What is diabetes?
Diabetes means that the body can no longer control the level of glucose (sugar) in the blood. Our bodies make insulin, which allows glucose in the blood to be used by the body for energy. At diagnosis, the level of glucose in your blood was too high because your body either did not produce enough insulin or, more commonly, was not using it efficiently.
Why is healthy eating important for Diabetes?
What you eat affects the levels of glucose and fat in your blood, your blood pressure and your weight.
By eating healthily and increasing activity levels some people will avoid or delay the need to take medication for diabetes.
If you are overweight, losing weight also helps avoid or delay the need for medication.
You many need to make some changes to what you eat and when you eat. However, others can eat the same foods as you because you will not need to buy special foods.
Guidelines for healthy living with diabetes
1. Eat the right amount of food to maintain a healthy weight.
2. Eat regular meals i.e. breakfast, midday and evening meals. Don’t miss meals.
3. Include starchy food (carbohydrate) at each meal and aim to have about the same amount each day. Try to make these wholegrain varieties.
4. Have two or three portions of vegetables each day.
5. Have two or three portions of fruit spread throughout the day.
6. Include pulses (e.g. beans and lentils) and oats regularly.
7. Eat less fat, especially saturated fat.
8. Eat oily fish regularly.
9. Cut down on sugar, sweet foods and sugary drinks. Special diabetic foods are not necessary.
10. Cut down on salt and salty foods.
11. If you drink alcohol do so in moderation.
12. Get more active, more often. Try to do some activity each day. Activity will help keep your blood glucose nearer normal levels.
Starchy foods (e.g. bread, rice, potato, pasta)
Eat some starchy carbohydrate foods with each meal. Your body breaks these starchy foods down into glucose, which you need for energy. Choose carbohydrates that are more slowly absorbed (lower glycaemic index [GI]) as they will keep your blood glucose levels more even, and keep you feeling fuller for longer.
Starchy foods are naturally low in fat. High fibre choices (wholemeal and wholegrain options) will help keep your bowels regular and look after your heart. Aim to eat similar portions of starchy foods at meals, this will help to keep your blood glucose levels more even.
Starchy Foods – Examples of a typical portion
Starchy Food – Crackers
Typical Portion – 5 Crackers, 4 rice cakes
Healthier Choices – 4 Rye crisp bread, 5 oat cakes, wholegrain crackers
Starchy Food – Breads: Sliced, rolls, chapatti, roti, pitta, nann
Typical Portion – 2 slices of bread or hard dough bread, 1 small chapatti, 1 large pitta, roti or wrap, 1/2 naan, 1 bread muffin
Healthier Choices – Wholemeal, wholegrain bread, multigrain, oat bread, 1 slice rye bread
Starchy Food – Breakfast cereals
Typical Portion – 2 Wheat biscuits/pillows, 1 medium bowl cereal or porridge oats
Healthier Choices – Wholewheat, bran or oat based e.g. shredded wheat, Weetabix, no added sugar muesli, porridge, Special K, All Bran
Starchy Food – Pasta/noodles (all kinds)
Typical Portion – 80-100g (3-4oz) cooked, 50-75g uncooked
Healthier Choices – Brown or wholegrain varieties
Starchy Food – Rice/cous cous
Typical Portion – 90-100g (4oz) cooked rice, 130g (5oz) cooked cous cous
Healthier Choices – Brown or wholemeal varieties. Basmati or easy cook rice.
Starchy Food – Potatoes/yam
Typical Portion – 6 new potatoes/ 1 fist sized jacket potato, 2 small pieces yam
Healthier Choices – Potato with skin, new or sweet potato
Starchy Food – Green banana, breadfruit, plantain
Typical Portion – 6 slices (80-100g) plantain, 2 –3 pieces breadfruit, 1/2 green banana
Healthier Choices – Boiled or steamed
Each portion contains approximately 30g carbohydrates. Your dietitian will advise you on how many portions to include daily.
Fruit and vegetables
Aim to have at least 5 portions of fruit and vegetables a day as they are low in saturated fat and full of vitamins, minerals, fibre and antioxidants which have a protective effect on the body.
A portion of fruit is:
• 1 large fruit e.g. apple, small banana, pear, orange or 2 small fruits, e.g. plums,apricots, prunes.
• 1 cup of berry fruits such as strawberries, raspberries
• 2 tablespoons stewed/tinned fruit without added sugar
• 1 small glass of unsweetened fruit juice (about 100ml)
• 10 large grapes
• 3 dates or prunes
• 1 tablespoon dried fruit e.g. sultanas, raisins
A portion of vegetables is:
• 2 tablespoons of cooked, raw, frozen or canned vegetables or beans
• A small bowl of salad
These foods are a good source of calcium and protein but can be high in fat. Chose lower-fat alternatives where you can. Aim for 2-3 portions a day.
A portion is approximately.
A portion of fruit is:
• 1/3 pint milk
• Small pot of yoghurt
• 2 tablespoons cottage cheese
• A matchbox sized portion (30g or 1 oz) of cheese
Meat, fish, cheese, eggs, nuts and beans
These foods are good sources of protein. Choose 2-3 small portions each day from the following list:
• 75-100g (3-4oz) lean meat or poultry
• 100-125g (4-5oz) fresh, tinned or frozen fish or fillet – preferably not fried
• 2 eggs – cooked without fats and oils
• 30g (1oz) or matchbox size piece of cheese or 2 tablespoon cottage cheese or low fat soft cheeses
• 4 tablespoons baked beans, lentils, red kidney beans, dahls, chick peas and similar beans
• 120g (5oz) tofu
• 30g (1oz) nuts or seeds or peanut butter
Note: Oily fish such as sardines, pilchards, mackerel, trout, kippers, herrings, red mullet, snapper or salmon are a good source of omega 3 fat and may protect against heart disease. Aim to eat them at least twice a week.
Food and drink high in fat and/or sugar
This includes foods such as cakes, biscuits, pies, pastries and chocolate. Having small amounts every now and again can be part of a healthy balanced diet. Try to keep these to a minimum if you are trying to lose weight.
Aim to have at least eight cups of fluid each day e.g. water, tea, coffee, low sugar or low calorie squash and diet drinks.
Foods with a high fat and oil content
If you are trying to lose weight, high fat foods are high in calories so it’s best to reduce them.
Ways to lower your fat intake
• Ready meals and fast foods may be high in fat or oil. Eat more freshly prepared ‘basic’ foods or look at the labels so that you can choose the low fat varieties.
• Eat fewer pies, pasties, crisps, nuts, corn or potato snacks and biscuits.
• Limit roast potatoes or chips to once a week or less.
• Limit cheese to 100g (4oz) a week. Try a low fat variety.
• Use skimmed or semi-skimmed milk rather than full cream milk.
• Use tomato or vegetable-based sauces for pasta rather than cream or cheese based sauces.
• Choose plain fish or fish in breadcrumbs rather than fish in batter.
Cooking and preparing food:
• Use all fats, spreads and oils sparingly.
• Grill, casserole, microwave or bake food rather than frying.
• Use low fat yoghurt rather than cream in cooking or on desserts.
• Remove skin and visible fat from meats before eating.
Types of fat
Having diabetes makes you more prone to heart disease. Consider being careful about the type of fat you eat because a diet high in fat, especially saturated fat, increases your risk of heart disease and stroke even more.
Saturated fats, trans fats and hydrogenated vegetable oils tend to raise your blood cholesterol level. Unsaturated fats, particularly monounsaturated fats and fish oils, offer more benefits to your health.
Fats to Reduce
- Butter, hard margarines, lard, goose fat, suet and ghee
- Hydrogenated vegetable oil, creamed coconut
- Meat fat, sausages, salami
- Pasties, pastry
- Dairy fats, including whole milk, full fat cheese, cream and crème fraiche
Fats to choose instead
- Margarines labelled (high in monounsaturates e.g. olive, rapeseed or vegetable oil based margarine
- Oils: olive oil, vegetable oil, rapeseed oil, sunflower oil, soya oil
- Fats found in oily fish, nuts, seeds and avocado
Food and drink high in fat and/or sugar
Check food labels and choose foods lower in saturated fat.
Eat a vegetarian meal twice a week by including beans, tofu or Quorn instead of meat or poultry.
Use olive oil, rapeseed oil or vegetable oil for salad dressings and in cooking.
Note: all foods containing fats and oils, even if they are healthy, are high in calories. Use sparingly if you are trying to lose weight.
Sugary foods and drinks
Sugary foods and drinks will raise your blood glucose levels. Small amounts of sugar within a food will not have a significant effect.
Ways to reduce your sugar intake:
Foods to try instead
• Reduce portions or try tablet or sprinkle sweeteners such as Canderel, Splenda, Sweetex, Silverspoon Sweetener, Truvia, Hermesetas
• Low-calorie or diet squash, fizzy drinks and flavoured waters
• a sweetener and low calorie drinking chocolate
• Low calorie or sugar free desserts and milk puddings using a sweetener
• 1 scoop of plain vanilla ice-cream, sugar free custards or whips
• Low fat or healthy eating yoghurts
• Sugar free jelly
• Fresh fruit, fruit stewed without sugar or fruit canned in juice.
Items containing sugar
• Sugar, honey or syrup added to drinks and cereals
• Sugar containing drinks
• Ordinary milky drinks such as drinking chocolate, malted milk drinks
• Sugary puddings and desserts such as sponge, pies and tarts
• Ordinary milk puddings and instant desserts
• Full fat yoghurts containing cream
• Ordinary jelly
• Fruit canned in syrup
Aim for a healthy weight
If you are overweight, especially where it is carried more around your waist, losing weight can reduce your risk of heart disease, high blood pressure, a stroke and can improve your diabetic control.
Top tips for weight loss
• Aim to lose weight gradually, making small changes you can stick to. This wayit will stay off.
• Be more active. Build up to 30 minutes walking each day.
• Eat slowly and sit down for meals
• Many people lose weight just by cutting down on fatty and sugary foods. If you don’t, then try smaller portions or use a smaller plate
• As a guide, a good sized portion of starchy carbohydrate is about a handful or fistful
• Try using cooking methods that don’t add too much extra fat or sugar
• Reduce your intake of alcohol
• Filling half your plate with vegetables is a good way to limit the calorie intake of your meal.
Ask your dietician or health care professional if you need more information.
Making sense of food labelling
There are three things you can look at on the food label: the front of pack nutrition information, the ingredients list and the nutrition panel.
Front of pack nutrition information provides the amount of energy, fat, saturated fat, sugar and salt in a portion of the product. Often they are colour coded red, amber, green to help you. It’s useful to compare products. The manufacturers idea of a portion may be different to yours so do check.
Ingredients are listed in order of weight. If the first or second ingredients is sugar, glucose, honey or syrup it is likely to be a very concentrated carbohydrate food. If the first ingredients are oil, hydrogenated vegetable oil, cream or cheese then it is likely to be a high fat food.
You can also look at the nutrition information panel. Most food labels give figures for both 100g or a ‘serving’ of the food.
Look at the figure for a 100g and compare it with the chart below to give you an idea of whether you would be eating a lot or a little of each nutrient.
- 22.5kg – A lot 5g – A little
- 17.5g – A lot 3g – A little
- 5g – A lot 1.5g – A little
- 3g – A lot 0.5g – A little
- 1.5g – A lot 0.3g – A little
Watch out for nutritional claims. Just because something is low in fat doesn’t mean it’s low in energy. Many low fat foods are high in sugar.
Special Diabetic Products
There is nothing to be gained from buying special diabetic products. They are often high in energy and may be expensive.
• Products containing sorbitol, mannitol xylitol or isomalt may cause stomachupsets.
• Use ordinary low sugar products instead.
The ideal is to get used to having less sweet foods. If you choose to use a sweetener then most tablet, powdered or liquid sweeteners are suitable.
• Powdered sweeteners containing aspartame, Stevia, acesulfame k, saccharin or sucralose ( e.g. Canderel, Splenda, Silverspoon Sweetener, Truvia, Sweetex, Hermesetas).
• Use the smallest amount of sweetener you can and try to use a variety of types. For example, if you have a fizzy drink containing aspartame (Nutrasweet), use a tablet sweetener based on saccharine or acesulfame k in your drinks.
If you do drink alcohol it is advised to drink in moderation. The advice is the same for both men and women – a maximum of 2-3 units of alcohol a day. It is also advised to have 2 alcohol free days a week.
One unit of alcohol does not mean one drink.
One unit of alcohol is:
1/2 pint beer, lager or cider (4% ABV)
1/3 pint beer, lager or cider (5% ABV)
1/2 standard (175ml) glass of wine (11-13% ABV)
1 small measure (25ml) of spirit e.g. gin, vodka, whisky
1 small glass (50ml) sherry
Tips for drinking alcohol
If you take insulin or some tablets take care when drinking alcohol as it can lead to low blood glucose levels (hypoglycaemia) several hours later.
Drink alcohol with a meal rather than on its own.
Avoid low sugar beers and lagers as they have a higher alcohol content, even if their sugar content is low.
Low alcohol wines are often higher in sugar than ordinary wine so it’s best to limit or choose a drier variety.
Drinks with a high sugar content (e.g. sweet cider, sherry, dessert wines and most liqueurs) should be limited.
Try sugar-free mixers.
Most people take far more salt in their food than their body needs. If you have high blood pressure, you may be able to reduce it by taking less salt.
Use less salt in cooking
Avoid adding salt to meals
Cut back on salty foods such as cheese, processed meats, ready-made dishes,
savoury snacks, packaged sauces and stock
Avoid salt substitutes like Lo-salt.
Ask a health care professional for more information about eating less salt.
Being more active
Being more active has important benefits for people with diabetes, including:
Reducing your risk of conditions including heart disease and stroke.
Lowering blood glucose levels and improving diabetes control.
Maintaining a healthy weight
The Department of Health recommends adults should aim to be active on a daily basis. Working towards a target of two and a half hours of moderate activity a week. This can be in bouts of 10 minutes and can include things like walking or cycling.
These targets may not be reachable for everyone. Any activity you do will have some health benefits. There are also exercises you can do while sitting in a chair. Talk to your diabetes healthcare team about the activities most suited to you.
Ideas for meals
Fruit or 1 small/medium glass of fruit and vegetable smoothie (try adding some oats to slow down digestion)
High fibre cereal or porridge with semi skimmed milk
Wholegrain bread or toast with a little margarine spread and a small amount of jam, marmalade or savoury spread
No added sugar muesli and natural yoghurt
Baked beans or egg on toast
– Quick meals
Sandwich with salad and tinned fish, lean meat, chicken, eggs or low fat houmous
Lentil or vegetable soup with a wholegrain bread roll
Jacket potato with filling such as baked beans, cottage cheese or tuna served with salad
Toast topped with baked beans, egg, tinned fish, cheese, tomatoes or mushrooms
Smoked mackerel or low fat houmous and salad pitta bread or wrap
– Main meals
Lean roast meat with boiled or dry-roasted potatoes and a selection of vegetables
Pasta with a tomato-based sauce and bowl of salad
Fish or cottage pie served with peas or green vegetable
Vegetable/lentil or lean meat curry with rice and salad
Spaghetti bolognaise made with lean mince and served with a salad
Stews and casseroles made with lean meat, beans and vegetables
Fresh fruit salad
Low fat, low sugar yoghurt
Stewed fruit and reduced sugar custard
Fruit tinned in natural juice
Sugar free jelly
– Between meals
If you need to lose weight, try to avoid snacking between meals or have a piece of fruit.
If you do choose to have a snack then try small portions of the following foods and have a small amount of margarine or low fat spread if required. Foods such as plain biscuits, fresh fruit, low fat yoghurt, chopped vegetables or wholegrain crackers.
Tea, coffee (without sugar)
Low calorie or no added sugar squash, fizzy drinks or flavoured water.
Note: Be careful with fruit juice and smoothies. It may be labelled ‘no added sugar’ but still contains a lot of natural sugars, which can have a big effect on blood glucose levels.
For further information:
Diabetes UK Careline: 0845 1202960
Produced by Sirona Dietitians, Nutrition and Dietetics, Sirona care & health
How to contact us:
Sirona care & health, Yate Westgate Centre,
Yate, 21 West Walk, Bristol BS37 4AX
Tel No. 01454 315355 (option 2)