Diet & Diabetes Cassie Ricchiuti Diabetes Dietitian Improving www.shropscommunityhealth.nhs.uk Lives In Our Communities
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Dietary management of diabetes Type 1 Consistent intake of carbohydrates (carbs) OR Carb counting Type 2 Healthy eating AND Carb awareness aiming for consistent intake OR Carb counting www.shropscommunityhealth.nhs.uk
5 Lets identify carbohydrates www.shropscommunityhealth.nhs.uk
www.shropscommunityhealth.nhs.uk
www.shropscommunityhealth.nhs.uk
www.shropscommunityhealth.nhs.uk
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www.shropscommunityhealth.nhs.uk
www.shropscommunityhealth.nhs.uk
www.shropscommunityhealth.nhs.uk
www.shropscommunityhealth.nhs.uk
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www.shropscommunityhealth.nhs.uk
www.shropscommunityhealth.nhs.uk
www.shropscommunityhealth.nhs.uk
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Point out the carbohydrates! www.shropscommunityhealth.nhs.uk
Cereal based starchy carbohydrates: (glucose) Breakfast cereals, pasta, bread, rice, flour based products (pastry, biscuits, cakes), cous cous, noodles, thickening agents (e.g. corn flour) etc. www.shropscommunityhealth.nhs.uk
Starchy vegetables: (glucose) Potatoes, parsnips, sweet potatoes, sweetcorn, peas, baked beans, pulses (lentils) www.shropscommunityhealth.nhs.uk
Fruit based carbohydrates: (fructose) Fruit, fruit juice, smoothies! www.shropscommunityhealth.nhs.uk
Milk based carbohydrates: (lactose) Milk, yoghurt, ice cream, custard.. www.shropscommunityhealth.nhs.uk
Protein Meat, fish (white and oily), seafood, eggs Check food labels of sausages and burgers as they may contain Foods which DON T directly affect glucose levels Fat Butter, lard, ghee, margarine, oils Dairy Cheese Vegetables Salad and most vegetables Drinks Water, sugar free and diet drinks and squashes. www.shropscommunityhealth.nhs.uk
The Eatwell Guide shows the proportions of the main food groups that form a healthy, balanced diet: eat at least 5 portions of a variety of fruit and vegetables every day base meals on potatoes, bread, rice, pasta and other starchy carbohydrates, choosing wholegrain versions where possible have some dairy or dairy alternatives (such as soy drinks); choosing lower fat and lower sugar options Improving Lives In Our Communities
The Eatwell Guide eat some beans, pulses, fish, eggs, meat and other proteins (including 2 portions of fish every week, 1 of which should be oily) choose unsaturated oils and spreads and eat in small amounts drink 6 to 8 cups/glasses of fluid a day If consuming foods and drinks high in fat, salt or sugar have these less often and in small amounts. Improving Lives In Our Communities
So what s changed? fruit and vegetables: at least 5 portions of a variety of fruit and vegetables a day fish: eat 2 portions a week, 1 of which should be oily red and processed meat: limit to less than 70g per day if you usually consume more than 90g every day Improving Lives In Our Communities
So what s changed? Label reading check the label on packaged foods choose foods lower in fat, salt and sugar Fluids 6-8 glasses per day Water, lower fat milk, sugar free drinks including tea & coffee all count Limit fruit juice/smoothies 150mls per day Improving Lives In Our Communities
Which has the greatest effect on blood glucose levels?
Timing and Amount of CHO The amount of carbohydrate has much greater influence on blood glucose than the type Amount = looking at portion sizes Reduce fatty and sugary carbohydrate foods Reduce portion sizes of starchy food if necessary Timing = Spreading out Spread carbohydrate foods through the day Eat regular portion sizes of carbohydrate foods.
Timing spread meals through day
Timing and Amount What foods increase the amount here?
Type of Carbohydrate Do all carbohydrate foods break down into glucose at the same rate?
Glycaemic index Glycaemic Index (GI) - Refers to how quickly CHO is digested and absorbed as glucose in the blood stream. CHO that is broken down quickly and releases glucose into the blood quickly is said to have a high G.I CHO that breaks down slowly and releases glucose slowly are said to have a low G.I A Cochrane review reported reductions of 0.5% in HbA1c in people with diabetes adopting a low GI diet.
Glycaemic Index (GI)
Meals Breakfast Slowly absorbed Quickly absorbed
Meals Lunch Slowly absorbed Quickly absorbed
Evening meal Meals Slowly absorbed Quickly absorbed
Healthy snacks during exercise 30-60g carbs during exercise Piece of fruit Cereal bar Fruit juice (150ml) 500ml sports drink Longer duration 30-60g per hours, after 3 hours use more fats as a fuel so may need less carbs www.shropscommunityhealth.nhs.uk
Healthy snacks after exercise Protein and carbohydrate together improve glycogen storage 2 hours post exercise 4g carb: 1g protein 20-25g protein optimal Milkshake, cereal & milk, lean meat sandwich, yoghurts, rice & tuna, cereal bar, fruit www.shropscommunityhealth.nhs.uk
Further Support Diabetes UK local Support Group www.type2diabetesandme.co.uk Careline 0345 123 2399 www.diabetes.org.uk - online community Diabetes Specialist Nursing service 01743 277693
Structured education programmes in Type 2 diabetes Shropshire Type 1 diabetes
Any questions? www.shropscommunityhealth.nhs.uk