Diabetes, the facts - and some recipes

Published Nov 12, 2015

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Cape Town - Diabetes remains a major cause of death in South Africa, and the prevalence of the condition continues to rise. '

“People with diabetes have to follow a special diet or have to eat special diabetic food” is just one of the common misconceptions surrounding diabetes.

To mark World Diabetes Day on November 14, Association for Dietetics in South Africa (ADSA) spokesperson and registered dietitian Ria Catsicas looks at some of these misconceptions - which can result in people avoiding health testing or seeking treatment.

 

1: People with diabetes have to follow a special diet or have to eat special diabetic foods

“Actually, people with diabetes do not have to follow a 'special' diet. The whole family should eat healthy unprocessed foods such as fresh fruit and vegetables; whole grains; lean meats and poultry; low fat milk and dairy products; seeds, nuts, legumes and plant oils.

“Everyone should avoid or limit eating processed foods such as fatty red meats, processed meats, all foods made from white flour and foods with a high sugar content. Healthy eating is good for all of us as it is essential for supporting our immune systems and protecting us against disease, as well as to ensure that we have optimal energy levels throughout the day.”

 

2: If I am diabetic, my food is going to be more expensive

“It is not necessary to buy expensive foods marketed to diabetics. Healthy eating can be economical, and is often cheaper than buying unhealthy treats. Buying fresh fruit and vegetables that are in season is certainly cheaper than buying processed fruit juices and soft drinks. If you eat fruits and salads as snacks and as dessert, you can save on the money you would have spent on buying biscuits, rusks, cakes, desserts, sweets and potato crisps. Legumes, such as lentils and beans, are cheaper than red meat and high fat hard cheeses. A tasty bean curry is, for instance, a much cheaper meal than a red meat alternative.”

 

3: Eating too much sugar causes diabetes

“There is truth in this statement, but it is too simplistic. Research shows that there is a correlation between the high intake of sugar-based soft drinks, energy drinks and fruit juices and the development of obesity. And, obesity, in turn, can be a significant contributing factor in the development of Type 2 diabetes. However, a person's complete diet must be taken into account. A diet that is characterized by the high intake of sugar, such as soft drinks, chocolates and sweets; as well as a high intake of refined starches, such as white or brown bread, pap, fast foods, biscuits, rusks and potato fries; while also poor in healthy foods such as fresh fruit, vegetables and whole grains, can contribute to the development of diabetes.”

 

4: People with diabetes cannot eat carbohydrates

“Not all carbohydrates are unhealthy. Both the type and the amount of carbohydrate foods you eat at a meal will affect your blood glucose levels afterwards. Therefore, for optimal blood glucose control it is important to control the quantity, and be aware of the type of carbohydrates you are going to eat. Small portions of whole grains, fruit and vegetables that are evenly distributed throughout the day can contribute to optimal blood glucose control. Research has also shown that the consistency of your carbohydrate intake from day-to-day can help to optimise blood glucose control.”

 

5: People with diabetes should restrict their fruit intake

“Yes, too much fruit can contribute to an increase in blood glucose levels. However, portion size is important. It is recommended that you consult your dietitian to calculate the amount of fruit that you should include in your daily diet.”

 

6: People with diabetes should be on a high-fat diet

“There is no research to date which has proved that a high fat diet can contribute to either weight loss or improved blood glucose control. To lose weight, your calorie intake from both foods and drinks must be less than your energy expenditure on both voluntary and involuntary activity. The restriction of any food group, whether it is carbohydrates or fats or proteins can contribute to weight loss. To achieve successful weight loss, people with diabetes need to adhere to an eating plan that restricts their usual calorie intake.

“Research has shown that diets promoting extreme macronutrient manipulation, whether it is carbohydrates or fats or proteins actually lessen people's adherence to the eating plan. It is much wiser for people with diabetes to develop sustainable healthy eating habits that can easily be incorporated into lifestyle for the long term. The best diet for a person with diabetes is a healthy eating plan that the person can adhere to. To facilitate adherence, a dietitian would take into consideration the individual's cultural preferences; their budget constraints; their age and gender; the logistics of their daily life, such as their work circumstances or travel requirements; as well as their weight status, the medications they use and their activity levels.”

 

7: There are no proven health dangers of consuming too much saturated fat

“It is well-established that a high intake of saturated fats can contribute to increased LDL cholesterol levels in some individuals. While it has not been proven is that increased LDL cholesterol levels contribute directly to cardiac events, this is because there are NUMEROUS compounding factors that would cause a heart attack. Atherosclerosis is an inflammatory condition and a high intake of saturated fats in a nutrient poor diet can aggravate inflammation. It has been proven that a high saturated fat intake in a nutrient poor diet can also contribute to decreased sensitivity of the body cells to the action of insulin.”

 

8: If I am diabetic, I should stop my medication and go on to a low-carb high-fat diet

“As a person with diabetes you should never stop your medication without your doctor's recommendation and agreement that this is the best medical course for you. It has been established that when diabetes is diagnosed most individuals would have already lost 50 percent of the insulin-producing capacity of the Beta cells in the pancreas. Therefore, the optimal way to manage diabetes is to follow a healthy diet; to lose weight if overweight; to engage in physical activity, such as walking three to five times a week for 40 to 60 minutes at a time; and, to take appropriate medication on your doctor's advice.”

 

9: If one of my parents has diabetes, there is nothing I can do about it - I will develop diabetes eventually

“If you have a genetic predisposition to diabetes, you have all the reason you need to embrace a healthy lifestyle. While genetics may only contribute 30 to 40 percent to the development of any condition, including diabetes, environmental and lifestyle factors may have a 60 to 70 percent impact. If you maintain a healthy body weight, stick to a healthy eating plan, manage your stress and get regular physical exercises, you have a very good chance of not developing diabetes.”

 

10: If I have diabetes, I can't exercise

“This is not true at all. Diabetes is a compelling reason to exercise regularly as physical activity plays a very important role in lowering blood glucose levels. Exercise also predisposes your body cells to being more sensitive to insulin, and of course, it helps to achieve and maintain a healthy body weight. If you use insulin it is important to check your blood glucose levels before and after physical activity. If you get results below 6m mol/l it is recommended that you lower your insulin dose or eat a healthy snack to prevent a hypoglycemic attack during or after exercise.”

* Ria Catsicashas a special interest in the medical nutrition management of diabetes, metabolic syndrome and obesity and is the author of the book “The Complete Nutritional Solutions to Diabetes”.

* To find a dietitian in your area who can assist you with personalised nutrition advice, visit www.adsa.org.za

 

DIABETIC FRIENDLY RECIPES

From NutritionConfidence

VEGGIE BURGERS

Makes 6 burgers

Ingredients

350g butternut cubes

350g sweet potato cubes

150g lentils, cooked

2ml ground cinnamon

2ml ground nutmeg

30ml extra virgin olive oil

Salt & pepper

1/2 cup ground almonds

1 whole iceberg lettuce

How to make it

Preheat the oven to 180°C.

Add butternut, sweet potato & oil to a roasting tray.

Sprinkle cinnamon, nutmeg, salt & pepper.

Roast in the oven for 30 min, until soft.

Leave butternut & sweet potato to cool.

Mix lentils, veg & half the almonds in a bowl.

Mash the mixture together until even.

Taste and add more seasoning if necessary.

Split the mixture into 6 evenly sized balls.

Shape into burger patties & coat in the remaining almonds.

Drizzle oil into a non-stick frying pan on medium heat.

Fry the patties for 1 min on each side until golden brown.

Wrap your burger up in a lettuce leaf & serve.

TIP: Add favourite burger toppings like guacamole, salsa & fresh sprouts

 

Dietitians say: Sweet potato is a low GI alternative to regular potato with a high soluble fibre & vitamin A content. Lentils & chickpeas contain a combination of protein, carbs, fibre, minerals, folate & vitamin B. Legumes' low glycaemic index keeps you full for longer!

 

 

ROOIBOS, POMEGRANATE AND CINNAMON ICED TEA

Recipe by Vanessa Marx

Makes 2L

Ingredients

4 rooibos teabags

2L water

1 cinnamon stick (+/- 5g)

1 orange, sliced with skin on

1 pomegranate, pitted

Honey, xylitol or sugar to taste (optional)

Ice to serve

How to make it

Boil 2L of water.

Put the tea bags into a large jug or bowl and add the boiling water.

Add the cinnamon stick and orange slices.

Leave the tea to cool to room temperature, or even better, leave to steep over night.

Strain the tea to remove the teabags, cinnamon and orange

Stir in honey, xylitol or sugar adding little bits at a time until the desired sweetness is reached. Diabetics, remember to use xylitol for a sugar-free option.

Add the fresh pomegranate jewels and top up with ice to serve.

Serve in large jars for a vintage feel and add some fresh herbs or edible flowers for a fresh summery touch.

 

Dietitians say: Cinnamon provides a natural sweet taste to food & beverages, without adding calories. Research suggests that cinnamon may have a beneficial effect on short term blood glucose control in type 2 diabetics. In traditional herbal medicine cinnamon is considered a remedy for respiratory, digestive & gynaecological ailments.

 

ORANGE AND ALMOND TORTE

Makes 1 whole torte (10 slices)

Ingredients

6 free range eggs

200g xylitol

Zest of 2 oranges

215g ground almonds

1tsp baking powder

40g flaked almonds

How to make it

Preheat the oven to 160deg C.

Crack the eggs into a large mixing bowl and add the xylitol.

Whisk the eggs and xylitol together until combined.

Add the orange zest, baking powder and ground almonds, and whisk into the egg mixture.

Grease a 23cm round cake tin.

Pour the torte mixture into the cake tin, and sprinkle the flaked almonds over the top of the mixture

Bake the torte for 20-30min, until light golden brown and firm to the touch.

Remove the cake tin from the oven and allow the torte to cool in the tin.

Once the torte is cool, carefully remove it from the cake tin and place it on a serving plate or platter.

Serve with low fat yoghurt & fresh orange slices.

TIP: The orange zest can be substituted with lemon or other citrus zest like grapefruit or lime. You can also add a teaspoon of ground cinnamon, some almond essence or a handful of poppy seeds!

 

WHAT THE DIETITIAN SAYS:

Xylitol is a naturally occurring alcohol found in most fruits & veg. It's a low calorie alternative to sugar with a low glycaemic index; resulting in a slow rise and fall in blood sugar levels.

Almond flour is a nutritious flour substitute due to its high mono-unsaturated fat and moderate protein content. Almonds are rich in vitamin E, B2, calcium, fibre and magnesium.

Eggs are great source of high-quality protein & the yolk is a source of vitamin A, B, D, iron and zinc.

IOL, adapted from a press release

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