Read the information on the container of the specific sweetener. The label should also state whether the sweetener is heat resistant and is suitable for baking and cooking. How much of the sweetener should be used to replace the equivalent amount of sugar is usually indicated in millilitres or grams.
Where possible I have indicated in the recipes in this book how much sugar each specific sweetener represents, so that you can replace it with another sweetener according to your circumstances and preference.
The fat content of your diet
Too much body fat and the excessive use of fat in the diet can stimulate insulin resistance because it suppresses insulin activity and can cause an increase in blood glucose.
Hyperlipidaemia
Diabetics have an increased risk of narrowing of the arteries and of developing cardiovascular diseases because of an increase in blood fat values in relation to total cholesterol, triglycerides and LDL cholesterol (which are deposited on the artery walls). This condition is called hyperlipidaemia. A fat intake of 20% to 30% (and in some cases even as high as 35%) of the total energy of the diet, is regarded as desirable. The body requires essential fatty acids because it cannot manufacture them. Fats are also important carriers of fat-soluble vitamins A, D, E and K. Research indicates that the high monounsaturated fatty acid content of olive oil, canola oil, nut oil, carotino oil (palm fruit oil), avocado and avocado oil, is advantageous for diabetics, particularly for the treatment of raised triglyceride levels. Despite claims to the contrary that do the rounds from time to time, reliable research studies continue to show that the intake of saturated fats and trans-fatty acids should be limited and that they should be replaced with mono- and polyunsaturated fats. It is a good idea to talk to your dietitian about this when she designs your meal plan.
Tips to reduce your fat intake
Make the following part of your lifestyle:
•Select small portions of lean red meat, chicken and fish. Remove the skin from poultry and cut all the visible fat off all meat. Steam, stew or grill food with a small quantity of oil at a lower temperature. When you stir-fry, add a few drops of boiling water as necessary to complete the stir-fry process with less oil.
•Oven roast meat on a grid in a roasting pan to collect the fat and meat juices.
•Make low-fat meat gravy from the meat juices in the pan by adding ice cubes to the juices to coagulate the fat. You can then remove the coagulated fat and ice cubes from the meat juices.
•Use minimal fat or oil when preparing food and, where possible, avoid using any fat at all.
•Use a spray bottle containing oil or lightly brush the pan with oil to prevent sticking, or use cooking utensils with a non-stick lining.
•Use soft butter or margarine sparingly and avoid whenever possible.
•Rather spread low-fat cottage cheese, low-fat dipping sauce, chutney, tomato sauce or low-oil mayonnaise on bread instead of margarine.
•Use “lite” or low-oil salad cream, lemon juice, balsamic vinegar and a few drops of olive oil instead of rich, fatty salad dressings.
•Replace cream in recipes with plain low-fat yoghurt, low-fat evaporated milk or soft tofu (soya curds).
•Replace cream cheese in recipes with ricotta or smooth fat-free cottage cheese.
•Replace a melted cheese topping with grated cheese that has been mixed with dry breadcrumbs, or mix some sesame seeds with the cheese and scatter over the dish.
•Replace rich puff or short-crust pastry with phyllo pastry. Brush the phyllo sheets lightly with milk or spray them with non-stick food spray.
•Use low-fat milk, yoghurt, cheese and ice cream.
•Read the labels of food products carefully to find out what fats they contain – including “hidden” fats.
•Restrict your intake of trans-fatty acids, which are formed when oil used for deep frying is heated. Hard margarine also contains trans-fatty acids, which are often indicated as “partially hydrogenated fat” on food labels.
High blood pressure
High blood pressure (hypertension) can in many cases be lowered by restricting salt intake and by losing weight if you are overweight. Try to limit your daily salt intake to not more than 5 ml (1 teaspoon).
Also keep the following in mind:
•Use minimal salt during food preparation.
•Do not use salt at the table.
•Avoid salted, processed foods such as sausages, polonies, ham, smoked and pickled fish and meat, droëwors and biltong.
•Limit your intake of foods such as ready-to-eat pizzas, pies, chips, salted nuts and salty biscuits.
•Limit your intake of sauces and pickles with a high salt content.
•Limit your intake of hard cheeses.
•Use herbs and spices to flavour food and to compensate for a low salt content.
•Be careful of flavour enhancers such as MSG (monosodium glutamate). Also look out for words such as “sodium” and “salt” on food labels.
•Instead of sprinkling salt on your food before eating, squeeze a few drops of lemon juice over it instead.
The use of alcohol
Despite research showing that the phytochemicals in red wine in particular are beneficial to health in relation to the prevention of cardiovascular disease, strokes, diabetes and Alzheimer’s disease, the negative effects of excessive alcohol intake should not be underestimated. Alcohol is often consumed “to relieve stress”. Although alcohol initially has a calming or sedative effect, it is in reality a depressant and damages the nerve cells. Excessive alcohol use also increases the load on the liver because it is the liver that has to break down the alcohol, which acts as a poison in the body.
Alcohol provides concentrated empty kilojoules, is metabolised rapidly and stored as fat, and it is therefore not a good idea for anyone trying to lose weight. Satisfy your thirst by first having a glass of water, so that you can enjoy your alcoholic drink slowly.
Diabetics must always remember that alcohol suppresses the production of glucose (from glycogen) in the body. If you therefore drink alcohol on an empty stomach, it can lead to hypoglycaemia and in extreme cases cause a coma. Alcohol also increases the effect of certain oral diabetic medications. Always have alcoholic drinks with a dry biscuit, fruit juice, milk or a meal. Because of their high sugar content, it is not a good idea to drink sweet wine, sweet sherry, vermouth or liqueurs. Also be careful with the cold drinks or mixers you add to alcoholic drinks.
It is recommended that alcohol intake should be limited to a maximum of two units per day for men and one unit per day for women. Recent research indicates that women should not drink alcohol every day because of the risk of developing breast cancer.
A unit is regarded as:
•25 ml spirits such as whisky, brandy, cane or vodka
•60 ml dry sherry, vermouth or port
•120 ml dry red or white wine
•200 ml low-kilojoule beer
Menu and meal planning
Like everyone else, the nutrient requirements of people with diabetes are influenced by a variety of factors, such as:
•Gender – male or female.
•Life stage – pregnant or breastfeeding women and children who are still growing require more nutrients.
•Age – children have higher nutrient needs than the elderly.
•Level of activity – active working people, those who regularly participate in sport, and children who play and run around a lot, have much greater