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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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Making 2&5 easy

November 3, 2014 by Sally Leave a Comment

We’re all so busy these days. How on Earth are we meant to able to consider our health and getting enough fruit and vegetables (our 2&5) into the meals we eat?

Often I see clients who, when I take their diet histories, they don’t even start to consider foods like fruit and vegetables until so late in the day that it’s actually too late to get enough of those important plant nutrients. Or when they’re doing it they find them so unappealing that there’s no incentive to make them want to eat more.

In this blog I hope to help you find it easier to get them all in and enjoy them, which in turn will help you to improve your own wellbeing, diabetes health, mental health, heart health and so much more!

The Australian Dietary Guidelines tells us:

“There are many nutritional, societal, culinary and environmental reasons to ensure that vegetables, including legumes/beans, and fruit are a major component of Australian dietary patterns. These foods are nutrient dense, relatively low in energy (kilojoules) and are good sources of minerals and vitamins (such as magnesium, vitamin C and folate), dietary fibre and a range of phytochemicals including carotenoids. Many of the sub-components of foods and their relationships have not been studied in detail, and it is expected that other sub-components – and their biological effects – are still to be discovered.”

From a diabetes point of view, they’ll help improve our immune system, mental health, good cholesterol, bowel health and help with weight management (just to name a few benefits!).

Perhaps a good start would be to look at ideas to include them in your meals across the day, and then provide you with some easy recipes – some of my personal favourites, and I encourage you to share your personal favourites below too in case they inspire someone else to enjoy more of these wonderful foods.

A good starting point is to know what the guideline is and how much a serve is. This snip from the Australian Dietary Guidelines for Adults brochure provides a pretty clear picture.

One of my best tips is to break up the intake of these foods across the day so that you’re not left with large amounts required at the end. Personally I aim to get 2-3 serves of vegetables at lunchtime and another 2-3 for dinner, and I one of my fruit serves at breakfast and one as a snack later in the day. But there are no rules about this. Here are some ideas that might help you.

Breakfast

Weekday breakfasts usually need to be fast to prepare and eat. So a bowl of high fibre cereal with a serve of fruit is one easy way to get you off to a good start. Think bananas, strawberries, blueberries. A milk based smoothie also works well here, as does multigrain toast with peanut butter and a squashed banana.

On weekends with a little more time, why not wilt some baby spinach leaves and panfry mushrooms and tomato, served on toast with an egg. Remembering that one medium sized tomato equals a serve, and half a cup of cooked veg (the mushrooms and wilted spinach) is another serve, you’re off to a great start with two vegetable serves already under your belt.

Lunch

I love lunchtimes in my office. I take the various ingredients to build my favourite salad and set aside an hour to build and eat it while I check my email and Facebook. My salads include mixed leaves, baby tomatoes (various colours if they’re available), Lebanese cucumber, onion, half a cup of 4 bean mix and a quarter of an avocado. That gives me around 3 vegetable serves and I salivate over every mouthful.

Of course leftover are also a top idea for lunch, especially ones high in vegetable ingredient, and can be served with baby spinach leaves to lift them.

And if you’re in a massive hurry and can only have time to make a sandwich, pile on the salad and take some extra veg in a box to nibble on with your sandwich. I just adore the flavour in the grape or Perino tomatoes, and cooked and cooled asparagus (in season at the moment) are such a treat flavourwise – I even enjoy it raw!

Dinner

A good place to start here is to remember the plate model, in that half your plate should be non-starchy veg or salad.

I’ll provide ideas below on some yummy ways you can make this happen. It is definitely the easiest meal to get those extra serves in, so 2-3 shouldn’t be a challenge at all.

Snacks

Of course a piece of fruit is an excellent snack, remembering you’re aiming for 2 per day, so if you’ve had one with your breakfast you only need one later in the day too. For us with diabetes they’re better off eaten at separate times to keep our BGLs more stable.

Five easy ideas to enjoy your vegetables

Simply steamed or microwaved to an ‘al-dente’ texture (ie not overcooked) mixed vegetables of your choice such as broccoli, zucchini, green beans and peas. Dress with the juice of a lemon, a finely chopped clove of garlic, extra virgin olive oil (equal amount to the lemon juice) and salt and pepper to taste. Delicious!
Start with a tin of tomatoes and add flavours such as garlic, anchovies and chilli. Then just add your choice of veggies and simmer in the sauce for 5 minutes or until they’re an al-dente texture (not overcooked). Tasty!
Take a bowl and add a huge variety of vegetables such as mushrooms, cherry tomatoes, capsicum, zucchini, pumpkin, beans, whole garlic cloves, onion and toss them in some extra virgin olive oil with fresh or dried oregano and salt and pepper to taste. Tip them into a baking tray lined with baking paper (for easy washing up) and roast at 180 degrees Celsius for about 30 mins. Also wonderful with crumbled feta cheese tossed through at the end, and delicious cold the next day for leftover lunches!
Soups and stews are such an obvious choice for those who find it hard to enjoy their veggies as all you need to do is add a whole load of mixed veggies into a large pot, cover with stock, simmer for 20-30 minutes and blend with your desired flavourings. How easy is that?!
Last but not least, if you have left over steamed vegetables it’s so easy to reinvigorate them by adding them into a mix of a few beaten eggs and some cheese and a few extra fresh herbs, baked for 30 mins at 180 degrees to make a frittata that will ‘Wow’ your guests. Also fabulous for next day lunches to help get your vegetable serves in. Yummo!

That’s probably enough to cover in this blog. I’ve give you quite a lot to consider. As mentioned, we’d love you to share your favourite ways of enjoying vegetables, and let’s talk about them more in our Diabetes Counselling Online groups such as Diabetes and Food – let’s celebrate it!, Diabetes Weight Matters and Men Living with Diabetes among others.

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Juggling Wellness and Diabetes

September 15, 2014 by Sally Leave a Comment

I’m writing this personal kind of blog on a Saturday. I love Saturdays. They encompass lots of things I love to do which all contribute to my wellbeing. This morning I was out on my run and because it’s Saturday and lovely Spring weather lots of my neighbours were also out and about. Nearly everyone I ‘ran’ into made the comment about how well I looked. I had at least 3 such comments this morning and they inspired me to share with you what I believe to be the key to being well with diabetes, or what works for me anyway.

This is important to me because I have diabetes and I’m turning 50 next year, so I know that if I don’t focus on being well myself I’m in a higher risk group to lose my wellness that is so important to me. I want to do all I can to hold onto it for as long as I can, so I can enjoy more of this wonderful life. I’m also passionate about helping others to be well too to the best of their ability, so here goes!

Sleep

Every Saturday I get to sleep in. Yay! To catch up on a few hours I may have missed through the busy-ness of my week. Time to give my body a chance to repair and relax. I usually get to sleep in until around 8am, which is a big improvement on my 6-6.30am starts on other days of the week. The only thing that stops me from doing this is waking early with a hypo, but this morning my BGLs behaved themselves. This week I found an awesome article in The Conversation on the importance of sleep which I encourage you to read. It’s just so important for our wellbeing, and especially so for us with diabetes.

Eating Well

As a dietitian you would know that I am particularly passionate on this topic! This is the only topic in today’s blog that I’m qualified to talk about as a health professional, and it’s such an important one! The Australian Dietary Guidelines that we follow actually makes the comment, “Diet is arguably the single most important behavioural risk factor that can be improved to have a significant impact on health.” It is something that I think about, read up on and focus on every day.

Today I started with my fibre rich, low-GI and high nutrient breakfast, a combination of two cereals that enjoy eating together topped with skim milk. I had a banana for morning tea and a delicious bowl of vegetable and low-GI carb rich Minestrone soup. This afternoon I’ll probably have a snack of a handful of nuts and another piece of fruit. We have a delicious lean meat and vegetable rich stir-fry planned which we’ll serve with plain Basmati rice, and I’ve marked out my favourite Black Cherry yogurt for dessert.

I know that I’m getting the nutrients I need to be well each day, and I’m sure it must also reflect in my outward appearance when I’m out on my run, makeup free in my daggy running shorts too lol

Regular Exercise

Nice segway to the exercise! Also lots of evidence here to support wellbeing, reducing inflammation, improving mental health and keeping our BGLs more stable. You may know that I’m a golfer. I try to play 18 holes in a comp twice a week, and 9 holes if I have time as a break in my day on a Friday. On the days I’m not golfing I do my best to get in at least the minimum recommended 30 minutes of moderate physical activity. Usually I try for 45 minutes. Since I’ve been doing this I have noticed a big improvement in the stability of my glycemic control as my fitness has improved. It’s so worth the effort even when you don’t really feel like it!

Family Time/Love

I’m incredibly fortunate to have so much love and support from my family, but I guess it works both ways in that I also love and support them! I believe that love and giving love is an important part of wellbeing. We hug each other a lot in our household, and in the wider family too. Have you hugged someone today and told them you love them?

Being sociable

Although I was out on my run, I enjoy stopping along the way on a Saturday as I have more time available to me to chat with my lovely neighbours in the suburb I live in. I chat with the children, and the parents, and the older people, and the neighbours who are my friends. To me this is important as I feel loved within my community too, and I know that I’m helping some of these people to feel loved too <3

Hard Work

I enjoy working. It keeps my brain active. It gives me a purpose and keeps me inspired each day to stay well and make the most of my life. The lovely Helen Wilde called me a workaholic this week, which made me think. You know I probably am a workaholic, but that’s because I love what I do and it makes me happy to help other people to be well. But I honestly try very hard to keep a balance with the other important factors in my life.

For those of you who are lucky to be retired or not have to ‘work’ as such I would encourage some kind of volunteer role as it can really be so rewarding and contribute to your wellness. We have some awesome volunteers who help us out at Diabetes Counselling Online. You can read more about our team and some of our ambassadors here. They’re so important in making our charitable organisation what it is.

Keeping the Balance

Of course, being Saturday, I also have household chores to do, preparation cooking for the week ahead, and I might even fit in a quiet hour of reading a book. It’s always a good day, and means I really relax and enjoy myself on my day of rest (and golf) Sunday.

If you try to imagine all these aspects (including any others you may have yourself) as a number of balls that you’re juggling, I believe that remaining well is all about keeping a balance amongst them. Sometimes you need to drop one ball to keep the others going smoothly, but don’t forget it and go back to collect it as soon as you can. I don’t see diabetes as one of those balls – it’s just part of me and often influences how I manage some of those balls/aspects.

Hopefully some of this will inspire you to focus on keeping your balls in the juggle, and know where you can make some positive changes to improve your own wellness. Diabetes Counselling Online actually has a whole section on the website on Diabetes & Wellbeing. Check it out!

You know we’re here to help. With love, 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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Healthy d-baking with guest Joan Bailey

September 8, 2014 by Sally Leave a Comment

One of our wonderful Diabetes Counselling Online volunteers, Joan Bailey, has type 2 diabetes. She also has two young daughters who both have coeliac disease. Joan loves to bake them yummy, homemade meals and treats for their lunchboxes. She also works hard to control her blood glucose levels and remain fit so that she’ll be healthy to look after her family in years to come. And she also enjoys the food that she creates for the rest of the family. This means that she needs to consider all the diabetes factors in recipes as well as making them gluten free and delicious.

In today’s blog Joan demonstrates how she does this and explains that often these healthier options are even more delicious than the original recipes. If you’re not gluten free, don’t worry as Joan has included gluten containing options too in her tips for healthier swaps

Over to you Joan:

Thanks Sally. I hope this blog highlights that for those of us who enjoy baking that it is still possible!

Today many low glycemic index (GI) recipes are available but sometimes a family favourite is hard to give up and obviously we still want to enjoy them at the end of the day.

So the only option is to identify the potentially high GI, high fat and high sodium elements within the recipe and swap them for diabetes friendly ingredients.

I personally think that taste-wise the healthier versions can taste even nicer and be more filling and satisfying!

Making the conversion

As we’ve learned through listening to Sally and other dietitians, when converting a recipe for diabetes the main components that should be addressed are the carbohydrate components (the sugars and the flours) as well as the total and saturated fat levels and the salt (sodium) content.

Once you get the proportions correct and the correct substitutions it is easy to do.

It does take a bit of trial and error, so it’s a top idea to write things down as you go. And just like anything you do, the more practice you get, the better you’ll be at making your original ‘guesstimations’ for the substitutions.

Beginning with a Brownie recipe

Let’s start with a basic brownie recipe and look at converting each component. This table shows what a difference the changes can make!

Original recipe	Amount of Nutrient	Substituted with	Amount of nutrient	% Difference
1.5 cups self-raising flour (337g)	Carb = 246g	1.5 cups chickpea (besan flour) plus a teaspoon of baking powder (225g)	Carb = 104.4g	-57.6%
½ cup sugar (225g)	Carb = 224.5g	½ cup Stevia	Carb = 0g	-100%
1 cup water		1 cup water
¼ cup cacao		¼ cup cacao
1 tblspn vinegar		1 tblspn vinegar
60mL full cream milk	Per 100gFat Total = 4.4gSaturated = 2.9	60 mL low fat milk	Per 100gFat Total – 1.2gSaturated 0.8	-73%-72%
1 tsp vanilla essence		1 tsp vanilla essence
6 tblspns sunflower oil	Per 100gFat Total = 100gSaturated = 11g	6 tblspns low fat yogurt	Per 100gFat Total = 0.3gSaturated 0.2g	-99.7%-98%

Now, this table took me a little while to put together, but I think it’s quite an eye opener as to the enormous differences we can make to help our health and wellbeing, just by making a few minor changes to the original recipe. Still looks and tastes as good as the original!

And just to further make the point, I put both recipes through the FSANZ Nutritional Panel calculator (following the directions in a past blog that Sally posted for Diabetes Counselling Online).

First is the original brownie recipe

And here’s my healthier version

Which would you rather have, especially when you know that this one tastes just as good as the original??

Are you amazed at the differences these changes have made?

And the taste also lived up to expections! My girls certainly enjoyed them – they didn’t last long!

Some other helpful ideas for your recipe conversions

Instead of icing sugar try low fat Philadelphia cream cheese thinned out with milk and sweetened with Stevia (cocoa – optional)
For pizza bases/pancakes/crumpets/muffins try swapping the plain white flour with chickpea flour, quinoa flour, buckwheat flour and spelt flour (for those who aren’t gluten intolerant). Coconut flour is also low carb, but I find its flavour spoils the flavour of the finished product.
Use low fat yoghurt! It makes a great alternative for mayonnaise, sourcream, ordinary cream and can directly replace oil in baking. Here is the link to an article that talks more about it.
Rolled outs and ground seeds also make an excellent substitution for flours. The calorie content does needs to be considered when using ground nuts and seeds. If one cannot have oats rolled quinoa could also be used. Love this Teresa Cutter recipe for Oatmeal Scones for when a special treat is in order.
I have not found a good replacement for syrups. I have tried dissolving Stevia in hot water and letting it cool down. (2tsp stevia to 1 cup water) this can be used in baking but the texture is not the same as syrup.
Sushi can be made with cauliflower rice or even quinoa if you wanted the low GI carbs
Quinoa can be substituted for cous cous to provide a lower carb amount (due more protein in the grain).

And now back to our Diabetes Counselling Online social media dietitian, Sally!

Wow Joan! Thanks so much for making such an effort to demonstrate just what a difference a little bit of thinking in your cooking can achieve. Those girls of yours are certainly fortunate to have a Mum who looks after them with good food for their wellbeing too!

Please add your comments below if you have other suggestions/tips that you’ve discovered that might interest some of our readers.

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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Carb Counting Queen: am I really good at Maths, or is it an illusion?

September 5, 2014 by helwild Leave a Comment

I’m always so profoundly moved by what people are so prepared to share with me. Recently I received the following lovely piece of writing from one of the Parents in our ‘Parents of Kids with Diabetes’ group on Facebook. Check out the link if you are the parent, carer or grandparent of someone with diabetes.

Thanks to Maureen Campey for sharing of your thoughts. Fabulous writing Maureen. Yes, the tears come, even if in secret. There are the times we ALL feel like the ‘carb counting Queen’, whether we have a child with diabetes, or have diabetes ourselves! As you say, it helps to be able to see the funny side. I think it also celebrates our confidence in our skills & knowledge, a confidence that we need to stay sane.

“Sometimes I feel sad, but there are times when you just have to laugh at the craziness of life as a mum of a Type 1 child. We were at a friend’s bbq recently and when I came home, I started to write this. Do you feel like this too? I’m happy to share this and just give you a laugh. x

The Carb Counting Queen

I am the carb counting queen. No carb is too complex for my capabilities. This title, it has to be said, was totally uncontested. There was no bloody revolution. There is no pretender to the throne.

A Saturday afternoon bbq? Sure, we’d love to come! Watch me as I glide, seemingly effortlessly, towards the buffet. Greeting friends on either side, they are totally unaware of my inner calculations. Think synchronised swimmer – all smiles above the water, craze of activity below. If karma exists, my maths teacher would be rolling about laughing.

Ok, here we go! Salad, all good: nice and plain. A top ‘filler upper’! Protein, yip: lots of chicken, and sausages. Fine, but wait! Was the chicken marinated? Best stick to sausages! Which carbs though? At least a modicum of healthiness! Bingo! Corn on the cob! One exchange down!

I bet there’s a loaf of bread somewhere, hopefully wholegrain! Always a ‘failsafe’ but so, so boring. Can I check out the pantry without seeming like a crazy lady? Ah look! Potato bake! Now, how did I calculate carbs in that one I made at home? Get the Mobile ‘phone out and have a look. There might be one on the ‘Carb Counter App’ or my faithful knave the ‘Traffic Light Guide’.

Is there a dessert I wonder? Fruit? Maybe iceblocks for the kids? Which brand? Would it be rude to ask? Please let it be at least font size ten on the packaging! So unseemly scrambling about for those newly prescribed glasses.

All that in a ten metre walk! Pass me a glass of bubbly! Now for the rest of the family!”

Maureen Campey

If you have some thoughts you’d like to share about living with diabetes, we’d love to hear from you. Send your writing to: [email protected] OR just write your thoughts after this post in the Comments.

Regards

Helen Wilde

Helen is a Senior Counsellor with www.diabetescounselling.com.au She has been the mother of someone with Type 1 diabetes since 1979, and has lived with Type 2 diabetes herself since 2001.

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