Eating well and carbs
The Eatwell guide represents a healthy, well balanced diet based on government recommendations.
This guide is used for the general population and provides a flexible approach to maintaining/losing weight. This approach relies on good portion control and accepting that food/drinks high in salt, fat and sugar should be taken in moderation. The guide is separated into segments and visually represents how much of each food group should be included as part of a total days intake.
When weight loss is the main focus of this diet, it can be beneficial to alter the segments to represent: ½ your day as fruit and vegetable, ¼ as protein, and ¼ as carbohydrate. The total calorie content also needs to be considered as the guidance only represents a national average, and experience tells us that some people may require considerably less than what is recommended on the Eatwell guide.
Fruit and vegetable:
- 5 portions of fruit and vegetables (1 portion = the palm of your hand).
- No more than 2-3 portions should come from fruit, and these should be equally spaced throughout the day.
- Eat a rainbow of colours to make the most of the all the different vitamins, minerals and antioxidants.
- Increase vegetable portions on your plate if you are cutting portions. This will keep you full without increasing the calorie content.
- Frozen, fresh, dried, tinned, juice/smoothie all count towards your 5 a day
- Juice/smoothie portions should be no more 125ml and only 1 glass will count towards your ‘5-a day’.
- Aim for wholegrain varieties where possible
- Avoid doubling up on carbohydrates i.e. spaghetti Bolognese with garlic bread
- Stick to good portions (fist sized, 75g or tennis ball size of dried pasta)
- Avoid sugary cereals
Dairy and Dairy alternatives:
- Aim for low fat low sugar options. Low fat Greek yoghurt with added fruit or flavourings is a good option.
- Stick to small portions of cheese, as it is high in fat and have a high calorie content
- Remember that dairy contains natural sugar called Lactose (With the Exception of ‘butter’ and ‘cheese’ due to the process they go through)
- Dairy alternatives are ok, but ensure that they are fortified with vitamins and minerals as they do not contain them naturally.
Beans, pulses, fish, eggs, meat, and other proteins:
- Aim for lower fat options where possible
- Trim visible fat before cooking meats
- Avoid frying in oil, use other methods such as grilling, boiling, poaching, and air frying
- Try to have 2 meat free days per week
- Aim to have 2 portions of fish per week (One of them should be oily fish)
- When buying tinned fish, aim for spring water instead of oil or brine as they contain high amounts of fat or salt.
Oils and spreads:
- Aim for unsaturated fats (Vegetable sources, excluding coconut oil) and limit saturated fats (Animal sources)
- When frying use 1tsp of oil per person being cooked for.
- Limit where possible, but enjoy the treats that you have i.e. birthday meal, monthly takeaway
Very low calorie diet (VLCD):
The very low calorie diet is a specialist option that should only be done with the support of a trained dietitian. As the name suggests, it is an intensive diet that restricts calorie intake to 800kcal per day. The way that this is achieved is usually through certain milkshakes/soups that have been fortified appropriately. The diet can be undertaken for 8-14 weeks dependant on the individual. There is a growing evidence base to show that this type of diet can lead to remission of type two diabetes in some individuals who have been recently diagnosed. However, even if remission is not possible, it can significantly improve your weight, reduce diabetes medications, as well as potential health benefits not related to diabetes such as; high blood pressure and heart health.
- This diet can be done with regular food, but it can be more difficult to achieve this effectively
- A medication review should be done before starting.
- You may experience symptoms in the first 1-2 weeks as your body adjusts. Symptoms include: feeling hungry, low energy, dry mouth, constipation/diarrhoea, headaches, dizziness, cramps, and hair thinning. Some of these symptoms are more common than others, and are usually short term.
Low Carbohydrate diet (LCD):
The low carbohydrate diet, not be confused with the Ketogenic diet, is managed by limiting carbohydrate intake. Carbohydrate is limited to 50 – 130g per day, anything less than 50g is classified as ketogenic and has no evidence for benefits to weight loss or diabetes remission. The aim of this is diet is to improve diabetes control through two main factors; weight loss, and reduced carbohydrate portions. The low Carbohydrate diet can be followed to lose weight, as part of a healthy lifestyle, and can also be followed after during the reintroduction phase of the Very low Calorie diet (See Very Low Calorie diet section). This diet can be difficult to follow, and should be attempted with the support of a dietitian.
- This diet may lead to remission in diabetes, but is more likely if you are making a significant change to your current carbohydrate intake as a result of following the diet.
- Remission will likely not be achieved if the diet is stopped.
- A medication review should be done before
Other diets you may come across:
There may be other diets that you come across, however not all of these diets have evidence. In some cases these diets may be unsafe to follow; some of these diets may also be considerably restrictive, which is not done correctly can lead to nutritional deficiencies and unhealthy relationships with some foods. If you are considering any of the following diets, please consult your GP and/or dietitian to ensure that you are safe to
Examples of other diets:
- Fasting diets i.e 5:2 diet, 16/8 diet, Warrior diet, alternate day fasting
- Dukans diet
- Ketogenic diet (Very low/no Carbohydrate diet)
- DASH diet (Dietary approaches to stop hypertension)
- Cambridge diet
- Atkins diet
- Paleo diet
Vegetarian diets of course can still be followed if you have diabetes. Generally the carbohydrate content should not change, from a meat eating diet to a vegetarian diet. However, if you are carbohydrate counting you may need to monitor pulses such as lentils, chickpeas and beans if they are being consumed in large quantities. If you are concerned or would like further information about a vegetarian diet with diabetes then you can contact the department and ask to speak with one of the dietitians.
With the growing popularity in following a Vegan based diet, whether for economic, ethical, or health reasons; it is important to state that this diet can be followed safely and healthily. To follow the vegan diet appropriately, it may be worth speaking a dietitian for expert advice.
Notes for veganism:
- Due to the restrictive nature of the diet, ensure that vitamins and minerals are enriched/replaced in the food you eat
- Consider a supplement for vitamins and minerals if you struggling to get a full range of vitamins and minerals in your food, particularly vitamin B12.
- Ensure that you are including a good variety of alternative proteins in your diet, and pairing them, i.e. beans on toast, lentils and rice.
- Eating a rainbow (different colour of fruit and vegetables)
- Ensure milk/dairy alternatives are fortified.
Managing your Carbohydrates
Carbohydrate counting is a method that requires some work to get right, but can result in good diabetes control and more freedom with what you eat. To carbohydrate count you will need to be taking 2 types of insulin, long-acting insulin and rapid-acting insulin and should ideally be waking up with results that are within a good range. There are multiple ways to carbohydrate count and with the ongoing improvements in technology and phone apps it doesn’t have to be difficult to follow.
Below are some of the things you may need to carbohydrate count:
- Food scales
- Measuring cups/jug/or something you can use to measure a portion
- Food labels, Carbs and cals or a carbohydrate reference guide
For more information on carbohydrate counting, please call the Solent diabetes dietitians or diabetes specialist nurses.
Online resources for carbohydrate counting information:
- Diabetes UK (https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/carbohydrates-and-diabetes/nuts-and-bolts-of-carb-counting/learn-about-carb-counting)
- BERTIE online (https://www.bertieonline.org.uk/admLogin.asp)
Nutrition support with Diabetes:
A lot of time is spent on weight management in diabetes, however sometimes the opposite may be required. In these cases it is important to speak and work with your dietitian to create a nutritional plan. Generally, all food can be consumed dependant on the diet you are following, and therefore when trying to gain weight it can be easy to eat high sugar products to achieve this. However, in this situation it is recommended to use low sugar product with high fat and protein contents as these will have minimal effect on blood glucose levels. The dietitians will be able to support with making better dietary choices in these situations.