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Top Ten Tips for healthy d-eating on a budget

May 26, 2014 by Sally 2 Comments

I’ve had a few requests for some ideas about how to eat healthy on a budget, especially with the costs of living with diabetes becoming ever higher. I’ve done some looking around and there’s loads of help out there.

Today’s blog is based around a handout I provide to my clients, but rather than focussing on all the points on that handout I thought it would be most useful if I chose my top ten favourite tips and provide helpful ideas and explanations for them, and give you links to other places you can look for more if you’d like to.

Before starting it’s important to remember that we need to follow the Australian Dietary Guidelines to ensure we include all the nutrients we need for overall wellness. Each meal should be balanced and include low-GI carbs, lean proteins and generous serves of non-starchy vegetables. Snacks should be based around fruit, nuts and dairy produce.

You may remember that I posted a blog on meal planning a few months ago and this is an awesome way to start on your money saving adventure by planning your meals and snacks and sticking to your plan. And if you’re of the opinion that fresh foods are more expensive than processed ones, think again. Take a look at this resource prepared by the Dietitians Association of Australia on The Real Cost of Healthy Food.

Sally Top Ten Tips

1) Shop to a list and focus on the five food groups

If you have a thoughtful list and don’t buy anything that isn’t on that list, you’ll make a huge dent in your usual food spending.

The Australian Dietary Guidelines further explains: “Spend most of your money on the Five Food Groups. Think hard about why you are buying discretionary foods and how much you really need to buy. This is especially important if you are trying to lose weight, because if you don’t buy it and take it home, it’s much easier to stick to your goals. If you would really like to have a high kilojoule food, buy the smallest amount that will satisfy you, the best quality you can afford and eat it slowly, savouring it with all your senses.”

Using the supermarket brochures as a guide to help you build your list and planning to purchase the products on special. Ensure you buy the five food groups foods before putting any treats in your shopping basket.

2) Carry a calculator

If you’ve prepared your shopping list and you know what your budget for your shopping is, then adding it up on a calculator as you go will help you to stay on track. Keep track of the amounts on the side of the list. Only shop for any extras after you’ve reached the end of the necessary items and know that you have budget left over for them.

3) Choose water as your drink of choice

Only deviate from water by choosing milk as an alternative to make up your required dairy serves through the day. Read here for more info on the importance of dairy and how you can include more in your day. If cost is an issue here, choose to buy home brand skim milk powder and make your own as needed – certainly use the powder for cooking. Same goes for yogurt which is a pricey item – yogurt makers are a very cost effective way of including yogurt in your diet.

4) Buy what’s in season and what’s on special.

You can check which vegetables are in season each month on the General Australian Seasonal Produce Guide. Check the supermarket specials listing either online or via the home delivered paper leaflets while you’re making your shopping list.

5) Buy and use the frozen, tinned or dried home brand products

Dried products such as lentils, soup mix, other legumes and rolled oats are all awesome sources of low-GI carbohydrate and fibre to help with our glycemic control, and they’re so much cheaper than the tinned, or fancy alternatives. When the budget’s tight for meat products, you can use the legumes to reduce the amount of meat you need in a meal or even happily enjoy a vegetarian version. Here are some awesome recipe ideas to help with this idea.

And if you’ve exhausted the fresh fruits and vegetables in season, the frozen and some tinned varieties can be a great buy and help to avoid wastage. I always keep frozen peas, corn, spinach and berries at home, so we’re not caught short with no ‘fresh’ vegetables. The frozen and tinned ones are just as nutritious. You can’t go past tinned tomatoes to make so many meals much tastier!

6) Familiarise yourself with your local supermarket

Keep a note of when they discount items for quick sale and arrange your visits on those days, remembering to only shop to your list.

7) Watch for significant specials on bulk items

Products that won’t spoil such as tins of tomatoes, tuna/salmon and baked beans, blocks of cheese that can be hand grated then frozen for ease of use, dried items such as basmati rice and pasta, and skim milk powder can save you lots if you keep your eyes open and check the supermarket brochures that are delivered to your home.

8) Don’t shop when you’re hungry

You know you will buy much more sensibly if you shop after lunch or after a good breakfast, or even after dinner as you won’t be guided by your hunger.

9) Look out for healthy eating on a budget recipes

There are lots of these around. Most of them use products that you should have in your pantry or that are in season. Taste has an excellent healthy budget recipes collection, as does Kidspot.com.au and there are many other sites that you will find if you Google ‘budget recipes healthy’ or similar.

10) Make the most of your leftovers

If you can buy a whole chicken or a whole roasting piece of meat it’s likely to be much cheaper per 100g, and will mean that you’ll have lots left-over to make extra meals for lunch, dinner and even breakfast.

The BBC Good Food website has some great leftover recipe ideas, as does Taste.com.au and many others – just keep an eye out for the lower saturated fats, lower glycemic index carbohydrates and lower sodium recipes wherever you can.

There are loads of ideas out there to help you. Some other really helpful links are:

The Australian Dietary Guidelines Healthy Eating on Budget page
The Dietitians Association of Australia Healthy Eating on a Budget page
The Australian Healthy Food Guide has articles on Smart Swaps and How to cut your bill in half and still eat healthily that may be helpful.
Choice Healthy Eating on a Budget
The Healthy Kids Healthy Eating on Budget

Remember that we’re eating for wellness so spend a little extra time to be prepared with delicious and healthy food ready when you need it, to help you avoid spending more and buying rubbish that you’ll only regret later.

If you have tips to share on eating healthily on a tight budget we’d love to hear them so please add them to the comments below.

Bon Appetite! 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.

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Nuts and D-health

April 28, 2014 by Sally Leave a Comment

Nuts are a fascinating food, and for us with diabetes they tick so many of our healthy eating boxes – fibre, nutrients, good fats, satiety and more! Today we’ll take a closer look at the reasons behind all those good stories with a focus on our D-health (remembering to choose unsalted ones). It’s important to remember with blogs like this that focus on one food type, that foods should be incorporated into a healthy varied diet. I like these words of David L. Katz to illustrate this point: “Eat a diet of wholesome foods reliably associated with good health across a vast and stunningly consistent literature.”

First up I’d like to introduce the photo at the top of this blog, as it is the new logo for the ‘Nuts for Life’ campaign and we’re fortunate to show it here as they launch their new campaign to help educate Australians on the health benefits of regular tree nut consumption #healthyhandful.

Last week I was chatting with Nuts for Life Accredited Practising Dietitian, Lisa Yates, who suggested the key messages for us with diabetes are:

People with diabetes can and should eat nuts (unless you’re allergic of course!)
Nuts are a healthy snack that will help control BGLs as they have a GI lowering effect when eaten with carbs due to their healthy fat content
Cashews and chestnuts are the only nuts that contain enough carbs to be GI tested (needs a minimum 10g carbs per serve) and they have a low GI. Cashews average GI 25 and chestnut meal has been GI tested and was 54. Since GI is related to particle size it makes sense that whole chestnuts not grounded will also be low GI
Nuts also help with improving insulin sensitivity
People with diabetes have an increased risk of heart disease and eating a daily handful of nuts will help reduce the risk of heart disease while managing weight and cholesterol
People who are overweight can eat nuts they will not cause weight gain and if eaten in a calorie controlled diet will help with weight loss. This is because we don’t absorb all the fat in nuts about 20% is excreted as trapped in the fibrous structure of chewed nuts. Nuts eaters have more fat in their stools than non nut eaters. Nuts also contain fibre, protein and fat which all work on various aspects of appetite control. 30g per day is the recommended daily amount = #healthyhandful

I’ll look closer at some of these claims and the evidence behind them, as well as explaining how nuts fit within the Australian Dietary Guidelines (hereafter called ‘the guidelines’) and provide you with some recipe ideas to help include nuts on a daily basis.

According to the guidelines nuts fit into the protein foods section and 30g (a healthy handful) is one serve. If you’d like to read more about Protein and diabetes you can check out a previous blog here.

In terms of definition of a nut the guidelines offers this one: “A nut is a simple dry fruit with one or two seeds in which the ovary wall becomes very hard (stony or woody) at maturity, and where the seed remains attached or fused with the ovary wall. Most nuts are indehiscent (not opening at maturity). Any large, oily kernel found within a shell and used in food may be regarded as a nut. Examples include almonds, pecans, walnuts, brazil nuts, cashew nuts, chestnuts, hazelnuts, macadamia nuts, pine nuts and pistachio nuts. The term ‘nut’ is applied to many seeds that are not botanically true nuts. These may include cape seed, caraway, chia, flaxseed, linseed, passionfruit, poppy seed, pepita or pumpkin seed, sesame seed and sunflower seed.” Lots of choices here then!

The guidelines tell us: “There is evidence to suggest that consuming nuts (65–110g per day) is not related to risk of weight gain in the short term”, and that “consumption of nuts and seeds may help reduce the risk of heart disease and is not associated with weight gain if total energy (kilojoule) intake is controlled.”

It goes on to explain a key point that I was keen to make in this blog, that: “Nuts and seeds are rich in energy (kilojoules) and nutrients, reflective of their biological role in nourishing plant embryos to develop into plants. In addition to protein and dietary fibre, they contain significant levels of unsaturated fatty acids and are rich in polyphenols, phytosterols and micronutrients including folate, several valuable forms of vitamin E, selenium, magnesium and other minerals. They are nutritious alternatives to meat, fish and eggs, and play an important role in plant-based, vegetarian and vegan meals and diets.” There’s an awesome ready reckoner for nuts available from Nuts for Life that lists all the different nuts and the levels of nutrients each of them contains per 100g. It’s one of my favourite resources that I give to clients to help them understand more about the food they’re eating.

Further on the topic of helping with cholesterol, the guidelines say, “Nut consumption provides benefits by enhancing anti-inflammatory processes and lowering serum cholesterol possibly due to the presence of phytosterols, which reduce cholesterol re-absorption and/or the effects of shifting dietary fat quality, notably replacing saturated with unsaturated fat. Nut consumption is also associated with increased levels of adiponectin, which has anti-inflammatory and anti-atherogenic properties. Early work suggests that the delivery of components such as tocopherols and phenolic acids may help to reduce lipid peroxidation and oxidative DNA damage, and there is some indication that walnuts with a relatively high content of the amino acid L-arginine may have an effect on vasodilation through nitrous oxide pathways. Other nuts are also significant sources of arginine. Proposed mechanisms for effects on weight control include increased satiety, increased faecal fat excretion, increased thermogenesis and increased fat oxidation.” Pretty impressive facts to encourage nut consumption I’d say!

The guidelines advice for pregnant women and young children

It’s also important to note that “Nuts are a problem for small children as their size and consistency increases the risk of inhalation and choking. For this reason, they should not be given to children aged less than 3 years.” And that, “Pregnant and breastfeeding women do not need to avoid consuming nuts for fear of causing an allergic reaction in their babies. Only women who are allergic to these foods themselves need to avoid them.”

On the topic of improving insulin sensitivity, it’s a little complicated to explain in depth at this point other than to say it’s related to evidence about increased amounts of the anti-inflammatory mono-unsaturated fats in nuts that reduce inflammatory processes in the body, thereby allowing improved insulin sensitivity combined with lowering the GI of other carbs and increased satiety leading to weight loss. I have lots of research papers on the topic if you’d like to learn more – perhaps improving insulin sensitivity could be the topic of a whole blog one day? Please let me know if you’re interested and I’ll add it to my list!

Specifically related to Lisa Yates’ points about how they related to us with diabetes, Nuts for Life offers a free downloadable fact sheet entitled, ‘Nuts and Diabetes’ where you can read more at your leisure. They also have many other fact sheets and resources, as well as some delicious recipes. It’s definitely a site worth bookmarking as Lisa advised me this week that there are some great additions to it on their way in the near future.

Other good nut recipes sites include the Australian Healthy Food Guide and Taste.com.au but please remember that not all the recipes will be suitable for us with diabetes, so choose carefully.

There’s a FAQ page on the Nutrition Australia site that you may also like to view that includes some other interesting points that I haven’t gone into here.

Remember that it’s a good idea to check with your Accredited Practising Dietitian before making changes to your diet and to learn what the right amount of nuts for you personally is, and it’s good to go armed with some factual information. You can find an APD near you via the Dietitian’s Association of Australia website, or you can book in for an e-consult with our e-dietitian via our Diabetes Counselling Online website.

Wishing you improved D-health! Please let me know if you have any questions as usual, and I would love to hear how you include nuts in your day! Sally

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After the #party’s over: #guilt #regret #acceptance

April 18, 2014 by helwild Leave a Comment

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So, the Moveable Feast of Eostre, the goddess of spring fertility, is upon us once again. It’s Easter. We have a full moon, rabbits & chickens, chocolate & sweet fruit buns with a cross baked into the top. For some religions, there are other, more sombre & deeply significant symbols associated with this part of our annual calendar. For most of us, there are 4 days off work, at a time of year when the moon is full, when the day & the night are almost of equal length, with the equinox falling just under 4 weeks before Eostre in 2014, on March 20th. The weather is generally pretty ‘liveable’, whatever hemisphere of this bounteous Earth we are living in.

The stage is set for a time of rest & relaxation, of time with family & friends, of contemplation, & of feasting. In our Northern hemisphere heritage & tradition, even though we are now living in the Southern hemisphere, the annual cycle away from the darkness & deprivation of winter means it’s time to make special purchases of foods that we normally reserve for special occasions: weddings, parties, birthdays, anniversaries. Some observe religious abstinence of some food for part of this time; but all spend at least part of this time feasting.

For about 38 years, our Easter has involved spending time with our extended family. In the early days, these Easter gatherings were held at our house in a small inland country town. We actually sent out invitations, & at first our brothers & sisters & our own parents came, bringing children, the occasional great grandparent, & the occasional dog. We needed caravans & tents for everyone to be able to sleep under cover, & occasionally the bathroom & septic tank struggled to cope. Luckily we were only a short walk from the Public utilities. The cousins bonded for life.

Later, once we acquired our scruffy little fibro beach shack, all the growing cousins brought friends; girlfriends, boyfriends. Meals were mostly eaten outside, huddled away from the sea breezes in a cold year, or gloriously somnolent in sunshine in a warm year. That’s the thing about Easter: it’s a Moveable Feast, so the weather can be like the end of summer; or it can be like the beginning of winter; or even both. We still needed a caravan or a tent some years, but bunks, sofa beds, mattresses on the floor, two showers & an outdoor hose, & two toilets helped a great deal. The septic tank needed regular emptying.

I remember a lot of laughter from those years. For most of those 38 years we were at the beach shack, & our time was taken up with sandcastles, swimming, searching rock pools for little crabs, midnight Jetty fishing excursions, sailing, rowing in a kayak or canoe. Food was abundant of course, as were leftovers. We played cards with gum nuts for stakes, Coon can, Pontoon, snap.

Nowadays our eldest daughter brings her family & we spend about 5 days at the shack. This year, because of the school holidays & other plans our family holiday ended on Good Friday. Traffic on the road to Adelaide was building up, & so they left before lunch today.

Our party this year included a full eclipse of the Moon, two red moons in a row, sunsets & dawns that were peacefully beautiful. Oh & the beginnings of a mouse plague. We swam in the sea, laughed, played games, built sandcastles & lego cities. We spotted our resident gecko, still skittering about inside the shack. We put down mouse bait, & threw out one little corpse. We enjoyed the fun of a 5 year old who wakes bursting with energy at 6.30 a.m. & wants to play baby pelicans (learning to fly & land) baby galahs, or baby seagulls. We enjoyed the seriousness of a tall 15 year old, who wants to share his thoughts & opinions about a myriad of topics. Both children are bursting with the joy of life.

Sure, we did enjoy some great, simple, homecooked meals. We didn’t buy takeaway. We didn’t eat chocolate. We didn’t have any chocolate with us. There are 3 people with diabetes in our party, & we aren’t that fussed about chocolate anymore. After the party’s over, what happens? There are the mechanics to be gone through: cleaning up, working out what to do with leftovers, perhaps extra sheets & towels to wash, if you’ve had house guests as we’ve had. But there is no time to waste on regret, guilt, or ‘shouldn’t haves’. The motto of ‘Acceptance‘, ‘going with the flow’, is the mantra that my daughter repeated many times over the past 5 days. ‘Don’t sweat the small stuff’ in life, whether it’s about food, children’s behaviour, TV programmes, the timing of how a day runs on holiday. It’s OK to change your mind, & also to accept that in many cases whatever decision you make is just fine. Managing diabetes is organised, stressful. Reducing stress can be as simple as letting go of the ‘need’ to be the one who manages, who seeks to ensure that everything is covered. It’s actually OK for things on holiday to not be tightly planned & organised.

Technically,our party is over for this year. Last night I was woken from sleep at 1 a.m. by the sound of young girls laughing out the front. Now I hear the sound of other people’s holiday long weekend just starting. People have arrived, having made a long drive from somewhere. My elderly neighbour on one side is from the Adelaide Hills, & he is having a Prawn feast with his extended family, including a new great grandchild. His elderly red dog is resting outside in the shade. On the other side, the young family of the second son is cooking up a Sausage sizzle. Their dog is a middleaged lab, all protective when he needs to be, & all tail waggingly friendly when he doesn’t. Everywhere I hear children playing, birds calling, wind, the sound of the sea on the shore. Out the front, two little boys aged about 9 are walking past, wearing shorts & fleecy jackets.

We have decided to stay on a little. I have been very unwell, & am still moving more slowly than usual.There is a lot to do. We have no need to rush back to the city, where our daily lives are. And it’s still so beautiful here. Our original plan was to head back today, but slowly our plan evolved into a different one. Acceptance includes being flexible, open to what life brings.

happiness comes from letting go of guilt

carpe diem

Helen

Helen Wilde is a Senior Counsellor with Diabetes Counselling Online. She has been the parent of a person with diabetes since 1979, and has lived with Type 2 diabetes herself since 2001.

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Wonderful wholegrains help with d-management and much more

March 17, 2014 by Sally 1 Comment

So often I refer to the Australian Dietary Guidelines, and today’s blog is no exception as I thought that Grains would be a great topic to explore as they’re so helpful for our diabetes management, weight management, avoidance of cardiovascular disease and to help us maximise nutritional requirements!

I’ll first look at why grains are important and what nutrients they include, then look at some of the variety of grains that are available to us, how many we need in our daily food intake and some new ways and recipes to include them. I think it’s interesting to know that this group is one that the guidelines are often not met, so hopefully this blog will make a difference for you.

As I hope you know by now, there are 5 different food groups listed in the Australian Dietary Guidelines (I’ll call them ‘the guidelines’ from now on). One of the key points under Guideline 2 (Enjoy a wide variety of nutritious foods every day) is to “enjoy grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties”, and for good reasons too!

The evidence for their inclusion in the guidelines gets a ‘Wow!’ from me with the guidelines telling us that:

• Cardiovascular disease: There is evidence of a probable association between the consumption of grain (cereal) foods (especially wholegrains and those with fibre from oats or barley) and a reduced risk of cardiovascular disease in adults (Grade B; Evidence Report, Section 6.3). Almost all the high level trials were conducted with oats, with the evidence of beneficial lowering of levels of LDL and total cholesterol levels. The protective effect was noted with between one to three serves per day of wholegrain foods (predominantly oats).

• Type 2 diabetes: There is evidence of a probable association between the consumption of grain (cereal) foods (especially wholegrains) and reduced risk of type 2 diabetes (Grade B; Evidence Report, Section 6.7). The evidence supports three serves per day of wholegrain foods conferring between 21% and 42% reduction in risk of type 2 diabetes.

• Excess weight: There is evidence of a probable association between consumption of three to five serves per day of grain (cereal) foods (mainly wholegrain) and reduced risk of weight gain (Grade B; Evidence Report, Section 6.6).

• Colorectal cancer: There is recent evidence suggesting that consumption of one to three serves of cereals high in dietary fibre per day is associated with reduced risk of colorectal cancer in adults (Grade C; Evidence Report, Section 6.2). Although previously the WCRF report noted a probable relationship, it recently reviewed the evidence and found it convincing that fibre-rich foods offer protection against colorectal cancer (see Appendix F). This is also supported by a recent systematic review and dose response meta-analysis of prospective studies showing that three serves of wholegrain and high fibre cereals per day reduced the risk of colorectal cancer.

• Other cancers: Recent evidence is inconclusive for an association regarding the consumption of grain (cereal) foods and risk of other cancers in adults (Evidence Report, Section 6.1).”

This section of the guidelines finishes up by reminding us of a very important reason for us to focus on whole grains rather than processed grains: “Because wholegrains contain more nutrients and phytochemicals, concentrated in the bran and germ, they are likely to have greater effects than refined grains (cereals). Wholegrains contain phenolic compounds with strong anti-oxidant capacity that may be protective against processes involved in the pathology of type 2 diabetes, cardiovascular disease and cancer. Choosing wholegrain options may also assist with satiety and help in not over consuming food beyond energy (kilojoule) requirements.”

What’s in grains?

When you think grains, you might think ‘carb source’ or ‘low GI’ or ‘high fibre’ and you’d be right on all counts! The guidelines advise us that they also contain “protein, B group vitamins, vitamin E, iron, zinc, magnesium and phosphorus. Other protective components are fermentable carbohydrates, oligosaccharides, flavonoids, phenolics, phytoestrogens, lignans, protease inhibitors, saponins and selenium.” Another “Wow!” from me

Types of grains

The National Grains & Legumes Council has a very helpful website which goes into all kinds of detail on the topic of grains (and legumes too).

I like this listing of the types of grains that The National Grains & Legumes Council website provides:

“There are a number of different types of grains found within the Poaceae family from ‘true’ cereal grains e.g wheat, oats, rice, corn (maize), barley, sorghum, rye, millet, to the ‘pseudo-cereal’ group e.g. amaranth, buckwheat and quinoa (pronounced ‘keen-wah’). The ‘pseudo-cereal’ group are not part of the Poaceae botanical family, in which ‘true’ grains belong, however they are nutritionally similar and used in similar ways to ‘true’ grains.” The links will take you to further nutrient and historical information about the grains as listed.

For those of us with coeliac disease (unable to eat grains containing the protein gluten), as well as it still being Coeliac Awareness Week (13-20 March), you’ll notice that many grains are gluten-free – corn, rice, sorghum, millet, amaranth, buckwheat and quinoa. Remember to NOT start a gluten free diet unless you’re tested first for coeliac disease, but there’s no reason not to include these gluten free grains in a healthy balanced diet as they’re full of great health benefits (as all wholegrains are).

How much should we have?

If this is too small to read, click on it and it will enlarge

How do we include them?

The National Grains & Legumes Council website offers recipes for both savoury and sweet ways to include more grains in our diets.

My other favourite ‘go to’ recipe websites include the Australian Healthy Food Guide (which also offers more great tips and advice on grains) and Taste.com.au that has a great selection of whole grain recipes.

So the main points to remember for us with diabetes is that we should aim for Whole Grains, rather than processed grains, and remember to ‘count the carbohydrates’ in the grains that we consume while aiming for the recommended number of serves each day. If you’re not sure what carbs are in the different types, use Calorie King to find out.

Click on the image if you need it to be larger

How do you ensure your intake of whole grains across your day?? If you’re not sure and would like to arrange a one-on-one e-consult with our e-dietitian (a free service for all Australians), just pop over and register here, or you can ask your questions and share your ideas below

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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Diabetes and healthy weight with a twist

February 17, 2014 by Sally 2 Comments

Hi Peeps with D!

This week I thought it would be good timing to discuss the First of the Five guidelines in the Australian Dietary Guidelines and what having a healthy weight means to us with diabetes.

The twist is that this Monday (today!) marks the start of Australia’s Healthy Weight Week (AHWW) we’ll take a closer look at what the Dietitians Association of Australia has planned for our population to help them achieve a healthy weight, what the Australian Dietary Guidelines say about it and most importantly, why a healthy weight is especially important to work towards when you have diabetes (all types included) as we do.

When you’re at your peak Wellness-wise, chances are you’ll be at the right weight for you too. And of course understanding Food and how it helps you towards wellness, combined with physical activity, makes a big difference. It can be quite a steep learning curve and is one of the reasons that I can find something to write about in my blog each week for us with D as the social media dietitian for Diabetes Counselling Online.

Guideline One reads:

“To achieve and maintain a healthy weight, be physically active and choose amounts of nutritious foods and drinks to meet your energy needs.

• Children and adolescents should eat sufficient nutritious foods to grow and develop normally. They should be physically active every day and their growth should be checked regularly.

• Older people should eat nutritious foods and keep physically active to help maintain muscle strength and a healthy weight.”

There is extremely good evidence to support that First guideline. The Australian Dietary Guidelines document explains this well: “Overweight and obesity are associated with increased risk of type 2 diabetes, cardiovascular disease, hypertension, metabolic syndrome, some cancers, musculoskeletal conditions, respiratory conditions, sleep apnoea, gall bladder disease, hernia, reproductive disorders, urinary incontinence, fatty liver disease, and depression and other mental health disorders. About 70% of people who are obese have at least one established comorbidity, resulting in medical costs that are about 30% greater than those of their healthy weight peers. Compared to having a BMI of 18.5–25 kg/m2, having a BMI of 30–35 kg/m2 reduces life expectancy by 2–4 years, and having a BMI of 40–45 kg/m2 reduces it by 8–10 years. The relative increase in mortality rate attributable to obesity tends to decline with age. Mortality and morbidity are also associated with the amount of weight gained in adult life.”

It goes on to remind us that “Many obesity-related conditions are preventable, and several are at least partially reversible through weight loss achieved by adopting a nutritious dietary pattern and active lifestyle.” which is why this special week has been arranged by the Dietitians Association of Australia.

Australia’s Healthy Weight Week (AHWW)

Fitting in perfectly for our look at Dietary Guideline No. 1, AHWW will be celebrated this week and runs from Monday 17^th to the 23^rd February 2014. You’ll see there are many events being arranged by Dietitians across the country this week designed to help people achieve their own healthy weight. Click here to look out for the ones near you!

The AHWW website also offers lots of tools to help you work towards your healthy weight including an e-newsletter, a guide to eating well including strategies to help keep you on track, information about physical activity, a wonderful cook book with easy to cook healthy recipes, a ‘fad-free’ meal plan and a whole lot more!

Do You Tweet?

If any of you are on Twitter, the DAA is also hosting a Tweetchat this Wednesday between 8pm and 9pm Sydney/Melbourne time on the topic of ‘Inspiring adults to participate in healthy home cooking and to choose the correct portion sizes.’ You can read more about it here, and they’ve also provided a ‘cheat-sheet’ so you can learn the basics before joining in the conversation. I’ll be there as @SallyMDietitian to represent us with Diabetes so it would be awesome if some of you came along as well.

Being a healthy weight is beneficial for our diabetes

The American Diabetes Association (2013) lists a key strategy for all people with diabetes as ‘Portion control should be recommended for weight loss and maintenance.’ The main reason for this strategy is that increased body weight can lead to increased insulin resistance and defects in insulin secretion (AIHW 2008).

The Australian Institute of Health & Welfare tells us that ‘in 2007–08, almost 520,000 people with diabetes (58%) also had cardiovascular disease, based on self-reported data from the National Health Survey (NHS)’. Being overweight dramatically increases your risk of developing a heart condition. I hope you know that we all need to look after our heart health.

Then there’s grade A (the best) evidence that is recommended by the American Diabetes Association (2013) for those with type 2 diabetes under ‘Energy Balance’ that reminds us, “Modest weight loss may provide clinical benefits (improved glycemia, blood pressure, and/or lipids) in some individuals with diabetes, especially those early in the disease process.” This relates to increased insulin resistance for those above their healthy weight range.

Sometimes it can be harder for people with diabetes to lose weight for various reasons including some of the medications prescribed, and the American Diabetes Association Nutrition Therapy Recommendations for the Management of Adults with Diabetes (2013) adds, “A number of factors may be responsible for increasing adiposity in people with diabetes, including a reduction in glycosuria and thus retention of calories otherwise lost as an effect of therapeutic intervention, changes in food intake, or changes in energy expenditure.”

And it should not be forgotten that being underweight can also lead to severe health issues relating to malnutrition, so be careful to let your health care team know if you’re losing weight unintentionally.

Of course eating well by following the Australian Dietary Guidelines and learning from the dietitian written blogs provided each Monday through Diabetes Counselling Online will help to improve our overall health knowledge which should also improve our diabetes management results.

If you have any concerns about your own wellness or weight, it may be useful to register for a personalised e-counselling session with one of our Diabetes Counselling Online dietitians – a free service provided for all Australians with diabetes, with only a small charge for those from other countries. Click here to register or find out more.

Hoping that you benefit from the suggestions made through AHWW over the next week or so, and please let me know if there are any questions or issues that you’d like further clarification on.

Wishing you all good health! 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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