Guest Post, Sally Marchini, Dietitian
As people with diabetes, it’s important that alongside managing the day-to-day needs of our diabetes we also pay attention to avoidance or awareness of issues that may creep up when we least expect it. Two such issues are celebrating their Australian national awareness week this week: Salt Awareness Week, through the Heart Foundation 10-16 March, and Coeliac Awareness Week, through Coeliac Australia 13-20 March 2014. It’s quite a long blog today as I’ve tried to include relevant info from these two organisations, but the idea is for you to understand how being aware of these issues can help Your diabetes control and overall health.
Salt Awareness Week 10-16 March
You may be aware that salt, or sodium chloride, is strongly associated with heart disease. We also know that people with diabetes are 3 to 4 times more likely to develop cardiovascular disease (including heart attack and stroke) than those who do not have diabetes, and that around 75% of people with diabetes die from cardiovascular disease, including heart attack and stroke. So, although sodium is not the only cause of heart disease, it is extra important for us to pay attention and consider how much of it we’re consuming.
A press release embargoed until today by the Heart Foundation reads: “On average, Australians eat around nine grams of salt a day (around one and a half teaspoons), far in excess of the Heart Foundation’s recommended maximum of six grams (one teaspoon) for healthy Australians and four grams (two-thirds of teaspoon) for people with existing high blood pressure or heart disease.
Most people are surprised to learn that about three quarters of the salt we eat comes from everyday supermarket foods rather than salt added at the table, which is why the Heart Foundation is running a campaign Halt Hidden Salt to get hidden salt out of everyday foods before they hit the supermarket shelves.”
On one hand, having diabetes can be a benefit in this respect as our bloods and blood pressure are (or should be) regularly checked by our GPs or D-team, however that doesn’t mean we can ignore the issue until it’s detected. It doesn’t have to be difficult to cut down on the amount of sodium we eat, and the good news is that after around 6 weeks your taste-buds will adjust to less salt in your diet.
The Heart Foundation has provided helpful tips on how we can reduce our salt intake:
Add something else
Rather than adding salt when you cook, use lemon juice, garlic, vinegar, or herbs and spices to add flavour. Avoid stock cubes, soy sauce, mustard, pickles and mayonnaise where possible, or at the very least, choose low salt varieties. Remove the salt shaker from your table as well to avoid adding salt to your and your family’s food.
Stick to fresh where possible
Remember to include a wide variety of fruit and vegetables, plain unsalted nuts and legumes and lentils in your diet. Try adding healthier options to your lunch box such as boiled eggs and salad, raw vegetable sticks with a reduced salt dip and fresh fruit pieces. You can also choose from the wide range of delicious Heart Foundation recipes, all of which help to reduce salt in your diet.
Check food labels
Reducing your salt intake can be as easy as switching brands and looking for products marked as ‘low salt’, ‘reduced salt’, ‘no added salt’ or ones that carry the Heart Foundation Tick. If you can’t see these labels, try to choose low salt foods (< 120mg/100g) or use the nutrition information to compare and choose the product with the least amount of sodium per 100g. Even foods like canned vegetables and baked beans can be high in salt, so make sure you check the nutrition information panel on the back or side of the package.
Know your foods
High levels of salt are often added to foods such as packet soups and sauces, pies, sausage rolls, sausages, chorizo, pizzas and ready meals so reduce the amount of these foods you eat. Try to only have takeaway and fast foods such as burgers, fried chicken and pizza as an occasional treat.
Limiting salty snacks like chips, pretzels, crackers and dip, and salted nuts to once a week will also help cut down the amount of salt you’re consuming. Make healthy snacks convenient by having fresh fruit pre-chopped, keeping low-fat yoghurt in the fridge, and healthy muffins in the freezer ready to be heated.
You can read more and join their campaign to ‘Halt Hidden Salt’ here.
Coeliac Awareness Week 13-20 March
The 2014 slogan is ‘Are you sick and tired of feeling sick and tired?’ For us with diabetes (any kind) it’s extra important that we take note of how our body is feeling. In addition to its ‘usual symptoms’ (sometimes none!) a condition like coeliac disease can also make your diabetes harder to manage (hence the photo of the rollercoaster!).
Research published in 2013 demonstrated that in Australia 1 in 60 women and 1 in 80 men are likely to have coeliac disease, and yet 80% of cases are undiagnosed which can lead to longer term health issues including (but not limited to) poor diabetes control, osteoporosis, anaemia, and certain cancers.
There’s no evidence to suggest that there’s a link between type 2 diabetes and coeliac disease, but there’s still plenty of cross-over in the two conditions due to the sheer numbers of people who have type 2 diabetes. However with type 1, we have something like a 10% chance as they are related autoimmune conditions, and about half of type 1s who have coeliac disease are asymptomatic (symptom free). Personally I was diagnosed with coeliac disease after my endo found that my iron levels were low so he ordered the blood test to check for coeliac disease which came back positive.
A Coeliac Australia member survey at the end of last year found that 56% of coeliacs wait longer than three years before diagnosis. This is a scary thought when all that time they’re at least suffering malnutrition issues if not a range of nasty symptoms causing people to feel ‘sick and tired’ without knowing why.
Accurate diagnosis is very important, so ensure you don’t ‘self-diagnose’ and think that going ‘gluten free’ will solve your issues. For a start with diabetes it’s more difficult to manage BGLs on a gluten free diet (though very possible when you learn how as I have done), but when you consider that as little as one one-hundredth of a piece of wheat bread per day is enough to cause damage in a person with coeliac disease even though not enough to cause symptoms, it’s important to see a specialist dietitian to understand how a strict gluten free diet (the only known treatment) can be achieved, and for us with diabetes, how it can be achieved AND manage our glycemic control.
You can read more about Coeliac Awareness Week here.
Sally Marchini is owner of her private practice (Marchini Nutrition), has had type 1 diabetes for close to 40 years and coeliac disease for many years too.