As National Diabetes Awareness Week runs from 12-17 November, the Nutrition Information Centre in the Faculty of Medicine and Health Sciences (FMHS) of Stellenbosch University (NICUS) has published 15 dietary recommendations to prevent or treat diabetes.
Three-and-a-half million South Africans - about 6% of the population - suffer from either type 1 or type 2 diabetes mellitus. According to the 2013 report on mortality and causes of death in South Africa, diabetes is the fifth highest cause of natural deaths in the country.
It is estimated that another five million South Africans have pre-diabetes, a condition where insulin resistance causes blood glucose levels to be higher than normal, but not high enough yet to be type 2 diabetes. However, many of these cases go undiagnosed.
It takes on average seven years for a person to get diagnosed with diabetes, as symptoms can be mild and may develop gradually. The result is that about 30 percent of people with type 2 diabetes have already developed complications by the time they are diagnosed.
Diabetes complications are serious and include heart disease, stroke, blindness, amputations and kidney failure. In most cases, these complications could have been avoided entirely by early diagnosis and proper treatment.
Diabetes is a complicated disease with different aspects to consider. To cover all these different aspects, a multifaceted health care team is required. This team should ideally consist of a physician, a diabetes educator and a dietitian.
Patients with type 1 diabetes who are on insulin therapy need specific eating and meal plans based on their insulin treatment and blood glucose control.
However, the disease process associated with insulin resistance and type 2 diabetes can be slowed and even partially reversed by following a healthy diet and lifestyle.
Dietary recommendations
- The dietary guidelines for diabetic people are based on the guidelines for healthy people without diabetes. Variety means eating different foods within a meal, on different days and preparing food in different healthy ways. This ensures that our diet contains sufficient nutrients and that it is more enjoyable.
- As little as 5-10% weight loss improves insulin resistance, therefore overweight and obese diabetics should be advised to lose weight.
- Eat at least three balanced meals per day.
- Drink at least six to eight glasses of water per day.
- Increase your fibre intake: eat whole wheat bread instead of white bread; eat oats, oat bran or whole-wheat cereals e.g. high-fibre cereal for breakfast; eat lots of vegetables and fruit; eat legumes regularly (peas, lentils, beans and soya), and include barley, samp, brown rice and whole-wheat pasta in your diet.
- Diabetic patients may benefit from low GI / GL foods as long as they are incorporated into a balanced diet, and the use of high fat low GI food items and a general disregard to portion sizes is avoided.
- Limit your fat intake, especially saturated- and trans fats (animal fats, full cream dairy products, chocolate, coconut, hard margarine, full cream products, baked goods for example. pies and cookies] and palm oils [e.g. coffee creamers and artificial cream). Rather include more mono-unsaturated fats in limited amounts in your diet (e.g. use canola oil or olive oil instead of sunflower oil, spread avocado or peanut butter instead of margarine on bread).
- Eat fish two to three times per week and chicken more regularly than red meat.
- Small portions of meat can be eaten daily. Replace meat more frequently with fish, chicken and legumes (peas, beans, lentils and soy and eggs). Polonies, Viennas and sausages are not healthy; rather eat beans, eggs, nuts, peanut butter or lentils.
- Eat at least five portions of fruit and vegetables every day. Buy vegetables and fruit in season and try to include as much variety as possible. Eat one fruit at a time and avoid the consumption of more than 125 ml fruit juice per day.
- Aim to eat or drink at least two cups of milk, cottage cheese or yoghurt per day. Low fat is better, it has all the protein and calcium, but less fat.
- Follow the correct cooking methods: boil, steam, bake/grill in the oven and braai over coals, thus limiting the addition of any form of fat (e.g. margarine, oil, mayonnaise, cream and cheese) during food preparation.
- Use small amounts of salt in food preparation and avoid the use of extra salt at the table. Rather use herbs, salt-free spices and flavouring instead of salt. Avoid processed foods with a high salt content.
- If you consume alcohol (beer and wine), use it in moderate amounts (one to two glasses a day) and always with a meal.
- Manage your carbohydrate and sugar intake by limiting or avoiding cake, cold drinks, sweets, cookies, and sugar-sweetened desserts and drinks (including alcohol), which are very high in energy, but low in nutrients.
