Canadian Diabetes Care Guide
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Healthy food choices

When first diagnosed with diabetes - was one of your first thoughts ... “I'll never be allowed to have sweets again." If it was, you are not alone! The thought that diabetes means your favorite foods ‘have to go’ can stop you in your tracks and keep you from learning about healthy food choices.

Fortunately, foods containing sugar can be part of a healthy meal or snack. Moderation is the key. A 'diabetes diet' is actually a healthy approach to eating that would be beneficial for anyone who is concerned about his or her health. Today, much of the focus in choosing meals revolves around balancing the four food groups and controlling portion sizes.

CHOOSING YOUR FOOD
Whether you have diabetes or not, the best approach for healthy nutrition is to follow Canada’s Guidelines for Healthy Eating. Eat a variety of foods as outlined in Canada's food guide. Have cereals, breads and other whole grain products, fruits and vegetables more often.

Choose dairy products that are lower fat, lean meats and foods prepared with little or no fat. Achieve a healthy body weight through physical activity and healthy eating. Limit salt, caffeine and alcohol.

PORTION SIZE MATTERS
As they say – too much of a good thing is not always a ‘good thing’!
A simple approach to keeping an eye on portions and making sure you have a variety of food is to use the plate method. It is easy and can help you manage any meal, anywhere. First, divide your plate in half. Fill one half with vegetables, preferably with more than one colour. Divide the remaining half into two, fill one quarter with your potatoes/rice/pasta or bread, and the remaining quarter with your meat. Add a fruit and a serving of milk and you are on your way to healthy portions and balanced meals.

Healthy eating is appropriate for everyone – and even more important when you have diabetes.

Healthy Eating Tips

  • Space your meals evenly through out the day with no more than 6 hours between meals. Eating at regular intervals helps you control your blood glucose.
  • Choose lower fat foods. Use lowfat dairy products, lean meats and limit added fats like margarine and butter.
  • Limit sugars and sweets such as sugar, candies and desserts.
  • The glycemic index is a measurement of how much your blood glucose increases when you eat certain foods. Foods with a low glycemic index can raise your blood glucose levels less than foods with a higher glycemic index.
  • Choose lower glycemic index foods more often rather than refined carbohydrates. These include bran cereals, whole wheat bread, lentils and legumes and fruits and vegetables.
  • If you are thirsty, choose water or diet pop.

Preparing your Meals

  • Bake, broil, boil, steam, barbecue or braise using nonfat pan spray.
  • To add more flavour to your meals try using: fresh and dried herbs, garlic, onions, vinegar, hot pepper sauce, lemon juice, mustard, extracts such as vanilla and almond and of course artificial sweeteners.

FAT FACTS
Our bodies need a little fat every day. It is an essential part of our diet. Fats are a source of energy and also serve as stored energy.

In foods there are two types of fats: SATURATED and UNSATURATED.

  • Saturated Fats come mainly from animal food products and are solid at room temperature. Meat fat, lard, butter and solid shortening are examples of saturated fats. Palm and coconut oils are also saturated fats. These types of fats are not desirable, as they tend to raise our cholesterol level.
  • Unsaturated Fats are liquid at room temperature and come from plant oils such as peanut, olive, corn, sunflower and canola. These are good fats as they tend to lower the level of cholesterol in the blood, but they also need to be limited.
  • Check labels for saturated and trans fat. Trans fats are found in many processed foods like crackers, cookies and snack foods. Aim for no more than 20g of both fats combined.

Be aware of products that contain hidden fats such as luncheon meats and sausages, nuts, chips, gravies and sauces, whole milk and cream.

CUTTING THE FAT

  • In Meats - trim off all visible fat before cooking and remove the skin from chicken.
  • In Salad Dressing choose light and fat-free varieties
  • In Mayonnaise (light brands or fat free are better). Add zip to your salads with herbs, vinegars and spices.

In MILK and DAIRY products

  • Use Skim or 1% Milk.
  • Eat Low Fat or Skim Milk Cheese (less than 20% butter fat).
  • Buy Fat Free Yogurts sweetened with aspartame.
  • Use low fat milk for coffee and tea. Avoid dairy substitutes that contain coconut or palm oil.

WHAT ABOUT SWEETENERS?

  • Maintaining a healthy weight is key to managing diabetes. Using a zero calorie sweetener instead of sugar is an easy way to make a big difference in weight management and help your carbohydrates go further. Sweeteners let you enjoy your favourite foods and beverages while managing carbohydrate and calorie intake to help maintain glycemic control. Sweeteners come in a variety of product forms and can be used in beverages, on cereal, fruit and in cooking and baking.
  • Watch for hidden sugar in products like presweetened cereals, some painkillers and cough syrups. Your pharmacist can help you choose. Watch for sugar words. Products containing words ending in ‘-ose’
    (e.g. dextrose) or ‘-ol’ (e.g. manitol) should be limited, also products listing sugar, honey, molasses.

BE LABEL WISE
Health Canada’s January 2003 Regulations make nutrition labeling mandatory on most food labels. Knowing how to read a food label will help you choose healthy foods, work out your portions, control fats and sodium, as well as help you keep count of carbohydrates and calories. Nutrition labeling, together with help from your dietitian, provides you with important tools to make informed food choices for meals and snacks.

Read the Nutrition Facts table on your food products. The label will show you the amount of food in a serving and the number of servings in a packet or can. (It ’s important that you check whether you are eating more, less or the same amount as the serving given). It shows the calories, and nutrients (fat, cholesterol, sodium, carbohydrate and proteins) per serving. It also gives the % Daily Value. The % Daily Value is based on a 2000 calorie a day diet and shows you what percentage of your daily nutrient requirement is contained in a serving. If you are on a more/less than a 2000 daily calorie intake you can adjust it accordingly.

EATING OUT
Diabetes doesn’t mean that you can’t enjoy eating out. Follow the same approach you do at home. Many restaurants offer heart healthy choices on their menu. Ask about ingredients and style of preparation when you are unsure. If portions are too large, share a serving or arrange to have some boxed as takeout. Avoid fried and battered foods. Have sauces, gravies and dressing served on the side so that you can control the quantity.

Eating out can often mean eating later than usual. If you take insulin or diabetes pills, talk to a member of your diabetes team about how to manage a delay in mealtime. Eating a small snack if there is a delay in your mealtime may help prevent a drop in your blood glucose.

ALCOHOL
Discuss safe use of alcohol with a member of your diabetes team. The Canadian Diabetes Association 2003 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada states the recommendation for alcohol consumption when you have diabetes is the same as for any other adult; no more than 2 regular drinks a day. (For men, less than 14 standard drinks a week; for women, less than nine standard drinks a week).

When consumed with food, moderate amounts of alcohol do not cause hypoglycemia (low blood glucose) or hyperglycemia (high blood glucose). Alcohol is not recommended if you have high triglycerides, have high blood-pressure, have had liver problems or you are pregnant or breast feeding.

Eat a snack if you have alcohol. With type 1 diabetes moderate consumption of alcohol 2-3 hours after the evening meal can cause low blood glucose the next morning. Alcohol can also mask the usual symptoms of low blood glucose. Speak to your educators about the safe use of alcohol.

If you take medications, check with your doctor/pharmacist, to make sure that it is safe to drink alcohol.

For a nutritional assessment and help with your individual nutritional requirements, book an appointment with your dietitian today. You can also find helpful resources and detailed nutrition information at Dietitians of Canada website, www.dietitians.ca.

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