User's comments:
"This is my lunch for today: Spaghetti (about 1 cup) made from durum wheat, a few cherry tomatoes, two mushrooms, a few carrot sticks, a few baby green beans, a few slices of cucumber, half a tin of tuna (in brine) and salad sprouts. For a salad dressing, I used natural fat-free yoghurt (about four heaped teaspoons).
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I'm currently weighing a whopping 147kg, have been diagnosed as insulin resistant and have hypertension. This week I made a re-evaluation of my lifestyle and eating habits and am trying to follow a low-GI diet and also started going to gym. Comments on this lunch would be great and I really need all the help I can get! My snack for later in the afternoon will be a Granny Smith apple."
Expert's comments:
It takes a lot of determination and courage to embark on a completely new way of life.
However, you should be encouraged to know that once you start feeling better, you will be able to continue motivating yourself to achieving optimal health.
The combination of diet and exercise is the best approach to achieving and ultimately maintaining desired weight loss. It is always difficult to do this alone and I would suggest you obtain the guidance of a registered dietician to help ensure that your new eating plan is appropriately balanced and practical for you.
The website for the Dietetic Association of South Africa (ADSA) is www.adsa.org.za. You will be able to find a registered, private-practicing dietician in your area. Another great help is to join a recognised weight loss programme such as Weigh Less. They endorse healthy, balanced eating as well as exercise and will help equip you to stay motivated.
Congratulations for joining the gym. Exercise is essential – not only for achieving weight loss, but also to reduce stress. It also plays a role in regulating blood glucose levels and reducing high blood pressure.
You should aim to be active for at least four to five days a week, for 45-60 minutes a day. Exercising aerobically for 30-40 minutes, four times a week can help improve insulin sensitivity.
Try to also be more active on a day-to-day basis, e.g. climb the stairs vs. taking the lifts, walk to the shops, park far away from the entrance to the shopping mall, do chores around the house, do gardening etc. If you struggle to find a whole hour a day, the same benefit can be obtained from breaking your allocated exercise time up throughout the day, e.g. three sessions of 20 minutes instead of one session of 60 minutes.
Regarding your weight, try not to make it your only focus and measure of health. Set short-, medium- and long-term goals and view these in conjunction with other measurements, such as percentage body fat and waist circumference.
To begin with, aim to lose approximately 5-10% of your current weight (7-14 kg) over a realistic period as this in itself is associated with enormous health benefits and reductions in disease risk. Losing weight sensibly means approximately 1-1,5 kg per week.
Bear in mind that muscle is three times heavier than fat mass, so if you are exercising more frequently and building muscle mass, your weight may in fact decrease very slightly at times. For this reason, losing centimetres rather than kilograms is often a better reflection of losing fat mass.
Your lunch is spot on – well done! Perhaps including some protein and/or a little fat in your snack will help control your blood sugar and energy levels a bit better. Here are a few summary points regarding your eating that will benefit you in terms of your hypertension and blood sugar control:
Don’t miss a meal. Eat three meals a day. If you get hungry between meals, eat small, healthy snacks in between.
Meals and snacks should contain a moderate amount of mainly fibre-rich carbohydrates, low-fat/lean protein, healthy fats and vegetables and fruit (this is very similar to the low-GI approach which you are following).
Regarding fats specifically, be careful not to only go for fat free. Increasing your intake of healthy, unsaturated fats and reducing unhealthy, saturated and trans fats, has been shown to help improve insulin action. Unsaturated fats include polyunsaturated and monounsaturated fats and are found in the following foods – fish, particularly oily fish (tuna, salmon, pilchards, sardines, and herring), canola oil, olive oil, avocado pear, peanut butter, nuts and seeds. Saturated and trans fats are found in animal sources such as red meat (visible fat), chicken (skin), dairy products (full cream and low fat), hard margarines, coffee creamers, coconut and coconut milk, baked foods and fried foods.
Overall, you should eat low fat and decrease the amount of added sugar. Limit fizzy cold drinks and always dilute fruit juice. Read food labels to assess fat content. A product is low fat if it contains <3g fat/100g and fat free has <0,5g fat/100g. Practically, one should aim for ‘lower fat eating’. Choose foods that contain fat between 3-10% and try to stick to about 10-13g fat/meal.
Eat five-a-day, i.e. 3-4 different coloured vegetables and 2-3 fruits.
Eating healthy shouldn't be boring – ensure variety so that you enjoy meal times. rather than finding it difficult to finish a meal. Don’t deny any foods – remember that everything has its place – even treats.
Eat lean red meat no more than 2-3 times a week and fish more than 1-2 times a week.
Include legumes in your diet – beans, peas, lentils, chickpeas, split peas.
Practice healthy methods of food preparation – stirfry with small amounts of canola or olive oil, grill, boil, poach, braai, bake, roast, and limit frying.
Use salt sparingly.
Drink lots of clean, safe water – 1,5 to 2 litres a day.
Control portion sizes.
Avoid eating after 8 pm in the evening.
Here are some ideas for healthy snacks:
Fresh fruit or fruit salad. Low-fat/fat-free yoghurt and mixed seeds can be added over the fruit
Dried fruit rolls, sticks and bars – e.g. SAD mebos sticks/bars
Health bars – e.g. Woolworths Cranberry & Almond Bar, Apricot & Sesame Seed Bar, Yoghurt & Nut Bar; Mixed Seed Bars, Jungle Oats Berry/Yoghurt Bars
1 small muffin (banana, carrot, date & nut, or bran) and a fruit
175ml yoghurt or 300ml drinking yoghurt (low fat/fat free) and a fruit
Peanuts and raisins or dried fruit and nut mix with a fruit
A slice of wholegrain bread, rice cakes, Cornthins Provitas or digestive biscuits with peanut butter and/or honey. Other toppings could include cottage cheese, cheese, Oxo, Marmite, avocado pear, fish paste, jam (obviously adding tomato, lettuce and cucumber to the topping will increase the nutritional value)
Vegetable bites, e.g. tomato wedges, cucumber or carrot sticks, celery sticks, baby tomatoes (fat-free or low-fat cottage cheese will add some taste variety)
Popcorn (made with a small amount of canola oil)
Biltong (no fat – ostrich, game meat, lean beef)
An easy guideline for food portions:
CARBOHYDRATES/ STARCH: Approximately the size of your fist; a tennis ball; 1 slice of bread
PROTEIN: The palm to length of your hand (no thicker than the ‘pinky joint’); 1-2 packs of cards
FRUIT: Size of your fist; a tennis ball
VEGETABLES: Unlimited
DAIRY: 1 cup of low-fat milk; 1 small tub of low-fat/fat-free yoghurt; matchbox block of cheese; 250-300ml drinking yoghurt
FAT: 1-2 level teaspoons of oil (canola/olive), ‘lite’ margarine, butter, peanut butter, regular mayonnaise; 1 tablespoon of reduced oil/ ‘lite’ mayonnaise and salad dressing; ¼ of a medium avocado; any spreads ‘thinly’ on breads/crackers; 1 small handful of nuts or seeds
For a consistent change in eating pattern, you should enforce balanced, healthy food choices and meal preparation for the entire family.
Diseases of lifestyle such as insulin resistance, diabetes, hypertension and cardiovascular disease are often hereditary, so it would be prudent to start changing the family’s approach. This would prevent conditions from developing in the future.
“Eating for sustained energy” (G. Steenkamp, L. Delport) is a very nice cookbook with fabulous low-GI meals that can be enjoyed by the whole family.
I wish you all the best on your exciting road to long-term healthy living!
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