Mindfulness Archives - Diabetes Counselling Online

Summary of a seminar by Dr Rosemary Stanton on plant based eating

February 23, 2015 by Sally Leave a Comment

Last week I went to a presentation called Paleo versus Plant based diets. I really wanted to share some of the information I was reminded of there with you. Upfront I’d like to make clear that I’m not sharing these to make you feel bad or guilty, so please don’t go there! Just to help you to reconsider and be mindful of what you put in your mouth due to the effect on your overall wellbeing as well as your diabetes management.

There were three key speakers. Dr Kate Marsh (a member of the Diabetes Counselling Online board) who is passionate about plant-based diets, Dr Rosemary Stanton who is probably the most well-known dietitian in Australia and Brenda Davis, a Canadian Registered Dietitian. The day wasn’t about diabetes, but they made several key points that I thought worth sharing with you related to improving your wellbeing by eating more plants. This doesn’t necessarily mean going vegetarian or vegan, but just cutting down on the animal-based foods.

Dr Kate Marsh showed us the evidence of how plant-based eating can improve diabetes management, and help people to avoid chronic disease in general.

Brenda Davis made direct nutrient comparisons between the Paleo and plant based diets, in many cases demonstrating how close the modern Paleo diet was to a vegan diet. But in this blog, I don’t want to discuss the Paleo diet as a ‘diet’ is not sustainable and although it has some strengths it’s not suitable to recommend on a population based level such as this blog. If you’re interested in this for your own health, I recommend a personalised consultation with your Accredited Practising Dietitian as some aspects of it may be dangerous for people with diabetes, especially in the longer term.

Instead I want to focus on Dr Rosemary Stanton’s presentation which was entitled ‘Why so many controversies?’ because it’s really a common sense (and of course evidence-based) approach to healthy eating. The changes she suggests are not too hard to try and really make sense when you think about.

Dr Stanton is a great advocate of the Australian Dietary Guidelines due to the enormous amount of research (over 55,000 pieces of peer reviewed published scientific research) and work by a committee of leading experts in the field of nutrition, public health, industry and consumer issues, and overseen by the Council of NHMRC that went into it to ensure that the Australian population would have not only the right amount of energy (calories/kilojoules) to maintain a healthy weight, but also would have the vitamins and minerals needed to keep us well and to help prevent chronic disease.

She began by explaining how we get so many mixed messages through the media and how important it is to check on advice that you read, as many of the people who talk about nutrition aren’t university trained experts in the field even though they may have passion on their side. Then she got to the part that I really wanted to share with you about own diets.

Dr Stanton explained that in comparison with Australian consumption patterns when the guidelines were being reviewed, the evidence suggests that we need to eat more:

Vegetables and legumes/beans – a variety of different coloured vegetables
Fruits
Whole grain (cereal) foods such as wholegrain breakfast cereals and wholemeal bread
Milk, yoghurt, cheese – preferably reduced fat varieties (except for children under 2 years)
Fish, seafood, poultry, eggs, nuts and seeds, and legumes/beans
Red meat (young women only)

There were also many areas as population that we could do with eating less of, and most of these related to our diabetes health such as:

Refined grain (cereal) foods such as white bread and low fibre cereals (these will spike our BGLs without providing our nutrient requirements)
High and medium fat milk, yoghurt and cheese (let’s stick with low fat to avoid the saturated fats and extra energy that we don’t need)
Red meats (adult males only)
Energy-dense and/or nutrient-poor foods and drinks which are high in saturated fat, added sugars, added salt and/or alcohol, such as sugar sweetened drinks, fried foods, hot chips, many take-away foods, cakes and biscuits, chocolate and confectionery and crisps.

Dr Stanton made the point quite strongly that although the foods in that last bullet point are referred to as ‘discretionary’ items in the guidelines, really it’s just ‘junk’ food and we’re better off without it and taking any extra energy needed from the main food groups of the guidelines themselves. This idea was explained further in the Diabetes Counselling Online blog I wrote on Snacking.

She talked about how our Modern Western diets currently emphasis:

foods and drink high in added fat, sugar, and salt
highly processed grains
meat dominates dinner
vegetables are only an accompaniment (often chips)
fruit juice preferred to fruit
full and medium fat milk, cheese, sweet yogurt , ice cream
alcohol (with or without food)

And if you think about this it’s just so true! For those of us who are not vegetarian, if you ask us what we’re having for dinner, the answer is ALWAYS a meat-based one. It’s just the way we’ve learned to think about our meals – maybe it’s time to consider this, recognise that it’s not doing us any good, and try to improve what we’ve in the past.

Dr Stanton suggested that the main changes needed are:

much more vegetables and legumes
more fruit
include nuts and seeds
far less junk (currently 36% of adult’s and >40% of children’s calorie/kJ intake)

Do many of you try to include ‘Meat Free Monday’? Here’s a link to a website dedicated to this idea with recipes from some of the top chefs that you might like to take a look at.

If you start to enjoy some of these, you might see how you can move closer to a plant-based diet without comprising on your enjoyment of the meals you’re eating. It doesn’t mean you have to give up your favourite steak – just try cutting down the size of it and increase the vegetable sides, or your pizza night – make it at home with healthier toppings, or even your night off cooking nights – by having frozen pre-prepared meals that you’ve made a batch of earlier.

Have you read my Diabetes Counselling Online blog called ‘Learning to Love Legumes’? It’s full of some great ideas and those legumes will provide you with more than enough protein to keep your tummy satisfied hunger-wise and those tastebuds happy too.

Dr Stanton’s ‘Take Home’ messages were a great reminder to us all when there is just so much conflicting information available via the internet. She says:

education is important and ongoing
get information from trusted sources (NHMRC), without a conflict of interest
don’t trust Dr Google
be sceptical of those with something to sell
with scientific papers, read the whole paper, not just the newspaper headlines or blog comments

And what sensible advice that is!!

I’d like to finish up this blog by sharing one of Brenda Davis’s presentation slides. She finished her talk on Paleo vs Plant-based diets by explaining about the longest living people in the world, those that live in the Blue Zone, and a quick rundown on what keeps them so healthy. Could you adopt some of these ideas into your own life?

Paleo vs Vegan diets Blue Zones Longevity Diet 1 Brenda Davis 2015 — Blue Zones Longevity Diet – Brenda Davis 2015 – Please click on the image to make it larger

Hoping this has helped you to consider some positive changes you can make to your own diet. 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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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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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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Christmas kindness and mindfulness

December 15, 2014 by Sally Leave a Comment

Christmas can be a tricky time for people with diabetes. As the dietitian for Diabetes Counselling Online I’d like to remind you all to be kind to yourself over the Christmas period and remember that diabetes is not a game of perfect – it’s what you do most of the time that makes the difference, especially as we’re doing it for the rest of our lives. In today’s blog I’d like to share some ideas by other dietitians and offer a few tips that will hopefully help you to be mindful of your wellbeing this Christmas/New Year period.

As we all have different types of diabetes, using different or no medications, and with so many variations in our day to day lives, I encourage you to check with your health professional before making any changes to your usual routine. These tips are meant as a guideline, so please use good sense in applying them.

Let’s start with a couple of previous Diabetes Counselling Online blogs I’ve written on food for Christmas.

A fresh look at the Christmas meal reminds us that we can choose to provide foods that although Christmassy, do not need to be laden with fat, salt and sugar.

Colours of Christmas – enjoying the festive foods with no regrets helps us to understand about shopping for Christmas treats, and a whole lot more including these great Christmassy food comparisons that help make your choices more mindful.

Did you know that:

A cupful of halved fresh apricots (155g) has only 10g carb (half a serve) and 265kJ/64 calories.
A cupful of cherries without seeds (145g) has 15.8g carb (one serve) and 363kJ/87 calories.
A cupful of strawberries with no stems (150g) has only 6g carb (possibly not worth counting!) and 162kJ/39 calories.
A scoop of low-fat vanilla icecream (50g) has 11.4g of low-GI carb and 258kJ/62 calories.

Compared with:

1 small slice of a Christmas fruit pudding (50g) has 30.4g carb (2 serves) and 785jK/188 calories (plus loads of saturated fat and sodium)
1 small fruit mince pie (40g) has 26.8g carb (2 serves) and 802kJ/192 calories (plus loads of fat and sodium too)

Dietitian Christmas articles

Speaking of being mindful, these next few blogs are written by Accredited Practising Dietitians (APDs) that focus on choices (not diabetes choices, but healthier choices) and there are some great tips in them that I’d like to share with you.

First up, I love these mantras by APD Deb Blakley from this article in The Scoop on Nutrition. Deb reminds us that we should enjoy ourselves at Christmas. Deb says it’s all about good food and good company. Her mantras are very sensible to ensure that we remain kind to ourselves and to others.

The Australian Healthy Food Guide magazine has also shared a few Christmassy articles to help us to maintain our health while we enjoy the Christmas celebrations. This one by APD Caitlin Reid provides 21 tips to stay healthy over the festive season. That’s a lot of tips! Have a read as even if only one or two mean something to you, then you’ll be in a better place.

This one by APD Zoe Wilson is entitled ‘Surviving the Silly Season’. In it Zoe offers 3 quick tips to help you make it through to the New Year without regrets.

And the last of the Australian Healthy Food Guide blogs is by APD Brooke Longfield who talks about managing alcoholic intake which we know adds empty calories as well as disrupting our diabetes management. Brooke has some very helpful ideas here.

Last but not least is a blog by APD Megan McClintock. I have to say this is my favourite one because its focus is on kindness and mindfulness which is something that can be so powerful when we’re managing a chronic health condition such as diabetes. Megan shows us which questions we should be asking ourselves and reminds us that there’s no point feeling guilt or being negative with our thoughts about food. She also provides 6 very practical tips to help.

Wow! That was a BIG read. I hope you found some tips in there that mean something to you and will help you to be kind to yourself and others. In summary it’s about choosing what you have at home and enjoying it mindfully without beating yourself up, and balancing your extra food enjoyment at Christmas with plenty of activity which has benefits of it’s own. Our main focus should be being kind to ourselves and others, enjoying the social aspects of being with family and friends and using any time off to recharge our batteries for a good start to the new year.

Wishing you and your families a wonderfully happy Christmas filled with love and laughter. 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 linked list of all Sally’s Diabetes Counselling Online blogs here.

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5 Tips for managing diabetes at events where food choices are likely to be poor

September 22, 2014 by Sally Leave a Comment

With party season well on its way, one of our members has suggested that it would be helpful to have a few easy to remember tips to help him from overeating and spinning out not only his weight that he’s been working so hard to keep under control, but also his blood glucose levels that he also works hard to keep managed through lifestyle measures. It’s such a great topic to suggest! So many of us do exactly that when we go to a party or a reception or even just out with friends to a buffet style lunch.

If you fail to plan then you plan to fail.

As is often the case with diabetes, a little forward planning goes a long way. So if we have a just a few (well 5) top tips to think through, hopefully you’ll find it much easier to manage and will feel so much better afterwards. We all know that post-party feeling of regret for the bad food choices we made.

I’d also like to remind you that diabetes is not a game of perfect. These tips aren’t meant to restrict you from enjoying a little of what you might not have access to in your usual life with diabetes, but more to make it easier to do so without extreme consequences of high BGLs and weight gain.

1) Before you go, eat and exercise

If it’s not a meal based event, such as a cocktail party, then ensure you eat a well balanced meal before you go so you won’t be hungry and can be more mindful of the choices you make.
Give yourself a target of about 5 tastings of food on offer so you don’t miss out.
One of our admins, Helen, suggests going for a big walk before the party to help minimise the BGL impact of birthday cake, as well as being extra careful in the surrounding days – great ideas Helen!
Don’t be afraid of saying ‘Not just at the moment thanks’ or ‘No thanks’ with a smile.

2 ) Look over what’s available before just diving in so you consider your choices

If it’s a buffet meal, don’t just go to the queue to join the buffet, but take a few moments to look over people’s shoulders to see what foods are offered on the table. This will help you to choose wisely and know you won’t be missing out so you won’t have to stack your plate just in case.

3) Memorise what the healthy plate looks like and fill up the veggie half first

After checking out the buffet, aim to fill at least half the plate with salad and undressed veggie options first. This can help to fill you up before you start on the more energy dense foods.
Look for healthier lower fat, lower GI carb sources to keep your BGLs happy, and then go for the lean proteins such as cold meats and seafood for the last quarter.
Try not to stack your plate, remembering that you wouldn’t do that at home and so you really don’t need the extra food.

Choose nutritious and unprocessed foods wherever possible (including avoiding marinades, sauces and creamy dressings that are high in sodium and kilojoules/calories)

4) Take a healthy plate with you to share if it’s a BBQ or private event

Skewered vegetables to go on the BBQ.
A salad contain low GI carbs such as legumes or quinoa or barley and other interesting ingredients.
A hummus dip with fresh veggies for dipping. It’s amazing how popular these items will be. You’ll be the star of the party.
Fresh fruit platters work well for afters.

5) Eat slowly and be mindful of how much you need

Wherever you are, the more slowly you eat, the more awareness you’ll have of when you’ve had enough to eat

If you’re worried that people will call you a party pooper, here are a couple of member suggested tricks so you can still enjoy the party without putting your health at risk.

Excuse yourself then go to the kitchen to fill your beer stubbie with water. Then no-one knows you’re not drinking beer.
Another of our members suggests, “I just get very selective. I hit on the chicken drumsticks and salad which are reliable offerings. Then it depends on how upmarket the buffet is. At our favourite buffet restaurant I gorge on seafood and then follow my nose to the cheese plate. A little bit of potato/rice/pasta salad to provide the carbs.” Go easy on the cheese Tiger!

Hoping this will help you get through the Spring and early Summer party season while managing your diabetes and overall health to the best of your ability. Remember to that it’s important for your wellbeing to be sociable and enjoy the celebrations that life brings.

It’s all about balance and a bit of planning.

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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