Busting food myths
THE government and health organisations such as Adsa (Association for Dietetics in SA) are urging South Africans to get tested for diabetes.
Maria van der Merwe, the president of Adsa, said: “There’s a lot of confusion and misinformation around diabetes and about how this diagnosis can change one’s life – especially when it comes to making dietary changes. This can be a significant barrier to being tested for diabetes. But managing diabetes through medical treatment, healthy eating and physical activity is achievable.
Adsa posed 10 myth-busting questions about diabetes and food to a panel of registered dietitians.
1. Do people with diabetes need to eat special foods?
Ria Catsicas: People with diabetes need to prioritise the intake of foods that are part of a healthy diet. There is no need to buy special or expensive foods. Foods that form part of a healthy diet are available at any grocery store and include wholegrains; fresh vegetables and fruits; dried beans, legumes and pulses; fish, chicken, lean red meat; low fat dairy products; seeds and nuts; and plant-based oils such as olive, canola, sunflower and other seed or nut oils. Thus, people living with diabetes have as wide a choice of foods as anyone else.
A challenge is that people may know what they should eat but find it difficult to change eating habits.
Diagnosed people will benefit from seeking guidance from a registered dietitian. Each person requires individual dietary guidance, with consideration of health status, medication, lifestyle and food preferences.
2. Eating fruits
Ria Catsicas: People with diabetes do not have to avoid fruit. All types of fruit contain fibre and have a low glycaemic load. It means that if you eat any fruit in moderation you will not experience a high blood sugar response. It is the amount of fruit you eat that matters and it is best to get your dietitian to check how much fruit you can consume.
3. Are carbohydrates ‘the enemy’?
Ria Catsicas: No, carbohydrates, also known as “starches”, are not “the enemy” for people with diabetes. Carbohydrates are the foods that affect blood sugar most significantly, but robust evidence has shown that starchy foods do not have to be avoided to attain blood sugar control.
The type and quantity of carbohydrates consumed affect blood sugar levels. Refined, ultra-processed carbohydrates should be avoided, including white and brown breads; white maize meal, and rice; fast foods such as slap chips, pizzas, vetkoek, bunny chows; baked goods such as pies, pastries, cakes and biscuits; and high sugar foods such as ice cream, sweets and chocolates.
There are a lot of tasty, high-fibre carbohydrate foods that should be included – dense seed and health breads; unsweetened, high-fibre breakfast cereals; rolled oats; wild brown rice; baby potatoes and sweet potatoes with skins on; legumes such as beans, lentils and chickpeas; and all fresh fruit and vegetables.
When it comes to quantity, a dietitian can help you determine the optimal portions of carbohydrates for you based on your weight, age, gender, activity level, levels of blood sugar control and types of medication you use.
4. What should a person with diabetes do to satisfy their sweet tooth?
Nasreen Jaffer: It is not true that a person living with diabetes cannot enjoy a sweet treat ever again. What is of greater importance is how much and how often these foods are eaten. A dietitian is able to guide on how to incorporate some treats, in moderation, while still managing blood sugar levels. They can also help to identify healthier alternatives that may well become favourite go-to treats.
5. Is Type 2 diabetes a mild form?
Ria Catsicas: No, it is a myth that Type 1 is worse than Type 2. The differences between the types are how they develop.
Type 1 normally develops in people of a younger age in a short space of time due to an auto immune disorder and people living with Type 1 diabetes are 100% dependent on injecting insulin.
Type 2 develops in older people over a longer period of time due to genetic predisposition, abdominal obesity, poor diet, inactivity and stress.
Insulin resistance and fatty infiltration of the pancreas cause the pancreas to produce too little insulin to control blood sugar levels within normal range.
Some people with Type 2 diabetes also use insulin while others use alternative medication. Both types are treated using medications, including injections to control blood sugar levels most optimally.
In truth, the worst type of diabetes is diabetes that is untested, undiagnosed or uncontrolled because this leads to dramatic health complications including blindness, loss of limbs and death.
6. Does Type 2 diabetes only affect overweight people?
Nasreen Jaffer: Type 2 diabetes does not only affect overweight people. However, overweight and obesity are the major risk factors for developing Type 2 diabetes because they lead to insulin resistance. Therefore, maintaining a healthy weight can prevent the onset of diabetes, and is an important cornerstone of managing diabetes.
7. Are people with diabetes at risk of going blind or losing their legs?
Nasreen Jaffer: No, not all people with diabetes will experience these complications of poorly managed or undiagnosed and unmanaged diabetes. These complications set in when the blood sugar levels are not maintained within the targeted levels over an extended period of time. This is why it is so important to be tested. The onset of complications can be delayed or avoided by maintaining optimal blood glucose control through medical treatment, diet and physical activity.
8. Should people with diabetes avoid physical activity?
Kgadi Moabelo: No, definitely not unless they are specifically advised to do so by their doctors. Physical activity offers significant benefits people with diabetes as it improves insulin sensitivity and supports the control of blood sugar levels. Physical activity also helps control weight, protect nerve damage and can delay the progression of complications.
Each individual should be aware of their unique glucose response to exercise, and tailor their activities accordingly. The general guideline is 150 minutes of moderate-intensity exercise weekly, such as walking, jogging, cycling and swimming; or 75 minutes of vigorous intensity activity per week.
9. Are there natural products to cure diabetes or support health?
Kgadi Moabelo: There are no plants or medicine that can cure diabetes. There are reports that more than 800 plant species may have beneficial effects on blood sugar levels.
However, there is a significant lack of research on safe dosage and administration.
It’s important to note that “natural” does not mean “safe”.
There may be medicinal plants that can help at the right dose, administered the right way, but the same plants can be toxic at the wrong dose or taken in another form. Discuss any supplementary or alternative treatments with your doctor.
10. Can a person with diabetes eat anything they like?
Kgadi Moabelo: It is crucial to eat a healthy diet even when the blood sugar level is controlled. Moreover, maintaining healthy body weight is important when managing diabetes. Therefore, focus on high-fibre carbohydrate foods, plenty of vegetables, low fat foods and limited salt intake.