• Lynne Reedman

Putting the “Eatwell Guide” into practice

(relevant for everyone...including people living with diabetes!)

By Karen Lewis

RGN, BSc., Msc.


I am a registered nurse and have had an interest in the care of patients with chronic disease for many years. Since 2007 I have been involved in health education; as well as running diabetes related workshops for DUET diabetes I am a coach for the NHS Diabetes Prevention Programme and an Associate Tutor in the School of Health at the University of East Anglia.

When Lynne asked me to contribute by writing (or tapping out!) a blog I thought about what word associations are often linked to diabetes…’food’ is high up there on the list, especially given the prevalence of Type 2 diabetes in the UK.


Routine has altered for many people with trying to work from home and for some trying to also juggle home-schooling, I thought I would share some information and tips to help put 'healthy/balanced' eating into practice. Life is often about balance and our food and drink intake is no different – we can’t be perfect all the time, as I remind the learners who come along to my sessions!

The Eatwell Guide is the government’s recommendation for all of us on how to achieve a healthy, balanced healthy diet. It classifies how much of each food group we should eat in the course of a whole day, in order to gain this balance (which we cover in the NHS Diabetes Prevention Programme). For people living with diabetes there are a few slight adjustments we advise (to be covered later).

The benefits of a healthy diet are numerous including, a reduced risk of certain cancers, strong bones and teeth, improved diabetes management and reduced risk of cardio-vascular disease. Deficiencies in some key nutrients, such as vitamin A, B, C and E, also zinc, iron and selenium, can weaken your immune system. A balanced diet is therefore vital to good health. It is certainly true at the moment that we are concerned with keeping our immune system in the best possible shape.


Attempting to change your eating habits, to have a healthier diet, can be quite a daunting task, a good place to start is with the planning of your meals.

Meal Planning:

Meal planning can be a way of putting the principles of the Eatwell guide into to practice. Other benefits of having a weekly meal plan include the avoidance of food wastage, and a saving of time and money.


How to make a start with Meal Planning:

Exercise 1: How am I doing with my current meals?

Start by writing down what your next meal is going to be.

Now, think about the portion sizes of the differing food groups i.e. vegetables and fruit, starchy carbohydrates, protein, dairy products and fat.

How does your meal compare to the proportions on the 'Eatwell' plate?

Ask yourself whether your choice would have been different if the meal had had more in-depth planning.

When planning your meals for the week ahead (or just one meal) consider:

Am I eating fish twice a week, including one* meal being an oily fish i.e. salmon, mackerel, anchovies, sardines, herring, and trout? Oily fish contains omega 3 which has a positive impact on heart health.

[*advise for people with diabetes is to eat two meals containing oily fish per week]

[photo by Caroline Attwood sourced from Unsplash.com]


Choose wholegrains and whole wheat options i.e. granary/ seeded bread,

steel cut oats for porridge, in order to have more fibre in your diet. Ideally,

we should eat 30 grams of fibre a day which helps to ensure slow release

of energy in the form of glucose in our blood.


Choose lower fat options and very few foods that are high in saturated fat, to

help improve our cholesterol levels.

Can you cook in batches to ensure that you have your own “ready meals”?

i.e. cook more than one cottage pie or other meal and freeze it to be able to

access healthy meals if you do not have time to cook.


Am I getting my 5 portions of vegetables and fruit in a day?

[People with diabetes are advised to limit fruit to 2 portions per day and be wary of over consuming fruit juices and fruit smoothies – one small 150ml glass per day. More advice regarding this and other food related advice can be found on the Diabetes UK website].



[Photo by William Felker sourced from unsplash.com]

Am I eating a variety of fruits and vegetables in order to ensure I am receiving the necessary range of vitamins and minerals?

According to the World Health Organisation (Fruit and Vegetable Promotion Initiative Report 2003):

  • Up to 2.7 million lives could be saved annually world-wide with sufficient fruit and vegetable consumption.

  • Low fruit and vegetable intake is among the top ten selected risk factors for global mortality.

  • Fruit and vegetables are important components of a healthy diet, and their sufficient daily consumption could help prevent major diseases such as cardiovascular disease and certain cancers.








Tip: planning ahead helps to create a shopping list of the items required to create the balanced meals you have chosen and makes it easier to ensure you have the necessary ingredients to stick to your plan!









Exercise 2: Reviewing the variety of fruit and vegetables in my diet?

Are you eating a rainbow? In other words, do you have a variety in the fruits and vegetables that you consume. Remember, that you should be aiming for 5 to 9 portions of differing fruits and vegetables a day (more vegetables and less fruit if you have diabetes).

Think about your vegetable and fruit intake, are you having enough variety? How could you improve on this?


It is difficult at the moment to sometimes access the fruits and vegetables we may want to obtain. Do not be discouraged, if you cannot obtain fresh vegetables or fruit. Frozen vegetables and fruits are usually frozen as soon as harvested and therefore contain high levels of vitamins and minerals. If you need to use canned fruit or veg use juice rather syrup options. These forms of vegetables and fruit do make up part of a healthy diet, and you can choose how much you want to use at each meal!


I would recommend you make use of the 'Eat well' NHS website and Diabetes UK to get specific advice on meals and recipes.


Matching your choices to the proportions of the Eatwell Guide is key to achieving a balanced diet. One way to ensure you are doing this is to imagine putting everything you had eaten in a whole day on a table, would it match the proportions of the good groups in the Eatwell Guide in terms of the different food groups. If the content does match, this is an indication that your diet is well balanced.


For people with diabetes, ideally each meal should be balanced, particularly with a similar quantity of carbohydrate. Achieving ‘carb consistency’ will help maintain stable blood glucose levels.


Tip: keeping a diary is a good way to monitor what you are eating. If you decide to seek additional advice on how best to manage your weight and/or health conditions such as diabetes, it will then aid any discussions you may decide to have with your doctor/practice nurse/dietician.


Consider:

What will you eat?

How much will you have? - how active you are needs to be taken into account too (our next blog will give some insight into 'energy balance' and how our weight is controlled)..

When are you eating (you may need more time to prepare foods on differing days)?

Who are you eating with?


Portion size is an important factor particularly for highly calorific foods as well as carbohydrate containing foods you consume – the effect of carbohydrates on blood glucose (sugar) levels can be huge. Larger portions can increase blood glucose levels out of the optimum range which can make it more difficult to manage diabetes (and can subsequently increase the risk of diabetes related health problems). Excess blood glucose is stored as fat causing weight gain (unhelpful if you are trying to maintain current weight or lose weight). A useful resource in helping with this is the ‘carbs and cals’ book (or app).


Try to keep away from processed food/ready meals as they tend to contain unhealthy fats, and high amounts of sugar and salt. This can result in you gaining weight or having a rise in your blood pressure and cholesterol levels.


Making changes to our diet can be challenging, however a small amount of pre-thinking and planning can make a big difference. Ideas for breakfast could include, porridge or sugar free muesli with skimmed or semi-skimmed milk (no added sugar). Wholegrain/multigrain/seeded bread or toast with nut butter (no added sugar or salt), or boiled or poached eggs. Natural yoghurt (or soy yoghurt) with a handful of berries, sprinkle of seeds and oats.

There are a number of light meals you could consider for lunch. Again, selecting a wholegrain approach would be beneficial. Baked beans, cheese (low fat if trying to lose weight i.e. feta, brie, cottage cheese), salads, humous and vegetable sticks, lentil or bean soup, chickpea curry, dhal or vegetable curry. Jacket potato with cheese or beans or chilli filling (no added butter or spread) with salad is another option.


Main meals can sometimes be our lunch or evening meal. Think about how you could incorporate fish into your diet as already discussed. For instance, grilled, poached or oven baked fish (i.e. salmon, cod, sardines) with lemon juice and herbs, fresh or frozen vegetables and or new or sweet potatoes would be a healthy choice.


Other main meals could include chicken (or tofu/halloumi/lean meat) and vegetable kebabs (with peppers, courgettes, tomatoes, onion) and yoghurt marinade with boiled/steamed brown rice. Or, stir fry: prawns (or quorn/tofu/chicken/lean sliced beef) and mushrooms, peppers, bean sprouts, water chestnuts with mixed grain rice or brown noodles.


Making Healthy Swaps


The ideas below are suggestions some people, who have come to the National Diabetes Prevention Programme sessions I run, have found useful…


New potatoes have less starch than older potatoes.


Cauliflower rice instead of normal rice.


Natural plant- based sweeteners i.e. truvia/stevia, instead of sugar.


Open sandwiches instead of a full one.


Choose a tomato based past sauce rather than a creamy one.


Serve meals with salad and veg instead of chips or potatoes – replacing potato chips or wedges with oven baked parsnip, carrot or beetroot chips.

[Please remember, people with diabetes need to be mindful of keeping the carbohydrate content consistent for each meal to maintain stable blood glucose levels].

[Photo by Dan Gold sourced from usplash.com]


Beware of misleading marketing claims


Reduced fat or sugar must contain at least 30% less fat or sugar than the standard version but, may still be high in saturated fat and sugar.


Diet products should be avoided as they are usually highly processed and unhealthy.


Diabetic foods are unnecessary as those with diabetes can use the Eatwell Guide and do not need specific products. These products are expensive, will still impact on blood glucose and may have a laxative effect.


I hope that I have given you some food for thought (please excuse the pun!) and insight into what may be possible and what to be aware of. Delicious and nutritious food doesn’t need to be expensive or time consuming to create, as the recipes on the Diabetes UK website show. As I often say to the groups I coach, we can’t be perfect all of the time but planning does help and aim for the 80:20 rule – 80% of the time follow healthy eating advice and 20% allowing for some ‘treats’ to be included…just be careful of portion size!


Additional resources and further reading:

www.nhs.uk/live-well/eatwell/food-labelling-terms/

Diabetes UK https://www.diabetes.org.uk/

InDependent Diabetes Trust https://www.iddt.org/

Carbs and Cals book https://www.carbsandcals.com/


Upcoming blog:

How is body weight controlled? Understanding energy balance


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