Diabetes at the RCH

Nutrition and diabetes

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    Diet

    The diet used in the treatment of diabetes is a healthy, well-balanced diet, planned to give all the necessary foods to meet your nutritional requirements. The healthy food pyramid can be used as a good guide for healthy food choices (see pyramid below).

    It is important to eat regular meals and snacks throughout the day i.e. 3 main meals (breakfast, lunch and dinner) and 3 snacks (morning-tea, afternoon-tea and supper). Never skip or delay a meal*. All meals and snacks should include carbohydrate containing foods and your intake of carbohydrates should be consistent* from day-to-day. Foods containing carbohydrate include bread, breakfast cereals, potato, rice, pasta, crackers, fruit, milk and yoghurt.

    A good understanding of carbohydrates is essential for families of children with diabetes. Regular contact with an Accredited Practicing Dietitian experienced in Diabetes care is highly recommended for children with diabetes. Your Dietitian can help with all aspects of nutrition and food including issues with food patterns and carbohydrate spread, growth and development, appetite, physical activity, or just further education and advice on food and diabetes.

    *these points may not be as relevant for children on insulin pump therapy; discuss with your Diabetes team.

    Pyramid

    Low GI and diabetes

    It is important to try and include at least one low-glycaemic index (low GI) food at every meal and every snack. Low GI foods increase the blood sugars more slowly and steadily and are more sustaining than foods with a higher GI. Check out the low GI food checklist. Sugar and foods containing added sugars can be included in moderation in a healthy low-GI based diet without upsetting diabetes control.

    Does that mean I should only eat low GI foods?

    No. There are some foods that have a high glycaemic index value that provide other important nutrients (vitamins and minerals) and are found in the base of the healthy food pyramid (the "eat most" section). These foods (e.g. watermelon and other tropical fruits) should not be excluded and can be eaten in conjunction with other low glycaemic index foods. Combining low and high GI foods together results in a moderate GI effect.

    There are also many foods that have a low glycaemic index but are high in fat or have poor nutritional value and are therefore found in the top section of the healthy food pyramid (the "eat least" section). These foods are not recommended to be eaten on a regular basis. So remember, glycaemic index value alone does not determine the suitability of a food - the guidelines of a healthy diet (as illustrated by the healthy food pyramid) are the most important considerations. Stick to the guidelines of the healthy food pyramid and select low glycaemic index food choices where practical.

    If you would like to read more about the GI the following references will be useful:

    1. The GI Factor, 2ndEdition, Brand Miller, Foster-Powell, Colagiuri & Leeds, Hodder & Stoughton, 1998
    2. Pocket Guide to the GI Factor for Healthy Kids, Brand-Miller, Foster-Powell, Gilbertson, Hodder 2001

    Making the changes from high GI to low GI choices

    High GI food Low GI alternative
    Bread (white or wholemeal) Bread containing lots of 'grainy bits' such as Burgen™, Helga's™ Soy and Linseed, Multigrain, pita bread or sourdough breads
    Processed breakfast cereals Unrefined cereal such as rolled oats, muesli or a low GI processed cereal such as Guardian™, Special K™, or All Bran™
    Plain biscuits and crackers Biscuits made with dried fruit and whole grains such as oats
    Cakes and muffins Make them with fruit, oats and wholegrains
    Tropical fruits e.g. watermelon, ripe bananas Temperate fruits e.g. Apples, stone fruit and citrus fruit
    Potato Sweet potatoes, corn, pasta and legumes
    Most rices Basmati rice, Doongara rice (Clever rice) or Mahatma brand long grain rice.

    Note: adding lemon juice or vinegar to a meal can also help to reduce the GI load of the whole meal

    Recommended low GI foods

    Breakfast cereals
    • Rolled oats (porridge)
    • MiniWheats® (plain)
    • All Bran® varieties
    • Vitabrits®
    • Uncle Toby’s Healthwise® for Heart Wellbeing
    • SustainTM
    • Vogel’s Cluster Crunch® 
    • Muesli (untoasted)
    • Guardian®
    • WeetbixTM Blends (formerly “Hi bran”)
    • Just Right ®
    • Semolina
    • Special K®
    • Uncle Toby’s Oat brits®
    Legumes
    • Baked beans
    • Kidney beans
    • Black-eyed beans/peas
    • Black beans
    • Lentils
    • Lima beans (butter beans)
    • Chickpeas
    • Soya beans/peas
    • Haricot beans (navy beans)
    • Split peas
    • Pinto beans
    Grains/Pasta
    • Rice: Basmati
    • Mahatma premium classic
    • Sun rice low GI range
    • Wild rice
    • Koshikari short grain
    • Sri Lankan red rice
    • Pasta: Any ‘wheat based’ types
    • Fresh noodles (rice, udon), soba noodles, vermiceli
    • Grains: pearl barley
    • Pearl cous cous, buckwheat
    • Bulgur, quinoa
    • Semolina, barley
    • Rye, oat
    • Bran
    Breads
    • Dense wholegrain
    • Stone-ground wholemeal
    • Mixed grain bread
    • Pumpernickel
    • BürgenTM: Soy-lin, Pumpkin seeds, Fruit and muesli, Rye, Wholemeal and seeds
    • Fruit and grain loaf
    • Oat bran bread
    • Traditional sourdough
    • White corn tortillas
    • Tip TopTM: 9-Grain varieties,
    • The One® lower GI white bread and Lower GI wholemeal, spicy fruit loaf
    • Barley/Rye kernel bread
    • Linseed rye
    • Wholemeal pita bread
    • Country Life: low GI whiteTMand multigrain
    Dairy foods
    • Milk 
    • Yakult
    • Yoghurt
    • Soymilk
    • Yoghurt drinks
    • Custard
    Fruits
    • Apples
    • Oranges
    • Grapes
    • Peaches
    • Dried apricots
    • Firm bananas
    • Cherries
    • Plums
    • Kiwi fruit
    • Sultanas
    • Prunes
    • Pears
    • Grapefruit
    • Apricots
    • Mango
    • Dried apple
    Vegetables
    Sweet potato CarismaTM , Nicola Potato Corn
    Miscellaneous
    • Popcorn
    • Milo® / Nesquik®
    • Nutella®
    • Oatmeal biscuits
    • Strawberry/Apricot Jam
    • Fruit Smoothie (milk based)
    Wholegrain crackers (e.g. Vita-WeatTM or Ryvita® Multigrain)
    Not all low GI foods are healthy everyday choices
    Chocolate Mousse Ice cream Chocolate

    *IMPORTANT: this is not an exhaustive list. There are many other brands available which may be suitable low GI choices. A good source of information is the Low GI Diet Shopper's Guide 2016 which is updated annually.

    Useful apps 

    Some apps that might be useful when on the  go and trying to count/ estimate carbohydrate content of mixed meals include;

    Calorie King

    This app generates a nutrition panel similar to that seen on product packaging. The beauty of this app is the ability to manipulate the portion size consumed while the app calculates the amount of each nutrient (carbohydrate in this case) for you! 

    Once the app is open, the first task is to search for the food you are enquiring about.

    If the specific brand is unknown the app generates an average for all brands or alternatively if the specific brand is known, you can scroll down the list to find it for more accurate information.

    Unfortunately for the time being this app is only available on IOS devices however can be accessed via web browsers on mobile devices and desktop computers at www.calorieking.com.au

    CKK

    FigWee

    This app is particularly useful for people who like a visual. The app opens similarly to Calorie King in that you have a search bar to search for the particular food required. Once found and opened, a picture of this food appears with a scale for adjusting the size of the portion along the right hand side of the image.

    As the item is scaled up or down in size, the nutritional information below the picture adjusts to represent the composition of that portion size.

    FW

    **This app needs to be purchased at $4.49 

    Easy Diet Diary

    This app is useful for a number of its functions, most relevant to diabetes is the ability to input your own recipes to assist with carbohydrate counting. Once the recipe ingredients and quantities have been inputted, along with the number of serves produced, the app automatically, using Australian food databases, generates a nutrition panel similar to those seen in apps mentioned above. 

    EDD

    EDD!