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Eating well without counting calories

August 11, 2014 by Sally 2 Comments

Some of us really dislike counting calories. It’s great for those who do, and many I know use tools/apps such as MyFitnessPal and others with success, but it’s not for everyone. This raises the question, if you’re not counting calories how do you know how much to eat to lose or maintain your weight/wellbeing?

A good place to start is to have an understanding of the energy density in carbohydrates, proteins, fats and alcohols, these being the four ‘macronutrients’ that provide all our calories/energy in the food we eat. May I suggest a quick review of a previous blog called ‘Energy In/Energy Out – understanding how much you need and where you get it’. In a nutshell though, carbohydrates and proteins provide about the same amount of energy, and fats and alcohol are about double the energy density of carbohydrates and protein.

Another excellent thing to keep in mind is the Australian Dietary Guidelines that indicates how many serves of each of the five food groups each of us should be aiming to include in our daily food intake.

The reason for highlighting this suggestion is it is easy to think that because something is healthy that means we can eat as much of it as we like. We know that monounsaturated and omega-3 polyunsaturated oils, including avocados, nuts and seeds, are good choices for heart health (as outlined in the Blog 2 on fats – which are the best types for us to enjoy?). Often if people think they’ll lose weight by cutting out one macronutrient, it just doesn’t work in the long term as they tend to balance out the energy they need by including more of another.

For us with diabetes, often people think they should cut down on their carbs to help with their blood glucose control (which can be helpful – read more in the blog Discussion on low carb diets) but end up eating more fat or protein in their daily routine to make up for the energy they’re missing in the carbs they’ve cut.

So the idea to understand how to make your meal and snack choices contain the correct amounts of the ‘macronutrients’ to keep your energy balance as well as the foods from all 5 food groups to provide you the nutrition you need for wellbeing.

The key, as always with diabetes, is ‘balance’.

There are a number of plate diagrams around. The traditional idea of a medium sized plate divided into quarters, with one quarter being carb foods (preferably nutritious and low-GI), one quarter being lean protein and the other half being non-starchy vegetables, with a small amount of good fats too is an awesome idea to keep in your mind.

The Australian Dietary Guidelines also reminds us that “an allowance for unsaturated spreads and oils for cooking, or nuts and seeds can be included in the following quantities: 28-40g per day for men less than 70 years of age, and 14-20g per day for women and older men.”

Carbohydrate foods

Choices here can come from the vegetables, grains, dairy and fruit (although we tend to save dairy and fruit for snacks). You might choose sweet potato, Carisma potato or sweet corn if you were having a vegetable based meal, and around 2-3 carb serves of these would make up the quarter serve of your plate. If you were having rice, pasta or another grain food, again you’d aim for 2-3 carb serves on your plate.

It’s easy to think about carb serves as roughly a small fist size.

Protein foods

One serve of a protein food as outlined in the Australian Dietary Guidelines is enough to take that quarter allocation on your plate:

65g cooked lean red meats such as beef, lamb, veal, pork, goat or kangaroo (about 90-100g raw)
80g cooked lean poultry such as chicken or turkey (100g raw)
100g cooked fish fillet (about 115g raw) or one small can of fish
2 large (120g) eggs
1 cup (150g) cooked or canned legumes/beans such as lentils, chick peas or split peas (preferably with no added salt)
170g tofu
30g nuts, seeds, peanut or almond butter or tahini or other nut or seed paste (no added salt)

You can read more about protein in the blog Protein and diabetes – do you get the balance right?. And it can be easy to think about protein serves by aiming for a serve the size of the palm of your hand (no fingers or thumbs).

Non-starchy Vegetables

This section is half the plate, and is where many people struggle to eat enough. It should be made up of about 3 serves based on the Australian Dietary Guidelines, and doesn’t include the starchy veggies that sit in the carbohydrate quarter.

A standard serve of vegetables is about 75g or:

½ cup cooked green or orange vegetables (for example, broccoli, spinach, carrots or pumpkin)
½ cup cooked, dried or canned beans, peas or lentils
1 cup green leafy or raw salad vegetables
1 medium tomato

Some great ideas to make the non-starchy vegetables work for you might include roasting them or a vegetable stew or curry with a tomato base. And there’s always a hearty salad with perhaps some cheese from your daily dairy serves, or good old lightly steamed vegetables. You can also skewer them to be barbequed, and stir fry them – the options are almost never ending.

So don’t be held back by some maybe old-fashioned ideas about vegetables not being exciting. Give some new ideas a try and learn to embrace their wonderful nutritious and delicious qualities. And if at the end of a meal, or even in between meals, if you can discover some ideas for these non-starchy vegetables you’ll be happy to learn that they’re low in all the energy containing macronutrients so eat more of these to keep you satisfied.

How much weight is a good amount to lose?

This is really a topic for another whole blog, but just briefly I’ll take the opportunity to remind you that ‘going on a diet’ doesn’t work in the long term. Even if you lose weight in the short term, it will come back plus some – the evidence here is overwhelming. By following the Australian Dietary Guidelines suggested daily serves for your gender/age and participating in regular physical activity you are likely to lose about a kilo a month and it should be sustainable. There is certainly a lot to eat in there and I challenge anyone to still be hungry when consuming all that food! To maintain a healthy weight it’s recommended that you add in 2.5 serves from the food groups that you enjoy the most.

The main point is to avoid processed and take away foods as often as possible. Try to be organised and take your own meals and snacks with you to help avoid temptation.

My last key point is to remind you about the importance of seeing an Accredited Practising Dietitian to help you with a personalised consultation so you know you’re getting everything you need to be your best.

I hope you’ve found this useful in helping you to understand how much of the different foods you need to include in each of your meals, as well as the extras you have such as dairy, fruit and nut serves for your snacks if you need/want them.

Please let me know if you any questions. Wishing you all an awesome week. 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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Discussion on low carb diets

July 28, 2014 by Sally 8 Comments

Australian Guide to healthy eating poster

By popular demand through a thread in our Facebook group Diabetes and Food – let’s celebrate it!, this topic deserves a blog to help explain some of the ‘stuff we hear’ around carbohydrates and type 2 diabetes. I’d also encourage people with type 1 diabetes to read this though, because some of the points made are also relevant for us! Up front I will remind you that everyone has individual requirements and should see an Accredited Practising Dietitian for a personalised consultation, so this is a ‘general guide’ only.

Firstly we need to understand what ‘low’ means in such a context as in my experience as an Accredited Practising Dietitian, people tend to associate ‘low’ with ‘virtually no’ carbohydrate. We’ll also look at some of the evidence that shows that ‘low’ carb diets can help with glucose control in type 2s, and why when drugs (other than metformin or SGLT2-inhibitors) are introduced it’s important to ensure more (quality) carb intakes as advised by your health professionals. And lastly (but certainly not leastly) we’ll review how, based on the Australian Dietary Guidelines, it’s possible to have a nutritionally balanced diet while watching your carb intake.

What does ‘low’ carbohydrate mean?

If you ask some people what they think ‘low carb’ means, you may hear that it’s about cutting carbohydrates out as much as possible. Straight up as a dietitian my alarm bells ring as carbs feature in all five of the food groups that we need for nutrients to ensure our wellbeing: vegetables (starchy vegetables like potato, sweet potato and corn), fruit, dairy, protein (when the likes of legumes are included, and especially in vegetarian diets) and of course, the important grain/cereal foods.

The American Diabetes Association defines a low-carb diet as 130g of carb per day. Does that surprise you?? The ‘trick’ with low carb diets is therefore to know how to choose your carbs wisely so that you’re still meeting your nutrient requirements, and also to know what to replace that carb energy with (remembering that carbs, proteins and fats make up our daily energy intake) so you don’t get too hungry and be encouraged to ‘cheat’.

Remembering that there’s 15g of carbohydrate in an ‘exchange’ or ‘serve’ that gives us close to 9 carb serves across the day.

If you’re on medication that helps your body to produce more insulin, or you’re providing insulin yourself on a fixed dose then this idea is dangerous to your health so please speak to your health professionals before making any changes to your diet.

Some benefits of lower carbohydrate diets

Of course we know that all carbohydrates break down to glucose which is the fuel needed by our bodies, but in modern diets often too much (and poor quality) of this ‘fuel’ is provided which can cause stress to our organs and worsen our diabetes control. So understanding the benefits of a lower carbohydrate diet can help us to stick with it for longer and balance the rest of our diets more easily.

Some of those benefits may include:

Lower incidence of high blood glucose levels (hyperglycemia)
Lower amounts of medications need to control hyperglycemia
130g/day is a sustainable amount, meaning it’s easier to stick to in the longer term
Putting your pancreas under less stress to produce insulin, thereby helping it to keep working for longer
By ensuring your 130g/day is nutritious and low-GI carb you may also improve your blood fat levels (cholesterol/triglycerides) which will lower your risk of cardiovascular disease
It doesn’t necessarily lead to weight loss – that depends on your total energy intake.

How do you manage it best?

Again I will mention how important having a personalised consultation with your Accredited Practising Dietitian is because everyone is different in many ways. Here I will make suggestions that I hope will help to get your head around combining the idea of low carb into your daily routine while still meeting the nutritional requirements as outlined in the Australian Dietary Guidelines foundation diet (see page 2).

In a nutshell, it’s about only choosing your carb sources from the 5 food groups and balancing that out with quality proteins and healthy fats. I encourage you to re-read the previous blogs I’ve written on those topics as highlighted.

Remembering that 130g/day equates to close to 9 carb exchanges/serves, your day might start to look a bit like this:

Breakfast: ¼ cup of raw rolled oats (1 serve carb) served with 125ml light milk (half a serve), a small banana (85g – 1 carb serve) and a tablespoon of LSA mix (for extra fibre/protein) = 2.5 serves total

Morning Tea: A 100g tub of low-fat yogurt = 1 serve total

Lunch: A sandwich made on wholegrain bread (the grainer the better – 2 serves) made with a protein serve and as much non-starchy veg as you can handle, either on the sandwich or as a side, using half an avocado as the spread (for your good fats), and a piece of fruit such as an apple or pear (both good low-GI fruits – 1 serve) = 3 serves total

Afternoon Tea: A 30g handful of mixed unsalted nuts = not worth counting carb-wise

Dinner: Remembering the balanced plate being one quarter carb, one quarter protein and half non-starchy vegetables, this works with so many meals. Aim for your carb serve to = 2 serves total

Supper: You’ve still got half a carb serve up your sleeve. I would encourage something like half a slice of grainy toast with peanut butter on it to give you the energy to get you through the night, but half a serve of low-fat dairy would also work well, or even a couple of squares of dark chocolate if you fancied it = 0.5 serves total

In this example you can see that we’ve incorporated 9 carb serves/exchanges and yet have included quality carbs at every meal.

Some final tips

Remember to include protein and some non-starchy veg with every meal.
Rice and pasta can be problematic a serve size is so small. Something I recommend that works for many people is to include the carb serves in the form of legumes (lentils, chickpeas, kidney beans, etc) in the pasta sauce and use low-carb alternatives such as those made from konjac root, or make pasta/rice out of vegetables such as grated zucchini or carrot or cauliflower. I sometimes serve my pasta sauces on mashed cannellini beans and frozen spinach (warmed of course!) and find it’s very satisfying.
Don’t forget to exercise! If the point of minimising your carbs is to control your BGLs, then even as little as ten minutes exercise after meals can make a fantastic difference to your readings. Do some self-experimenting about how much your BGLs drop after say 10, 20 or 30 minutes walking after meals, and then if you want to include more quality carbohydrates in some meals, you’ll know how to manage better.

I hope this has proved useful for you, and that you have a better understanding of how a low-carb (130g/day) might help with your diabetes control. Of course please ask any questions below and I’ll be happy to address them for you.

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Protein and diabetes – do you get the balance right?

March 24, 2014 by Sally 1 Comment

With diabetes it’s important that we consider all the nutrients that contain energy (macronutrients) and understand what their roles are and how to ensure that we have enough of them for our Wellbeing. Protein is one of the four macronutrients that also include carbohydrates, fats and alcohol. Also, as protein is one of the 5 food groups that feature in our Australian Dietary Guidelines (hereafter referred to as’ the guidelines’), I thought it would be a good topic to take a closer look at with a focus on our diabetes. It is a huge topic, so we’ll start here and maybe revisit at a later date.

We’ll start today by looking at which foods contain protein and why it’s important to include protein in our diet from a healthy eating point of view for all Australians. We’ll look at what the guidelines tell us about the six categories within this fascinating group. We’ll also look at protein as a form of energy, and will cover what the evidence from scientific research tells us is the right amounts to include in our diet to maintain our muscle mass and healthy weight. And we’ll finish off with a question I’m often asked by people with diabetes who enjoy regular physical exercise on whether they need to increase their protein intake. Take a deep breath and hold on tight – it’s a biggie!!

As we know carbohydrates break down to glucose that is our body’s preferred fuel and one that we keep a close eye on with our diabetes. If we look at proteins in the same light, they break down to amino acids that allow our bodies to carry out repairs and other important cellular functions.

Also relating to our knowledge of carbs, you know that carbohydrates with low glycemic index will help us to feel satisfied for longer (read more about the glycemic index of carbohydrates here)… Well, that’s a role that proteins also play in our diets and is a good reason that it’s important to include both low-GI carbohydrates and a serve of protein foods (as well as a great variety of vegetables) in our main meals.

At this point it would be a good thing to have a quick review of one of my previous Diabetes Counselling Online blogs, ‘Energy In/Energy Out – understanding how much you need and where you get it’ which reminds us that “energy is obtained by oxidation of fuels which include carbohydrates, fats, proteins and alcohol”.

In terms of micronutrients in protein foods, the guidelines tell us: “This food group provides a wide variety of other nutrients such as: iodine, iron, zinc, vitamins, especially B12, and essential fatty acids.

“Lean red meats are a particularly good source of iron, zinc and B12 and are easily absorbed. Iron is especially important during infancy and for adolescent girls, pregnant women, menstruating women and endurance athletes.

“The iron and zinc in animal foods is more easily absorbed by the body than in plant foods such as nuts, seeds and legumes/beans. However, the vitamin C found in fruit and vegetables will help the absorption of iron from these non-animal foods.

“Legumes provide many of the same nutrients as lean meats, poultry, fish and eggs and because of this they have been placed in this food group as well as the vegetable food group. They are essential in vegetarian and vegan eating patterns to get enough of the key nutrients found in this food group.”

Health Benefits of Protein foods

Again this is best explained by the guidelines: “Lean red meat provides a very good source of nutrients, however consumption of greater than 100/120g per day of red meat, which is more than double the recommended amount, is associated with an increased risk of colorectal cancer and renal cancer. So remember to also eat other foods from this food group. Non meat options such as legumes provide many of the same nutrients as meats, poultry, fish and eggs. In fact, nuts and seeds may help reduce the risk of heart disease and are not associated with weight gain if total energy intake (kilojoules) is controlled.

“There are also many benefits in eating fish. Consumption of fish more than once a week is associated with a reduced risk of developing dementia in older adults. Consuming fish at least twice a week has even further benefits with reduced risk of cardiovascular disease, stroke, and age-related macular degeneration in the eyes. Aim for about 2 serves of fish a week, preferable oily fish.”

How much should we eat?

The guidelines clearly explain how much is in a serve, and how many serves we need (adult serves are shown in the image above).

65g cooked lean red meats such as beef, lamb, veal, pork, goat or kangaroo (about 90-100g raw)
80g cooked lean poultry such as chicken or turkey (100g raw)
100g cooked fish fillet (about 115g raw) or one small can of fish
2 large (120g) eggs
1 cup (150g) cooked or canned legumes/beans such as lentils, chick peas or split peas (preferably with no added salt)
170g tofu
30g nuts, seeds, peanut or almond butter or tahini or other nut or seed paste (no added salt)*

*Only to be used occasionally as a substitute for other foods in the group (note: this amount for nuts and seeds gives approximately the same amount of energy as the other foods in this group but will provide less protein, iron or zinc).

The guidelines continue: “To ensure adequate iron and zinc, about half the serves from this food group should be lean meat (for example beef, veal, lamb, pork, kangaroo). For those who do not eat animal foods, nuts, seeds, legumes (including tofu) can provide some iron and zinc, plus a good mix of plant-based protein. Non meat diets that include milk products, eggs, nuts/seeds and legumes can provide all the essential nutrients required for health. Vitamin B12 is only found in animal products and a supplement may be desirable if eating a non-animal diet.

“Beware that smoked, salted and preserved foods from this food group, such as ham, bacon and salami, are usually higher in saturated fat, salt, and contain chemical properties that may be responsible for increased health risks. Because of this, most of these food choices are placed in the discretionary food group, and consumption of these foods should be limited.” Especially for us with diabetes!!

I tell my clients that a good guideline for balanced eating is to include one protein serve with each main meal with their several serves of low GI carb to help ensure that you don’t get hungry before your next meal or snack. As we can add 2.5 serves of ‘discretionary’ choices to our daily food intake, the protein section is a good area to add one or two extra serves from, as from a diabetes point of view protein doesn’t have much effect on our blood glucose levels and will save us from getting hungry and potentially damaging our wellbeing plan. Remember to beware of the processed ones!

Including them across your day can be as simple as:

Nuts on your cereal, eggs or baked beans on toast – work well at breakfast time.

Legumes such as 4 bean mix or others in salads, soups or casseroles, tinned fish, cheese, eggs or cold meats in sandwiches or salads – work well at lunch time.

Beef, chicken, fish or vegetarian alternatives work well for our evening meal served with low-GI carbs and a variety of vegetables. Our featured image today is a Salad Nicoise which includes 2 types of protein – eggs and salmon – with the wonderful salad greens.

You may even work your day differently, but hopefully you get the idea about including your serves evenly spread across the day to help you stick with your healthy eating plan.

Do we need extra protein if we’re exercising?

This is a question I’m often asked as a dietitian, and often clients come to me for weight management who are doing lots of great exercise and wonder why they’re not losing weight. Turns out more often than not they’ve been advised by someone who isn’t trained as a dietitian that they ‘need’ protein powder in addition to their usual diet to help them build muscle. This just simply isn’t true if you’re meeting your daily protein requirements with quality protein foods, and choosing protein as your discretionary ‘extras’ if you feel you need a bit more.

If however, you’re trying to gain weight and you have diabetes, quality lean proteins can be an excellent way to help you achieve this. More and more evidence is coming to light that indicates we don’t need to minimise protein intake due to diabetes. Please take note though, if you have medical issues such as kidney disorders, you should seek medical advice first.

Phew! That *was* a huge topic! As usual please let me know if you have any questions, or feel that there points that weren’t covered in enough detail. As mentioned at the top, we may revisit this topic down the track. Just a reminder that if you’d like personalised advice from our e-dietitians, just register here.

Wishing you happy and healthy eating, Sally

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

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A smooth(ie) way to ensure nutrient sufficiency over Christmas

December 23, 2013 by Sally 4 Comments

As suggested by a member of the Diabetes Counselling Online Diabetes Weight Matters closed Facebook group, today’s blog is on the topic of ‘smoothies’. It’s very timely as this being the week before Christmas (only 2 days to go!!) as so many of us are short on time.

Smoothies are a great topic to chat about because they can involve ingredients from all the major food groups, they’re convenient and easy to make, as well as being both nutritious and delicious. In today’s blog I’ll cover how they can help you meet your dietary guidelines in certain food groups as well as providing a few recipe ideas to get you started if you like the idea.

When we look at the Australian Dietary Guidelines (for Adults) which are designed to show us how to eat best for health and wellbeing, some people find it tricky to include all the serves from all of the five food groups:

Vegetables and legumes/beans – 5-6 serves per day
Fruit – 2 serves per day
Grain (cereal) foods, mostly wholegrain and/or high cereal varieties – 3-6 serves per day
Proteins – lean meat and poultry, fish, eggs, tofu, nuts and seeds, and legumes/bean – 2-3 serves per day
Dairy (Milk, yogurt, cheese) and/or alternatives, mostly reduced fat – 2.5-4 serves per day

I should point out here in the beginning that it’s also important not to exceed those recommendations, especially if you’re watching your weight, so understanding your energy needs is important. Don’t fall into the trap of thinking that just because something is healthy you can eat as much of it as you like! We need to balance our energy intake with our nutritional requirements for good health. The National Medical Health and Research Council (NHMRC) reminds us: “Energy is not a nutrient but is required in the body for metabolic processes, physiological functions, muscular activity, heat production, growth and synthesis of new tissues”.

So, unless you’re an athlete who needs to gain muscle density or are generally malnourished, I do not recommend adding protein powers and the like to your smoothies. Just use fresh ingredients and you’ll have everything you need. You can read more about our energy requirements in the blog I wrote last week: ‘Energy In/Energy Out – understanding how much you need and where you get it’ and more about the benefits of low-GI foods here which are also a great selling point for smoothies, especially those made on dairy or soy milk alternatives.

Convenience

In terms of convenience, all you need for a smoothie is quality ingredients and a blender of some sort. I use a stick blender to save on washing up, but any kind will do. They take only between 5-10 minutes to make, so are perfect for people in a rush trying to get the nutrients and energy they need. Perfect too for those who say they can’t do breakfast as there’s not enough time, and they can be consumed on the run (although I wouldn’t recommend that if you can avoid it). They can replace a meal if you’re in a hurry, and are perfect as a snack too.

Meeting your nutrient needs

Many people find the areas that are hardest to include are the vegetables, fruit and dairy and smoothies are perfect to boost those areas. Proteins can also be included in the form of nuts and seeds which are highly nutritious, but watch those portion sizes as they’re also high in energy. (I wouldn’t advise using raw eggs due to related health safety concerns.) Including grains such as oats and quinoa flakes are another good option.

Low fat milk based smoothies (1 cup = 1 dairy serve) made with fresh fruit and berries can create a delicious snack that provides a serve from two groups, and if you use berries you can even minimise the carb serves to about one serve. If you choose frozen fruit, your smoothie becomes a frozen smoothie – so great for afternoon tea on a hot day.

Many people use vegetables such as spinach, kale, tomato and others to boost their vegetable intake, which is actually a very sensible idea if you’re struggling with so many serves and you understand the fabulous health benefits that come from including a variety of plant-based foods, remembering there are over 3000 different plant (phyto) nutrients!!

One member of the Diabetes Weight Matters group posted that she had just started green smoothies: kale & spinach, berries and a small OJ. She had chosen the juice as it mixed better with the vegetables than dairy would do, but she wanted it to be low GI and not to high in carbs. The way to go here is to include a whole piece of fruit such as an orange or an apple so you get the benefit of the fruit fibre, and then top up with water if you need more liquid.

Helen Edwards, our founder at Diabetes Counselling Online wrote a blog recently on a “pick me up, guilt free, chocolate, banana, blueberry, walnut smoothie”! This one covers dairy, fruit, and protein food groups. Here she is enjoying every sip!

Recipe ideas

My favourite online recipe sites are those that include nutrient values with their recipes, so we can keep track of both our carbohydrate numbers and our overall energy intake numbers.

My first call is always the Australian Healthy Food Guide because all their recipes are dietitian approved. Here I found The Breakfast Super Smoothie – loving their tip to turn breakfast into a lunch-time treat: pour smoothie into a drink bottle, freeze overnight and pack it into your child’s lunch box. It’s a little high in carbs for those aiming for 2-3 serves at breakfast, but you could just make a smaller serving or cut some of the juice, oats or the honey out of it.

Australia’s Taste.com.au is another great site for recipes that offers the nutrient values too. They had loads of smoothie recipes, so I chose a veggie-based one to share with you – great to use when you feel that you haven’t had enough of your vegetable serves. Doesn’t this sound yummy?? – Carrot, beetroot, apple and celery juice. And only 34g of carbohydrates

There are masses of smoothie recipes around, so try a few out and see how you go. We’d love you to share the ones you enjoy with us here on our Diabetes Weight Matters or Diabetes & Food – let’s celebrate it! Facebook groups, and I’ll be back next Monday with a summary of my dietitian blog posts over the 2013.

Wishing you all a wonderful, safe and happy festive season!

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Label reading made easy for healthy choices

September 16, 2013 by Sally Leave a Comment

Eating well involves following the Australian Guide to Healthy Eating by consuming foods from the 5 food groups in the right amounts (averages for adults provided) and to drink plenty of water:

Plenty of vegetables of different types and colours, and legumes/beans – the more the merrier!
Fruit – aiming for 2 pieces per day
Grain (cereal ) foods, mostly wholegrain and/or high cereal fibre varieties, such as breads, cereals, rice, pasta, noodles, polenta couscous, oats, quinoa and barley – 4-6 serves per day
Lean meats and poultry, fish eggs tofu, nuts and seeds, and legumes/beans – 1-3 serves per day
Milk, yogurt, cheese and/or their alternatives, mostly reduced fat – 2.5-4 serves per day

Avoiding processed foods is helpful in achieving a healthy diet, but practically, it is not always possible.

To avoid being ‘sucked in’ by the marketing words that companies use on their packages to encourage you to choose them, if you learn a couple of easy steps you can know that your decisions and comparisons are based on solid fact.

For us with diabetes, the key points we need to watch (additional to carbohydrate) are fat, saturated fat, sodium and fibre. Then we should also consider if the product has a low glycemic index as that will help to determine how the included carbohydrate will affect our blood glucose levels.

To keep it simple we can break label reading down to two easy steps.

Step One is to look at the ingredients list on the product.

Ingredients are always listed in order of amount included in the product. This means that if you read the first three to four ingredients and they don’t list saturated fat, sugar (or other high-GI starches) and sodium (salt) then already you know that the product is likely to be suitable for diabetes health.

Step Two involves looking at the Nutrition Information Panel.

To make all products equal we choose to look at the ‘per 100g’ column. If you tried to compare using the per serve column you’ll soon notice that not all serving sizes are the same.

By using the ‘per 100g’ column it allows us to look at the macronutrients (fat, saturated fat, protein and carbohydrate) as percentage figures (so we know the source of the calories/kilojoules in the food is coming from) as well as allowing an even comparison against all products which makes memorising the numbers we’re looking for significantly easier.

Next we aim to be as close to these guidelines as possible for:

Total Fat at less than 10g/100g (except for margarine, nuts & seeds and avocado)
Saturated Fat at less than 2g/100g
Sodium to be less than 125mg/100g (up to 400mg/100g in some products such as stocks, breads, savoury crackers and sauces)
Fibre to be greater than 7.5g/100g (except for products that don’t contain fibre, like dairy)

Baker IDI Diabetes and Heart Institute produce a helpful resource for label reading that basically follows this guideline with pictures if you want further information.

When it comes to carbohydrates, that’s where we’re interested in the serving size remembering that 15g of total carbohydrate = one serve. Serving sizes will differ on different brands and similar products, so always check so you don’t assume incorrectly when allowing diabetes medication for these carbohydrate foods.

Please let me know if you have any questions.

Sally Marchini

Sally is the Social Media Dietitian with Diabetes Counselling Online, owner of her own business and type 1 diabetic for over 30 years

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