Because most people with type 2 diabetes are overweight, weight management and reduction should be the major consideration. The good news is, if you are overweight, you benefit from even a small weight loss. Weight loss markedly reduces the risk of developing type 2 diabetes and prevents the progression of pre-diabetes to type 2 diabetes. It can also reverse the failure to respond to drugs for diabetes that develops after responding at first weight loss can increase life expectancy, help lower blood pressure and improve energy levels and mobility.
The benefits of weight loss are seen rapidly, even when relatively little weight has been lost. A rapid fall in blood glucose occurs as soon as the energy intake of the diet is reduced. Over time, the blood pressure declines and the cholesterol falls. The triglycerides drop and the good cholesterol (HDL) rises. Even a modest reduction of 10 per cent of body weight has a significant positive effect on your coronary artery disease risk.
Unfortunately, your genetic make-up has a significant influence on your ability to lose weight and on the amount of weight you lose. Several studies have shown that people with type 2 diabetes lose less weight than people without diabetes. This can be disheartening and frustrating — especially when trying to explain not being able to lose weight to less-than-sympathetic workmates, family, friends or diabetologists. But, hang in there — even when weight loss isn’t possible, weight maintenance is an excellent goal, and you can certainly implement measures to improve the quality of your diet, weight loss or not.
Diabetologists recommend that carbohydrate that’s high in fibre and low in fat should contribute between 40 and 50 per cent of your total daily kilojoule intake. An important part of achieving this target is avoiding the sources of carbohydrates that contain lots of kilojoules, but offer little nutritional value.
You probably already have some idea about which carbohydrates only provide ‘empty’ kilojoules. Some examples include cakes, biscuits, sweet pastries, honey, jam, ice-cream and sweet yoghurt, chocolate, soft drinks, cordials and sugar added to drinks and breakfast cereal.
The best carbohydrate choices for you are those that are highest in fibre and lowest in fat — studies have shown that a diet featuring these types of foods can lower blood glucose and cholesterol levels.
Fibre is the part of a food that’s not digestible and so adds no kilojoules but has health benefits. Fibre is found in all fruits, vegetables and cereal grains, and the more unprocessed the grain (or fruit or vegetable), the higher the fibre content.
Protein is used by the body for growing and repairing tissues. For this reason, it was thought that you could build your own muscle by eating lots of protein (actually, you build up muscle by exercising). Although children and young adults need more protein because they’re growing, adults need relatively little in order to maintain their current level of muscle.
Protein in your diet comes from chicken, pork, beef, eggs, milk and other dairy foods, nuts and legumes (or pulses). The protein component of these foods doesn’t raise blood glucose levels.
For most adults, two moderate-sized serves of protein per day are sufficient. Because milk, yoghurt and legumes are sources of protein and carbohydrate, they can be included in the diet to satisfy your requirements for both food types.
If you’re unsure about the mix of carbohydrates and proteins that’s right for you, see your specialist diabetologist for an individualised assessment.