Health24.com joined dietician Noel Bekkers on a Diabetes Tour through Pick n Pay Hyper in Brackenfell. As we moved from aisle to aisle, we learnt fascinating things on how to make the right food choices if you're diabetic, or cooking for someone who is.
These countrywide Pick n Pay tours are done once a year to debunk common diabetes myths. The principle message is that the dietary guidelines for all diabetics should be the same as a healthy eating plan advised for everybody – that is less fat, less sugar, less salt and more fibre-rich foods, as well as planning the consumption of foods which have a low blood-sugar response (low glycaemic index foods).
In this guide, we bring you the highlights of what we've learnt. It's worth noting, however, that a healthy diet isn't your only ticket to better health. It's just as important to regularly monitor your blood glucose levels, and to visit your doctor and go for blood tests at least once a year.
Fruit & Veg
Different vegetables and fruit contain different nutrients, making eating a variety each day vitally important. Brightly coloured fruits and vegetables such as cling peaches, pawpaw, apricots, butternut, pumpkin, carrot and spinach are predominantly rich in vitamin A, while citrus fruits and green leafy vegetables can substantially boost your vitamin C intake. And that is just the tip of the goodness – all vegetables and fruits contain a multitude of other "goodies" called phytochemicals. Scientists are only now beginning to discover the links between these and all sorts of health benefits.
- Other good fruit options include frozen mixed berries, canned fruit in juice, Rhodes Fruit to Go, dried fruit, non-sugar-coated fruit bars and Safari Breakfast Booster. Steer clear of sugary fruit products such as fruit dainties, and eat dried and canned fruit in moderation.
- Good alternative vegetable options are canned tomato products, canned asparagus, canned ratatouille, gherkins, peppadews, pickled onions, beetroot (fresh and bottled), and bottled tomato-based pasta sauces (with less than 3g fat per 100g).
- As a general rule, raw vegetables are always better than cooked veggies.
- Take note of portion sizes. While vegetables can be regarded as "free" foods (namely you can eat as much as you want to), fruit can add kilojoules to your diet. Recommended portions are 1 small fruit or 100ml fruit juice, 1 tablespoon or 2 - 3 pieces of dried fruit.
- Go for fruits and vegetables that are in season – these are less expensive.
Fats & Oils
This can be a tricky area of the grocery store if you don't know what to look out for. Although fats should form part of a healthy diet, the wrong fats can be bad for your heart and your waistline. Try to eat no more than three portions as a female and five portions as a male of fat/oil a day. A portion is a teaspoon of oil/butter, 5-6 olives or a ¼ avocado, 2 tsp peanut butter or 1 tablespoon nuts or seeds.
What to choose:
- Go for lighter spreads, which not only contain less fat, but usually also less sodium (salt).
- Opt for light salad dressings. The best is to check the nutrition labels on the bottles and to go for a product that contains less than 3g of fat per 100g. It's also a good idea to make your own salad dressing at home, using balsamic vinegar, lemon juice, herbs, and a little olive oil.
- Avocado, olive and canola oil are good alternatives to sunflower oil. Other good fat choices are macadamia oil, peanut oil, sesame-seed oil, olives, fresh avocado, hummus, all Flora tub margarines, Flora Proactiv, and reduced-oil salad cream.
- Mix salad cream with low-fat or fat-free Bulgarian yoghurt to lower the fat content of your meal. This also helps to extend the product, which saves money.
- Replace cream in recipes with fat-free Bulgarian yoghurt.
Dairy products should form an important part of your diet. These foods are not only good for your bones, but research shows that it could help you to keep the kilos in check. Try to eat two to three portions of dairy per day. A portion is one cup of milk/yoghurt, a matchbox-sized piece of cheese, or ½ cup of cottage cheese.
What to choose:
- Always choose low-fat or fat-free instead of full-cream dairy products.
- Drinking yoghurt is a good on-the-run snack. Once again, go for low-fat or fat-free varieties.
- Be careful when you're shopping in the cheese section. Remember, cheese is a high-salt, high-fat product. Go for lighter cheeses (take note, "white" isn't synonymous with "light") such as low-fat cottage cheese, Clover low fat or reduced-fat cheddar cheese. Compare the fat contents of products by checking the nutrition labels (fat per 100g).
- Coffee creamers are a definite no-no, and milk blends should also rather be avoided. These are high in sugar and saturated fat.
- If you don't like the taste and colour of fat-free milk, try the long-life version. You might like the taste more.
- Use a strong-flavoured cheese such as mature cheddar for Béchamel sauce. The stronger flavour means that you won't need to use as much cheese. It's also a good idea to grate the cheese and put it on top of the dish instead of in it.
Meat, Chicken & Fish
Protein foods should form part of your diet, but their intake should be carefully managed as these foods can be high in fat. Eat no more than three portions of protein a day. A portion is the size of the palm of your hand or a deck of cards.
What to choose:
- Go for fish, poultry and ostrich. Pork is also a good option – once you remove the fat, it's considered a white meat. If you do buy red meat, opt for lean cuts.
- Choose chicken breast fillets, as these contain less fat. If you do choose breasts or drumsticks, remember to remove the skin prior to cooking.
- Limit your intake of organ meats, as these are high in cholesterol.
- Bacon should only be used as a treat. But if you're buying it, always opt for back bacon.
- Processed meats such as salami and polony are high in fat, so rather steer clear of this section of the store. Roast beef and pastrami are recommended choices of cold meat.
- Lean game or ostrich biltong is recommended and a portion is 30g (1/3 palm of the hand).
- If you can't afford fresh fish, canned pilchards, tuna or sardines can be a less expensive option. Sardines, pilchards and salmon are also high in omega-3 heart friendly fats.
- Don't fry meat; rather grill or bake it in the oven.
Beans, peas and lentils are highly underrated foods. These legumes are a fantastic source of soluble fibre, which helps to lower cholesterol. Try to include these foods in your diet every day. A portion for a meal constitutes ½ cup of cooked legumes or simply add 1-2 tablespoons to any meal.
What to choose:
- Go for baked beans in tomato sauce, three-bean salad, canned beans, canned lentils, canned chick peas, dried split peas, dried sugar beans, dried split lentils, dried whole brown lentils, 4-in-1 soup mix, and soy mince.
- Add beans or chickpeas to stews, casseroles and soups. In summer, add it to salads.
- Prepare your own three-bean salad at home - it's great to have with a braai.
- Tinned legumes are a convenient and healthy choice. If you have high blood pressure, rinse the brine water off after opening the tin.
Carbohydrate foods should form the basis of all your meals. But too many high glycaemic index (GI) refined carbohydrates can wreak havoc with your blood-sugar levels, so it's important to make the right choices.
What to choose:
- Opt for low-GI bread as this will help to keep your blood-sugar levels steady. Heavier breads such as seed loaves are good alternatives. Other recommended breads include wheat-free rye bread and Anat mini pitas.
- Be careful of certain toasted muesli products as many of these contain too much sugar and fat. Choose wholewheat Pronutro, oats porridge, All-Bran flakes, High-Fibre bran, Nature's Source mueslis, FineForm low-GI muesli, Vital Muesli, Morevite, Alphen Lite muesli, Bokomo Morning Harvest muesli, and Bokomo Fibre Plus.
- Steer clear of crisps and crackers as these are generally high in fat. Good alternatives are home-made/microwave popcorn, Bokomo Quick Break brand-and-raisin cereal bars, Fine Form breakfast bar, and Nestlé Nutren Balance cereal bar.
- Other good starch options include stampkoring (wheat rice), barley, brown rice, basmati rice, durum-wheat pasta, sweetcorn, sweet potato or new baby potatoes and legumes.
- Add two tablespoons of oat bran to your breakfast cereal – this will increase your soluble-fibre intake.
- Instead of buying commercially prepared cookies and rusks, rather bake your own. Use less sugar and use canola oil instead of sunflower oil. In muffins and premixes, replace the oil in the recipe with puréed apple. If you do buy biscuits at your grocery store, go for ones without fillings. An Ouam Nutrirusk or a plain digestive biscuit as a treat once or twice a week is advised.
The best choice of drink is, of course, water. But for a bit of variety, you can add other drinks to your diet. Aim for a fluid intake of 1.5 to 2 litres a day, depending on your activity levels and the climate.
What to choose:
- Fruit juices and cordials add kilojoules to your diet, so it's best to limit their use or to go for sugar-free varieties. The best options are Brooke's low-calorie cordials, Soda-Stream sugar-free concentrates, Cedar Lite concentrates and Hall's Lite concentrate. 100% pure fruit juice is very concentrated in sugar – dilute 100ml with water. Your taste buds will adjust to the less sweet taste. For a different choice, try tomato juice or add pure lemon juice to iced water – it is refreshing and delicious!
- Recommended fizzy cold drink choices are sugar- and caffeine-free colas, Schweppes Lemon Lite, all unflavoured sparkling and still mineral waters, all light ice teas, Aquelle Lite flavoured water, and Chelé sugar-free mixers.
- One (for a female) or two (for a male) small glasses of wine per day can form part of a healthy diet, but first discuss your alcohol intake with your doctor. A recommended choice of wine is Drostdy Hof Extra-Light.
- Hot drinks can be a good source of fluid and, when mixed with milk, a source of calcium. Go for rooibos tea, herbal tea, decaffeinated coffee, cocoa, Nesquick, Milo and Horlicks light.
- Mix wine with sparkling water and/or lots of ice to make it go further.
- Mix a teaspoon of cocoa with sweetener and fat-free milk for a low-kilojoule drink in winter.
- Start to move away from sweetened beverages (and foods, for that matter). Gradually train your palate to appreciate things without sweetener, like tea and coffee, natural yoghurt with fruit etc.
The Pick 'n Pay Shopping Tour for Diabetics takes place once a year at branches across South Africa. Contact Pick 'n Pay for more info.
- (Carine Visagie, Health24, November 2008)