According to the World Health Organisation, diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces.
Insulin is a hormone that regulates blood sugar (glycaemia). Hyperglycaemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage of many of the body’s organs (heart, blood vessels, eyes, kidneys and nerves).
The best way to prevent or delay these damages is by controlling glycaemia and maintaining a healthy weight. There are three important factors that must be followed: medication, if prescribed by a doctor (insulin or oral anti-diabetics), regular physical activity and a healthy diet.
These are the strategies for a healthy diet:
• Six to seven small meals a day, avoiding long periods without food (more than three hours between each meal). The longest fasting period is during the night and should not be longer than eight hours;
• A plate of food should be divided into three different sections: divide the plate in half. Then divide one of the halves in half once again. Fill the largest section with non-starchy vegetables (e.g. lettuce, cabbage, broccoli, cauliflower, tomatoes, onion, cucumber, mushrooms or spinach). In one of the quarters add a protein (e.g. turkey or skinless chicken, rabbit, fish, eggs or tofu). In the other quarter, add a carbohydrate (e.g. rice, pasta, potatoes, beans, chick peas, lentils, peas, whole grain breads).
The amount of carbohydrates you eat will reflect your glycaemic values after the meal, but it varies from individual to individual. It depends on various factors including how active you are and what, if any, medication you are taking. Some people are active and can eat larger quantities of carbohydrates; others have trouble eating large quantities of this type of food.
It is especially important to know the value of carbohydrates in food so that you can have a variety of meals with the same amount of carbohydrates.
• Try to start each meal with two to three portions of carbohydrates and find the balance, reducing or increasing if necessary, using the portion values;
• Lunch and dinner are extremely important meals. They will influence blood glucose levels during the night.
• Fruit and dairy products are absorbed more quickly than grain and starchy foods; another strategy to control glycaemia is to eat fruit or dairy products together with food of slow absorption (one small slice of brown bread or three cream cracker biscuits without sugar or two small melba toasts).
• Remember that you will need about three or four oranges for a fresh fruit juice; this means three to four portions of quick absorption carbohydrates. It is preferable to eat one piece of fruit instead of drinking the juice.
• Food rich in fibre slows down carbohydrate absorption. Whole-wheat bread is rich in fibres; avoid white bread. Include the following in your diet: pulses (beans, chickpeas, lentils, broad beans, peas), whole-wheat pasta and rice, sweet potatoes; the amount of fibre in these are higher than in white rice or pasta, and normal potatoes.
• Starting your meal with a vegetable soup will help you to increase the amount of fibre.
• Al dente pasta and boiled potatoes are better choices compared to over-cooked pasta or mashed potatoes. Absorption of nutrients takes place quicker when food particles are broken down such as in mashed potatoes or puréed food
• Choose low-fat and sugar-free dairy products (milk, yoghurt, cheese, curd cheese).
• Avoid sugar-rich products (ice cream, cakes, jam, honey, biscuits, sweets, sweet drinks and all products with added sugar). Leave them for special occasions in small amounts. During these occasions avoid other sources of carbohydrates and eat them together with lots of vegetables; use a natural sweetener (eg. stevia) for your coffee or tea; drink water during the day (1.5 litres a day).
• Choose low-fat cooking methods (grilling, boiling, and stewing with lots of water, oven roast with simple sauces made from vegetables and a small amount of olive oil). Avoid fries, fast-food or adding fatty sauces to food (pizza, pastry, cream sauce, béchamel, mayonnaise).
• Reduce the amount of salt when cooking as well as other salty foods (snacks, chips, hamburgers, processed food). Herbs add a natural healthy flavour to dressings and meals (garlic, parsley, coriander, thyme, mint, lemon juice, oregano). The use of these ingredients as a salt substitute will also help to control blood pressure;
• Alcoholic drinks are only allowed in small quantities always during a meal (e.g. one glass red wine with the meal for controlled adult diabetics). Large amounts of alcohol cause uncontrolled glycaemia.
In addition to these strategies, don’t forget to keep active (walking, swimming, cycling, etc). Practising physical activities regularly is imperative for controlling the levels of glycaemia.
By Marina Augusto
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Nutritionist Marina Augusto works for the Hospital Particular do Algarve Group
