South African Cookbook for Diabetes. Hilda Lategan

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СКАЧАТЬ salt intake and by losing weight if you are overweight. Try to limit your daily salt intake to not more than 5 ml (1 teaspoon).

      Also keep the following in mind:

      •Use minimal salt during food preparation.

      •Do not use salt at the table.

      •Avoid salted, processed foods such as sausages, polonies, ham, smoked and pickled fish and meat, droëwors and biltong.

      •Limit your intake of foods such as ready-to-eat pizzas, pies, chips, salted nuts and salty biscuits.

      •Limit your intake of sauces and pickles with a high salt content.

      •Limit your intake of hard cheeses.

      •Use herbs and spices to flavour food and to compensate for a low salt content.

      •Be careful of flavour enhancers such as MSG (monosodium glutamate). Also look out for words such as “sodium” and “salt” on food labels.

      •Instead of sprinkling salt on your food before eating, squeeze a few drops of lemon juice over it instead.

      The use of alcohol

      Despite research showing that the phytochemicals in red wine in particular are beneficial to health in relation to the prevention of cardiovascular disease, strokes, diabetes and Alzheimer’s disease, the negative effects of excessive alcohol intake should not be underestimated. Alcohol is often consumed “to relieve stress”. Although alcohol initially has a calming or sedative effect, it is in reality a depressant and damages the nerve cells. Excessive alcohol use also increases the load on the liver because it is the liver that has to break down the alcohol, which acts as a poison in the body.

      Alcohol provides concentrated empty kilojoules, is metabolised rapidly and stored as fat, and it is therefore not a good idea for anyone trying to lose weight. Satisfy your thirst by first having a glass of water, so that you can enjoy your alcoholic drink slowly.

      Diabetics must always remember that alcohol suppresses the production of glucose (from glycogen) in the body. If you therefore drink alcohol on an empty stomach, it can lead to hypoglycaemia and in extreme cases cause a coma. Alcohol also increases the effect of certain oral diabetic medications. Always have alcoholic drinks with a dry biscuit, fruit juice, milk or a meal. Because of their high sugar content, it is not a good idea to drink sweet wine, sweet sherry, vermouth or liqueurs. Also be careful with the cold drinks or mixers you add to alcoholic drinks.

      It is recommended that alcohol intake should be limited to a maximum of two units per day for men and one unit per day for women. Recent research indicates that women should not drink alcohol every day because of the risk of developing breast cancer.

      A unit is regarded as:

      •25 ml spirits such as whisky, brandy, cane or vodka

      •60 ml dry sherry, vermouth or port

      •120 ml dry red or white wine

      •200 ml low-kilojoule beer

      Menu and meal planning

      Like everyone else, the nutrient requirements of people with diabetes are influenced by a variety of factors, such as:

      •Gender – male or female.

      •Life stage – pregnant or breastfeeding women and children who are still growing require more nutrients.

      •Age – children have higher nutrient needs than the elderly.

      •Level of activity – active working people, those who regularly participate in sport, and children who play and run around a lot, have much greater nutrient requirements than inactive or passive people.

      •Ratio of body weight to height – if a person is underweight or overweight and if he/she would like to gain or lose weight.

      •Blood glucose, medication – blood glucose readings and medications such as insulin and diabetic tablets can determine the distribution of meals during the day and the choice of food types.

      •Financial circumstances – cheaper substitutes for certain types of food may have to be chosen.

      •Personal circumstances – having a family, the size of the family or limited cooking and cooling facilities can influence meal planning.

      It is clear from the above that it is impossible to provide meal plans, menus and portion sizes that will accommodate all circumstances and meet the needs of everyone, within the scope of a book like this. Even if you use this cookbook it is still important to consult a registered dietitian for a suitable menu plan and portion sizes for you and/or your family. If you have a good meal plan at your disposal you can choose recipes from the book and make meals (and their consequences) a pleasant experience.

      Guidelines for adapting your meal plan and menus

      Read this section together with the information about healthy eating habits and the guidelines for good nutrition provided.

      To control your blood sugar effectively, having “regular meals” means spreading three meals – consisting of a variety of foods – of more or less the same size, throughout the day and having snacks as required between breakfast and lunch, again between lunch and supper, and then once again before going to bed (when necessary).

      Sometimes it may be necessary to have a more substantial breakfast to help you get through a very busy morning and to eat less food later in the day because your level of activity tends to decrease then and your energy requirements are therefore lower. In such a case the energy value of your breakfast would possibly be closer to 40% or 50% of your total daily intake.

      An adequate volume of liquid must be included in the form of water, rooibos tea, green tea, Ceylon tea and, less frequently, coffee. Drink a limited amount of artificially sweetened cold drink (not more than 500 ml per day) and always try to first quench your thirst with water. Fruit juice should preferably be diluted with water and also consumed in limited quantities because the carbohydrates in the juice are absorbed rapidly and can therefore lead to a rapid rise in blood glucose. Avoid fruit juice if your blood glucose is not well controlled.

      Make fruit lollies for children by diluting unsweetened fruit juice with the same amount of water (this helps it to freeze harder) and freeze the juice in suitable lolly containers. Alternatively, put 200 ml cartons of juice (like Ceres) in the freezer and cut off the top seam of the carton of frozen juice before serving. A lolly like this will keep a child busy for ages, whereas the juice would have been gulped down in a flash!

      Some of the rapidly-acting types of insulin which are injected before each meal are available in the bloodstream within minutes, but the half-life or period during which the insulin is active in the bloodstream is also much shorter, which means that it will no longer be effective when the between-meal snack is eaten. In such a case it is not necessary to have a snack between meals. A liquid such as a cup of tea or a diet cold drink is regarded as adequate, and this contributes to a lower energy intake, which is an advantage for healthy slimming. People who use this kind of insulin are also inclined to be less hungry between meals and find a between-meal snack unnecessary.

      When longer-acting insulin is injected at bedtime, it is important to have a snack before going to bed to prevent low blood sugar in the early hours of the morning. If you regularly СКАЧАТЬ