Diabetes and diet

These days, there are general dietary recommendations which apply to everyone: not too much fat, not too much sugar, low alcohol intake and natural, high-fibre foods.

Modern diabetes diet: plenty allowed and little forbidden

In the past, diabetics were not allowed to eat several different foods. Diets were often unbalanced and one-dimensional as a result of the numerous forbidden foods. The dietary recommendations today for diabetes mellitus type 2 sufferers have a sound scientific basis. They were developed by European organisations in collaboration with national associations such as the German Society for Nutritional Medicine (DGEM), the German Nutrition Society (DGE) and the German Diabetes Association.

Whilst diabetics used to be subject to strict rules regarding diet, a healthy balanced diet is now recommended for diabetics.

The current dietary recommendations for diabetics barely differ from those of a general healthy diet. The main criteria is that food intake is balanced and rich in nutrients. Type 2 diabetics who consequently change their diet can often bring down their blood sugar levels to normal levels. Type 1 diabetes sufferers find it easier to control blood sugar levels.

Controlling weight without dieting

Crash diets and one-sided diets are particularly inappropriate for diabetics since weight fluctuations often affect the heart and circulation and lead to complications. Obesity occurs if the energy intake provided by food over a long period exceeds the amount than the body can consume. For example, if a person eats 60 kilocalories more than the body needs, a person's weight will increase by approx. 3 kg in one year. You cannot get rid of the weight accumulated over the course of years in just a few weeks. Ideally, weight should be reduced slowly and steadily by approx. 500 g per week.

Picking up weight quickly after a successful diet is known as the yo-yo effect

Less fat makes you slim

Energy can be most easily saved in the daily diet if the fat content of the food is reduced. One gram of fat provides double the number of kilocalories as one gram of protein or one gram of carbohydrates. Fat therefore contributes significantly towards obesity, regardless of whether it comes from butter, low-fat margarine, cheese, sausage or chocolate. A total lack of fat is also not recommended, because the body relies on fat elements (fatty acids) for regulating blood pressure and hormone production. The fat-soluble vitamins A, D, E and K can also only be used with the help of dietary fat.

An adult needs around one gram of fat per kilogram of normal weight, and losing weight requires a daily fat intake of no more than 60 g. A sensible breakdown of the daily fat quantity is given below:

• 20 g spreadable fat
• 20 g cooking fat and dripping
• 20 g hidden fat in food

Although many people already use cooking fat and spreading fat sparingly, they still eat more fat than is good for them. This is due to the fact that two thirds of the daily intake of fat comes in the form of fats hidden in food. It is not always easy for consumers to detect the hidden fat content in dishes and foodstuffs or to properly estimate the content. Whilst the fat content in milk and dairy products is often overestimated, pastries, ready meals and fast food products provide significantly more fat than is often assumed. Most hidden fats are eaten with meat and sausage products. It is therefore not enough to buy skimmed milk and low-fat yoghurt if you continue to eat meat and sausages, fried foods or greasy pastries which are high in fat, on a regular basis.

More than 60% of fats eaten daily are invisible to the naked eye.

It depends on the type of fat

Not just the quantity, but also the type of consumed fat is important. Animal fats have a different composition from vegetable fats. More saturated fats occur in lard, bacon and fatty meat and sausage than in vegetable oils. The body needs these fatty acids in smaller quantities than are frequently consumed.

Lean meat is not only lower in calories but also richer in minerals than fats. Many kinds of meat, e.g. chicken and veal, turkey breast, lean beef and pork are low in fat and also rich in protein.

Lean meat is not only lower in calories but also richer in minerals than fats. Many kinds of meat, e.g. chicken and veal, turkey breast, lean beef and pork are low in fat and also rich in protein.

Meat is part of a balanced diet. However, it should not be consumed in large quantities.

Diabetes mellitus is not curable in the sense that the disease completely disappears, though with good blood sugar control, diabetics can live a completely symptom-free and normal life.

Fish is a particularly valuable source of fat. It meets the demands of a modern lifestyle: fish is rich in vitamins and minerals, contains valuable protein and is mostly lower in fat than the equivalent portion of meat. Marine animals however are unique in that they contain fat compounds which are not present or barely present in other foods, i.e. omega-3 fatty acids. These compounds are key elements in counteracting omega-6 fatty acids which are mainly present in animal foods. If both fatty acid groups are consumed in balance, they work together to control blood pressure, good circulation as well as physical and mental fitness. Two to three fish dishes per week contribute towards a balanced fat intake. Whether the fish is eaten hot or cold is not relevant in this respect. Cold fish on bread or salad is just as nutritious as cooked fish. Salmon and herring are particularly good sources of omega-3 fatty acids. But it's not just fish that provides these valuable compounds: omega 3 fatty acids are also found in smaller quantities in green vegetables, nuts and seeds.

Fish is rich in vitamins and minerals, contains valuable protein and is generally lower in fat than a similarly-sized portion of meat.

Reduce fat

Whether you choose butter or margarine for your bread is primarily a question of quantity and taste. For diabetics who prefer margarine, unhardened margarine brands are recommended above those that are chemically hardened. Unhardened spreads do not contain any trans-fatty acids. These compounds are made when plant oils are subjected to a chemical process to make them spreadable, and they are available in some types of margarine as well as in frying and deep-frying fats and the products manufactured from these. These also include chips, crisps, puff pastry products and many ready-made and fast food meals. Trans-fatty acids are more difficult for the human body to break down than natural fatty acids, they stay in the blood longer, deposit on vascular walls more quickly and promote the development of arterial sclerosis (hardening of the arteries). Many studies have proven that trans-fatty acids increase the level of LDL cholesterol, known as "bad cholesterol", in the blood. Consumers can see whether or not a spreadable fat contains trans-fatty acids by carefully studying the packaging: the comments "unhardened", "not transesterified" or "not chemically hardened", indicate that the product does not contain any trans-fatty acids. The best way to reduce elevated levels of cholesterol in the blood is to make sure your diet is not only low in fat, but also high in fibre.

Butter and margarine are part of an everyday diet for most people in Germany. While butter as a fat from milk has been used "since time immemorial" in the human diet, margarine has only been available for around 150 years.

Fibres lower blood sugar and cholesterol

The fibres contained in cereals, fruit and potatoes are important sources of energy. In human metabolism, they are broken down into glucose, which is then taken up into the blood stream for obtaining energy. Some organs and specific body tissues, for example the brain and nerves, obtain their energy solely from carbohydrate metabolism. In this process, it is less often the case that energy obtained from the sugar compounds is made available quickly; instead, it is provided for as long as possible. It is particularly important in diabetics' diets that the majority of foodstuffs consumed contain sugar components that are released slowly. Fibre slows the speed of blood sugar absorption.

As fibre swells up in the stomach, it ensures a long-lasting feeling of fullness and contributes to preventing or reducing excess weight. Carbohydrates are released more slowly from high-fibre foodstuffs. As a result, the blood sugar level increases more slowly and undesirable blood sugar peaks are avoided.

In order to achieve these effects, it is necessary to eat 30 to 40g of fibre per day. The minimum quantity of fibre cannot be achieved from fruit and vegetables alone. Other important sources of fibre are wholegrain baked goods, wholesome cereal flakes and cereals, as well as nuts and seeds. Just two slices of wholemeal bread (100g) contain a total of around 8.4g of fibre, while a portion of wholegrain cereal (50g) provides 5g. Fibres from grains are particularly valuable for diabetics because they improve the effect of insulin. It is not only the fibre content of the foodstuff but also its preparation that impacts blood sugar: sugar is released more slowly from fruit that has not been chopped up and peeled than from fruit which has been, and boiled potatoes release sugar more slowly than roast potatoes. Because meat and fish do not contain any fibre, vegetables or salad should also be part of every meal. Ideally, a portion of vegetables is 200g per person, with a salad portion being around 140 grams.

Vegetables and salad should be part of every main meal.

Dietary fibres are also part of the carbohydrate group, and are important for satiation and intestinal health. Carbohydrates are important sources of energy. They are mainly found in grains and grain products, for example bread, cereal, rice, pasta and oatmeal. Potatoes, fruit and sugar also provide carbohydrates. Since the body constantly consumes energy, it has to be continually supplied with more from food and drink.

Sweets within reason

Household sugar and dextrose are simple carbohydrates. These sugar compounds are absorbed much more quickly from the intestine into the blood than the starch contained in bread, potatoes and grains. The faster sugar is flowing into the bloodstream, and the more of that sugar there is, the more insulin the pancreas produces. If too little insulin is released, or if the effect of this hormone is reduced, blood sugar levels remain elevated. Reduce simple carbohydrates by not drinking sugar-heavy drinks, for example.

Fruit and vegetables protect against illness

Whilst people need less energy as they get older, the level of vitamins and minerals they need stays just as high. Taking in enough vitamins and minerals is particularly important for diabetics, to prevent accompanying diseases such as eye conditions, nerve function disorders and damage to blood vessels. Eating plenty of fruit and vegetables contributes significantly to illness prevention. As plant-based foodstuffs are low-calorie whilst also being rich in vitamins, minerals, dietary minerals and plant-based pigments, it is recommended that you eat a portion of fruit or vegetables five times a day. A portion is equivalent to one or two handfuls. One portion of uncooked vegetables can also be replaced with a glass of fruit or vegetable juice.

It is recommended that you eat a tasty, balanced and wholesome diet, which may also include a small quantity of sweets.

Milk products strengthen your nerves

Cheese, yoghurt, milk and soured milk provide valuable protein, which the body needs for renewing cell structures. Dairy products also include calcium, which is essential for healthy bones. The magnesium content is also important, as is the level of vitamins B2 and B6. These vital substances support nerve function. In order to sufficiently supply the body with all the nutrients it needs, it is recommended that you consume a dairy product three times a day. Low-fat curd is particularly valuable: not only does it have the lowest fat content of all dairy products, but also the highest protein content. Curd cheese is a truly a master of versatility in the kitchen. Delicious spreads can be prepared in just a few minutes using spices, herbs or vegetables, which can replace sausage and cheese. Curd can be used to replace cream in dressings and sauces, and combining it with fruit quickly creates a healthy dessert or low-calorie snack.

Drinking right improves circulation

The human body relies on being sufficiently hydrated. Drinking plenty of fluids improves blood flow and promotes circulation to your organs. How much liquid you need depends on various aspects including your weight and level of physical activity. Most people need around two litres of liquid per day.

Quelle: Renate Frank, Dipl. Oecotrophologin Ernährungberatung