and sodium levels on that label before buying them…

One of our often discussed favourites in the Diabetes and Food – Let’s celebrate it! Facebook group is the Goodness SuperFoods Barley Max wrap which does tick all the boxes, so is a great one to try if you haven’t already.

I don’t want bread!

Of course no-one is suggesting that we *have to* eat bread. Many people I know choose to avoid it for various reasons, and that’s what suits you, then it’s easy to meet your grain serve guidelines in other foods.

It’s also worth mentioning that everyone is different as to how different carbs affect your BGLs, so a little self-experimenting with testing your BGLs before and 2 hours after meals can go a long way with various foods so you can have a better feel as to how those foods effect you personally.

I hope you’ve found this blog on bread helpful in making your choices best for your diabetes and general wellbeing. Sally

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Breakfast with diabetes

November 17, 2014 by Sally 13 Comments

Many people have been asking me about their breakfast choices lately, so hopefully this blog will help to answer some of your own breakfast questions. They usually want to know how to choose a good breakfast cereal, how much of it to have to keep them feeling satisfied til morning tea without disrupting their blood glucose results too much, what they can have instead of cereal that is quick and easy and still healthy and how to enjoy a breakfast out without tipping the scales too much.

Before starting though I’d like to remind you to not make any changes to your current diabetes routine without first checking with your own health care professionals. These are meant as general guidelines only.

Why do we need it?

As people with diabetes, breakfast is important to us for several reasons:

It helps to get our blood glucose levels of to nice level start, especially when we include a moderate amount of low-GI carbs
It helps us to manage our appetite better as the day progresses, especially so we don’t end up very hungry and tempted to make poor choices
It fuels our brain so we can mentally function better and cope better with the curve-balls that diabetes can throw at us
It helps to reduce insulin resistance by providing us with the low-GI energy that our bodies need to function better

What should be in it?

A good starting place is a reminder that with each meal we should include low-GI carb sources, preferably 2 carbohydrate serves as a minimum, and a protein serve to ensure we have the slow release of glucose to keep our brain fuelled for peak performance and our tummies happy so we don’t crave poor food choices by morning tea. Extra fibre also doesn’t go astray.

How to choose a good breakfast cereal?

If you recall our earlier blog on label reading, when reading cereal packet labels we should be looking for whole grains, nuts and fruit with little or no added sugar or oil in the ingredients listing if possible. Ideally we’d like the fibre to be at around the 10-15g/100g level, but if it isn’t then extra can be added in the form of bran, psyllium or chia seeds to boost it.

Remember too that if you have nuts included in your cereal it may fall outside of the total fat value of 10g/100g, saturated fat 2g/100g targets that we aim for, but as long as there are no other fats listed then all the fat is from the nuts so it’s okay.

So if you’ve got the whole grains and the nuts and the dried fruit and the low-fat milk or plain yogurt for added protein and low-GI carb, you should find all the reasons listed above satisfied for the importance of your breakfast.

How much of it should I have?

Certainly an important consideration as too much could upset your glycemic control, rather than helping it, and could also contribute to unwanted weight gain.

Everyone is different and the answer will depend on your activity levels, on your hunger and of course on your diabetes management objectives.

This is where it’s important to check with your own d-team, preferably an Accredited Practising Dietitian, about how much is right for you.

What can I have instead of cereal?

So many clients I see tell me they don’t like cereal, and that’s fine. We all have different tastes. There are many other breakfast options that are suitable for people with diabetes.

Multigrain toast and muffins with an egg or baked beans for added protein and extra veggies to help you meet your 5 veggie serves are awesome. Avocado and fresh tomato on toast (no need for a spread) is also a great way to get started. And peanut butter works on toast to give you the extra protein serve to keep you feeling fuller for longer.

Fruit smoothies also work well for those of you who struggle to eat in the mornings.

Cooked breakfasts are also wonderful when you have a little more time, and including veggies in there is a great idea.

I actually really like the ideas included in this blog by one of our Diabetes Counselling Online Facebook group members, Dr Lyndal Parker Newlyn: The Beauty of Breakfast that also talks about why it’s so important to get into this healthy habit.

What about eating out for breakfast?

Eating out can work well if you remember the diabetes basics about low-fat, low sodium and whole grains.

Choose meals like a bircher museli with fresh fruit and plain yogurt, or spinach, mushrooms and tomatoes on multigrain toast, or served with baked beans for that low GI carb with protein included.

And enjoy a coffee made on low-fat milk for the good low-GI carb and protein hit.

Traditional breakfast ideas that should be reviewed for better diabetes management

The first thing that springs to mind is fruit juice. Traditionally many Australians enjoy a glass of juice with their breakfast. With diabetes it’s not an ideal option when you consider that we’re aiming for two pieces of fruit per day and a glass of juice provides the carb energy of closer to 4 pieces of fruit without the fibre.
Avoid crumpets – yes, even the wholemeal ones. Not only do they have a high glycemic index but they’re also high in sodium (sodium bicarbonate is used to make the holes) and most people like to have butter or margarine on them which adds unneeded extra fats.
Doubling up – Some of my clients tell me they have both cereal and toast, and unless you’re having a half serve of each, you probably don’t need to have both. This is where many of my clients see a rise in their BGL readings 2 hours after breakfast, when basically they’ve just had too much for their system to manage.

What do you eat for your diabetes breakfast?

Please share below what your favourite breakfast ideas are, in case they spark someone’s tastebuds into action. We have different tastes, so the more ideas we can share the better!

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 linked list of all Sally’s Diabetes Counselling Online blogs here.

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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

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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Blog 2 on Fats – which are the best types for us to enjoy?

July 21, 2014 by Sally 4 Comments

In today’s blog we’ll focus on which fats we should include in our diets, why this is so, and how much we should be having. Last week in the introduction to fats and d-health blog we talked about how it’s important for us, especially as people with or at risk of diabetes, to understand about the different types of fats, or fatty acids, and choosing the right fats in the right amounts can benefit our wellbeing in many ways. We explored what the different types of fats are and where they’re found, as well as how much the Australian Dietary Guidelines recommends for people with diabetes.

I need to keep this explanation relatively simple as fats and their pathways is actually quite a complex topic that, even with indepth study is tricky to explain in a short blog. I recommend that if you would like more detailed information that you go see your Accredited Practising Dietitian for personalised advice and further explanation. I also encourage you to remember that the Australian Dietary Guidelines Foundation Diet provides an excellent balance of nutrients for our wellbeing so is an excellent point of reference to know what we should be consuming for our wellbeing.

Off we go! The Mediterranean diet is currently being discussed as a very healthy way of eating, and research continues to back this up. If we just look at the fat types within that diet you’ll see a focus on monounsaturated fatty acids (being the predominant fatty acids in olive oil, canola oil, avocado and nuts) and the long chain omega-3 polyunsaturated acids (as found in deep sea fish and some plants). The research in this area is ongoing but at this stage it mostly indicates that diets higher in these types of fats help with weight maintenance as well as improving the quality of blood fats and longer term studies also showing reduced all cause mortality including cardiovascular disease.

There is also emerging evidence that demonstrates the importance of the ratio of saturated fats to anti-inflammatory fats that, being out of balance, is potentially a big cause for our Australian population’s high risk of cardiovascular disease.

Why is this important?

Recently released data through Australia’s Health 2014 that looks at the whole population and indicated that cardiovascular disease costs $7.7 billion or 10% of total expenditure and was also the leading cause of death. We also 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, and people with diabetes are up to six times more likely to suffer from atherosclerosis than people without diabetes.

The National Diabetes Services Scheme website also reminds us that “People with type 2 diabetes often have ‘abnormal’ levels of blood fats (cholesterol and triglycerides). Not only are the blood fat levels different to those of a person without diabetes, the cholesterol also tends to ‘behave’ differently.” All the more reason to heed the advice provided by the Australian Heart Foundation and backed up by the Dietitians Association of Australia to avoid those saturated and trans fats.

Although I have type 1 diabetes, I’m not willing to take chances of developing heart conditions (as the rest of our healthy population should consider too) so choose foods higher in monounsaturated fats and omega 3 polyunsaturated fats whenever I can, along with the low-GI carbs which are also known to help reduce blood fats compared with high-GI carbs.

Why those particular fats?

When we look at the reason (without going into miniscule detail) that we’re advised to choose monounsaturated and omega-3 polyunsaturated fats wherever possible, it is because monounsaturated fats are shown to follow non-inflammatory pathways and omega-3s (particular from deep-sea fish) promote anti-inflammatory reactions in our bodies. Compare that with saturated fats which are recognised as being pro-inflammatory (they cause inflammation, which causes detriment to our health in several ways).

There is also some evidence that the other main type of polyunsaturated fats, omega-6s, may be seen to take the inflammatory route and compete with the omega-3s. The jury is still out on this, and the potential inflammatory effect of omega 6 can be seen as merely an “interesting theory” at this stage. Accredited Practising Dietitian Sonia Navidi recently wrote about this issue in her blog (Nourish Me Simply), and it seems at this point in time to be a sensible view towards omega-6 fatty acids. Sonia writes:

“Interesting theory, but does it play out?

Actually, no, at least as far as the latest evidence is concerned. A Science Advisory from the American Heart Association, published in the prestigious journal Circulation in 2009, gives an excellent review of the evidence. They note that while Omega-6 acts as a precursor to compounds that promote inflammation in the body, it actually also acts as a precursor to compounds that are either anti-inflammatory, or help our arteries in other ways. They note that, while the theory of Omega-6 being pro-inflammatory has been around for a while, there is no solid evidence to support it.

They also state that:

“On the basis of the intakes of omega-6 [polyunsaturated fatty acids] used in the randomized trials, metabolic studies, and nonhuman primate studies discussed below, reductions in [coronary heart disease] risk might be expected with omega-6 [polyunsaturated fatty acid] intakes of 10% to 21% of energy compared with lower intakes, with no clinical evidence for adverse events.”

* Brackets inserted where the original source gave an acronym.”

So at this point in time the main fats to avoid are saturated and trans fats found in animal products as well as palm and coconut fats. Also, trying to ensure that we have plenty of omega 3s and monounsaturated fats in our diets.

If you’re interested in reading more about coconut oil being in this ‘avoidance’ group when it seems to be claimed as healthy by some on the internet, please read this explanation by the Dietitians Association of Australia.

How do I get more healthy fats in my life?

The Australian Heart Foundation has this very handy Omega-3 meal planner to help you reach the recommended 500mg/day for the general population. People with diabetes need more than this, but you should seek individualised advice from your health professionals/Accredited Practising Dietitians to know what’s right for you.

Let’s finish up today’s blog with some recipes containing healthy fats, remembering that the quality of the carbohydrate is also important.

Atlantic salmon has the highest amount of naturally occurring omega 3s of our Australian fish. This Salmon and White Bean Mash recipe will give you the omega 3s along with the nutritious and low-GI carbs of the white beans, and only 2 carb exchanges per serve.

As a vegetarian option how about these Cashew and Brazil Nut Burgers? You can read more about nuts in my blog, but generally speaking nuts are high in monounsaturated fats. You could swap the cous cous for quinoa to make it gluten free if you need to, and of course hummous is made on olive oil – also high in monounsaturated. This one has 2.5 carb exchanges per serve of nutritious low-GI carbs.

This Avocado and Four Bean pasta recipe looks and sounds delicious with only 1.5 carbohydrate exchanges per serve. The monounsaturated fats in the avocado will help to ensure a low glycemic index and will keep your hunger satisfied for longer too.

And there are lots more where these came from. To find these ones I went to some of my favourite recipe sites including Taste.com.au, Nuts for Life and Australian Healthy Food Guide and searched terms such as ‘salmon’, ‘healthy fats’, olive oil and then looked for ones with the qualities of good fats and low-GI nutritious carbs that are so important to us with diabetes.

In Summary

The take-home message is that we should be choosing more monounsaturated fats (good sources include olive and canola oil, avocadoes and nuts) and omega-3 polyunsaturated fats (good sources include deep sea fish, walnuts, linseeds and soy products), while reducing our intake of saturated fats (from animal based products, coconut and palm oil) and trans fats (found in many processed foods).

Please share any questions you have about this blog, let me know if there’s anything else you’d like to know about fats, and of course we’d love you to share your favourite recipes that you enjoy for good health.

Sally

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