Healthy diet for diabetes Healthy eating is an important part of managing your diabetes, so you need to be aware of what, when and how much you eat every day. Eating a healthy diet helps to keep your blood glucose levels within your target range, which reduces the risk of developing diabetes-related complications. There is no such thing as a diabetic diet. People living with diabetes can enjoy the same foods as everybody else. As a starting point, we recommend people follow the Australian Dietary Guidelines Healthy Eating for Adults and Healthy Eating for Children. Where to find dietary advice What should I eat Eat a variety of vegetables and legumes/beans Eat 2 serves of fruit a day Grain foods such as breads, cereals, rice and pasta Lean meat, fish, poultry and nuts Milk, yoghurt, cheese or dairy alternatives Sugar Drink water Between-Meal Snacks Maintaining a healthy weight More information Where to find dietary advice Diabetes Australia recommends that everyone with diabetes visit an accredited practising dietitian for individualised dietary advice. Talking to an accredited practising dietitian can help you learn how to make better food choices and improve your health. A dietitian can also help you put together a food plan that meets your individual dietary needs. If you have been diagnosed with gestational diabetes (or have type 1 or type 2 diabetes and are pregnant) your dietitian can help you develop a healthy eating plan to maintain healthy blood glucose levels and meet your special nutritional needs throughout your pregnancy. To find a dietitian in your area, contact: Dietitians Australia – look for the “find a dietitian” search on https://dietitiansaustralia.org.au/ or call 1800 812 942 our contact centre. Dietitians are accessible and are usually based in many local hospitals, diabetes centres and community health centres. You can consult a dietitian in-person, by telephone or by telehealth (a video call). Medicare may provide a rebate on dietitians’ fees if you have a chronic condition, like diabetes, and are referred by your doctor under a Chronic Disease Management Plan. If you have private health insurance you may also receive a rebate from your health fund, depending on the type of cover you have. What should I eat A healthy diet is the foundation of diabetes management and a healthier way of life for everyone. We believe there is no one-size-fits-all approach to food and diabetes and that’s why people should talk to a qualified health professional to develop an approach that suits them. Healthy eating is all about enjoying a variety of foods from each of the five food groups: vegetables and legumes/beans fruit wholegrain foods such as breads, cereals, rice and pasta lean meat, fish, poultry, tofu, tempeh and nuts milk, yoghurt, cheese or non-dairy, calcium fortified plant alternatives. To help manage your diabetes: Choose more whole, unprocessed foods and less processed or packaged foods Eat regular meals and spread them evenly throughout the day Get to know what type and how much carbohydrate foods to eat for you Look to follow a low GI diet and reduce the GL of your meals Eat a diet lower in fat, particularly saturated fat If you take insulin or diabetes tablets, you may need to have between-meal snacks, check with your healthcare team if this is necessary for you Everyone’s needs are different – all people with diabetes should see an accredited practising dietitian in conjunction with their diabetes team for individualised advice. Low carb eating If you’re interested in following a low carb approach read our position statement Low carb eating for people with diabetes. Watch Diabetes Australia’s low-carb eating for people living with diabetes Q&A (video) with Professor Grant Brinkworth from the CSIRO. Find out more about carbohydrate food and how they affect blood glucose levels. Join today – for FREE! Join Diabetes YOUnited Essential membership for FREE and enjoy a range of benefits to help you live well with diabetes. Join today! Energy balance Eating well is all about finding the right balance of food that works for you. Matching the amount of food you eat with the amount of energy you burn through activity and exercise is important. Putting too much fuel in your body can lead to weight gain. Limit foods high in energy such as take away foods, sweet biscuits, cakes, sugar sweetened drinks and fruit juice, lollies, chocolate and savoury snacks. You can also review your portion size and eat mindfully to manage the amount of energy you eat. Learn more about mindful eating. Along with healthy eating, regular physical activity can help you to manage your blood glucose levels, reduce your blood fats (cholesterol and triglycerides) and maintain a healthy weight. Learn more about exercise and diabetes. Mindful eating Mindful eating is a technique you can use to help you to enjoy your food more as well as to help you to avoid overeating – no one likes to feel bloated and over-full. Overeating can cause weight gain or prevent weight loss, or increase blood glucose levels if the food contains carbohydrate. So, by eating mindfully you can enjoy your food, and manage your weight and your blood glucose. How do I mindfully eat? Focus on your food – reduce eating distractions by turning the television off and putting your phone, book or newspaper aside. Take your time to enjoy your food. Eat while using all your senses – savour all of the sensations: look at the food and enjoy its sight, smell the aroma, feel the sensation in your mouth, taste the flavours. If you are using cutlery, put your cutlery down once you put the food in your mouth. Take your time to chew. Then swallow the food. Most people will eat less, even of their favourite treat foods, if they eat them mindfully. Your body has time to tell your mind “that’s enough”. As you eat, listen for the body signals that tell you that you are no longer hungry or you have had enough of that food. Be curious and conscious – observe the signs that show that you’re comfortably full. Pause in the middle of eating and ask yourself how the food tastes, and what your current hunger level is. How hungry/full am I? You can use a rating system to help you become aware of your hunger and fullness cues – it may take some time to re-learn them – you might like to rate how hungry or full you are on a scale of one to ten where you think about how hungry you are before a meal and set an intention of how you would like to feel at the end of the meal. Hunger /fullness Physical sensation 1 Starvation, need to eat now, hunger pains, shaky, light headed 2 Slight pain in stomach, hard to concentrate, lack of energy 3 Beginning of physical signs of hunger, stomach growling sometimes 4 Could eat if it were suggested 5 Neutral 6 Satisfied 7 Can feel food in stomach 8 Stomach sticks out 9 Bloated, clothes feel tight, sleepy and drained 10 Definitely full, stomach uncomfortable, no energy, physically sick Trust your subtle feelings of hunger or fullness, honour your hunger – eat enough to be satisfied while remembering what your intention was to feel like at the end of eating. Stop eating when you feel satisfied or even when you feel neutral. Later, reflect on how you feel and if you have a higher hunger/fullness rating at the end of eating compared to your intention don’t beat yourself up about it but recall how you felt part way through your eating so you can how much you eat at the next similar meal. Why do I eat what I eat? Consider what prompts you to choose particular foods and portion sizes. Is it habit? Or convenience? Or stress and emotions? When you think about all factors which influence your eating you may be surprised. For example, the plate size you use can make you serve larger portions if it’s a large plate or smaller portions if it’s a smaller plate. Emotional eating Most people know what happens to their eating choices when they feel stressed, sad or emotional. We tend to eat “sometimes” or treat foods, often in larger portions than we would normally. Then you feel “bad” or like you have failed to achieve that healthy eating ideal which is promoted. When we feel “bad” we tend to eat more of that “sometimes” or treat food, so it becomes a poor eating cycle. Don’t judge yourself. Be kind. Say to yourself what you would say to another person. Tomorrow is a new day, you can “get back on the horse”, so to speak, and keep working towards healthy eating. And remember, always enjoy your food! Eat a variety of vegetables and legumes/beans Eating a wide variety of vegetables every day is a great way to make sure that you are getting the nutrients you need to stay healthy. As well as providing important nutrients and loads of fibre, vegetables are very low in kilojoules meaning they are great food to fill up on without having to worry about your waistline. Most Australians need more vegetables in their diet. For good health, we should all be eating at least 5 serves of vegetables every day. A serve of vegetables is equal to ½ cup cooked green or orange vegetables, beans, lentils or other legumes; 1 cup of salad or ½ a medium potato. Types of vegetables include: Carrots, broccoli, cauliflower, peas, corn, zucchini Potato, sweet potato, pumpkin Lettuce, baby spinach leaves, kale, cucumber, tomato Chickpeas, kidney beans, lentils Frozen or canned vegetables are great alternatives for fresh vegetables and are just as nutritious. These are also often cheaper, easy to prepare and may be easier to access in remote areas. Just make sure to choose canned vegetables with no added salt. Finding it hard to reach your five serves of vegetables? Try these tips to get more veggies into your day: Eat a variety of colours of vegetables every day including red, green, orange and white choices Cut up vegetables into sticks and store in the fridge for an easy and healthy snack Add vegetables to every meal. Add grated or chopped vegies into soups, casseroles or pasta dishes. Add beans to meat dishes such as bolognese sauce or taco mince. Buy vegetables in season or from local sources such as farmers markets for best value for money and long-lasting freshness. Check out our recipes. Eat 2 serves of fruit a day In Australia we are lucky to have a huge variety of delicious fruit all year round. Like vegetables, fruit provides many important nutrients and is packed with fibre. It is recommended to eat 2 serves of fruit a day. Canned and frozen fruit are also great choices for quick and healthy snacks or to add to your favourite meals. Make sure to choose canned fruit in natural juice rather than syrup. Tip off the juice and syrup. Example serves of fruit include: 1 medium apple, pear, banana or orange 2 small apricots, plums or kiwi fruits 1 cup of canned fruit (no juice) ½ cup of 100% fruit juice (no added sugar) 4 dried apricots or 1 ½ tablespoons of sultanas Tips to enjoying fruit every day: Choose fresh fruit over fruit juice or dried fruit Top your breakfast cereal with your favourite fresh fruit instead of sugar or honey Try fruit as a dessert with low fat yoghurt or custard Buy fruit in season or from local sources such as farmers markets for best value for money and long-lasting freshness. Grain foods such as breads, cereals, rice and pasta Choose wholegrain varieties, such as multigrain bread, wherever possible to make sure you get long lasting energy and plenty of fibre and B group vitamins. The grain foods group includes food like: breads breakfast cereal rolled oats rice pasta noodles crispbreads crumpets polenta cous cous quinoa Often people are concerned about eating too many foods from this food group, particularly if they are trying to manage their weight. However, these foods tend to be very low in fat and will keep you fuller for longer, particularly if you choose wholegrain options. Keep an eye on your portion sizes and try to reduce the amount of butter, margarine or other high fat spreads that you add to these foods. A serve of grain foods is equal to: 1 slice of bread 1/2 a bread roll 1/2 cup of cooked rice or pasta 2/3 cup of breakfast cereal Great grain tips: For variety, experiment with different grain foods like cous cous or polenta. They are very quick to prepare and delicious served with casserole dishes Add pearl barley to soups for an extra burst of energy Try different types of breads for your lunch time sandwiches including sourdough bread, wholemeal pita bread or multigrain wraps. Read more about carbohydrates. Lean meat, fish, poultry and nuts This food group is the main source of protein, iron and vitamin B12 for our bodies. Iron is particularly important for women and the iron in meat is more easily absorbed than the iron from other foods such as vegetables and legumes. Meat is an important part of the Australian diet but we tend to eat bigger servings than we require. A protein serve is equal to: 65g of cooked lean red meat such as beef, pork or lamb (about 90-100g raw) 80g of cooked lean chicken or turkey (100g raw) 100g of cooked fish (about 115g raw) 2 large eggs 1 cup of cooked or canned lentils, chickpeas or other beans 170g tofu, or 30g unsalted nuts For those who don’t eat meat, alternatives such as lentils, chickpeas or other beans are important sources of protein. However, everyone could benefit from eating these types of foods more often. The fat in meat tends to be saturated fat so be sure to choose lean cuts of meat wherever possible and remove all visible fat from your meat before you cook it. More tips to lower the fat content: Try low fat cooking methods such as grilling or stir frying. Flavour your meat with low fat marinades and herbs such as mixed herbs, garlic and lemon juice. When cooking casseroles and stews allow them to cool slightly and skim the fat off the top before serving. Reduce the amount of meat you use in a recipe and replace with legumes like kidney beans, chickpeas or lentils (this will save money and add more fibre too!). Try to eat more fish every week and grill or bake your fish rather than deep frying. Try to include 1-2 meat-free meals each week by swapping in other protein-rich foods like eggs, tofu or other legumes. Milk, yoghurt, cheese or dairy alternatives Dairy foods such as milk, yoghurt and cheese are an important source of calcium and protein. Most adults are recommended to eat at least 2 ½ serves of dairy each day. For good health try to choose low fat or skim varieties of milk, yoghurt and cheese. An example serve from this food group is: 1 cup of milk (250ml) 2 slices of cheese 200g tub of yoghurt ½ cup evaporated milk If you don’t eat dairy foods, calcium fortified soy or plant-based milk or yoghurt are great alternatives. Other non-dairy sources of calcium include green leafy vegetables, canned fish with bones like sardines or salmon and almonds. Dairy tips: Snack on low fat yogurt or wholegrain crackers with cheese Try adding your favourite fruit to natural yoghurt to reduce added sugars Choose plain milk over flavoured varieties Add cheese to your sandwiches, pasta or vegetable dishes Sugar A healthy eating plan for diabetes can include some sugar. It is ok to have a sprinkle of sugar on porridge or a scrape of jam on some low GI high fibre bread. However, foods that are high in added sugars are low in nutrients should be eaten only sometimes and in small amounts. In particular, limit high energy (kilojoule or calorie) foods such as sweets, chocolates, lollies, cakes, biscuits, and standard soft drinks. Some sugar may also be used in cooking and many recipes can be modified to use less than the amount stated or substituted with an alternative sweetener. Select recipes that are low in fat (particularly saturated fat) and contain some fibre. Alternative sweeteners As mentioned above small amounts of sugar as part of a balanced meal plan shouldn’t have a large effect on blood glucose levels. However, sweeteners such as Equal, Stevia, Sugarine and Splenda can be used in place of sugar, especially if they are replacing large amounts of sugar. Foods and drinks that have been sweetened with an alternative sweetener, such as diet soft drinks and cordials, sugar-free lollies etc., are also best enjoyed occasionally, as they do not have any nutritional benefit and may often take the place of more nutritious foods and drinks, such as fruits, vegetables, dairy products, nuts and water. Drink water Water is needed for most of the body’s functions and the body needs to be kept hydrated every day. Water is the best drink to have because it contains no extra kilojoules and won’t have an effect on your blood glucose levels and it’s great for your kidneys. Other good choices are tea, coffee, herbal tea, water, soda water, plain mineral water. If you want a sweet drink occasionally, try products labelled ‘diet’ or ‘low joule’. If you choose to drink alcohol limit your intake to no more than ten standard drinks per week, no more than four standard drinks on any one day and include some alcohol-free days each week. Between-Meal Snacks People with diabetes on certain types of tablets or insulin may require a snack between each meal and for supper. However, most people aiming to manage their body weight are advised not to have snacks between meals. For specific advice, discuss this with your doctor, dietitian or credentialled diabetes educator. There are lots of healthy choices that can be used as snack foods. Select fruit that is in season (e.g. an apple, a banana, a peach, a pear, 3 small apricots, 1/2 a cup of grapes, and 1 cup of strawberries or a slice of rockmelon or watermelon). Other suggestions are listed below: Fresh or tinned fruit (e.g. 1 peach, 3 apricots, 1 pear, 2 mandarins, grapes, 1/2 a mango, 3 plums, 1 banana, 1 orange, 1 circle of pineapple) – drain the juice off Vegetable sticks (e.g. celery, carrot, capsicum, snow peas) with 1 tablespoon of low fat dip. Celery boats filled with 2 tbsp of cottage cheese and chopped tomato 30 grams of mixed, unsalted nuts 1 slice of raisin toast (sliced thinly or ½ a slice of café thickness raisin toast) or multigrain bread 1 tub of low-fat, unflavoured yoghurt 1 cup or 250 mL reduced fat milk 30 grams of salt reduced pretzels Vitawheat biscuits topped with cottage cheese, tomato and chives 1 cup of plain popcorn 1/2 wholegrain English muffin with tomato slices and 1 slice of reduced-fat cheese. 2 toasted wholemeal or grain pita bread triangles with 1 tbsp low fat tomato salsa dip. 2 small sushi rolls (avoid using soy sauce) 1 small can of baked beans Read more about between-meal snacks. Maintaining a healthy weight Diabetes and body weight A healthy body weight is important for everyone. If you are above your most healthy weight, then small weight loss (5-10% of body weight) can make a big difference to your diabetes management. You may find measuring your waistline to be a better way of monitoring your weight rather than scales. In general: women should aim for a waistline of less than 80 cm men should aim for a waistline of less than 94 cm. Appropriate measurements for different cultural groups should be discussed with your GP. Some positive steps you can take to reduce your waistline are: eating a healthy balanced diet. This may include decreasing your kilojoule and total fat intake, often by reducing your discretionary (sometimes) food and drink intake. Read more about healthy eating here (link) participate in regular physical activity ask for individualised advice from your doctor, dietitian or diabetes educator. Weight is a sensitive topic for many people and achieving weight loss and maintaining weight loss can be difficult. If you would like additional support with weight loss or maintaining a healthy weight speak with your doctor, dietitian or diabetes educator. More information Recipes Modifying recipes Diabetes cookbooks Eating out & take-away Cholesterol Carbohydrates, protein and fats Should I drink alcohol? Reading food labels Coeliac disease & diabetes Healthy eating for older people