Mental Health Archives - Diabetes Counselling Online

Yoghurt, probiotics and d-health

March 10, 2015 by Sally Leave a Comment

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

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Guest Blog:Thanks Teacher

February 22, 2015 by helwild 1 Comment

Our guest poet, Maureen Campey, has written another great poem about Parenting a child with diabetes. This time, Maureen has written about her teenage son starting a new year of High School, one of those momentous hurdles that we all face as parents.

Here are Maureen’s wise words.

Sending our kids back to school always brings its own set of worries and frustrations. My T1 14yr old has gone back to a new set of teachers. He seems pretty cool with it all. My ‘coping mechanism’ seems to have become, Writing Poetry! Weird, I know but it helps me get it out of my system. I hope you don’t mind if I share!

Dear Teacher

Hi, hello, it’s me again.
Please don’t roll your eyes!
I’m not a helicopter parent,
I come in peace!

I need to explain
That my child will be carrying an invisible pancreas.
You won’t even know it’s there.
He will carry it with him wherever he goes.
He will do its job and look after it
But sometimes he may grow a little weary.
Your help may be needed as he mustn’t let go of this tiresome load.

Scared? Don’t be!
Imagine how he feels all day, every day
Yet he keeps on going.
Your job is small and help is at hand for you.

My child must calculate many things at the same time.
He must think like a pancreas.
Can you imagine?
As well as trying to learn,
He must anticipate the effect of every action and piece of food
Whilst travelling from class to class, and teacher to teacher.
No mean feat!

I will make sure you are given the knowledge you need.
I ask that you are willing to accept your role.
Let him be and don’t become a helicopter teacher.
He is not perfect.
Do not expect gratitude,
There will be no immediate reward for what you do
But know that he will go on to live a full life
Having learnt from you that this burden can be shared.

You will never know the gift you have given my child
But please know that I will be forever in your debt.

Maureen Campey

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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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While we’re busy making other plans..

August 7, 2014 by helwild 2 Comments

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

How do we find balance?

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

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

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

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

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

Helen Wilde

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

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

carpe diem

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A poem from a diabetes Mum: I lost a layer of skin

August 6, 2014 by Helen-Edwards Leave a Comment

One of our members has written this beautiful and moving poem about her child with diabetes – she has agreed to share it. We are sure many of you will identify.
thank you Maureen
xx

I lost a layer of skin
I lost a layer of skin as we entered the hospital on the day of the diagnosis.

I didn’t feel it fall off.
It certainly didn’t hurt.
It gently slipped off with less than a whisper, unnoticed, like a soft, satin scarf.
I wish I had noticed it leaving.

I imagine it floating gently over the roofs of nearby houses,
carrying with it the half formed dreams I alone held for my child,
leaving behind only rawness.

Over days, weeks and months a strange new layer has grown in its place.
It’s a bizarre contradiction – tough yet sensitive.

Watching the drops of intense ruby blood makes it want to shred itself
Glimpsing needles pierce the stomach where raspberries were once blown makes it ache.
seeing the sombre eyes of a child learning to cope leaves a hollowness.
Dragging a weary body through night times of wakefulness leaves it feeling prickly.

It’s certainly more careworn than the layer it replaces
but it’s strong and it needs to be.
It bears the brave scars of battles: some internal and silent, some of epic proportions.
Hiding the multitude of maternal fears which largely remain unshared has hardened the carapace.

It has to be tough for the times when it’s all too much for a child who just wants the old normal.
The old normal isn’t coming back.

I like to imagine
that I’ll find that layer of skin again some day and fashion a purpose for it in this new existence,
for there is hope.

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