Plant-based diet and diabetes 4 August 2020 What is a plant-based diet? There is no one precise definition of a plant-based diet. A lots of different eating patterns that fall under this category. However, the common elements are obviously eating more plant-foods and less animal-products. For some, it simply means eating more plant-food than usual. For others it means eating minimally processed plant-based foods and no animal-products such as red meat, chicken, eggs, dairy, fish, seafood and anything containing gelatine etc. Six types of plant-based diets Salas-Salvado et al (2019) outline some of the plant-based diets you may have heard of before: DASH (Dietary Approaches to Stop Hypertension) diet: A diet based mostly on eating fruit, vegetables, and low-fat dairy products, and include whole-grains, poultry, fish and nuts. Reduced consumption of saturated fat, red meat, sweets and sodium Macrobiotic diet: Emphasises locally grown, whole-grain cereals, pulses (legumes), vegetables, seaweed, fermented soy products and fruit, combined into meals according to the ancient Chinese principles of balance known as yin and yang Mediterranean diet: High intake of olive oil as the principle dietary fat, fruit, nuts, vegetables and cereals; a moderate intake of fish and poultry; a low intake of dairy products, red meat, processed meats and sweets; and a moderate intake of wine with meals Pescatarian diet: Plant-based diet including fish or other seafood, but not the flesh of other animals Vegan diet: Plant-based diet avoiding all animal foods such as meat (including fish, shellfish and insects), dairy, eggs and honey, as well as products such as leather and those that are tested on animals Vegetarian diet: Plant based diet avoiding all animal flesh-based foods and animal derived products. Some modified versions allow eggs (ovo), dairy products (lacto), or a combination of both. Whatever the definition, a large and growing body of research suggests eating more plant-based foods is beneficial for our health, animal welfare and the planet’s health, especially if underpinned by health-gaining farming practices (improved soil and nutrient yields) and systems. How does eating more plant-based foods help improve diabetes management? Minimally processed plant foods are foods that haven’t been overly processed. This might include whole oats as opposed to refined porridge powders or oatcakes. These foods retain much of their beneficial nutrients such as fibre and healthy oils and have little salt and saturated fat which are often added with processing. Dietary fibres Dietary fibres are extremely beneficial for promoting good gut and overall health. Fibres (also known as prebiotics) fuel good gut bacteria (probiotics/ microbiota) so they can multiple and out populate harmful bacteria (bugs). These bugs also support our gut cells to stay healthy (ie. prevent cancers) and strengthen our immune defence to help prevent conditions like food intolerances and food-borne illnesses. Fibre, together with adequate water, also help with easy and regular bowel movements and slows digestion. This can be helpful for more stable blood glucose levels when it comes to food-induced natural rises. Nutrients Eating a wide variety of plant-foods means you consume lots of vitamins, minerals, healthy fats and oils, and plant-chemicals (phytochemicals) that are essential for good health. Strong cell, organ and bone structure, not to mention the immune system, are reliant on these nutrients. Having a weakened immune system means that you are more prone to getting illness (viruses), diseases and suffering from poor healing which can make managing blood glucose levels very difficult. Minimally processed plant-based foods contain little salt or saturated fat, unlike many highly processed and animal-product foods. Salt and saturated fat can cause higher blood pressure and LDL-cholesterol levels which can clog and close blood vessels. Blood vessels, large and small transport blood and nutrients including oxygen, glucose and vitamins around the body to the muscles, eyes, kidneys, the heart and the brain. Keeping our blood vessels as healthy as possible is vital in helping reduce the risk of long-term diabetes complications such as diabetic retinopathy and foot problems. In 2019 the Heart Foundation recommended Australians, particularly those living with diabetes who are at greater blood vessel and heart disease risk, enjoy more plant-based foods like vegetables, fruit and wholegrains, and less animal-based and highly processed foods, as they contain saturated fat, salt and minimal fibre. For more information on these recommendations and what they outline for people living with diabetes, please see here. How to increase your plant-based food consumption Diabetes is a complex condition and how we manage diabetes to enjoy good short- and long-term health is very individual. What we choose to eat and or the food choices we have access to, can play a significant role in how well our diabetes can be managed. However, our food choices are just one of many balls to juggle at any one time. Others include regular contact with the healthcare team, staying active, taking care of other health conditions, stress levels, sleep, and taking medication. Therefore, a more simple and sustainable approach to increasing plant-based food choices might be more achievable, if you’re wanting to move in that direction. There are many factors that affect our food choices. this includes being time poor, our stress levels, access to healthy food choices, where we live and cost. What we know if you’re struggling to eat more plant foods, is that you’re not alone. Only 7.5% of Australians adults are eating the recommended 5 serves of vegetables a day despite 30% of us wanting to eat more vegetables. Perhaps a simple and relatively easy start to incorporating more plant-based foods in our diets is finding enjoyable ways to add more vegetables into our existing meals. Here are a few ideas on how to add more vegetables to some common everyday meals: Breakfast Omelette: add tomato + mushrooms or sweet corn Toasties: add tomato + English spinach or mushrooms Open toasted sandwich or bruschetta: add avocado + spinach leaves + tomato or basil leaves Home blended juices: add carrot + English spinach + boy choy stems + beetroot or ginger Lunch Soups: add tomato + carrot + peas + lentils + corn + bok choy Wraps: add shredded carrot + lettuce + tomato + corn + capsicum or avocado Toasties: add tomato + mushrooms + capsicum + English spinach or legumes ie. baked beans or lentils Bento box or poke bowl loaded them up with vegetables Stuffed hot potato or sweet potato: add lentil or other pulses/beans + corn + tomato + capsicum, Spanish onion or avocado Soft or hard tacos: add lentil or other pulses/beans + shredded lettuce + corn + capsicum + tomatoes + avocado + Spanish onion or chives Salads eg. Tabbouleh add more vegetables such as lentils + tomatoes Dinner Lasagne: add more tomato + lentil or other beans + English spinach + mushrooms and add a side green salad Homemade pizza: load it up with mushroom + tomato + Spanish onion or snow peas, corn, English spinach, roasted eggplant or pumpkin Stir-fries: add carrot + snow peas + green beans + corn + capsicum + broccoli + cauliflower Spaghetti Bolognese: add tomatoes + English spinach + diced carrot + lentils + mushrooms or corn Grilled or skewered fish or other protein: add roasted vegetables; eggplant + beetroot + zucchini, + broccolini + asparagus + tomatoes + mushrooms + carrot + pumpkin + capsicum or zucchini Meat or lentil balls: add mushrooms + shredded zucchini + carrots + tomato For more advice on plant-based diets, recipes and or meal and snack ideas speak with your dietitian or call the Diabetes NSW & ACT helpline 1300 342 238 to discuss with one of our dietitians. Caroline Clark, APD
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