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NHS Diet Advice for Diabetes

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In the UK, current 2016 NHS diabetes diet advice is that there is no special diet for people with diabetes.

Many people with diabetes focus on the carbohydrate content of their meals and prefer a low-carb diet for tight blood glucose level control.

The NHS (and Diabetes UK) recommend a healthy, balanced diet that is low in fat, sugar and salt and contain a high level of fresh fruit and vegetables.

This guide reviews the diet advice the NHS gives to people with diabetes and discusses to what degree the advice is sensible.

What does the NHS advise?

The NHS provides the following diet advice for people with diabetes: [147] [148]

  • Eat plenty of starchy carbohydrates with a low glycemic index (low GI)
  • Increase the amount of fibre in your diet
  • Eat plenty of fruit and vegetables – at least 5 portions per day
  • Cut down on fat and saturated fat in particular
  • Choose foods with unsaturated fat instead – such as vegetable oils, reduced fat spreads, oily fish and avocados
  • Choose low-fat dairy products
  • Choose lean meat – such as skinless chicken
  • Avoid fatty or processed meat
  • Eat fish at least twice a week and ensure you have oily fish at least once a week
  • Eggs and beans are other good sources of protein
  • Cook food by grilling, baking, poaching or steaming instead of frying or roasting
  • Avoid fatty or sugary snacks – such as crisps, cakes, biscuits and pastries
  • Eat snacks such as fruit, unsalted nuts and low-fat yoghurts
  • Cut down on sugar
  • Eat less salt – have less than 6g of salt (2.4g of sodium) per day
  • Cut down on alcohol
  • Don’t skip breakfast
  • Keep hydrated – aim to drink between 1.6 and 2 litres of fluid each day

Is the NHS advice sensible?

Whilst a number of these points are undoubtedly sensible, some of the recommendations have been criticised by patients and some leading UK healthcare professionals.

The following points are sensible:

  • Eat plenty of vegetables
  • Have sufficient fibre in your diet
  • Cut down on sugar
  • Cut down on processed meat
  • Eat fish regularly
  • Cut down on energy dense, processed food – such as crisps, cakes, biscuits and pastries
  • Cut down on alcohol
  • Cut down on salty processed foods

However, some of the recommendations may inadvertently lead to poorer diet choices.

The recommendations for people with diabetes to eat plenty of starchy carbohydrate and avoid fat from meat and dairy could lead to poorer blood glucose control, particularly in people with type 2 diabetes.

Should I base meals upon starchy carbohydrate?

The NHS advises people, including those with diabetes, to base meals around food with starchy carbohydrate such as:

  • Potatoes
  • Cereals
  • Pasta
  • Rice
  • Bread

The problem with this advice is that even starchy carbohydrates with a low GI can have a pronounced effect in raising blood glucose levels.

Starchy carbohydrate may be problematic for many people with type 2 diabetes as carbohydrate requires greater insulin production than fat or protein does. Research studies have shown that greater insulin production increases the effect of insulin resistance.

By advising people with insulin resistance and type 2 diabetes to base their meals around carbohydrate, the NHS diet advice increases the underlying problem of insulin resistance.

People with type 1 diabetes may find that having meals based on starchy carbohydrate helps them to better estimate insulin doses. By contrast, some people with type 1 diabetes have reported better success by following a low carbohydrate diet. Adjusting to a low carbohydrate will require care and dedication and the support of your diabetes health team.

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How to Lose Weight Fast: 3 Simple Steps, Based on Science

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There are many ways to lose a lot of weight fast.

However, most of them will make you hungry and unsatisfied.

If you don’t have iron willpower, then hunger will cause you to give up on these plans quickly.

The plan outlined here will:

  • Reduce your appetite significantly.
  • Make you lose weight quickly, without hunger.
  • Improve your metabolic health at the same time.

Here is a simple 3-step plan to lose weight fast.

1. Cut Back on Sugars and Starches

The most important part is to cut back on sugars and starches (carbs).

These are the foods that stimulate secretion of insulin the most. If you didn’t know already, insulin is the main fat storage hormone in the body.

When insulin goes down, fat has an easier time getting out of the fat stores and the body starts burning fats instead of carbs.

Another benefit of lowering insulin is that your kidneys shed excess sodium and water out of your body, which reduces bloat and unnecessary water weight (12).

It is not uncommon to lose up to 10 pounds (sometimes more) in the first week of eating this way, both body fat and water weight.

This is a graph from a study comparing low-carb and low-fat diets in overweight/obese women (3).

The low-carb group is eating until fullness, while the low-fat group is calorie restricted and hungry.

Cut the carbs, lower your insulin and you will start to eat less calories automatically and without hunger (4).

Put simply, lowering your insulin puts fat loss on « autopilot. »

BOTTOM LINE:Removing sugars and starches (carbs) from your diet will lower your insulin levels, kill your appetite and make you lose weight without hunger.

2. Eat Protein, Fat and Vegetables

Each one of your meals should include a protein source, a fat source and low-carb vegetables. Constructing your meals in this way will automatically bring your carb intake into the recommended range of 20-50 grams per day.

Protein Sources:

  • Meat – Beef, chicken, pork, lamb, bacon, etc.
  • Fish and Seafood – Salmon, trout, shrimps, lobsters, etc.
  • Eggs – Omega-3 enriched or pastured eggs are best.

The importance of eating plenty of protein can not be overstated.

This has been shown to boost metabolism by 80 to 100 calories per day (567).

High protein diets can also reduce obsessive thoughts about food by 60%, reduce desire for late-night snacking by half, and make you so full that you automatically eat 441 fewer calories per day… just by adding protein to your diet (89).

When it comes to losing weight, protein is the king of nutrients. Period.

Low-Carb Vegetables:

  • Broccoli
  • Cauliflower
  • Spinach
  • Kale
  • Brussels Sprouts
  • Cabbage
  • Swiss Chard
  • Lettuce
  • Cucumber
  • Celery
  • Full list here.

Don’t be afraid to load your plate with these low-carb vegetables. You can eat massive amounts of them without going over 20-50 net carbs per day.

A diet based on meat and vegetables contains all the fiber, vitamins and minerals you need to be healthy. There is no physiological need for grains in the diet.

Fat Sources:

  • Olive oil
  • Coconut oil
  • Avocado oil
  • Butter
  • Tallow

Eat 2-3 meals per day. If you find yourself hungry in the afternoon, add a 4th meal.

Don’t be afraid of eating fat, trying to do both low-carb AND low-fat at the same time is a recipe for failure. It will make you feel miserable and abandon the plan.

The best cooking fat to use is coconut oil. It is rich in fats called medium-chain triglycerides (MCTs). These fats are more fulfilling than others and can boost metabolism slightly (1011).

There is no reason to fear these natural fats, new studies show that saturated fat doesn’t raise your heart disease risk at all (1213).

To see how you can assemble your meals, check out this low carb meal plan and this list of 101 low carb recipes.

BOTTOM LINE:Assemble each meal out of a protein source, a fat source and a low-carb vegetable. This will put you into the 20-50 gram carb range and drastically lower your insulin levels.

3. Lift Weights 3 Times Per Week

You don’t need to exercise to lose weight on this plan, but it is recommended.

The best option is to go to the gym 3-4 times a week. Do a warm up, lift weights, then stretch.

If you’re new to the gym, ask a trainer for some advice.

By lifting weights, you will burn a few calories and prevent your metabolism from slowing down, which is a common side effect of losing weight (1415).

Studies on low-carb diets show that you can even gain a bit of muscle while losing significant amounts of body fat (16).

If lifting weights is not an option for you, then doing some easier cardio workouts like running, jogging, swimming or walking will suffice.

BOTTOM LINE:It is best to do some sort of resistance training like weight lifting. If that is not an option, cardio workouts work too.

Optional – Do a « Carb Re-feed » Once Per Week

You can take one day « off » per week where you eat more carbs. Many people prefer Saturday.

It is important to try to stick to healthier carb sources like oats, rice, quinoa, potatoes, sweet potatoes, fruits, etc.

But only this one higher carb day, if you start doing it more often than once per week then you’re not going to see much success on this plan.

If you must have a cheat meal and eat something unhealthy, then do it on this day.

Be aware that cheat meals or carb refeeds are NOT necessary, but they can up-regulate some fat burning hormones like leptin and thyroid hormones (1718).

You will gain some weight during your re-feed day, but most of it will be water weight and you will lose it again in the next 1-2 days.

BOTTOM LINE:Having one day of the week where you eat more carbs is perfectly acceptable, although not necessary.

What About Calories and Portion Control?

It is NOT necessary to count calories as long as you keep the carbs very low and stick to protein, fat and low-carb vegetables.

However, if you really want to, then use this calculator.

Enter your details, then pick the number from either the « Lose Weight » or the « Lose Weight Fast » section – depending on how fast you want to lose.

There are many great tools you can use to track the amount of calories you are eating. Here is a list of 5 calorie counters that are free and easy to use.

The main goal is to keep carbs under 20-50 grams per day and get the rest of your calories from protein and fat.

BOTTOM LINE:It is not necessary to count calories to lose weight on this plan. It is most important to strictly keep your carbs in the 20-50 gram range.

10 Weight Loss Tips to Make Things Easier (and Faster)

Here are 10 more tips to lose weight even faster:

  1. Eat a high-protein breakfast. Eating a high-protein breakfast has been shown to reduce cravings and calorie intake throughout the day (192021).
  2. Avoid sugary drinks and fruit juice. These are the most fattening things you can put into your body, and avoiding them can help you lose weight (2223).
  3. Drink water a half hour before meals. One study showed that drinking water a half hour before meals increased weight loss by 44% over 3 months (24).
  4. Choose weight loss-friendly foods (see list). Certain foods are very useful for losing fat. Here is a list of the 20 most weight loss-friendly foods on earth.
  5. Eat soluble fiber. Studies show that soluble fibers may reduce fat, especially in the belly area. Fiber supplements like glucomannan can also help (252627).
  6. Drink coffee or tea. If you’re a coffee or tea drinker, then drink as much as you want as the caffeine in them can boost your metabolism by 3-11% (282930).
  7. Eat mostly whole, unprocessed foods. Base most of your diet on whole foods. They are healthier, more filling and much less likely to cause overeating.
  8. Eat your food slowly. Fast eaters gain more weight over time. Eating slowly makes you feel more full and boosts weight-reducing hormones (313233).
  9. Use smaller plates. Studies show that people automatically eat less when they use smaller plates. Strange, but it works (34).
  10. Get a good night’s sleep, every night. Poor sleep is one of the strongest risk factors for weight gain, so taking care of your sleep is important (3536).

Even more tips here: 30 Easy Ways to Lose Weight Naturally (Backed by Science).

BOTTOM LINE:It is most important to stick to the three rules, but there are a few other things you can do to speed things up.

How Fast You Will Lose (and Other Benefits)
Obese vs thin woman

You can expect to lose 5-10 pounds of weight (sometimes more) in the first week, then consistent weight loss after that.

I can personally lose 3-4 lbs per week for a few weeks when I do this strictly.

If you’re new to dieting, then things will probably happen quickly. The more weight you have to lose, the faster you will lose it.

For the first few days, you might feel a bit strange. Your body has been burning carbs for all these years, it can take time for it to get used to burning fat instead.

It is called the « low carb flu » and is usually over within a few days. For me it takes 3. Adding some sodium to your diet can help with this, such as dissolving a bouillon cube in a cup of hot water and drinking it.

After that, most people report feeling very good, positive and energetic. At this point you will officially have become a « fat burning beast. »

Despite the decades of anti-fat hysteria, the low-carb diet also improves your health in many other ways:

  • Blood Sugar tends to go way down on low-carb diets (3738).
  • Triglycerides tend to go down (3940).
  • Small, dense LDL (the bad) Cholesterol goes down (4142).
  • HDL (the good) cholesterol goes up (43).
  • Blood pressure improves significantly (4445).
  • To top it all off, low-carb diets appear to be easier to follow than low-fat diets.

BOTTOM LINE:You can expect to lose a lot of weight, but it depends on the person how quickly it will happen. Low-carb diets also improve your health in many other ways.

You Don’t Need to Starve Yourself to Lose Weight

If you have a medical condition then talk to your doctor before making changes because this plan can reduce your need for medication.

By reducing carbs and lowering insulin levels, you change the hormonal environment and make your body and brain « want » to lose weight.

This leads to drastically reduced appetite and hunger, eliminating the main reason that most people fail with conventional weight loss methods.

This is proven to make you lose about 2-3 times as much weight as a typical low-fat, calorie restricted diet (464748).

Another great benefit for the impatient folks is that the initial drop in water weight can lead to a big difference on the scale as early as the next morning.

Here are a few examples of low-carb meals that are simple, delicious and can be prepared in under 10 minutes: 7 Healthy Low-Carb Meals in 10 Minutes or Less.

On this plan, you can eat good food until fullness and still lose a ton of fat. Welcome to paradise.

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Diet During Pregnancy

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Dieting During Your Pregnancy

What does diet during pregnancy mean? When we refer to diet during pregnancy, we are not speaking about restricting calories or trying to lose weight. Dieting to lose weight during pregnancy can be hazardous to you and your baby, especially since a weight loss regimen may restrict important nutrients such as iron, folic acid, and other important vitamins and minerals.

Therefore, we recommend avoiding popular diets such as Atkins, South Beach, The Zone, Raw Food Diet, and so on.

The type of diet we encourage during pregnancy refers to fine-tuning your eating habits to ensure you are receiving adequate nutrition for the health of you and your baby. Healthy eating during pregnancy is critical to your baby’s growth and development. In order to get the nutrients you need, you must eat from a variety of food groups, including fruits and vegetables, breads and grains, protein sources and dairy products.

Typically, you will need to consume an extra 300 calories a day.

Food Groups

It is always important to eat a variety of foods throughout the day making certain you get the nutrients both you and your baby need. Here is a look at the food groups and some suggested sources for creating a healthy diet during pregnancy.

Diet During Pregnancy: Food Groups

Fruits and Vegetables: Fruits and vegetables contain many important nutrients for pregnancy especially, Vitamin C and Folic Acid. Pregnant women need at least 70 mg of Vitamin C daily, which is contained in fruits such as oranges, grapefruits and honeydew, and vegetables such as broccoli, tomatoes, and brussel sprouts.

In order to prevent neural tube defects, 0.4 mg of folic acid per day is recommended. A good source of folic acid can be found in dark green leafy vegetables (other sources of folic acid include legumes, such as black or lima beans, black-eyed peas, and veal). You should have at least 2-4 servings of fruit and 4 or more servings of vegetables daily.

Diet During Pregnancy: Fruits and Vegetables

Breads and Grains: The body’s main source of energy for pregnancy comes from the essential carbohydrates found in breads and grains. Whole grain and enriched products provide important nutrients such as iron, B Vitamins, fiber and some protein, even. You can get the required amount of folic acid from fortified bread and cereal.

Depending on your weight and dietary needs, you should consume anywhere between 6-11 servings (6-11 oz) of breads/grains daily.

Protein: Meat, poultry, fish, eggs, and beans contain the protein, B vitamins and iron needed in pregnancy. Your developing baby needs plenty of protein, especially in the second and third trimesters. Iron helps to carry oxygen to your growing baby, and also carries oxygen to your muscles to help avoid symptoms such as fatigue, weakness, irritability, and depression.

The U.S. RDA recommends about 27 mg per day. Lean beef, chicken, lamb, liver, turkey, and veal are good options. Fish and some other seafood can be a good nutritional choice for pregnancy, within guidelines. Fish that contain high levels of mercury should be avoided. (Read more about Fish and Mercury Levels). You should consume at least 3 servings of proteindaily.

Dairy Products: At least 1000 mg of calcium is needed daily to support a pregnancy. Calcium is essential for building strong teeth and bones, normal blood clotting, and muscle and nerve function. Since your developing baby requires a considerable amount of calcium, your body will take calcium from your bones, if you do not consume enough through your diet (which can lead to future problems, such as osteoporosis).

Good sources of calcium include milk, cheese, yogurt, cream soups, and puddings. Some calcium is also found in green vegetables, seafood, beans and dried peas. You should consume at least 4 servings of dairy productsdaily.

A Complement to Nutrition

Prenatal Vitamins: Although the main source of vitamins and nutrients needed during pregnancy should come from your diet, a daily prenatal vitamin can help fill small gaps—just in case you unintentionally do not get enough key nutrients. Prenatal vitamins should be taken up to three months before conception, if possible.

Consult your healthcare provider about which supplement is best for you.

REMEMBER – a prenatal vitamin, or any other supplement can only complement a healthy diet during pregnancy.

Diet During Pregnancy: A Complement to Nutrition

Sample Daily Menu

The following sample menu will give you some idea of what a pregnant woman should typically consume in a day for a healthy diet during pregnancy. Three small, but balanced, meals and three light snacks throughout the day are a good rule of thumb to ensure you and your baby’s nutritional needs are met.

Breakfast: Oatmeal cereal, banana, 1 slice whole wheat toast, 2 tsp jam, 1 cup skim milk

Snack: 1 cup yogurt, grapes

Lunch: Turkey (if deli meat, do not eat cold – heat to steaming to avoid Listeria) and cheese sandwich on whole wheat bread, small bag potato chips, pear, and 1 cup skim milk

Snack: Raw veggies and low-calorie dip

Dinner: 4 oz chicken, 1 cup wild rice, 1 cup veggies, 1 cup skim milk

Snack: fresh fruit or low-fat frozen yogurt

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Eight tips for healthy eating

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Base your meals on starchy carbohydrates

Starchy carbohydrates should make up just over one third of the food you eat. They include potatoes, bread, rice, pasta and cereals.

Choose wholegrain varieties (or eat potatoes with their skins on) when you can: they contain more fibre, and can help you feel full for longer.

Most of us should eat more starchy foods: try to include at least one starchy food with each main meal. Some people think starchy foods are fattening, but gram for gram the carbohydrate they contain provides fewer than half the calories of fat.

Keep an eye on the fats you add when you’re cooking or serving these types of foods because that’s what increases the calorie content, for example oil on chips, butter on bread and creamy sauces on pasta.

Eat lots of fruit and veg

It’s recommended that we eat at least five portions of a variety of fruit and veg every day. It’s easier than it sounds.

Why not chop a banana over your breakfast cereal, or swap your usual mid-morning snack for a piece of fresh fruit?

Unsweetened 100% fruit juice, vegetable juice and smoothies can only ever count as a maximum of one portion of your 5 A DAY. For example, if you have two glasses of fruit juice and a smoothie in one day, that still only counts as one portion.

Eat more fish – including a portion of oily fish

Fish is a good source of protein and contains many vitamins and minerals. Aim to eat at least two portions of fish a week, including at least one portion of oily fish. Oily fish contains omega-3 fats, which may help to prevent heart disease.

Oily fish include:

  • salmon
  • mackerel
  • trout
  • herring
  • fresh tuna
  • sardines
  • pilchards.

Non-oily fish include:

  • haddock
  • plaice
  • coley
  • cod
  • canned tuna
  • skate
  • hake

If you regularly eat a lot of fish, try to choose as wide a variety as possible.

You can choose from fresh, frozen and canned: but remember that canned and smoked fish can be high in salt.

Cut down on saturated fat and sugar

Saturated fat in our diet

We all need some fat in our diet, but it’s important to pay attention to the amount and type of fat we’re eating. There are two main types of fat: saturated and unsaturated. Too much saturated fat can increase the amount of cholesterol in the blood, which increases your risk of developing heart disease.

The average man should have no more than 30g saturated fat a day. The average woman should have no more than 20g saturated fat a day, and children should have less than adults.

Saturated fat is found in many foods, such as:

  • hard cheese
  • cakes
  • biscuits
  • sausages
  • cream
  • butter
  • lard
  • pies.

Try to cut down on your saturated fat intake, and choose foods that contain unsaturated fats instead, such as vegetable oils, oily fish and avocados.

For a healthier choice, use just a small amount of vegetable oil or reduced-fat spread instead of butter, lard or ghee. When you’re having meat, choose lean cuts and cut off any visible fat.

Sugar in our diet

Regularly consuming foods and drinks high in sugar increases your risk of obesity and tooth decay.

Sugary foods and drinks, including alcoholic drinks, are often high in energy (measured in kilojoules or calories), and if eaten too often, can contribute to weight gain. They can also cause tooth decay, especially if eaten between meals.

Many packaged foods and drinks contain surprisingly high amounts of free sugars. Free sugars are any sugars added to foods or drinks, or found naturally in honey, syrups and unsweetened fruit juices.

Cut down on:

  • sugary fizzy drinks
  • alcoholic drinks
  • sugary breakfast cereals
  • cakes
  • biscuits
  • pastries

These foods contain added sugars: this is the kind of sugar we should be cutting down on, rather than sugars that are found in things such as fruit and milk.

Food labels can help: use them to check how much sugar foods contain. More than 22.5g of total sugars per 100g means that the food is high in sugar, while 5g of total sugars or less per 100g means that the food is low in sugar.

Get tips on cutting down sugar in your diet.

Eat less salt – no more than 6g a day for adults

Eating too much salt can raise your blood pressure. People with high blood pressure are more likely to develop heart disease or have a stroke.

Even if you don’t add salt to your food, you may still be eating too much. About three-quarters of the salt we eat is already in the food we buy, such as breakfast cereals, soups, breads and sauces.

Use food labels to help you cut down. More than 1.5g of salt per 100g means the food is high in salt. Adults and children over 11 should eat no more than 6g of salt (about a teaspoonful) a day. Younger children should have even less.

Get tips on cutting down on salt in your diet.

Get active and be a healthy weight

Eating a healthy, balanced diet plays an essential role in maintaining a healthy weight, which is an important part of overall good health.

Being overweight or obese can lead to health conditions such as type 2 diabetes, certain cancers, heart disease and stroke. Being underweight could also affect your health.

Check whether you’re a healthy weight by using our Healthy weight calculator.

Most adults need to lose weight, and need to eat fewer calories to do this. If you’re trying to lose weight, aim to eat less and be more active. Eating a healthy, balanced diet will help: aim to cut down on foods that are high in saturated fat and sugar, and eat plenty of fruit and vegetables.

Don’t forget that alcohol is also high in calories, so cutting down can help you to control your weight.

Physical activity can help you to maintain weight loss or be a healthy weight. Being active doesn’t have to mean hours at the gym: you can find ways to fit more activity into your daily life. For example, try getting off the bus one stop early on the way home from work, and walking.

Being physically active may help reduce the risk of heart disease, stroke and type 2 diabetes. For more ideas, see Get active your way.

After getting active, remember not to reward yourself with a treat that is high in energy. If you feel hungry after activity, choose foods or drinks that are lower in calories, but still filling.

If you’re underweight, see our page on underweight adults. If you’re worried about your weight, ask your GP or a dietitian for advice.

Don’t get thirsty

We need to drink plenty of fluids to stop us getting dehydrated – the government recommends 6-8 glasses every day.

This is in addition to the fluid we get from the food we eat. All non-alcoholic drinks count, but water and lower-fat milk are healthier choices.

Try to avoid sugary soft and fizzy drinks that are high in added sugars and calories, and are also bad for teeth.

Even unsweetened fruit juice and smoothies are high in free sugar. Your combined total of drinks from fruit juice, vegetable juice and smoothies should not be more than 150ml a day – which is a small glass.

For example, if you have 150ml of orange juice and 150ml smoothie in one day, you’ll have exceeded the recommendation by 150ml.

When the weather is warm, or when we get active, we may need more fluids.

Don’t skip breakfast

Some people skip breakfast because they think it will help them lose weight. In fact, research shows that people who regularly eat breakfast are less likely to be overweight.

Breakfast has also been shown to have positive effects on children’s mental performance and increase their concentration throughout the morning.

healthy breakfast is an important part of a balanced diet, and provides some of the vitamins and minerals we need for good health.

wholegrain, lower-sugar cereal with fruit sliced over the top is a tasty and nutritious breakfast.

Source : www.nhs.uk

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