Diet and weight
In Berkshire West, all newly diagnosed diabetic patients are offered an appointment with dietician and again later if they are struggling with controlling their weight. If you need further help from the dietician in the first 6 months, you can refer yourself back to the dietician; otherwise your GP or practice nurse will need to refer you again.
The Dieticians see mostly new Type 2 diabetic patients and also Type 2 diabetic patients whose blood sugars are poorly controlled. Dieticians are starting to see more new Type 1 diabetics, especially those being treated with insulin either twice or four times a day.
Nationally, about 80% of Type 2 diabetic patients are overweight (BMI 26 - 30) or obese (BMI over 30). Type 2 diabetic patients who progress to having to use insulin are more at risk of further weight gain and obesity, so it is very important to try and control your weight.
The dieticians teach patients “carb-counting” and will also advise about food labelling. Many patients don’t understand what to look for on food labels. Nutrition labels can help you choose between products, and keep a check on the amount of foods high in fat, salt and added sugars that you're eating. Some front of pack nutrition labels now use red, amber and green (traffic light) colour coding.
Further information about food labelling is available on the NHS choices website.
The dieticians will also offer advice on other areas for example: managing your diet during Ramadan.
If you need extra help and encouragement to lose weight, your GP or dietician can refer you to one of several weight management groups run locally.
The dieticians have clinics at Newbury and Wokingham hospitals; at their base at 689 Oxford Rd, at Whitley health centre and also in Hungerford
Even though you are diabetic, you should still be able to enjoy a wide variety of food. There are many ways that you can try to make your diet is as healthy as possible; for example:
- Avoid skipping meals and space out your breakfast, lunch and evening meal over the day. This will not only help control your appetite but will also help control your blood sugar levels.
- The amount of carbohydrate you eat is important to control your blood glucose levels. Especially try to include those that are more slowly absorbed as these won’t affect your blood glucose levels as much. Examples include grainy breads such as granary, pasta, potatoes, rice and cereals, bran cereals and natural muesli.
- Choose wholegrain bread, brown rice and pasta, where possible, rather than white
- Eat plenty of fibre-rich foods such as oats, beans, peas, lentils, seeds, fruit and vegetables. These can help to maintain the health of your digestive system and prevent problems such as constipation.
- Eat at least five portions of a variety of fruit and vegetables a day in place of foods higher in fat and calories. This will provide you with vitamins, minerals and fibre to help you to balance your overall diet.
- Avoid foods containing a lot of fat, especially saturated fat such as fried food, and choose to eat low fat foods where possible. Use less saturated fat by having less butter, margarine and cheese.
- Choose unsaturated fats or oils, especially monounsaturated fat (eg olive oil) as these types of fats are better for your heart. As fat is the greatest source of calories, eating less fat will help you to lose weight if you need to.
- Choose lean meat and fish as low fat alternatives to fatty meats.
- Choose lower fat dairy foods such as skimmed or semi-skimmed milk, low fat or diet yogurts, reduced fat cheese and lower fat spreads.
- Grill steam or oven bake instead of frying or cooking with oil or other fats.
- Avoid creamy sauces and dressings, choosing tomato-based sauces instead.
- Avoid foods containing a lot of sugar, sweetened drinks, sweets, cakes and chocolate. Using sugar-free, no added sugar or diet fizzy drinks/squashes, instead of sugary versions can be an easy way to reduce the sugar in your diet.
- Reduce the salt in your diet where possible as too much salt can raise your blood pressure, which can lead to stroke and heart disease. Limit the amount of processed foods you eat (as these are usually high in salt) and try flavouring foods with herbs and spices instead of salt.
- Drink alcohol in moderation only - a maximum of 2 units of alcohol per day for a woman and 3 units per day for a man. Alcohol contains lots of calories so think about cutting back further if you are trying to lose weight. Never drink on an empty stomach, as alcohol can make hypoglycaemia (low blood glucose levels) more likely to occur when taking certain diabetes medication.
- Try to eat at least two portions of oily fish each week. Examples include mackerel, sardines, salmon and pilchards. Oily fish contains a type of polyunsaturated fat called omega 3 which helps protect against heart disease.
Berkshire Health Promotion service has produced a number of interesting leaflets about healthy eating available to order (at a small charge) from Berkshire Health Promotion service or by Telephone: 01753 638678
Other sources of information about healthy eating that you may like to read include:
The Diabetes UK web site has interesting section about food and recipes, including information to help you if you are carbohydrate counting, a guide to menu planning and over 250 calorie counted recipes to try, which have been specially adapted, tasted and nutritionally analysed.
In addition, there is a free to download “Carbs count” e-book which gives an introduction to carbohydrate counting and insulin dose adjustment.
There is also a carbohydrate reference list, which can be used to help you work out the amount of carbohydrate you are eating and drinking at meal times and snacks, so that you can match this with the correct dose of insulin.
The Diabetes Research Wellness Foundation website has a booklet that you may find useful: A healthy diet and diabetes
You may find this a helpful reference book: “Carbs & Cals: A Visual Guide to Carbohydrate & Calorie Counting for People with Diabetes” (Publisher: Chello Publishing Limited; 4th edition (29 Nov 2010); recommended retail price £12.99 but available cheaper from various booksellers). This paperback book contains over 1,200 photographs of popular food and drink items, arranged into 15 colour-coded sections, and clearly showing the amount of carbohydrate and calories in each photo.
The Diabetes.co.uk website has produced a BMI (Body Mass Index) calculator which can be worked out from knowing your weight and height.
The NHS Choices website has a section called “Live Well” that includes lots of information about healthy eating, including:
- a 12-week weight loss plan;
- lots of suggestions about how simple changes to your lifestyle can help you achieve a healthy weight;
- information about a healthy, nutritious diet,
- Healthy recipe ideas for meals low in fat, saturated fat, sugar and salt but high in taste; and which can help you get your 5 a day.
- a BMI healthy weight calculator and a healthy eating health assessment
Weight No Longer (WNL)
This is a weight loss programme run by NHS dieticians in Reading, Wokingham and West Berkshire, for anyone who needs to lose weight for health reasons. This course advises on safe weight loss and supports people to make positive and permanent lifestyle changes to manage their own health for the future.
To register on the next course ask your GP or nurse to refer you.
Contact details for more information can be found in the local services section of this web-site, under Local NHS Services
Eat 4 health is a weight loss programme run in Reading, West Berkshire and Wokingham for anyone wanting to lose weight or lead a healthier lifestyle. Learn how to eat well, lose weight, and keep it off. 45 minutes of gentle physical activity. Perfect for burning calories and ideal for those new to exercise.
They run daytime and evening courses at various venues across Berkshire West, including one evening course in Reading specifically for Men ONLY
Simply register on the next course by calling eat 4 health on 01189 822954 or email; email@example.com
Or ask your GP or Nurse to refer you under the 'GP Exercise Referral Programme'
Cut the waist is a website with very detailed advice and information about losing weight. It is written by a local GP, Dr Andrew Brewster
NHS Change 4 Life is a website that offers information on how to:
The Diabetes Research Wellness Foundation - publishes “The Diabetes Wellness Patient Information Series” – leaflets which are freely available on request from their web-site. These include information about a healthy diet and diabetes
The DRWF Diabetes Information Leaflets are also available to play as audio files