NHS Diet Advice for Diabetes

NHS advise that there is no special diet advice for people with diabetes
NHS advise that there is no special diet advice for people with diabetes

In the UK, current 2013 NHS diabetes diet advice is that there is no special diet for people with diabetes.

Many people with diabetes focus on the carbohydrate content of their meals and prefer a low-carb diet for tight blood glucose level control.

The NHS (and Diabetes UK) recommend a healthy, balanced diet that is low in fat, sugar and salt and contain a high level of fresh fruit and vegetables.

NHS dieticians' advice

Earlier this year, top NHS dieticians were reported as providing the following tips for people with diabetes.

Together, these can be said to sum up the NHS approach to controlling type 2 diabetes with diet.

  • Eat plenty of starchy carbohydrates
  • Eat carbohydrate foods with a low GI
  • Avoid high GI foods, especially between meals
  • Eat regular meals and healthy snacks
  • Don’t miss breakfast
  • Don’t skip meals
  • Avoid all unhealthy/hydrogenated fats
  • Choose low-fat dairy products
  • Check food labels
  • Choose lean meat and remove fat and skin
  • Avoid fried and fast food, and baked goods
  • Keep hydrated and avoid binge-drinking

Base meals upon starchy carbohydrate

The NHS advises people, including those with diabetes, to base meals around food with starchy carbohydrate such as:

  • Potatoes
  • Cereals
  • Pasta
  • Rice
  • Bread

The advice has caused some controversy over people with diabetes. Read more about the debate around NHS carbohydrate advice.

Have plenty of fruit and vegetables

The Department of Health recommends we eat at least 5 portions of fruit and vegetables a day. The 5 portions should ideally be different fruit and vegetables.

Fruit juice counts as one portion, and a smoothie can be up to 2 portions.

Transcript

The NHS provides guidelines to help people make healthy food choices. The same advice applies to people with and without diabetes.

The NHS advises people with diabetes to eat a source of starchy carbohydrates at each meal. Starchy carbohydrates include rice, pasta, bread and cereals. Choose lower GI versions or whole grain varieties where possible as these are more slowly absorbed and contain more nutrients. The NHS advises people to base 1/3 of our meals on starchy carbohydrate.

This advice has courted some controversy from people with type 2 diabetes, who report that this amount of carbohydrate can make diabetes harder to control.

Testing your blood glucose before and after meals can help you to see how blood glucose levels respond to different levels of carbohydrate.

The NHS advises people aim to have at least 5 portions of fruit and veg each day. Nutritional research has shown that eating a minimum of 5 portions of fruit and vegetables a day can reduce the chances of suffering heart attacks, strokes and some cancers.

Examples of a portion include an apple or an 80g serving of fruit and vegetables. 80g will usually be around 3 heaped tablespoons of foods such as berries, carrots or peas.

The NHS encourages people to eat at least 2 portions of fish a week, with one of these being oily fish.

  • Examples of oily fish include mackerel, sardines, pilchards and fresh tuna.
  • Non-oily fish includes haddock, plaice, cod and tinned tuna.

The NHS advises most people to consume less saturated fat. Where possible, they advise to choose unsaturated fat in preference to saturated fat.

  • Examples of sources of unsaturated fat include avocado, nuts and vegetable oils
  • Examples of sources of saturated fat include red meat, crisps, biscuits and butter

People with diabetes have extra reason to eat less sugar as sugar has a fast and direct impact on blood glucose levels. Products with a tendency to contain higher amounts of salt include tinned soups, ready meals and other tinned or packaged foods sauces. Check the side of tins and packages to see how much sugar and salt they contain.

Eat less saturated fat

The NHS recommends people to eat less saturated fat and advises eating foods containing unsaturated fats such as:

  • Oily fish
  • Unsalted nuts
  • Avocados

Rather than foods containing saturated fat such as:

  • Cheese
  • Biscuits
  • Sausages
  • Pies

Choosing leaner meats such as chicken or trimming fat off cuts of red meat can help to reduce saturated fat.

Eat more oily fish

Oily fish is a good diet option because it contains important minerals as well as being a good source of omega-3 fats. Eating at least 2 portions of fish a week is recommend, with at least 1 of those portions being oily fish.

Eat less sugar and salt

Cutting down on sugar comes expected for people with diabetes. It is also recommended to cut down on salt.

The Department of Health advise eating less than 6g of salt each day.

What is considered high salt levels?

Foods with more than 1.5g of salt per 100g are considered to be high in salt.

Eat breakfast

The NHS advises eating breakfast each day and not being tempted to skip the first meal of the day.

Research shows that a low GI breakfast can help to prevent overeating through the rest of the day.

Keeping hydrated

Aim to drink at least 1.2 litres of fluid each day.

Note this includes:

However, this does not include alcohol.

On warmer days, more than 1.2 litres of fluid may need to be consumed.

Explore Diabetes & Diet
Your Comments
 
It is now abundently clear that the NHS dietary advice is totally without any sense of reason or worth.Indeed I consider it to be lethal. It probably has contributed to the painful and unecassary early demise of many diabetics who just cowtow to anything their gp tells them ( lower case gp intentional ).We are not bred to the eat the refined processed c**p that the nhs are in league with the food police and manufacturers with.I ditched all carbs and eat lots of fat, and I am going strong with diabetes 18 years post total heart transplant ! I have seen the light !Happy new year all !
Posted by Superchip, Suffolk on Wednesday, January 02, 2013
Confused, I have been diabetic for 20 years the so called specialist encourages taking carbs with meals. Ie potatoes, rice and so on not so sure about that, just lost control for some reason and was advised to avoid these foods by people who have the condition and I have control again
Posted by Steve coleman, Notts on Wednesday, October 10, 2012
Almos two years ago I read in Scientific American that large-scale research failed to show any benefits from the much vaunted 5 a day. The recommendation was 9 portions of fruit and vegetavblre a day although no scientific evidence was adduced to support this recommendation.I am sold on the idea of going for low GI foods, and avoiding sugar, salt and saturated fat as much as possible. I grill rather than fry. and rec meat does not form a significant part of my diet.I find a lot of the dietary advice confusing because what I read in the UK is not always in agreement with what I see on US sites. My feeling is that there is insufficient scientific evidence to support many of the recommendations I have seen. I suspect that moderation is as good an answer as most of what I have come across.
Posted by Spalpeen, Cheltenham on Monday, October 01, 2012
I am confused again and have lost my book on how to plan my meals. My doctor has me on 45 carbs. all three meals, can you sent me guide on the amount of wholesome food to eat Thanks in advance for any imforation you can send me . I will make copies of it on my email address I have been a diabeta for 28 yrs.I am very poor health and I think part of this is what and how I eat
Posted by Annetta Cox, United States on Sunday, September 30, 2012
The NHS diet advice is decades out of date and probably contributing to the early demise of its victims. It doesn't much matter whether you get glucose from potatoes or Cadbury chocolate eggs. In fact the Cadbury eggs probably have a lower glycemic load due to the high fat content. It is time for the NHS to join the 21st century and start treating diabetics seriously. In the meantime, it is best to get your diet advice from the US government and places like Harvard Medical School or The Mayo Clinic. When it comes to Diabetes self-management, the NHS is not our friend.
Posted by Bob Morgen, London on Tuesday, August 07, 2012
I have been told to cut down on potatoes, rice, pasta as well as sugar. I am now confused as the diet plans I have read say to eat carbohydrates like potato rice and pasta
Posted by Peter Jackson, St Ives on Tuesday, July 24, 2012
Very interesting article in the Times today in which it appears that American Doctors regard carbohydrates as being something diabetics should avoid or keep to a minimum. Their advice seems to have worked well for the patient around whom the article is based and he has been able to prove an improvement in his wellbeing but no increase in his cholesterol levels which he feared. Anyone else tried this or have views on it?
Posted by John B, waterlooville on Tuesday, July 17, 2012
@ John Elliot: I suggest you go and see your GP as soon as possible regarding your blurred vision, and would also suggest you check on a safe level of water consumption as six litres may be excessive. Too much water can actually be very damaging to your body. The basic diet to follow is one which has a lot of low GI foods (wholegrains, pulses, lean meats), but check the GI of foods such as fruit. Safe fruits are ones like kiwis, berries and grapefruits. By sticking to low GI it means that the foods release glucose (sugar) into your body slowly, instead of the sudden sugar rush you get with high GI foods such as chocolate. This sudden spike in sugar is not good for type II diabetics, as the body cannot process the sugar quickly enough, causing high blood sugar (hyperglycaemia). Eat at regular times throughout the day, and make sure you are getting exercise. It is also important to cut down on fat and salt, both which put people at greater risk of things like heart attacks and stroke. I hope this helps a bit!
Posted by L Wa on Tuesday, June 26, 2012
I have just found out I am diabetic and I am drinking 6 litres of water a day, am in the toilet a lot. My eyes are hurting and I have blurred vision. I am confused by the food regime, please help.
Posted by John Elliott, Epsom on Thursday, June 14, 2012
Last week I had pins and needles tingling in my tongue when I was stressed and this week I have a pins and needles tingling in my lower lip. Could this be a sign of prediabetes?The doctor has recommended an aspirin a day.
Posted by Caroline Machin, Portsmouth on Thursday, June 07, 2012
Dana H. If your mother won't give up sugar, try the more expensive sugar substitutes. Although they are not supposed to be healthy, what I do is not stick with one, so that I'm not eating the same type too long. At the moment I'm taking Stevia, which is expensive but sweet. What I've learned is that if I don't have sugar substitutes, I will eventually crave for something with sugar in it. Good luck!
Posted by Mousemat, Uk on Tuesday, May 15, 2012
I am a type 2diabetic. When I first went on to insulin I put on a lot of weight. According to my consultant at the time he advised that I should lose weight as being overweight was not good for diabetics. Somewhat of a contradiction. I asked why this was but got no reason apart from keep on using the insulin. As for carbs, was advised to keep them to a minimum. What are we diabetics supposed to believe. No wonder the NHS is in trouble.
Posted by Jill Mitchell, Tiverton Devon on Tuesday, May 15, 2012
I have been told I have Diabetes 2. Since I had Swine Flu I have gradually gone off eating dinners don't even fancy them. All I want to eat are tinned fruit and (ghastly confession) cakes and puddings. What is going on?
Posted by Pauline Love, West Norfolk on Tuesday, May 15, 2012
I find it incredulous to read this! I thought it had been well known for several years now that carbs are the evil for diabetics, due to carbs turning into sugars once digested. Yet here we have NHS guidlines and dieticians telling diabetics to stock up on loads of carby foods, such as bread, potatoes, pasta and rice! This goes against everything I have learnt since being diagnosed diabetic and everything my blood sugars say! In my experience eating a low carb diet and cutting back on these items is the way to go! The proof is in the pudding so to speak and the mmol numbers dont lie! I find it highly disturbing that this information is being given to both existing and newly diagnosed diabetics when it is totally inaccurate! Mind you, it just about sums up the level of diabetic care within the NHS!
Posted by Rachel, Devon on Thursday, April 12, 2012
My husband found out yesterday he has type 2 diabetes and was put on tablets. Does anyone know why after his mid-day meal his reading hi on the reader when he took his tablet at breakfast. I'm not sure what to do as this is all new for us both.
Posted by JacquiMiller , Ipswich on Monday, April 02, 2012
My husband found out yesterday he has type 2 diabetes and was put on tablets. Does anyone know why after his mid-day meal his reading hi on the reader when he took his tablet at breakfast. I'm not sure what to do as this is all new for us both.
Posted by vicki, boston, lincolnshire on Saturday, March 31, 2012
Was told today I have diabetes and given appt to see diabetic nurse. Not sure how I feel at the moment about it all but do feel the doctor has not given me enough info and can't wait to see the nurse. Diet, exercise and meds I think is what the treatment is going to be.
Posted by sue, Hampshire on Wednesday, March 21, 2012
Hi, After battling with diabetes for 17 years (type 1) from BS ranging 21mmols, 18mmols, 14mmols, 12mmols consecutively, I finally found the solution to REDUCE CARBS! But what suprises me the most is the disencouragement from my diabetic team who prefer I'd eat 'normal' and increase my insulin. Is there something I'm missing? It's really interesting other diabetics felt the same attitude from the doctors. After all, I feel far better mentally and physically (lost 20kg in weight) and reduced my overall Novorapid by 50%. However, there is one piece of advice that type 1's must take on board (not sure about type 2) is that its a gradual reduction of carbs rather than radical as you may experience severe hypos. Anyhow, my focus really is on diabetic doctors and their strange reactions to low carb diets. Would love to here from your stories.
Posted by Adam on Saturday, March 17, 2012
I have just spent 10 days in hospital at the mercy of the hospital meals system. I have never usually had a problem because it has always been pretty good. But this time I was in, the portions were small and lacked choice. You could have a hot meal but it was always stodgy or a sandwich. They were ok but very bland. Corned beef was just corned beef. When it came to the hot puddings - omg they were apalling. Fruit cake was like sawdust, apple crumble and custard bland, rice pudding tasted of nothing but you could taste the sweetener which was bitter. Having brought it up with the hospital because I got so fed up of a banana and strawberry yoghurt. The response was that they had dieticians who gave them guidelines to follow. Hot puddings are made with reduced sugar or no sugar. I challenged this as at home I do eat the same as my family, except my pudding is usually a smaller portion. Her reply was that I could tell the nurses that I will look after my own dietary needs. I had to laugh. It is nigh on impossible to get a slice of toast at 9.00pm at night or a biscuit at 10am for a snack. Many times I was starving and my blood sugars were at 3.0. I could just imagine saying to them, I am going to look after my own needs what maybe said to me or what they would think. At 47 years and having had diabetes for 21 years, I think I should know what I can eat and how to eat it. I felt like a naughty child for asking for anything. I don't appreciate a nurse telling me what I can and can't eat. My sugars are spot on and I do eat a balanced diet and if I want syrup sponge, I will have it.
Posted by laineynic, Kendal on Thursday, March 15, 2012
I agree that carbs are changed to sugars so will push up your reading. Low GI carbs are to be had in moderation too. A good low GI diet book by Gabie Steenkamp and Lisbett Delport are brilliant. Lovely recipes and easy to follow diets.
Posted by Jen Owen, Whitburn on Thursday, March 01, 2012
Been type 1 for 16 years - variable levels of control and I hate people pointing the finger at me for that. I have experimented and followed the advice of my clinicians but my sugars have been terrible for the past 3 years and it has affected my mental health. Guess what.... I have always been told to match my insulin to my carbs. No one has ever suggested that I restrict carbs in any way (I always have with refined sugars). I have recently read Bernstein and other low carb ideology (which flies in the face of conventional medical wisdom). I have always been told to increase my insulin not lower my carbs. Well, for the past 10 days, I have totally restricted my carb intake cutting out bread and wheat products, increased my protien and fat intake and I have had the best blood sugars in 16 years! I FEEL GREAT mentally and physically, lost half a stone all from my waist, halved my insulin use (what would Novo and Lilly make of it if all type 1s halved their insulin needs??!!...they are a commercial enterprise afterall)! anyway 100 grammes of carb a day, maybe 150 on special occasions. I figure the least time in the red zone, the better for my immediate and long term health (no thanks to the NHS).
Posted by Tim, Portsmouth on Tuesday, January 31, 2012
This is palpably wrong. No one ought to recommend a high carb diet for diabetes. Read 'Sugar Nation' by O'Connell and other books. I wouldn't go over board on fruit either. Go for lots of fish, oily fish, salmon, sardines, lots of lovely veg. Cut out all diet foods, processed foods. Drink water. Avoid alcohol.
Posted by Lydia, London on Saturday, January 28, 2012
If anyone remembers their school biology lessons with salivary amylase and starch they will remember that the piece of bread (brown or white) you just ate will already be in the process of being converted to glucose by the time it reaches your stomach. I agree with a previous poster. Search for "Dr Bernstein diabetes" or "dsolve diabetes" and you can find out how to get blood glucose levels back to those of a non-diabetic.
Posted by Jess Hurch, N.E. Scotland on Thursday, December 01, 2011
I was diagnosed type 2 in June of this year and I must say I am shocked at the lack of support for diet. I have seen a dietitian once. Considering diet plays a big part in this condition I have been very disappointed in the service. On the NHS website it states that a plan would be implemented to help regulate diebites. Not so, just as every one seems to be stating - here's the tablets just get on with it
Posted by Elizabeth, Glasgow on Saturday, November 19, 2011
How can eating loads of carbs be helpful for a diabetic? I've been type 2 for 2 yrs now and before that developed gest. diabetes and went on insulin in 2nd month of pregnancy. What I found was that bread, whichever it was: white, brown, wholemeal, seeded... any kind, played havoc on BSugar levels, worst than a bar of chocolate. And yet, doctor's advice is eat 'plenty of carbs'! Are they 'experimenting' on us?
Posted by TU on Tuesday, August 16, 2011
I am 69 and just been diagnosed type 2. Like many people I have spoken to doctors/nurses and certain websites all tell you what not to eat but never tell you what you can eat. It would be nice if someone would come up with a seven day set of menues i.e breakfast, lunch and dinner so we the befuggled can actualy eat without worrying.
Posted by John Whyment, Lincoln on Saturday, July 23, 2011
My Mother has just come out of hospital last Monday having gone in with very high blood sugar levels which have now been reduced but she still wants to buy sugary things! How can I get her to eat sensible snacks and the right kind of carbs for her diet? I am seriously worried about her health; her weight has dropped dramatically and is thin and haggered looking. All in the past 2 years since my Father died. I really have tried to tell her but she will not listen and I do not want her in hospital again. Any advice?
Posted by Dana H, Tunbridge Wells on Wednesday, July 20, 2011
Could somebody provide a good daily diet to follow? ie Monday through Sunday. That would be a good help to me.
Posted by david graham, lincoln on Saturday, June 25, 2011
I have been type 2 for nearly 2 years. I have seen a doctor 3 times in this time. I just apply for a repeat perscription for metformin every 2 years. I have had no advice on diet, just told to cut down on sugar, eat a lot less fat and to look after my feet!!! Any help/advice on what I should be eating would be appreciated because the NHS are not providing much support at all.
Posted by Traceyr, Wakefield on Tuesday, June 14, 2011
Many, many diabetics find the NHS diet inadequate to control diabetes. I believe its primary function is, in fact, to help you lose weight. Which is a treatment for Diabetes. It however can cause you worse readings and for things to deteriorate, requiring more medication. Do yourself a favour and read Dr Bernstein's Diabetes Solution. Forget that fat is an enemy, sugar (all derivatives) and high amounts of carbohydrates are. Test - test all the time, see what makes you get spikes. See the Diabetes 101 website. It's a little depressing, but you'll get some good info there. And, for the love of god, a single reading above 7mmol or an HbA1c above or at 7 are NOT good readings, whatever your GP says. I was horrified the other day to see a site recommending that if BG was below 8mmol at bedtime - to have a snack to avoid a hypo!
Posted by Dave White, Dorchester on Thursday, May 19, 2011
NHS Diet Have been reading on the above page, a comment from beredeza. Its about wanting advice on diets. The tone of the letter? Makes him/her sound very confused and low. I therefore would like to know how are things going for him/her. Dannny
Posted by grandfatherd, Wakefield on Tuesday, March 01, 2011
This is aimed at Berezda in Devon: Change your doctor! The advice and help available is so much better than that which you seem to be getting. As for diet, try to minimise saturated fats and sugar. Keep hydrated. Balance your diet. You may have other issues that affect your diabetes, on which I am not qualified to comment. Try Diabetes.co.uk DVT may be treated with warfarin or similar. I assume you're on metformin? Dont panic and dont be afraid to ask. Good luck!
Posted by circuit basher, Oxon on Friday, February 18, 2011
All diets for sufferers of type two diabetes should be based on the complete avoidance of trans fats which are produced by passing vegetable oils such as rapeseed, sunflower and corn oil over a hot nickel catalyst. Until recently this was largely done with an additional input of hydrogen thus producing hydrogenated fats. Now the hydrogen has been turned off in the main meaning the resulting oils are thinner and contain more trans isomer bonds. The resulting trans fatty acids cause type 2 diabetes, obesity, CV disease Alzheimers and many more deadly illnesses. Eat only "cold-pressed" oils.
Posted by carefixer on Thursday, December 16, 2010
In reply to Beredeza, Devon on Mon 31st May 2010, I don't know much about diet or controlling diabetes but I'd advise you to find a good kinesiologist. Make sure they're registered and if you know anyone who's been to one ask them questions. Also do things you enjoy and bring some joy back into your life, because you're worth it. Try Yoga, it'll bring balance to your mind, body, spirit, maybe thats what you're looking for?
Posted by Rachel, Ayrshire on Monday, October 04, 2010
please be aware that there are many diabetic forums on the internet, some are better than others. some actually realise it is better to take action on your own rather than wait. if you google certain user names and 'diabetes' you may eventually find a forum that actually teaches you and shows you what is going wrong instead of just rubbing your hand and telling you ' you will be ok'. YOU are in charge of YOUR diabetes. dont let others tell you how to manage it.
Posted by mcmoby69, bury lancashire on Tuesday, July 20, 2010
I've found brown rice and lasagne the best foods to keep my sugar low. Brown rice takes about 40mins to cook but it's amazing, sometimes my sugar level after eating doesn't even change and I've had a good plate full of food. Lasagne also feels like a good meal but contains hardly any pasta so is great :)
Posted by Rachy on Monday, July 19, 2010
I am type 1 diabetic. I was type 2 for just over 2 years, but there was no control and blood sugars were all over the scale; have never been able to get anyone at all to tell me what I should or should not eat. GP says I should see dietician, but can't get appointment for 5 months. Levels bounce between 11 and as high as 27. Use 20 units PM and 6 units AM Cant eat much fruit/veg as chronic irritable bowel, don't like fatty stuff and can't eat salads. Take levels every AM before eating. Totally unable to bring down the levels, and I don't want to die, which is what will happen unless these come down drastically. Never, ever have a hypo. Desperate for help. Why won't anyone tell me anything? Even the diabetic clinic dont help... just 'watch what you eat' is meaningless without details, and that's all I can get them to say! Severely diminished circulation in right leg after untreated DVT following hip operation in 1996 - untreatable.
Posted by beredeza, devon on Monday, May 31, 2010
Eating plenty of carbs is not a good way for all diabetic 2 sufferers. For some of us, it causes a spike in blood sugar levels, so for some its not advisable. Low fat products are again not beneficial to some diabetics - and so is the old saying 'everything in moderation'. I find if I eat low carbs, some dairy fat and a truly well balanced approach to my diet, I am beginning to take control. The NHS approach is not a healthy approach for me.
Posted by Yvonne Tyrrell, London on Wednesday, April 07, 2010
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