These medications have been heralded for their ability to suppress appetite and aid weight loss, but did you know that GLP-1 is a natural hormone you can stimulate without injections or prescriptions?

Glucagon-like peptide-1 (GLP-1) plays a vital role in regulating metabolism, the intricate system responsible for managing your energy, weight, and blood sugar levels.

With the right habits, you can enhance your body’s natural GLP-1 production, helping you manage weight and maintain overall health sustainably.

Understanding GLP-1s and their role

GLP-1 is a hormone released in the gut in response to eating.

It has several important roles:

• Regulating blood glucose: GLP-1 increases insulin secretion and reduces glucagon levels, keeping blood sugar steady.
• Controlling appetite: It signals your brain to reduce hunger and enhances feelings of fullness.
• Slowing digestion: By delaying gastric emptying, GLP-1 ensures a steady release of nutrients and energy.
• Promoting energy balance: GLP-1 helps the body decide when to store or use energy.

Medications that mimic GLP-1 can be effective for weight loss, but their side effects such as nausea, muscle loss, and gastrointestinal discomfort make them unsuitable for everyone.

Research published in The Lancet warns that 40% of weight lost using these medications is lean muscle mass which can be difficult to regain.

Additionally, weight often returns once the medication is discontinued.

Natural methods of enhancing GLP-1 not only sidestep these issues but also offer long-term benefits for metabolic health.

• Rise of dangerous weight loss black market sparks concern
• W8Buddy app paves the way for enhanced weight management in the NHS
• MHRA: 68 people hospitalised with weight loss injections

How to naturally boost GLP-1 levels

Research suggests that lifestyle choices can significantly impact GLP-1 production and effectiveness.

1. Optimise your diet

Excessive sugar and refined carbohydrates flood your system with glucose, causing blood sugar spikes and crashes, so you want to reduce digestible glucose.

“Glucose rollercoasters” disrupts hormonal balance, including GLP-1.

Replacing sugary snacks with complex carbohydrates like whole grains, beans, and lentils can help stabilise blood sugar levels and improve GLP-1 activity.

2. Prioritise high-protein foods

Foods such as eggs, fish, poultry, and plant-based proteins are known to stimulate GLP-1 secretion.

Studies show that meals high in protein can significantly increase satiety by enhancing GLP-1 release.

Starting your day with a protein-rich breakfast sets the tone for steady energy throughout the day.

3. Increase fibre intake

Dietary fibre, particularly from fruits, vegetables, and whole grains, slows digestion and promotes the release of GLP-1.

Research from The American Journal of Clinical Nutrition highlights that fibre-rich diets not only support GLP-1 but also improve insulin sensitivity and gut health.

4. Engage in regular physical activity

Exercise is a powerful, natural stimulant for GLP-1. Studies in Diabetes Care have shown that both strength training and aerobic exercise can enhance GLP-1 levels improving appetite regulation and glucose metabolism.

Even simple activities like a brisk 10-minute walk after meals can help stimulate GLP-1 release.

5. Prioritise sleep

Sleep and hormone regulation go hand in hand. Poor sleep disrupts GLP-1 production and increases levels of ghrelin, the hormone that stimulates hunger.

Research from The Journal of Clinical Endocrinology & Metabolism suggests that getting 7–8 hours of quality sleep each night supports hormonal balance and reduces cravings.

6. Manage stress

Chronic stress elevates cortisol which can interfere with GLP-1 production and other metabolic processes.

Incorporating stress-relieving practices like mindfulness, yoga, or breathing exercises can help maintain a balanced hormonal environment.

• Reason why GLP-1 receptor agonists impact muscle mass explained
• Mounjaro comes out top in battle of the weight loss drugs
• Intermittent Fasting: Guide to Fasting and How it Works

Habits for long term GLP-1 optimisation

Changing your lifestyle can feel overwhelming but habit formation is the key to long-term success.

By linking new behaviours to existing routines – a technique known as habit stacking – you can make sustainable changes.

For example, pair your morning coffee with a short walk or add a handful of fibre-rich seeds to your breakfast.

It’s also important to rely on habits rather than willpower.

Research from Psychological Science highlights that willpower is a finite resource which diminishes throughout the day.

In contrast, habits are automatic behaviours that require less mental effort allowing you to maintain healthy routines effortlessly.

Boosting GLP-1 naturally isn’t just about appetite control; it’s about creating a lifestyle that supports your body’s natural processes.

One Meal A Day (OMAD) is a form of intermittent fasting that has gained popularity for its simplicity and prospect of significant health benefits.

Unlike traditional eating patterns which typically involve 3 meals a day, OMAD involves eating all of your daily calories in a single meal.

By doing this, you restrict food intake to a very short window of approximately 1 hour each day.

This is an extreme version of intermittent fasting, grounded in the belief that prolonged periods without food can lead to improved health outcomes and weight management.

• Time Restricted Eating: Beginner’s Guide
• Low Carb Diet and 7-day Meal Plan
• Carnivore Diet: The All Meat Diet

How OMAD works

The concept of OMAD is quite straightforward: eat once and then fast until the next day’s mealtime.

This approach is not just about limiting food intake to one meal a day.

It is also key to adhere to the same eating window daily to stabilise the body’s internal clock.

Flexibility in choosing the mealtime allows individuals to align their eating window with their lifestyle, making it a theoretically accessible approach to weight management and health improvement.

Advantages of OMAD

As with any eating approach, there are a range of potential advantages and disadvantages.

Potential for weight loss

OMAD’s restriction to a single daily meal can naturally lead to a reduction in calorie intake, thereby facilitating weight loss.

This aspect of OMAD can be particularly beneficial for weight management.

However, it’s important to acknowledge that OMAD may not suit everyone and that individual experiences can vary.

Limited research suggests that intermittent fasting can improve insulin sensitivity, thereby potentially aiding in blood sugar regulation.

• Intermittent fasting can help reach remission for type 2 diabetes
• Rishi Sunak follows intermittent fasting diet: “I don’t eat on Mondays”

Save time

Planning and preparing one meal a day is simpler and less time-consuming than traditional diets.

Disadvantages

Sustainability

The strict nature of OMAD makes it challenging for many to sustain long-term. Some people may find this approach leads to increased hunger.

Nutritional deficiency risks

With only one meal to provide daily nutrients, there’s a heightened risk of deficiencies.

Potential for binge eating

The restriction can lead to overeating during the eating window, negating some of the diet’s benefits.

Potential blood glucose fluctuations

For people with diabetes, OMAD poses potential risks including significant blood sugar fluctuations.

Lack of food intake for extended periods may lead to hypoglycemia (low blood sugar) while the consumption of a day’s worth of calories in one meal might cause hyperglycemia (high blood sugar).

Therefore, individuals with diabetes considering OMAD should do so under medical supervision.

Research

While studies on intermittent fasting show promise for weight loss and improved metabolic health, research specifically targeting OMAD is less abundant.

Some evidence suggests potential benefits in weight management and insulin sensitivity, which are critical for people with diabetes.

Nevertheless, the research is ongoing, and current findings should not be seen as conclusive.

• Beyond weight loss: health benefits of prolonged fasting investigated
• Fasting diet that concentrates on eating early in the day could lower type 2 diabetes risk
• Fasting-mimicking diet: how it benefits our heart health

While OMAD presents a simplistic and potentially effective approach to dieting, it requires careful consideration and is not universally suitable.

The diet’s extreme nature means it may offer benefits for some, particularly in terms of weight loss and metabolic health.

However, it also carries risks. Speak to your doctor before adopting this dietary approach.

Unlike time-restricted eating which focuses on eating within specific daily windows, intermittent fasting involves various patterns of eating and fasting cycles.

Fasting cycles can range from daily 16-hour fasts to full-day fasts a couple of times a week.

People with type 2 diabetes are known to use this approach to manage insulin levels and subsequently blood glucose levels, helping to support a healthy weight.

What is intermittent fasting?

Intermittent fasting refers to alternating periods of eating and fasting (not eating).

The aim is to time meals in a way that allows the body to use its stored fat for energy more efficiently.

Common intermittent fasting methods include:

• 16/8 method: fast for 16 hours and eat during an 8-hour window.
• 5:2 diet: eating normally for five days of the week while restricting calories on the other two days.
• Time-restricted eating: which focuses on limiting your daily eating periods to specific windows of time with less emphasis on what you eat and more on when you eat.

How does intermittent fasting work?

Intermittent fasting helps improve insulin sensitivity.

During fasting, insulin levels drop which prompt the body to switch from glucose to stored fat for energy.

This process burns body fat and supports weight loss.

During extended fasts, the body increases autophagy – the removal of damaged cell components – and increases growth hormone levels.

• Rishi Sunak follows intermittent fasting diet: ‘I don’t eat on Mondays’
• Fasting-mimicking diet: how it benefits our heart health

Benefits of intermittent fasting

Research indicates that intermittent fasting can improve various aspects of health.

These include:

• Enhanced insulin sensitivity and improved insulin resistance
• Lower blood sugar levels
• Improve blood pressure
• Reduce cholesterol levels
• Reduce inflammation
• Weight loss

This makes it particularly appealing for people with type 2 diabetes, or those seeking to lose weight.

Additionally, fasting can improve metabolic efficiency, reducing oxidative stress and inflammation.

Fasting for people with diabetes

Many people with and without diabetes practice fasting.

For people with diabetes, intermittent fasting can provide a method for controlling blood sugar levels and reducing dependency on medication.

However, it’s essential to approach intermittent fasting with caution and with medical supervision, especially for those on blood glucose-lowering medications in order to avoid hypoglycemia.

Tailoring fasting schedules to your health needs and monitoring your blood sugar levels closely are crucial steps for safely integrating intermittent fasting into your diabetes management plan.

• Water fasting: benefits of a water fast disappear soon after it ends
• Intermittent fasting can help reach remission for type 2 diabetes

Practical tips for success with intermittent fasting

To succeed with intermittent fasting:

• Start slowly with shorter fasting periods and gradually increase the duration as your body adjusts.
• Stay hydrated during fasting periods by drinking water, black coffee, or tea.
• Break your fast with balanced meals that include a mix of proteins, fats, and low in carbohydrates.
• Listen to your body and adjust your fasting schedule as needed based on how you feel.

Make sure you go at a pace that suits you, and speak to your doctor before incorporating intermittent fasting into your lifestyle.

Unlike traditional diets that focus on ‘what’ to eat, TRE focuses on ‘when’ to eat.

What is time-restricted eating?

Time-restricted eating is a dietary strategy that limits food intake to a specific number of hours each day.

The core principle is synchronising your eating patterns with your body’s circadian rhythms. The circadian rhythm is a natural process that regulates the sleep-wake cycle and repeats roughly every 24 hours.

By limiting the eating window, people can potentially improve their metabolic health parameters by aligning nutrient timing with the body’s internal clock.

Example eating windows:

Common frameworks within TRE involve 8-hour eating windows followed by 16-hour fasts (16:8 method), or more extended fasting periods such as a 20-hour fast with a 4-hour eating window (20:4). These are not one-size-fits-all, as the efficacy and comfort of these methods can vary significantly among individuals.

You may have heard of the 5:2 diet where calories are reduced for a number of days, rather than a number of hours each day.

How does time-restricted eating work?

During periods of fasting, the body shifts its energy source from glucose to stored fat, promoting fat loss.

The focus on time-restricted eating is not about reaching ketosis.

• Nutritional ketosis vs diabetic ketoacidosis (DKA)

Concurrently, aligning food consumption with daylight cycles optimises your body’s metabolic processes as the endocrine system and metabolic regulation are closely tied to circadian rhythms.

TRE works by minimising exposure to food and hunger hormones like ghrelin and potentially correcting insulin resistance by reducing the frequency of insulin release.

What does the science say?

Research into TRE has shown several potential health benefits:

• Fasting diet that concentrates on eating early in the day could lower type 2 diabetes risk
• Intermittent fasting can help reach remission for type 2 diabetes
• Combining time-restricted eating and HIIT brings health benefits for women with obesity
• Better benefits for fasting females discovered

Studies have demonstrated time restricted eating’s potential in reducing the risk of chronic conditions including type 2 diabetes, heart disease, and neurodegenerative diseases.

Beyond weight management and metabolic health, TRE has benefits, including:

1. Improved mental clarity and concentration due to the production of ketone bodies during fasting
2. Enhanced cellular repair and resilience through the removal of waste material from cells
3. Potential extension of lifespan and reduction in the risk of age-related diseases

While findings are promising, more extensive human studies are necessary to establish comprehensive guidelines and recommendations

What is autophagy?

One of the pivotal biological processes linked to TRE is autophagy.

Autophagy is a cellular mechanism that involves the breakdown and recycling of damaged cell components. Autophagy is triggered during periods of fasting and is akin to your body cleaning up  dysfunctional cellular components and reducing the likelihood of pathological cell growth.

This process is crucial for cellular rejuvenation, homeostasis, and defense against various diseases.

By promoting autophagy, TRE potentially supports the body’s natural defense mechanisms, contributing to overall health and longevity.

How do I break a fast?

Break your fast with nutrient-dense, low-carb, and real foods to maximise the benefits of TRE.

Ideal food choices include:

1. Lean proteins (chicken, turkey, tofu) to support muscle health.
2. Healthy fats (avocado, nuts, olive oil) for sustained energy.
3. Fibre-rich vegetables (leafy greens, cruciferous vegetables) to enhance digestive health.
4. Berries and other low-glycemic fruits for antioxidative benefits.

As with any dietary approach, consult your healthcare team before starting time restricted eating to ensure it aligns with your health and goals.

Is time restricted eating and intermittent fasting the same thing?

Time-restricted eating (TRE) and intermittent fasting (IF) are terms that are used interchangeably in the media but they refer to slightly different fasting strategies.

Time-restricted eating focuses on limiting your daily eating periods to specific windows of time with less emphasis on what you eat and more on when you eat. Most TRE protocols advise a fasting period of 12 to 16 hours, which includes the time you are sleeping, and a feeding window of 8 to 12 hours.

The primary goal of TRE is to align eating patterns with the body’s natural circadian rhythm.

Intermittent fasting comprises of a broader range of eating patterns that alternate between periods of fasting and eating.

These patterns can be daily, as in TRE, or over longer cycles, such as 24-hour fasts once or twice a week, or alternate-day fasting. This approach doesn’t always connect eating patterns to circadian rhythm. Instead, it focuses on longer periods of calorie restriction, which can lead to weight loss and other health benefits due to reduced calorie intake and factors like improved insulin sensitivity.

Time-restricted eating is essentially a form of intermittent fasting with a specific focus on circadian biology.

Apple cider vinegar (ACV) has been a type of vinegar made from fermented apple juice.

TikTok has been rife with claims about apple cider vinegar gummies affecting blood glucose management and weight loss – so what is the truth?

Apple cider vinegar, like many natural remedies, has its place in the discussion of diabetes management. However, it’s essential to approach it with a balanced perspective, understanding its potential benefits and limitations.

What is apple cider vinegar (ACV)?

Apple cider vinegar is a liquid made from fermented apples combined with yeast, which ferments the sugars and turns them into alcohol. Bacteria is added which turns it into acetic acid, the main active compound in vinegar.[1]

You can buy ACV as a liquid, pills, powder, or gummies.

Does apple cider vinegar affect diabetes?

Several studies have suggested that apple cider vinegar may have benefits for blood glucose control.

Improved insulin sensitivity

A study published in the journal Diabetes Care found that vinegar can improve insulin sensitivity during a high-carbohydrate meal in individuals with insulin resistance or type 2 diabetes.[2]

• Apple Cider Vinegar: research “scratches the surface” of ACV’s benefits
• Apple cider vinegar shown to significantly reduce post-meal blood glucose

Reduced blood sugar levels

A study found that consuming a small amount of apple cider vinegar before bed may reduce fasting blood sugars in the morning.[3]

While these findings are promising, it’s essential to note that ACV is not a replacement for medications. Always consult with your healthcare provider before making any changes to your health.

Weight loss

A small study following 39 people for 12 weeks found that consuming ACV twice daily helped people leading a low-calorie diet to lose extra weight.[6]

A study from 2018 found that apple cider vinegar helps with weight loss in rats eating a high-fat diet by making them full more quickly, resulting in weight loss.[7]

• Fewer carbs for breakfast can improve blood glucose levels

Who should avoid apple cider vinegar?

Most people can consume apple cider vinegar without issue. However, people taking medications that affect potassium levels or diuretics should avoid ACV as it may interact with the medications they are taking.[4]

People who have had weight loss surgery should also avoid ACV due to its acidic nature which can exacerbate symptoms in individuals with ulcers or acid reflux.[5]

Debunking myths

It’s crucial to approach the topic of apple cider vinegar and diabetes with a discerning eye. While ACV may offer some benefits for blood sugar control, it is by no means a cure for type 2 diabetes or a miracle weight loss drug.

Managing diabetes (regardless of type) requires a holistic approach, including a low-sugar, real-food diet, regular exercise, and, if you are prescribed it, medication.

People following the carnivore diet eat a diet of meats, fish, eggs, and dairy products, but exclude all vegetarian, or plant-based foods.

As such, followers of a strict carnivore diet avoid fruits, vegetables, grains, and legumes.

The meat only diet has gained popularity in recent years, particularly on social media, as a way to improve health, lose weight, and alleviate certain medical conditions.

• Cancer-related mortality risk reduced by eating meat
• High intake of eggs and red meat make your farts smell worse

The carnivore diet is also referred to a as a zero carb diet, made famous by Shawn Baker, MD, an orthopedic surgeon and influencer in the carnivore diet movement.

Other proponents include Kelly Hogan and Jordan Peterson (whose daughter Mikhaila Peterson introduced him to the carnivorous diet).

This is presumably as the carnivore diet is a form of a low carb diet.

Does research support a carnivore diet?

Proponents of the carnivore diet argue that it is a natural and evolutionarily appropriate diet for humans. It is proposed that our ancestors ate mostly animal products and our bodies are well adapted to digesting and utilising them.

However, as it is a relatively new diet, there is limited scientific research on the long-term effects of a carnivore diet.

Some small studies have suggested that a carnivorous diet may improve markers of health, such as weight loss, blood sugar control, and inflammation.

However, it is important to note that these studies have been small and short-term, and more research is needed to fully understand the potential benefits and risks of such a diet.

Additionally, a carnivore diet can be nutritionally inadequate and lacks essential nutrients found in plant-based foods, that’s why it’s important to consult with a doctor or a dietitian before adopting such a diet.

Carnivore diet menu

A carnivore diet can comprise:

• Red meat such as lamb, pork, and beef
• Organ meats
• Chicken and turkey
• Fish
• Eggs
• Lard
• Bone marrow
• Butter or ghee
• Salt and pepper
• Water
• Bone broth
• Sauces are permitted if they are made only with meat drippings and no additional binding ingredients

What to avoid on a carnivore diet

Foods to avoid are:

• Fruit and vegetables
• Nuts and seeds
• Legumes
• Bread
• Pasta
• Grains, including whole grains
• Alcohol

The diet is low in unhealthy processed foods and thus naturally low in added sugar.

Concerns with a carnivore diet

The carnivore diet is also low in fibre. Fibre is important for maintaining healthy digestion and preventing constipation.

Fibre is only found in plant-based foods and lack of fibre in the diet can lead to digestive issues and an increased risk of colon cancer.

The carnivore diet is also low in essential micronutrients such as vitamins and minerals, which are important for maintaining overall health. These micronutrients are found in plant-based foods and a diet lacking in these nutrients can lead to deficiencies and an increased risk of chronic diseases.

• High intake of red meat linked with cognitive decline
• High intake of processed meat increases risk of type 2 diabetes

Another concern is that the carnivore diet is low in antioxidants and phytochemicals, which are compounds found in plant-based foods that have been shown to have anti-inflammatory and anti-cancer properties. These compounds help to protect against chronic diseases such as cancer and heart disease.

The diet may not be sutiable for certain groups of people. People who must limit their protein intake such as those diagnosed with chronic kidney disease should not follow this dietary approach.

Conclusion

In conclusion, the carnivore diet is a dietary pattern that consists of only animal products and excludes all plant-based foods.

While proponents argue that the diet is natural and evolutionarily appropriate for humans, there is a lack of scientific evidence to support the long-term safety and efficacy of the carnivore diet.

Fruit juice contains a large amount of sugar which raises blood sugar levels very quickly. Therefore, people with diabetes are usually best to avoid drinking fruit juice.

As a general rule, eating whole fruit is healthier than drinking fruit juice or fruit smoothies.

Once regarded as a healthy drink, recent research indicates that that regular consumption of fruit juice may increase the

risk of developing type 2 diabetes

What’s in fruit juice?

Aside from

vitamin C
and calcium, fruit juice contains:

• Calories – 250ml glass of unsweetened orange juice typically contains around 100 calories, compared to the 60 calories in an actual orange
• 
  Fructose (a form of sugar)
  – half a pint of fruit juice contains more sugar than the World Health Organisation recommends ideally having in a day (30g of sugar for men, 24g for women)
• 
  A lack of fibre
  – juice always contains less fibre than whole fruit and highly processed juices may not contain any fibre

How does fruit juice affect blood sugar?

Sugar levels in fruit juice can cause a significant spike in blood sugar levels, increasing the risk of

hyperglycemia
(too high blood sugar levels).

The glycemic index, which is used to reflect the impact on blood sugar levels of individual foods, places orange juice between 66 and 76 on a scale of 100. This makes fruit juice a high GI drink and high GI foods and drinks are best avoided by people with diabetes under most circumstances.

One situation in which fruit juice can be useful is to raise blood sugar quickly in response to

hypoglycemia
(too low blood sugar).

Fruit juice and fructose

Fruit juice is high in a form of sugar called fructose. Fructose needs to be processed by the liver and research suggests that a diet that is high in fructose may cause the liver to be overwhelmed, leading to problems such as

non-alcoholic fatty liver disease
and type 2 diabetes.

It is important to note that table sugar is made up of 50% fructose and 50% sucrose. There a diet high in sugar will also be high in fructose.

These points are significant because it means that over-consumption of fruit juice or having fruit juice in addition to a high sugar diet may increase the risk of health problems.

Benefits of fruit juice

Fruit juice has some benefits, however the benefits are generally outweighed by the disadvantage of the sugar content.

Fruit juice is a good source of nutrients such as vitamin C. However, it is better to get vitamin C from eating small portions of whole fruits or eating leafy green vegetables.

Leafy greens have a strong advantage over fruit or fruit juice in that they have much less effect on raising blood sugar levels.

Whole fruit is a better option than fruit juice

It is better to consume whole fruit than fruit juice. Whole fruit has the advantage of having soluble fibre for instance.

Soluble fibre
can helps to improve digestion and slows the rate of the rise in blood sugar. It also means that whole fruit represents a less concentrated form of sugar.

It should be noted that people with diabetes should approach whole fruit with some caution too as many whole fruits have a lot of carbohydrate.

The bottom line is that whole fruit is better than fruit juice but should be eaten in moderation. Small portions of fruit are better.

Does drinking fruit juice increase the risk of diabetes?

Studies have found that drinking three portions of fruit juice a week was associated with an eight per cent increase in diabetes risk.

Conversely, eating blueberries, grapes, apples and pears was associated with reduced risk. The researchers found that replacing fruit juices with three helpings of certain

whole fruits
a week would lower the risk by seven per cent.

Some whole fruits reduced the risk more than others. For grapefruits and bananas, there was a five per cent decrease, whereas blueberries reduced the risk by 26 per cent.

What about vegetable juice?

Juiced

non-starchy vegetables
have a lower glycemic index and contain fewer carbohydrates than juiced fruit. The glycemic index of whole vegetables is lower still.

As with fruit, a proportion of the fibre from whole vegetables is likely be lost during the juicing process. Juiced vegetables can play a part in a healthy diet, particularly if juiced vegetables do not replace having whole vegetables.

Diets for type 2 diabetes should be built around the principles of healthy eating with a focus on foods that do not adversely affect

blood glucose levels

As a general guide, your diet should include a good variety of vegetables, sources of unsaturated fats such as nuts, avocados and oily fish, while processed foods should be avoided.

Type 2 diabetes and the NHS diet

NHS

diet advice
generally recommends eating starchy carbohydrates with each meal, as well as more fruit and vegetables, at least two portions of oily fish a week, and less saturated fat, salt and sugars.

The most disputed part of the advice is the recommendation to eat starchy carbohydrates at each meal.

Many people with type 2 diabetes find that even

low GI sources
of starchy carbohydrate (such as basmati rice and whole grain bread) tend to significantly increase blood glucose levels.

Performing blood glucose tests before and two hours after meals can help you see which foods, and in what quantities, are appropriate for you.

• Read more on
  
  pre and post meal blood testing

Low-carb diets and type 2 diabetes

Low-carbohydrate diets tend to be popular with people with type 2 diabetes, with many people reporting improved blood glucose levels on a

low carb diet, which can also help to reduce dependency on medication.

But despite their popularity and apparent effectiveness, low-carb diets, have yet to be endorsed by the NHS. Read more about

low-carb diets and NHS recommendations.

The

Low Carb Program provides education on diet and in particular a lower-carb lifestyle which helps people with type 2 diabetes reduce their HbA1c and weight and is the highest rated diabetes app used in the NHS.

People who are taking medication for type 2 diabetes should be aware that low-carb diets could raise the likelihood of

hypoglycemia
so it’s recommended to speak with your doctor before starting such a diet.

Raw food diets and type 2 diabetes

Raw food diets can be viewed as effective detox diets.

Some of the health advantages of

raw food diets
are a result of the reliance on freshly prepared food and the high amount of fruit and vegetables involved.

Raw food diets are quite restrictive and it’s recommended that you check with your doctor before starting a raw food diet to ensure you get a good balance of nutrients.

Very-low calorie diets and the Newcastle study diet

A study known as ‘the Newcastle diet study’ showed that a very-low calorie diet could be particularly effective at reversing the symptoms of type 2 diabetes. Then, in 2016, the diet was shown to

reverse type 2 diabetes for up to six weeks

Since the results were published, a significant number of people with

type 2 diabetes
have been keen to give the eight-week long diet a try.

Very-low calorie diets such as the Newcastle diet are viewed as being quite extreme and are not recommended without supervision from a doctor.

• 
  Very low calorie diets
• 
  The Newcastle diabetes diet

Tea is one of the nation’s favourite drinks and research suggests it’s also a healthy drink. Tea brings a number of health benefits including improving insulin sensitivity.

However, research notes that some the benefits are best experienced if you drink your tea without milk.

Benefits of tea

Research suggests the following benefits may be enjoyed from tea:

• Improving insulin sensitivity
• Maintaining healthy blood pressure
• Preventing blood clots
• Reducing risk of cardiovascular disease
• Reducing risks of developing
  type 2 diabetes
• Reducing risks of developing
  
  cancer

How does tea help diabetes?

Teas such as black tea, green tea and oolong tea contain polyphenols which researchers believe may increase insulin activity. A number of studies have shown positive effects of tea:

• Drinking two cups of tea each day could help you live longer
• Green tea and coffee found to reduce risk of death among type 2 diabetes

Can tea prevent diabetes?

Polyphenols are known to have anti-oxidative properties which can help protect against inflammation and carcinogens.

In other words, the properties in tea can help to prevent type 2 diabetes as well as

cancer.

Other factors for preventing type 2 diabetes include:

• Eating minimal amounts of
  processed foods
• Eating fresh vegetables regularly through the day
• Including physical activity into each day
• Not smoking
• Keeping alcohol intake low

Tea and stress relief

Tea also contains tiny micronutrients called flavonoids which can help parts of the body to function better.

There are many different types of flavonoid and each have different health properties.

One flavonoid of interest that is found in tea is theanine which can help to control blood pressure and lower stress.

Which type of tea is best to drink?

The latest research indicates that green and black teas are as effective as each other in providing health benefits.

Other type of tea which have been found to have benefits include:

• Oolong tea
• Chamomile tea
• Rooibos tea
• Ginger tea

Effective
management of diabetes cannot be achieved without an appropriate diet.

People with diabetes represent a large subsection of society and there will be range of variety in terms of dietary requirements from person to person.

As a result, there is no one diabetic diet that will work for everyone and people should pick a diet that matches their individual needs.

Ideally, patients with

newly diagnosed diabetes
should receive advice from a dietitian soon after diagnosis.

Which diet is right for me?

There are a wealth of diets that have proved to be either popular with or of interest for people with diabetes.

We’ve compiled some of the more prominent of these diets, looking at both the benefits and disadvantages of each diet.

• 
  Diet for type 1 diabetes
• 
  Diet for type 2 diabetes
• 
  5:2 diet
• 
  Acid-alkaline diet
• 
  Atkins diet
• 
  Carbohydrates and diabetes
• 
  Carnivore diet
• 
  DASH diet
• 
  Detox diet
• 
  Dukan diet
• 
  Gluten free diet
• 
  Glycemic index diet (GI diet)
• 
  Glycemic load
• 
  Ketogenic diet
• 
  Low calorie diet
• 
  Low carb diet
• 
  Low carb high fat diet
• 
  Low fat diet
• 
  Meal replacement diet plans
• 
  Mediterranean diet
• 
  Newcastle study diet
• 
  NHS diet advice
• 
  Paleolithic diet
• 
  Raw food diet
• 
  South beach diet
• 
  Vegan diet
• 
  Vegetarian diet
• 
  Very low calorie diet
• 
  Zone diet

What are the aims of dietary advice?

When you receive advice from your doctor or diabetes team about your diet, they will often make suggestions in order to:

• Provide a knowledge of healthy eating
• Encourage lifestyle changes in order to reduce obesity and
  ensure optimal weight
• Maintain blood glucose and lipids as near normal as possible
• Reduce the acute (short term) complications of diabetes such as
  
  hypoglycemia
  and
  
  hyperglycemia

Dietary
Goals

• Ensure an adequate and balanced nutritional intake
• Limit rapidly absorbed carbohydrate intake
• Monitor body weight encouraging weight maintenance and weight
  reduction when necessary
• Avoid hypoglycemia

Weight Reduction

If you are carrying extra weight, and are classed as either

overweight or obese, weight loss has been shown to improve insulin sensitivity and glucose tolerance.

Modest weight loss of 5-10 kg in one year can significantly improve health outcomes.

General guidance on healthy eating

General guidance on healthy eating from the NHS will generally be based upon the following set of guidelines:

• Increasing intake of
  
  low GI carbohydrate
  foods
• Increasing fruit and vegetable intake.
• Reducing
  
  saturated fat
  intake
• Reducing sugar intake
• Reducing salt
• Safe and sensible alcohol consumption

The NHS advice on carbohydrate intake in particular has met a fair amount of criticism from people with diabetes.

Read more on the

debate surrounding NHS dietary advice

Lifestyle

Patients should follow dietary advice as part of lifestyle modification
including appropriate exercise regimes and smoking cessation.

When choosing what to drink, there are a couple of main considerations relevant to your diabetes to take into account.

The first consideration is whether, or how much, the drink will

affect your blood sugar levels

The other main consideratio, which will be relevant to all of us to some degree but of particular relevance for those of us watching our weight, is to consider the calorie content of drinks.

Water

You can’t go too far wrong with pure water. It provides the hydration your body needs and is, of course, zero carbohydrate and zero calories.

Milk

Moderate carbohydrate content which may need to be accounted for, particularly in people with type 1 diabetes, if drinking close to or more than 100ml.

Milk tends to be a good source of energy and people that wish to watch their weight will need to take into account the calorie content of milk. Skimmed tends to have around half the calories of whole milk.

Fruit juice

Fruit juice is usually regarded as a healthy option but it should be noted that fruit juices have a relatively high carbohydrate content. The calorie content of fruit juice is similar to that of skimmed milk.

Despite being quite high in carbohydrate content, fruit juice needn’t be totally avoided and can be a good option before taking a sustained period of exercise as the activity may help to balance out the rise in blood sugar levels from the juice.

To ensure you get good nutritional value from fruit juice, ensure you have real, unsweetened fruit juice.

Fruit squash and cordials

Fruit squash and cordials tend to be sweetened but some sugar free versions may be available. Squash and cordials don’t carry the nutritional benefits of real fruit juice but can be a lower carbohydrate and lower calorie alternative to sugar soft drinks.

Sugary soft drinks

Sugary soft drinks
are high in both carbohydrate and calories and generally contain no nutritional value aside from energy, which can lead to taking in more energy than the body needs, or leading to not taking in enough vitamins and minerals.

Sugary soft drinks are generally best avoided but can be useful if you specifically need to raise your blood glucose levels, such as before, during or after exercise or to help treat a hypo.

Diet soft drinks

Diet soft drinks
tend to be popular with people with diabetes as they are low in carbohydrate and low in calories.

Diet soft drinks tend to use artificial sweeteners and other artificial agents to provide sweetness, flavour and colour. Whilst soft drinks are recognised as safe for consumptio, research has raised some questions over potential health issues and some people may prefer to limit or avoid their exposure to soft drinks as a precaution.

Tea

Research into the effects of non-milky tea has identified a range of health benefits, including improving insulin sensitivity and helping maintain healthy blood pressure. Lovers of milk in tea will be disappointed to know that the health benefits generally aren’t realised when milk is added to

tea

Coffee

There are probably few foods or drinks that get such a mixture of good and bad headlines as coffee. Confusingly,

coffee
has been linked with both increased and decreased risks of developing type 2 diabetes.

Studies looking into moderate coffee consumption (2-3 cups a day) have shown some health benefits, including a lower risk of type 2 diabetes, whilst high coffee consumption (5 or more cups a day) has been linked with a higher risk.

Note that milky coffees such as lattes can be high in calories, with larger lattes sometimes varying between 100 and 300 calories.

Sugar in hot drinks

Many people enjoy sugar in hot drinks but people with diabetes are better off having drinks without sugar where possible as one or two teaspoons of sugar in each drink can add up over the course of a day.

2 spoons of sugar in 5 hot drinks a day is as much calories and carbohydrate as a can of full sugar cola.

Alcoholic drinks

When having alcohol, there are a few things to consider:

• How the drink will affect blood sugar levels
• The calorie content of the drink
• Whether alcohol will interact with any medication you take

Alcoholic drinks
can be responsible for raising and lowering blood glucose levels so it’s useful to understand how different alcoholic drinks can affect your sugar levels.

For those keeping an eye on their weight, it’s important to note that alcohol is significant source of calories. For example, a single pint of regular beer has 200 calories, which is as many calories as a large slice of pizza.

Some medications interact with alcohol. It is advisable to check the patient information leaflet enclosed with your medication and consult your doctor if you have further questions.

Studies have shown that the diet helps with weight loss and may also reduce insulin resistance, both of which are of particular interest for many people with type 2 diabetes or borderline diabetes.

One reason for the popularity of the diet is that it allows a certain amount of flexibility, in comparison to low calorie diets, on most days of the week. Many people use fasting alongside a low carb diet.

Theory behind the 5:2 diet

The idea of the diet is that short periods of fasting prompt the body to repair damage but not enter a starvation mode of conserving energy.

Whilst the theory has yet to be conclusively proved, clinical studies have shown promising results for the diet, however it has only been examined over relatively short time spans, of less than a year. There are several ways that intermittent fasting can be used to manage blood glucose levels, however this guide focuses on the 5:2 approach.

How the 5:2 diet works

The 5:2 intermittent fasting diet is based on a simple idea. For 5 days a week you stick to meeting the daily calorie intake advised for people of a healthy weight, that being:

• 2,500 kcal per day for men
• 2,000 kcal per day for women

For the other 2 days each week, the diet stipulates that you have only around 25% of the values above, which is equal to:

• 600 kcal on these days for men
• 500 kcal on these days for women

The fasting days can be taken at any time during the week as long as you do not take 2 fasting days consecutively.

Benefits of the 5:2 diet

Clinical studies have shown that the benefits of intermittent fasting are largely similar to those of a calorie restricted diets.

The most commonly reported benefits among people from following the 5:2 diet:

• Weight loss
• Decreased levels of triglycerides and LDL cholesterol
• Reduced blood pressure
• A reduction in insulin resistance

Research has shown that periods of fasting can help to improve life expectancy and decrease risks of diseases including nerve disorders, Alzheimer’s disease and cancer.

However, whether these benefits apply to a 5:2 fasting diet cannot be confirmed as long term clinical studies have yet to be performed.

Is the 5:2 diet suitable for people with diabetes?

Whilst shorter term studies have displayed promise for intermittent fasting diets, long-term safety of the 5:2 diet is yet to be determined.

As with any diet plan, you should always consult your GP or diabetes health team before making any significant changes to your diet as they could affect blood glucose levels or impact on your medication.

Type 2 diabetes and the 5:2 diet

The fact that intermittent fasting shows evidence of improving insulin sensitivity may be an attractive option for people with a BMI over 25, borderline diabetes (prediabetes) or with type 2 diabetes but not on blood sugar-lowering medications.

The diet may be good for people who can handle single days of significantly restricted calorie intake in preference to modest calorie restriction every day.

On fasting days, the body will be forced to use stored energy from the body, fat and stored sugar (glycogen), which can help with weight loss and may improve blood glucose and cholesterol levels.

If you are on insulin, or hypo causing medication, such as sulphonylureas or glinides, an intermittent fasting could significantly increase the risk of hypos. Your doctor should advise you on whether the diet is appropriate.

Type 1 diabetes and the 5:2 diet

If you have type 1 diabetes, following a 5:2 diet could make diabetes management more difficult to achieve and could significantly increase the risk of hypoglycemia.

If your health team are happy for you to start an intermittent fasting diet, they may wish to monitor you more closely to reduce the likelihood of hypoglycemia or increased ketone levels occurring.

Evidence of the 5:2 diet

A study published in 2010 reviewed 107 women, between the ages of 30 and 45, with BMI values ranging between 24 and 40.

The participants were randomly assigned to one of two diets, either continuous energy restriction (CER) or intermittent energy restriction (IER). The CER dieters had a reduced calorie intake of 1,500 kcal through the week, while the IER diet group followed the 5:2 fasting plan.

At the end of the study, both sets of dieters lost a similar amount of weight on average, and similar improvements were also seen in levels of triglycerides, LDL ‘good’ cholesterol and blood pressure.

One area, however, where intermittent fasting was shown to be stronger than continuous calorie restriction was in reducing fasting insulin levels and insulin resistance.

How to follow the 5:2 diet

Depending on your outlook, the 5:2 diet may be seen as more or less practical than a continuously reduced calorie diet.

The benefit being that on most days you needn‘t consume less than the daily recommended calorie limit. However, some people may find that calorie intakes of 500 or 600 calories a day are too low to be practical.

For best results, it’s recommended to follow basic healthy eating rules, such as having a good intake of vegetables, fruit, and limiting intake of processed foods where possible.

During the fasting days, you will need to rely on very low calorie meals to stay within the daily 500 or 600 calorie counts.

Read recent research to support the benefits of fasting:

• Eating a big breakfast aids in appetite control and weight loss
• Better benefits for fasting females discovered
• Fasting helps men at risk of type 2 diabetes control blood glucose levels, study reports

5:2 diet fasting meal plan

An example of good meal picks on fasting days include those based low fat foods such as:

• Eggs (65 kcal per medium egg)
• Grilled chicken breast without the skin (190 kcal per 100g)
• Prawns (105 kcal per 100g)
• Non-battered white fish (135 kcal per 100g)

Vegetables tend to be low calorie but if you need very low calorie vegetables, the following vegetables are particularly good options:

• Cucumber (15 kcal per 100g)
• Celery (20 kcal per 100g)
• Bell pepper (26 kcal per 100g)

Along with vegetables, fruit is one of the healthiest food groups and contains an important source of vitamin C which helps to keep our cells healthy.

Can someone with diabetes eat fruit?

People with diabetes can eat fruit. However, fruit can be quite sugary so bear this in mind to prevent blood sugar levels rising too high

Daily recommendations of fruit

The Department of Health advises us to consume at least 5 portions of fruit or vegetables a day. The American Diabetes Associations recommends fruit as a good option if you’re

having a dessert

Effect on diabetes

Fruit is naturally quite high in sugars and fruit will typically have more carbohydrate than non-starchy vegetables. Some fruits are more sugary than others.

For example, banana and oranges are examples of more sugary fruits whereas berries are examples of less sugary fruits.

You may find therefore that you need to choose smaller portions of certain fruits

depending on your blood glucose levels

Fruit juices and smoothies typically contain a lot of fruit sugar so exercise caution with how much fruit juice you consume.

Health benefits of fruit

Fruit helps to supply us with fibre, minerals and vitamins, and they are particularly high in their supply of vitamin C.

Vitamin C is important for preventing our cells being damaged. Fibre helps digestion and is linked with helping reduce

cholesterol levels

As with vegetables, different fruit have different characteristics.

For example grapefruit contains a healthy amount of vitamin A and potassium whereas berries are good sources of vitamin K and manganese.

The US Centers for Disease Control and Prevention note that eating the recommended quantity of fruit and vegetables may reduce susceptibility to chronic disease and cancers.

Which fruits are lowest in carbs?

A question that is often asked is which fruits have the lowest carbs/sugar content:

Health risks of fruit

Whilst fruit is recognised as being a very healthy food, the relatively high sugar content of fruit juices has been linked by research with higher incidences of colorectal cancer. The Western Australian Institute for Medical Research found, in a study, that those that drank fruit juice had increased instances of

colorectal cancer

Cancer Research responded to the study by stating: “This isn’t a large study, and it doesn’t give us clear answers about whether different fruits and vegetables affect the risk of cancer in parts of the bowel.”

Dried fruit is higher in carbohydrate than undried fruit and non-organic dried fruit may also be preserved with sulphites. Sulphites in food may have been linked with bringing on symptoms in asthmatic people. Sulphites may appear on food labels as ‘sulphur dioxide’ or an ingredient containing the words ‘sulphite’ or ‘sulfite’.

A low glycemic index diet can be particularly effective for people with diabetes if portion control is also applied to those foods with higher carbohydrate content.

This is the basis of working out a food’s

glycemic load

Low GI diets are diets which incorporate foods which are more slowly converted into energy by the body.

The NHS notes that low GI diets can be a suitable option for people with diabetes as they can help to

blood glucose levels
more stable than diets based around high GI foods.

What does low and high GI mean?

The glycemic Index ranks food depending on the rate at which the body breaks it down to form

glucose

High GI foods are those that are quickly broken down into glucose. Typical examples of high GI foods include white bread, sweetened drinks, biscuits, potatoes and oranges.

Low GI foods are those that are broken down more slowly by the body. Typical examples of low GI foods include whole grain bread, milk, beans, leafy vegetables and berries.

What do low GI foods do in relation to diabetes?

As low GI foods tend to break down more slowly, they are less likely to cause a rapid increase in

blood sugar levels
compared to high GI foods and therefore they are a better option for keeping stable blood glucose levels.

Favouring low GI foods over high GI foods leaves you feeling more satisfied over a longer period of time, and less likely to feel hungry before the next meal.

What do high GI foods do in relation to diabetes?

High GI foods break down very quickly causing blood glucose levels to rise sharply. People with diabetes refer to sharp rises in blood sugar levels as ‘spikes’ in blood sugar.

Furthermore, for those who produce their own

insulin, high GI foods can force the body to try to produce a surge of insulin to counteract the quick acting carbohydrates and a common consequence of this is a feeling of hunger within 2 to 3 hours, which can leave the dieter craving more food.

For people with diabetes, this can be particularly dangerous as the ability of the body to control

blood glucose levels
is reduced or non-existent.

For this reason, people with diabetes have to be careful when it comes to eating high

GI foods

Benefits of low GI diets

Low GI diet generally have the following benefits:

• Have a higher nutritional value than higher GI equivalents
• Provide prolonged release of energy
• Reduce the immediate demand for insulin following eating
• Allow for a varied diet to be eaten
• Glycemic index charts make food choices easy to follow

Disadvantages of low GI diets

The main disadvantage of low GI diets for people with diabetes comes if the overall

carbohydrate
content of meals is too high for the body to comfortably cope with.

For example, a large portion of a bran based cereal for breakfast will typically be low GI but could contain a relatively high value of carbohydrate.

In this case, the carbohydrate content of the meal could be too high for some people with diabetes, causing their blood glucose levels to rise too high over a period of hours.

However, this needn’t be such a problem if

portion control
is applied to any foods that have a higher carbohydrate content.

When the glycaemic index value of a food and its carbohydrate content are taken into account together, this is the basis of working out the glycemic load of a portion.

What foods are considered low GI?

Low GI foods that are considered suitable for people with diabetes include

• Some
  
  fruit
• 
  Non-starchy vegetables
• 
  Whole grains
• Nuts
• 
  Lean meats
• 
  Unsweetened dairy produce
• legumes

Care should be taken with fruits and vegetables as the GI value of these food groups can vary quite significantly.

• 
  Lower GI fruits
  
  include berries, plums, kiwi fruit and grapefruit.
• 
  Higher GI fruits
  
  include bananas, oranges, mango, grapes, raisins, dates and pears.
• 
  Lower GI vegetables
  
  include lettuce, broccoli, cabbage, cauliflower and peppers.
• 
  Higher GI vegetables
  
  include carrots, potatoes, parsnips, beetroots and sweetcorn.

Information can be very confusing with many news and healthy living magazines suggesting foods that can help diabetes.

To help make some kind of sense, we present our guide on which foods can help diabetes.

Picking a sensible diabetic diet

The following guidelines provide a good basis for a diabetic diet.

• Foods with a low GI (glycaemic index)
• Include lean meats, fish or other sources of protein
• Include plenty of fibre
• Try to take in a relatively low amounts of saturated fat and salt

Fruit and vegetables

Vegetables are a very good choice.

They contain a good quantity of vitamins and minerals and are a great source of fibre. Some vegetables have more effect on blood sugar than others so you may need to pick vegetables with a lower GI.

Fruits are also a good source of fibre and vitamins but people with diabetes will often find that some fruits are better than others for their

Protein

Protein can be very useful as it is more slowly broken down by the body than carbohydrates.

As a result, it has less of an effect on blood sugar and can help you to feel fuller for longer. Good protein sources include oily fish and lean meats, such as grilled skinless chicken.

Whole grains

Whole grain foods are those containing oats, barley, wheat where the full grain is used.

Foods made from grains have quite a high concentration of carbohydrate so people with diabetes will benefit by testing their blood sugar before and after eating grain based foods to see whether their blood sugar is being raised too high

Much modern food is made from over processed grains, such as plain flour, many breads, white rice and pastries. However, whole grains varieties do exist. Breads with a higher amount of fibre, for instance, are generally better than those with a low amount of fibre. Similarly, brown rice is a better choice than white rice.

Nuts, herbs and spices

Nuts can be a good food choice.

Avoid salted nuts and try to limit the quantity of nuts you eat as they have a high calorific value. Don’t let the calories put you off completely though, nuts are a great source of fibre and vitamins and can be beneficial for cholesterol.

Walnuts, almonds, brazil nuts and macadamia nuts are good choices.

Herbs and spices are not only a great way to add flavour to food, they’re also another good source of vitamins. Adding herbs and spices to food can help to replace adding extra salt.

Which foods should people with diabetes avoid?

Try to limit all of the following:

• White bread, white pasta and pastries
• Ready meals
• Take away food

Some people may be comfortable completely ruling these foods out of their diet whereas others may want to occasionally include some of these foods every now and again. The key is to be able to pick a sensible limit and be able to stick to it.

Many people also suggest staying away from so-called Diabetic Food

Eat according to your blood glucose meter

Everyone is different, so what works for one person is no guarantee it will work for another. It’s worth knowing and being aware of general guidelines and then testing to see how different foods affect your sugar levels

One tried and tested method is to try different foods and meals by testing your blood sugar before eating (taking any medication as you usually would) and then testing your blood at two hour intervals.

A blood test before eating, 2 hours after and 4 hours after will be a good test for most meals, however, some low GI foods (such as whole meal pasta) may need a test 6 hours after to see the effect of the food.

Gluten-free diets can be challenging, but are essential for people with coeliac disease and diabetes. Coeliac disease and

type 1 diabetes
are both autoimmune diseases.

Therefore, it is not uncommon for someone to have both conditions.

For people with diabetes,

coeliac disease
presents an extra difficulty with making food choices to avoid foods with gluten.

On the plus side, the need to avoid many pre-prepared foods can be a positive way of maintaining a healthy diet.

What is gluten?

Gluten is a

protein
present in foods made out of grains such as wheat, barley and rye.

Oats are a grey area as it contains a protein that is similar to gluten which some people with coeliac can tolerate but others may not.

How does avoiding gluten help in coeliac disease?

As the body recovers from coeliac disease and eating gluten, it will absorb food in a different way, which can make it more difficult to

manage your diabetes

Untreated coeliac disease means that when gluten is eaten the lining of the small intestine becomes inflamed and less productive in absorbing food.

When a gluten-free diet is properly followed, the intestine starts to heal and the ability to absorb food increases.

Who else may follow a gluten free diet?

Other people who may be sensitive to gluten are people with wheat or gluten allergies. Coeliac disease is not an allergy.

Which foods need to be avoided in a gluten free diet?

Foods that will typically need to be avoided include those made with flour such as bread, pasta, breakfast cereals, bagels, pies, biscuits and cakes.

However, many pre-prepared foods contain gluten as a binding agent which can greatly reduce the number of options available.

The range of foods which may contain gluten can include:

• Soups
• Sausages and processed meats
• Curries
• Ready meals
• Ice cream
• Many sauces and dressings

Even

vitamins
may include gluten so people who need to follow a gluten free need to be particularly aware when making food choices.

To help people with gluten sensitivity, packaged foods in the UK must by law indicate if they contain gluten.

Which foods are gluten free?

You might be asking yourself, at this point, “What can I eat?”. There is still a range of food that can be eaten. As much of the pre-prepared food may contain gluten, you may find you need to eat more home cooked food.

Fruit, vegetables, meat, fish, beans, nuts and most dairy produce can be eaten and rice and potatoes are available on a gluten free diet too.

As coeliac disease is relatively common (affecting about 1% of us), a number of specifically gluten free produce exists, such as gluten free breads and gluten free flour.

Look out for packaged foods that have a ‘crossed grain’ symbol or use the terms:

• Gluten free
• Suitable for coeliacs
• Suitable for a gluten free diet

The coeliac disease charity Coeliac UK regularly updates a directory of suitable foods.

Do I qualify for food on prescription?

People with coeliac disease are able to claim certain gluten-free staple foods, such as:

• Gluten-free bread
• Pasta
• Flour
• Crackers on
  
  prescription

Speak to your doctor about what is available. The charity Coeliac UK also has useful information in their Food and Drink Directory.

How does a gluten free diet affect blood sugar levels?

Generally people with diabetes on a gluten free diet should not experience a great change in

blood sugar levels

The same amount of food in someone who has stuck to a gluten-free diet will be absorbed to a greater degree than those with coeliac disease who are not on a gluten-free diet.

This can mean that insulin requirements may be slightly higher and it can also mean that in some people there may be less chance of hypoglycemia occuring.

What side effects might I need to be aware of on a gluten free diet?

Nutrient deficiencies can be a potential side effect when observing a gluten-free diet. As a result, your doctor may need to prescribe supplements to you or prescribe specialist gluten-free products to help avoid deficiencies.

Whilst nutrient deficiencies are possible on a gluten-free diet, it should be noted that deficiencies of not following a gluten-free diet will be much greater if you have coeliac disease.

It is important for people with diabetes to understand what foods consist of so that blood glucose levels can be well managed.

Food is divided into

5 main groups

from which we need to eat from daily.

This section details the main food groups and details a selection of foods within these groups to make managing your diet easier.

• 
  Dairy
• 
  Eggs, beans & pulses
• 
  Fish
• 
  Fruit
• 
  Lean meat
• 
  Non-starchy vegetables
• 
  Processed foods
• 
  Red meat
• 
  Starchy vegetables
• 
  Whole grains

Non-starchy vegetables

Non-starchy vegetables are vegetables with a relatively low carbohydrate content per 100g.

As a guide, vegetables with 5g or less of carbohydrate per 100g of weight could be defined as a non-starchy vegetable.

Non-starchy vegetables
are a very healthy food group which meals should be based around. Non-starchy are low in carbohydrate and calories but rich in fibre and many nutrients which keep our body in great shape.

The American Diabetes Association (ADA) recommends that non-starchy vegetables should make up half of your plate’s contents at main meals.

Fruits

Similar to vegetables, fruits are also rich in nutrients and fibre. Fruit can also be rich in fructose, which raises blood sugar levels quickly, so people with diabetes may find that certain fruit is better for their blood sugar levels than other fruits.

The ADA recommends a small piece of fruit as a

healthy dessert option

Starchy foods

Starchy foods include starchy vegetables and whole grain foods. The ADA recommends that a quarter of main meals are made up of starchy foods.

Starchy vegetables
are vegetables with a relatively high carbohydrate content. Starchy vegetables can be a good source of fibre and other nutrients.

Whole grain foods
are starchy foods made from grains such as wheat, barley, oats, maize and brown rice. In unrefined, whole grain form, the grain has three parts to it, the germ, the endosperm and bran.

The germ and bran carry much of the nutrients and fibre which is why whole grain foods are much more healthy than refined versions. The key to spotting whether a food, such as bread, pasta or rice, is whole grain is to check whether it has a significantly higher fibre content than white versions of these foods.

High protein foods

High protein foods include poultry, red meat, fish, beans and eggs. The ADA recommends that a quarter of main meals is made up of high protein foods which includes meat, fish, beans and eggs.

Lean meat

Lean meat
is meat with a relatively low fat content and therefore a lower calorie content too compared with non-lean meats. Examples include skinless chicken and pork chops with the fat trimmed off. Lean meats are a good source of protein which the body needs to build and repair body tissue. Protein can also be turned into glucose if the body requires more energy.

Red meat

Red meat
is another good source of protein. If red meat has a relatively low fat content, it can also count as lean meat.

It is important to note though that it is predominantly processed red meat that has been linked with the health concerns.

Fish

Fish is another good source of protein and also contains a good source of omega 3, an essential fatty acid which aids brain function. The NHS recommends eating two portions of

fish
a week, with at least one these portions being of oily fish, such as salmon, mackerel and sardines.

Eggs, beans and pulses

Eggs, beans and pulses are good sources of protein. Eggs are a good source of choline which benefits the brain as well as reducing inflammation. Beans and pulses make for a low fat source of protein whilst also containing useful minerals such as iron.

Dairy

Dairy produce is derived from animal’s milk. Dairy foods contain a good source of calcium and protein.

Dairy products can contain a significant quantity of fat which can add to our

calorie intake, however, low fat version are widely available for those that wish to reduce the fat and calorie content from their dairy intake.

The ADA recommends taking in around half a pint of milk a day.

Desserts and sweets

Desserts and sweets
are nice to eat but aren’t often so good for blood glucose levels so sweets and desserts are best limited to smaller quantities or for having less often.

However, there are other ways to enjoy desserts without risking a jump in blood sugar levels.

Fruits such as berries can be had for dessert and cake recipes can be cleverly adapted to replace wheat flour with almond flour and some

sweeteners can be used in place of sugar

A low calorie diet gives a target intake of calories each day.

A low calorie diet, which may also be referred to as a calorie restricted diet, provides a steady way to achieve

weight loss
and is usually a key part of weight loss plans such as those used by slimming clubs.

A low calorie diet is commonly advised for anyone people with diabetes that is overweight to some degree.

What is a low calorie diet?

The NHS defines a low calorie (

kcal

) diet of:

• Between
  
  1,000
  
  and
  
  1,500
  
  calories per day for
  
  women
  
• Between
  
  1,500
  
  and
  
  2,000
  
  calories per day for
  
  men
  

The calorie target is designed to be less than the calories your body will expend (through organ functions and activity) through the day, therefore causing your body to break down body fat to cover the calorie short fall.

Because of its broad definition, there can be many different types of low calorie diet. So, any low fat diet or any low carbohydrate diet, as examples, that meet the low calorie diet criteria would also be low calorie diets.

Steady weight loss

A low calorie can help you to lose weight at a steady level over an extended period of time and some weeks may produce less pronounced

weight loss
than other weeks.

A low calorie diet is generally not designed to achieve rapid weight loss, but to achieve success over a longer period of time.

A low calorie diet can therefore have long term success particularly if you are willing to accept it as part of your every day routine.

Balanced diet

It is important to aim for a balanced diet whilst following a low calorie diet to ensure you are not missing out on the right vitamins.

Don’t fall into the trap of focusing too much on calorie counts and missing out on nutrients from important

food groups
such as fruit and vegetables as a result.

Unless additional restrictions are applied, a low calorie diet will usually allow enough room for the intake of a good range of vitamins and minerals from a variety of food sources.

A dietitian can help you to ensure that your diet is well balanced.

Counting calories

Packaged foods are required to include calorific information, however, in some cases you may need to weigh the food and/or use mathematics to figure out the calorie content of the portion you have.

For non-packaged foods like fruits and vegetables, there are a good number of available sources of calorie counting tables which range from books to

smartphone apps

Full calorie counts are available at some

restaurants
whilst some restaurants may list which meals are less than a defined calorie value. If the calorie content is not provided, you may need to try to form a best estimate.

Note that when we refer to calories, we are referring to kilocalories, often denoted as

kcal

Watch out for the other measurement of energy kilojoules (

kJ

). 1 kcal is equal to over 4 kJ so it is best not to mix these up. Always look for the energy value in

kcal

Book review:


Carbs & Cals: A Visual Guide to Carbohydrate & Calorie Counting

Exercise

The NHS recommends that we take 2 and 1/2 hours of

exercise
a week. Exercise acts as a good compliment to a low calorie diet as it encourages the body to better metabolise the food we take in.

When we exercise, we use a form glucose (glycogen) stored in our muscles as well as glucose from our blood.

After exercising, these muscles will continue to take glucose from the blood to replenish their stores of glycogen. Therefore as well as supporting weight loss, exercise can also help to keep

blood glucose levels
down.

Slimming clubs

Many of the slimming clubs in the UK advocate low calorie diets to achieve steady and achievable weight loss.

Slimming clubs will often provide meal plans and exercise targets in addition to offering social support and motivation from others taking part in the club.

• Read more on
  
  slimming clubs

Depending on the type of treatment regimen you use to control your diabetes, there are some vitamins and minerals that may be beneficial for your condition.

Before adding any vitamins or adding dietary supplements to your daily diet, discuss these changes with your healthcare team and doctor to ensure they are safe alongside any prescribed medication you’re on.

ALA
and GLA

ALA (alpha-lipoic
acid) is a versatile and potent antioxidant, and may function to help diabetic
neuropathy and reduce pain from free-radical damage.

Also, some studies
link ALA to decreased

insulin resistance
and thus the control of blood
sugar.

GLA (gamma-lipoic acid) is another naturally occurring antioxidant that
is present in evening primrose oil, borage oil and blackcurrant seed oil. GLA may improve the function of nerves damaged by diabetic neuropathy.

Biotin

Biotin works
in synergy with insulin in the body, and independently increases the activity
of the enzyme glucokinase.

Glucokinase is responsible for the first step
of glucose utilisatio, and is therefore an essential component of normal
bodily functioning.

Glucokinase occurs only in the liver, and in sufferers
from diabetes its concentration may be extremely low. Supplements of biotin
may have a significant effect on glucose levels for both type 1

and type
2 diabetics

Carnitine (L-Carnitine, Acetyl L-Carnitine)

Carnitine
is required by the body in order to correctly use body fat in the production
of energy. It is naturally occurring and derives from hydrophilic amino
acids. Diabetics who try carnitine generally respond well, and high levels
of fat in the bloodstream (cholesterol and triglycerides) may fall fast.

Carnitine helps to break down fatty acids in the body and binds acyl residues.
For these reasons, it may be useful to prevent

diabetic ketoacidosis

Chromium

Chromium
is a crucial nutrient in the body’s fight against diabetes. By using either
brewer’s yeast stocked with chromium, or chromium chloride, diabetic
patients may be able to improve glucose tolerance, lower their fasting
glucose levels, decrease insulin levels and cut cholesterol and triglyceride
levels, whilst

increasing HDL-cholesterol levels

Several principal double-blind studies have shown that supplemental chromium
may raise glucose tolerance in patients with both type 1 and type 2 diabetes.

Exercise
also increases the concentration of tissue chromium. Chromium
may have a role to play in pre-diabetics and women suffering from gestational
diabetes.

Coenzyme
Q10

Coenzyme
Q10 is a compound that occurs naturally in the body, and may be able to
help with carbohydrate metabolism. It is has been proven that animals suffering
from diabetes are coenzyme Q10 deficient.

Clinical trials using coenzyme
Q10 suggest that supplementation may significantly lower blood sugar levels.
Coenzyme Q10 also oxygenates the blood, and therefore may be able to help
in some cases of

diabetic retinopathy

Inositol

Inositol
is an important part of several key bodily processes including the health
of cell membranes and blood cholesterol levels. Furthermore, inositol may
have a role to play in reversing the effects of

diabetic neuropathy
(nervous
damage) caused by diabetes.

Manganese

A deficiency
of manganese is common amongst diabetics, and in some circles it is thought
to actually be a part of the cause of diabetes. Manganese could be a key
co-factor in the way enzymes within the body handle glucose metabolism.

Magnesium

Magnesium
tends to decline in people with diabetes, and may fall to dangerously
low levels amongst those suffering from severe diabetic retinopathy.

Magnesium
deficiency has been shown to directly influence the blood sugar control
of type 2 diabetics.

Magnesium deficiency may interrupt the insulin secretion
process, and also increase insulin resistance.

When using supplemental
magnesium, diabetics may be able to lower their insulin dosage.

Niacin

Niacin can be for people with high cholesterol and may be used in combination with circulation treatments.

High levels of niacin may actually impair glucose tolerance and therefore some people with diabetes may be advised not to take it. Speak with your doctor if you are in doubt.

Potassium

Administering
insulin to the body, the treatment regime employed by many diabetics, may
cause a potassium deficiency. By supplementing a healthy diet with potassium,
sufferers from diabetes may improve their sensitivity to insulin, and the
effectiveness of the hormone.

Taurine

Taurine is
not used in protein synthesis, but is generally found in protein-rich foods.

Type 1 diabetics often suffer from low taurine levels, and this can in
turn affect the thickness of the blood and increase the risk of heart disease.
Supplementary taurine for diabetic patients may be able to correct levels
of blood viscosity.

Vanadium

Vanadium
supplements may lead to a slight increase in sensitivity to insulin, and
may therefore allow diabetic patients to decrease the amount of insulin
that they need to keep their blood sugar levels under control. Studies
on both animals and humans have proved links between vanadium levels and
normal blood glucose.

Vitamin
B6

Neuropathy,
the severe damage caused to the nervous system by high blood sugar levels,
may be associated with deficiency of vitamin B6, also known as pyridoxine.

Pyridoxine supplements may be able to improve glucose tolerance, particularly
for sufferers from gestational diabetes, or impaired glucose tolerance
caused by the birth control pill.

Vitamin B6 also has a strong role to
play in the prevention of diabetes-related complications.

Vitamin
B12

Vitamin B12
may have a strong role to play when treating diabetic neuropathy.

The presence
of vitamin b 12 is necessary for the correct functioning of nerve cells,
and therefore taking it as a supplement may help to reduce nerve damage.

In extreme cases, the extra effect of intramuscular B12 may be necessary.

Vitamin
C

Type 1 diabetics
generally have low vitamin C levels. By increasing the amount of vitamin
c in the bloodstream, the amount of sorbitol may be lowered.

Sorbitol is
a harmful sugar when it accumulates, and its presence may lead to increased
risk of diabetic complications such as retinopathy, neuropathy and kidney
damage. In the case of type 2 diabetics, vitamin c may play a role in improving
glucose tolerance.

Vitamin D

Vitamin D
has a number of benefits for your health. Produced by the body in response to sun exposure, it is thought to help boost insulin sensitivity, which is vital for blood glucose regulation.

Vitamin E

Vitamin E
can oxygenate the blood, fight toxins and improve the activity of insulin
within the body. When the body has an insufficient amount of vitamin E,
internal structures can be damaged by enhanced free-radical damage.

Increasing
vitamin E in the bloodstream may decrease the likelihood of developing
type 2 diabetes, and in type 2 diabetics may improve glucose tolerance.
Furthermore, the antioxidant nature of vitamin E may reduce the risk of
diabetic complications.

Zinc

The presence
of a zinc deficiency in the body has also been suggested to contribute
to the development of diabetes in some humans

Zinc itself may be a crucial
element in insulin metabolism. Zinc is well-known as a powerful guardian
against viral infections, and may also act to protect beta cells from destruction.
Type 1 diabetics are often zinc deficient, and supplements have been shown
to lower blood sugar levels in some type 1 cases.

Extreme low-calorie diets, such as the 600 calorie diet studied by Newcastle University have been hailed as extremely effective in helping people with diabetes to control their blood glucose levels.

In some instances, reports of temporary

diabetes cures
have been reported from following an extreme low-calorie diet for a short period.

Is this the 600 calorie diet that was in the news?

A Newcastle University study, funded by

Diabetes UK, examined 11 people with diabetes who slashed their food intake to 600 calories per day for 8 weeks.

Three months later, 7 of the 11 people studied were free of diabetes.

As with other

very low calorie diets, you should consult a doctor before undertaking such a diet.

What was involved in the diet used in the study?

The diet was predominantly based around:

• Optifast meal replacement sachets, which provided 75% of the calories (600 cals)
• The other 200 calories came from non-starchy vegetables.

Note:

The diet is referred to as the 600 calorie diet (rather than the 800 calorie diet) due to the meal replacement aspect of the diet totalling 600 calories.

How does an extreme low-calorie diet affect the body?

An extreme low-calorie diet (usually based on diet drinks and non-starchy vegetables) reportedly prompts the body to expel fat clogging the pancreas, helping people with

type 2 diabetes
to ‘wake up’ their insulin producing cells.

So low-calorie diets bring blood glucose levels down?

In the aforementioned study, people with diabetes who did not get the special diet were also assessed.

After one week, those on the extreme low-calorie diet had pre-breakfast

blood glucose levels close to normal
This was in line with decreasing fat levels in the pancreas.

So the study cured people of type 2 diabetes?

The study showed marked improvements in blood sugar levels to the extent where the participants appeared to be cured.

However, as is the case with

pre-diabetes, those participants who benefitted the most from the study will still need to be disciplined with their diet and exercise to prevent or delay the return of diabetes symptoms.

Were there any side effects of the diet?

A number of side effects were observed in participants during the first few days of the diet, such as:

• Headaches
• Dizziness
• Hunger
• Tiredness
• Cold

People involved in the study were advised to keep up their fluid intake and wrap up to keep warm.

Since the initial study, a significant amount of research has been funded by Diabetes UK into the very low calorie approach, which has demonstrated that it can support remission of type 2 diabetes, even for people who are considered ‘skinny’.

• ‘Game-changing’ study suggests type 2 remission possible even at lower body weight