A closer D-look at Australian Dietary Guideline 3

Guest Post Sally Marchini, Dietitian

To date we’ve covered quite a few topics from our Australian Dietary Guidelines including :

• Guideline 1 – ‘Diabetes and healthy weight with a twist’
• Guideline 5 – ‘Food safety – a major consideration in the heat of the Aussie summer’
• and a few from Guideline 2 – eating a wide variety from the 5 food groups: , 2 blogs on dairy foods (1 and 2), water, wholegrains, legumes, protein, and there’s more to come in this area.

So today I thought we’d look at Guideline 3 which is particularly important for those of us with diabetes. It is “Limit intake of foods containing saturated fat, added salt, added sugars and alcohol”

Of course the reasonings behind this guideline are based on solid evidence about the relationship of these types of foods with heart health issues and other chronic health conditions that are also strongly associated with higher risk factors for those of us with diabetes. I don’t want to be negative and lecture you on how bad these foods are, but rather remind you about how to avoid them and show how swapping them for better options will help to keep our hearts, diabetes control and general wellbeing in good working order, whilst still allowing us to enjoy treats every now and then.

A good starting place would be to have a quick read over of a couple of previous blogs including ‘Energy In/Energy Out – understanding how much you need and where you get it’, and ‘Confused about fats &  sugars? The answer is not black and white’.

Guideline 3 has the most words of all the guidelines because it explains 4 different parts. We’ll take a quick look at the 4 parts, and I’m sure we’ll return to many of them in future blogs too:

1.   Limit intake of foods high in saturated fat such as many biscuits, cakes, pastries, pies, processed meats, commercial burgers, pizza, fried foods, potato chips, crisps and other savoury snacks.

–     Replace high fat foods which contain predominantly saturated fats such as butter, cream, cooking margarine, coconut and palm oil with foods which contain predominantly polyunsaturated and monounsaturated fats such as oils, spreads, nut butters/pastes and avocado.

–     Low fat diets are not suitable for children under the age of 2 years.

2.   Limit intake of foods and drinks containing added salt.

–     Read labels to choose lower sodium options among similar foods.

–     Do not add salt to foods in cooking or at the table.

3.   Limit intake of foods and drinks containing added sugars such as confectionary, sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, energy and sports drinks.

4.   If you choose to drink alcohol, limit intake. For women who are pregnant, planning a pregnancy or breastfeeding, not drinking alcohol is the safest option.

It really important that we remember that we eat whole foods rather than specific nutrients, and don’t get hung up on those specific nutrients but understand how eating fresh minimally processed foods will contribute to our greater wellbeing.  Dr David Katz explains this point very well in a recent article he wrote for the Huffington Post where he goes into some detail on this point. I encourage you to read it as his words make very good sense.

And last week’s blog on Protein & Diabetes – do you get the balance right? explained that:  “As we can add 2.5 serves of ‘discretionary’ choices to our daily food intake, the protein section is a good area to add one or two extra serves from, as from a diabetes point of view protein doesn’t have much effect on our blood glucose levels and will save us from getting hungry and potentially damaging our wellbeing plan. Remember to beware of the processed ones!“

The Guidelines tell us that “Discretionary foods should only be consumed sometimes and in small amounts. While discretionary foods can contribute to the overall enjoyment of eating, often as part of social activities and family or cultural celebrations, if their intake is not reduced, most Australians need to greatly increase physical activity to ‘burn up’ the additional energy (kilojoules) from discretionary foods to help achieve and maintain a healthy weight (see Guideline 1).”

Now I’ll quickly run through the 4 areas that we’re watching in Guideline 3 (more detail can be found in the guidelines document here):

1)            Saturated Fat

The best advice comes straight from the guidelines: “The Guidelines are realistic and practical, allowing a small amount of unsaturated oils and spreads to reflect culinary behaviour, while ensuring that the energy these foods provide are within the total energy constraints of the diet. Dietary fat included in the Foundation Diets comes mainly from fish, lean meats, poultry and milk, yoghurt and cheese products, with a small allowance of unsaturated oils/fats/spreads. Where more energy is required in moving from Foundation to Total Diets, additional serves of these and/or other foods containing fats can be included, such as additional nuts and seeds, unsaturated spreads and oils, and/or discretionary foods.

“However, where possible, the best choices are foods where unsaturated fats exist in greater quantities than saturated fats. As well, people who are shorter, smaller or sedentary may have little or no scope within their usual dietary patterns for any discretionary foods and drinks. The extra energy (kilojoules) provided by these foods and drinks is an additional reason to limit them.”

I won’t go into more detail than this on the topic of fats, as there’s just too much to cover. I hope though that you have a good feel that if you’re adding discretionary choices to your everyday diet, you’re better off adding from the 5 food groups than including processed and sweetened foods and drink that will not add any nutritional benefit to your intake.

2)            Salt

You’ll notice that the week before last with Salt Awareness Week covered the sodium issues in some detail in the first half of the blog ‘Twin reasons for d-awareness this week: salt and coeliac’. I encourage you to re-read that as there were many tips included.

3)            Sugars

As people with diabetes we are usually quite aware of sugars in our diets, and my previous Diabetes Counselling Online blogs on the glycemic index will help you if you’re not sure here.  I would say this one’s pretty obvious for us, so I won’t go into more detail than sharing what the guideline says:

“Sugars are carbohydrates – examples include fructose, glucose, lactose and sucrose. When sugars occur naturally in foods such as fruit, vegetables and dairy products, they are referred to as intrinsic sugars. However, the major source of sugar in the Australian diet is sucrose from sugar cane that is added to foods and is termed extrinsic sugar. Sucrose is widely used in processed foods and drinks as a sweetener and also plays a role as a flavour enhancer and preservative.”

I also like this sentence from the guidelines (other than for hypo treatments of course!): “From a nutritional perspective, good health can be achieved without the addition of sugars in any form to the diet.”

4)            Alcohol

The guidelines explain best that: “For many people, an alcoholic drink is a regular and enjoyable part of meals. In terms of nutrition, alcohol is uniquely the only substance that is both a food providing energy and a drug affecting brain function. For these reasons, advice on alcohol is included in these Guidelines.

“Drinking alcohol has health, social and economic costs and benefits for both individuals and populations. There is some evidence that people who drink small quantities of alcohol may have better health outcomes than those who do not drink, but such findings have been challenged. Heavy drinking has no health benefits and studies consistently report that abstainers have better health outcomes than heavy drinkers.”

This topic of alcohol really needs a blog of its own to do it justice, so I’ll just finish here with the paragraph from the guidelines that is aimed at people with diabetes:

“As alcohol and hypoglycaemia have independent but additive effects on cognitive function and behaviour, it is recommended that people with type 1 or type 2 diabetes abstain from alcohol if they plan to drive. Alcohol worsens medical conditions associated with diabetes, such as liver disease, hypertension and advanced neuropathy. People with type 1 or type 2 diabetes may need to take special precautions when drinking and should discuss alcohol use with a health professional.”

Making the Swap to healthier choices

There’s quite a lot of support out there if you’re looking for help to cut down on these elements of your diet. Of course, the obvious choice is to see an Accredited Practising Dietitian who will walk through your eating pattern with you and make suggestions to suit your personal tastes and medical requirements.

The Dietitians Association of Australia provides a helpful resource that offers Ten Smart Swaps For Every Occasion. They also have a section on the website called Smart Eating For You, including this terrific list of Smart Eating Tips.

I think that covers Guideline 3, but you can see there’s lots of extra reading in there to come fully up to speed with it. This again reinforces the importance of having personalised consultations with an Accredited Practising Dietitian.

Sally