Diet Is Key in Managing Diabetes – Part 2

– Understanding Good and Bads Fats, Portion Size Control and Calculating Your Glycaemic Levels

By Shabana Shaw

Fats play a very important role in a human’s body, hence they must be included in their correct portion size in your diet.

Nutritionist Abigail Caleb who is a Senior Technical Officer – Food Security and Nutrition at the Caribbean Public Health Agency (CARPHA) explained that fats are nutrients or nourishing substances required by the body to fulfil a wide range of functions, and form part of the body structure.

“Fats provide cushion and protect all the organs of our body; they provide warmth, carry and store the fat-soluble vitamins (A, D, E, and K) around the body and provide important chemicals the body needs for its functions (e.g. hormones), among others,” she said.

However, fats play a complex role in the management of diabetes. Eating too much fat can lead to the body taking in more calories than it otherwise needs which can result in weight gain which can affect a patient’s diabetes control.

The three different types of fat are unsaturated, saturated, and trans.

Good Fats – Unsaturated Fatty Acids

According to Caleb, unsaturated fatty acids, categorised as monounsaturated and polyunsaturated come in the form of liquids even when refrigerated. They are found mostly in plant sources (vegetable oils) and fish, and may improve insulin control.

“Unsaturated fats are found in olive oil, peanut oil, canola or rapeseed oil, avocado pear, flaxseed, wheat germ, nuts & seeds – walnut, soybeans and fishes, especially salmon, sardines, trout, herring, mackerel, anchovies, tuna,” she stated.

Bad Fats – Saturated Fatty Acids

Saturated fatty acids are the ‘hard’ fats which are found in foods from animals (high in red meat), except for coconut and palm oils. High intake of saturated fats may increase insulin resistance and increase one’s risk of cardiovascular (heart) disease.

“Full cream dairy products (milk, butter, cheese, cream; red meats (pork, beef, lamb), meat fat (bacon, chicken skin, pork fat); coconut oils and milk; lard; ghee; and mayonnaise contains high amounts of saturated fats,” the Nutritionist counselled while emphasising that most junk and fast foods contain this type of fat.

Trans Fatty Acids

Trans-fatty acids are made artificially by adding hydrogen which aids in giving processed foods a longer shelf life. They are known for being low in nutritional value and negatively affect cholesterol levels by increasing ‘bad cholesterol’ and decreasing the ‘good cholesterol’.

“This is the most unhealthy and dangerous type of fat which can lead to elevated increased risk for cardiovascular (heart) diseases and poor glycaemic (blood sugar) control,” she warned.

Trans fats are commonly found in margarine (hard), vegetable shortening and commercial baked products and fast and junk foods.

Therefore, persons living with diabetes should avoid foods that contain trans-fatty and avoid consumption of simple sugars (sugar, honey, molasses, syrup, jam, jelly, chocolate, sweets, candies, pastries, cakes, pies, cookies, carbonated drinks, packets juices mixes and fruits canned with sugar).

On one hand, healthy fats can play a beneficial role in managing diabetes by stabilising blood sugar levels and contributing good heart health once consumed in small to moderate amounts. On the other hand, unhealthy fats can cause a spike in blood sugar levels and increase a person’s risk of heart disease.

It should be noted that a overconsumption of any type of fat/high fat diet worsens blood glucose/ sugar control and increases the risk of (type 2) diabetes and cardiovascular (heart) diseases.

Understanding Glyceamic Index (GI)

The Glyceamic Index (GI) is the ranking of foods based on their effect on blood sugar levels. Caleb clarified that GI is measured by how slowly or quickly carbohydrate (carbs)–containing foods are digested and increase blood glucose/sugar levels over a period of time, usually 2 hours.

“It is best to control total carbohydrate intake, that is, balancing among the carbohydrate content categories – high carbs, moderate carbs, low carb and zero carb foods,” she expanded.

Foods with a high GI are rapidly digested and absorbed, leading to a swift increase in blood sugar while low GI foods are digested more slowly, resulting in a gradual rise in blood sugar levels.

High GI Foods	Some Fruits: mango, banana, avocado Some Vegetables: ripe tomatoes, carrots, beetroot
	Ground Provision: sweet potato, cassava, boiled and baked potato
	Shellfish: shrimp, prawn, lobster, squid
	All Sugary Foods, for example: white bread, rice cakes, bagels, cakes, doughnuts, croissants and most packaged breakfast cereals and instant oatmeal

“These foods should be eaten in moderation or temporarily avoided (with the exception of sugar foods which should be avoided at all times) if complications arise or if there is poor control of blood glucose/sugar levels as they tend to elevate blood glucose/sugar levels more than other foods,” the Nutritionist advised.

However, it is more effective to eat a variety of foods from the Caribbean Six Food Groups while controlling the total carbohydrate intake of the diet, she added.

Low GI Foods	Fruits: apples, berries, oranges, lemons, grapefruit
	Vegetables: green leafy vegetables (callaloo, pakchoi, spinach, lettuce, cabbage), ochroes, christophene/chocho, eggplant/baigan, squash, bell peppers. broccoli, carrots, cauliflower
	Legumes: lentils, black beans, chickpeas, kidney beans
	Meat and Seafood: chicken, turkey, duck, all fishes especially tuna, salmon, mackerel, sardines
	Whole grains and seeds: quinoa, oats, barley, chia seeds, flax seeds

IMPORTANT NOTE: To ensure you eat a low GI diet, choose whole grains over refined grains, fish and skinless poultry over red meats, incorporate lots of vegetables with moderate consumption of fruits and add legumes and nuts as a source of protein.

Portion Size Guidelines

Portion size refers to the amount of food served in one meal and is crucial in maintaining a healthy diet and overall health.

Caleb explained that when food is placed onto a 9-inch plate, one should divide the plate into four equal parts. 

Here is a breakdown of how you can maintain portion control.

¼ for starches (provision, rice, pasta, flour products, etc)

¼ for protein (fish, chicken, peas & beans, etc.)

¼ for cooked vegetables (carrots, okra, cabbage, etc.)

¼ for raw vegetables (lettuce, cucumber, tomato, etc.)

Caleb recommends that the largest meal(s) should be had at the time of day when the diabetic is more active, and more likely to avoid blood glucose/sugar spikes.

She also emphasised that maintaining a consistent meal schedule and avoiding skipping meals can be beneficial for blood sugar management.

“This will help maintain blood glucose/sugar levels steady throughout the day, avoiding spikes and dips that create an incessant feeling of hunger and can lead to hypoglycaemia (abnormally low blood glucose/sugar levels) which if not adequately treated may result in a coma,” the Nutritionist cautioned.

Persons living with diabetes should avoid unhealthy foods and drinks (high in fats, sugar and sodium salt).  It is important that you work closely with a registered dietitian or nutritionist for personalised dietary advice on how to pair healthy fats with meals.

Limiting processed foods is one way of reducing the consumption of unhealthy fats, sodium/ salt and added sugars. Mindful eating in a consistent manner and the appropriate portion size is also key in managing diabetes.