When prescribing diet plans for diabetics, endocrinologists and dietitians often make recommendations such as having meals at regular times, restricting if not completely eliminating foods with simple and/or refined sugars and carbohydrates and switching to a high fibre diet.
However, it’s often easier said than done, with patients less likely to adhere to the prescribed dietary plan especially if meals appear tasteless and unpalatable.
We speak to Celeste Viviers, registered dietitian from Nutrilicious on navigating dietary challenges for diabetics.
Q: What are a diabetic’s main challenges when consuming a diet plan you prescribed and how can these be overcome?
A: Often generic, ‘one-size-fits-all’ diets are given to patients. These diets are usually very rigid with rules regarding meal times and food types. Very often some of the patient’s favourite foods are eliminated completely when they need not be. This generally demotivates the patient and often when I see them they are quite surprised to learn that they can still eat their favourite foods or do not have to eat bland, boiled foods for the rest of their lives.
The diet prescribed to the patient should be individualised. As dietitians we look at various aspects of a patient’s life likely to influence their diet and food choices e.g. lifestyle, psychosocial factors, demographics, economics, personal preferences etc. and then plan a diet accordingly. This improves compliance.
Education is key. Many patients will hurry through the nutritional component of their education about diabetes, but it is so important. Education will empower the patient to make healthful choices in the future that will have a big impact on their diabetes management. So often, a few lifestyle and dietary tweaks are all that is needed to control the condition.
Lack of time is another major concern for patients. Many believe that healthful foods and diets take large amounts of planning and preparation, but really it is a matter of being organised. Take time to discuss suitable alternatives with your dietitian. Ask for recipes and menu plans. These all ease the burden on the patient.
Q: What sort of support can family members and caregivers provide to a diabetic especially when encouraging him or her to eat according to your diet plan?
A: Family and caregiver support is crucial in diabetes management. In many cases, the patient may not be the one who selects and prepares the food and meals. The person who purchases and plans the food and meals needs to be educated about the diet to provide the correct foods and meals to the patient. I always encourage the family or caregiver to attend the education sessions with the patient.
There is no need for a special meal to be prepared for the patient. The diabetes diet is, in every aspect, a healthy eating diet, so the rest of the family should be eating in a similar fashion. This makes meal preparation easier as well as helping the diabetic feel included at meal times.
For example, in cutting out sugary food or carbohydrates for the family meals, look out for healthy fats that could effectively provide energy while maintaining satiety. Increasing the amount of fish for healthy omega fatty acids, using MCT oil or olive oil in your meals could help the whole family eat healthier as well.
Q: What useful shortcuts/ hacks would you recommend to family members and caregivers when preparing meals for diabetic patients? Please provide up to five.
Menu Planning: It is very difficult to follow any diet by opening the fridge and just preparing a healthy meal. Menu planning ensures that the meals are balanced and correctly distributed. It gives you an overall view of your menu. I recommend menu planning for a week at a time. This also helps economically as we have less waste.
Availability: Menu planning gives you time to shop for the food, to ensure we have it at home. For instance, if you are hungry and look in the cupboard and find only crisps, you are more likely to eat the crisps or go to the convenience store down the road and grab something quick and easy. If you have a bowl of fresh fruit ready to eat at home, you are more likely to eat that. Stock up on healthy snack items such as unsalted, baked nuts; dried fruit; wholegrain crackers; small pots of yogurt. Replace carbohydrates with healthy fats for energy replacement and satiety as healthy oil like MCT oil, and olive oil are easy to store and versatile in application.
Food Preparation: After buying fruit and vegetables, immediately wash them and place the food in storage containers and keep in the fridge. When prepared this way, they are ready to grab and eat or toss into a salad or dish when needed. Pre-portioned meals and snacks helps with portion control too. Boil some eggs and keep in the fridge for a quick snack. Chop up some cheese into bite sizes and store in small food containers to grab and go.
My Healthy Plate: My Healthy Plate is designed by the Health Promotion Board for Singaporeans. It provides a visual representation of what a healthy plate at each meal should look like. The basic idea is that half your meal should be made up of vegetables and/ or fruit, a quarter should contain wholegrain carbohydrates and the remaining quarter should be filled with protein-based foods. Typically, I find that most Singaporean meals are made up of half carbohydrates and half protein with two token slices of cucumber or salad leaves for vegetables. To help my patients, I provide lists of suitable carbohydrates, proteins and vegetables and then encourage them to select one or two from each group and then apply the My Healthy Plate portioning principle.