A Healthy Diet

David Kinshuck


Addicted to eating



Your dietician

We all need a healthy diet, whether or not we have diabetes, and this page describes a standard healthy diet.  Many of us need to lose weight, and this page describes a plan.If we are trying to lose weight, we often need small portions. If we are trying to eat healthy and need recipes and links to wonderful websites, these are here.

Everyone with diabetes should see a dietician once a year, and certainly at the time of diagnosis, shortly after that, and at regular intervals. This page should supplement the individual advice that a dietician can provide.

Unless you have an excellent understanding what you need, and practice it, make sure you see a dietician. A dietician is available to every NHS patient..if not, insist your Primary Care Trust ensures you have an appointment. A careful diet is very helpful, BMJ 2010.  A low calorie and salt diet reduces retinopathy progression (Archives 2010)


Healthy food, fibre, fruit and vegetables

New Zealand healthy food pyramid

New Zealand healthy food pyramid



People who overweight tend to eat less fibre....foods high in fibre are not very fattening but they help to fill you up more easily. For instance a brown bread salad sandwich is just as filling (but less fattening as it has fewer calories) than a white bread plain cheese sandwich.

The US National Cancer Institute now recommends 9 portions a day of fruit and vegetable...and eating this much fibre will mean you will not be as hungry and therefore eat less bread, meat etc.

A portion: a fruit portion may be a handful of grapes, medium size banana,  not all at once..shoud be spaced out during the day. The amount of carbohydrate needed depends on the amount of exercise taken.





A meal plate


Canadas adopted plate

A meal should be proportioned as opposite. 50% vegetables (eg salad) and fruit; grains (such as brown rice) , and protein (such as fish or beans or lentils).

The meal could be a curry, chinese, rissoto, stew etc, but these are the ideal proportions of the ingredients of the meal.







Vegetarians and other issues

Other dietary issues are important:


Glycaemic index (GI)

graph of glycaemic index (glycemic)

Food with a high glycaemic index GI (red) cause a dramatic rise in blood glucose. Lower glycaemic foods are healthier (green)



Generally foods with a low glycaemic index (GI) are healthy, because insulin (injected or natural) has enough time to redistribute the glucose to the body's tissues. These have a glucose profile shown in green. These make people feel 'full' after a meal and help keeping weight down. See

Generally foods with a high glycaemic index are unhealthy, as the glucose rises too quickly to be redistributes and will do some damage (shown in red). They may even may you more hungry as their effect wears off, as in eating hamburgers....you may still fell hungry even if you have had far more calories than you need.

Examples of low GI foods


Energy from starchy foods..bread, potatoes, rice or pasta  

energy should come from carbohydrate

Our daily energy requirement should come from starchy foods, such as rice or pasta.  

  1. Brown rice has a particularly a low glycaemic index, and is ideal.
  2. Many people with diabetes have found giving up bread is helpful, although a small amont of bread is not harmful.
  3. Medium amounts of carbohydrate is best...too much or too little is unsafe, so a low carbohydrate diet increases mortality Lancet 18.


Cut down on fat  

cut down on fats, especially processed transfats and saturated fats

A little fat is helpful, such as polyunsaturated fat (sunflower oil). The fats in nuts are healthy, but nuts are 'fattening' as they have a lot of calories, so they are best in small amounts, perhaps replacing the saturated fat of red meat and full-fat dairy food. A new paper reviews 'healthy fats' here .


Healthy oils & margarines


when used cold olive oil (mono-unsaturated, healthy at low temperature; saturated at high temp's)
when used for cooking rapeseed oil & sunflower oil
margarines most of these seem to have unhealthy fats such as transfats, and too much salt. Of these Flora seems the healthiest. The Olive Oil margarines are not as healthy as olive oil itself. Why not replace these with a dressing made with olive oil.
butter has saturated foot and is best avoided in large amounts


Protein...fish, pulses, red meat, white meat

We need 0.8-1gm/kg/day. Pulses and fish are the healthiest sources of proteins.

Most UK diets would be much healthier if protein with pulses replaced most of the red meat (lamb, pork, beef), and probably white meat (chicken & turkey) .

Small amounts of nuts have healthy proteins..but too many are fattening.



Pulses /recipes include
  • low salt/sugar baked beans,
  • lentil stew, lentil curry
  • vegetable stew with beans,
  • vegetable curry with beans
  • vegetable hot pot, hummus, and so on.
  • chick-pea
  • broad beans
  • recipes

Portion sizes for each meal: 75 gm pulses (pulses: beans, lentils), 50 gm fish/meat & others.







Cut down on sugar and refined carbohydrate ('ultraprocessed' foods).  

a mars a day makes the sight go away

Sweet foods and refined carbohydrate, and all 'ultraprocessed' foods are now considered harmful. For example, a hamburger or even a sandwich, may actually may you hungrier,

Brown bread has a lower glycaemic index, and is healthier. But most UK bread has too much salt...it is best in small amounts.


Cut down on salt

Sources of salt in our diet
15% of contribution from salt natural in fresh food
15% of contribution from salt what we add at the table
70% of contribution from salt from convenience and processed food, most of which have salt added
Amount in processed food
1% of the foods content in cereals, such as corn flakes
>2% of the foods content vegetarian canneloni (tesco's); Special K cereal

Reduce salt added in cooking by using more herbs and spices instead. Gradually cut down on the salt you add to your food at the table. Most salt comes from processed food.


Food & insulin training and the DAFNE regime


Diabetes education courses


NICE have recommended that everyone using insulin should have training to allow them to achieve good control of their diabetes. One course is the DAFNE course, for users of multiple dose insulin regime who want their diabetes well controlled. But very few people have had DAFNE training, and very few diabetes nurses and doctors.

The DAFNE (and other courses) course teaches you how to measure how much carbohydrate you eat, so you can match this as accurately as possible with your insulin. In this way, if you use a rapid acting insulin, if you eat 2 portions of pizza instead of one, you have extra insulin as you eat the second portion. If you have an apple, you have a tiny extra dose on insulin.

This method helps you achieve better diabetic control without more hypos. NICE recommend a programme of structured diabetes education in the months after diagnosis, and recommend patient education should be available when needed annually; most of this should be educational and interactive, but it also needs to include a formal review of self monitoring/insulin adjustment.


Carbohydrate counting

Carbohydrate Counting: www.goodcontrol.org


To achieve good control, insulin users need to be able to determine the carbohydrate content of a meal, and adjust the insulin dose accordingly. This is discussed here (University of Leicester, permission to use applied for) clearly explains how to count carbohydrate. (Page 8 onwards).

Essentially you have to start to weigh the carbohydrate for each meal for a while, until you learn the portion sizes. You work out how much insulin you need for 50g of pasta, or 50 g rice, and so on. You then inject different amounts of insulin of adjust your insulin pump according to the type of carbohydrate, the amount, and so on.

Even fatty foods will need some extra insulin, and you can learn how much. This site teaches you to count your carbohydrates, so you can work out your insulin dose (you need to register and log in).


Working out if you are overweight..your BMI

Type 2 diabetes may be caused by being overweightUse this calculator  or use this graph to work out if you are overweight:

work out if you are overweight

Your weight in relation to your height gives an estimate of how much of your body is made up of fat. This measure is known as the body mass index (BMI).


The DiRECT Study for type 2 diabetes

See  A strict diet can make the type 2 diabetes go into remission, especaily if it has been recently diagnosisd, and is recommended by many professionals.   See Tom Watson Guardian 18



Diet Jigsaw ...use your mouse & click (BMJ Oct 2006)

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Surgery for obesity

This can be very helpful. An excellent review for professionals , NICE guidelines for patients, patient.co.uk. Bariatric surgery can be better than conventional therapy NEJM 2012 and another NEJEM 2012 if obese.


New drugs

These are for type 2 patients only, and are discussed here. (Exenatide (Byetta) & Liraglutide (Victoza) are new drugs that lower glucose levels and aid weight loss.)


Different foods

Guardian Yale University's Overall Nutritional Quality Index (scores out of 100)
A high score..healthier

  • Broccoli 100
  • Blueberries 100
  • Okra 100
  • Orange 100
  • Green Beans 100
  • Pineapple 99
  • Radish 99
  • Summer squash 98
  • Apple 96
  • Green cabbage 96
  • Tomato 96
  • Clementine 94
  • Watermelon 94
  • Mango 93
  • Red onions 93
  • Non-fat milk 91
  • Fresh figs 91
  • Grapes 91
  • Banana 91
  • Avocado 89
  • Oatmeal 88
  • Atlantic salmon fillet 87
  • Blackberries 83
  • Cod fillet 82
  • Raw almonds 82
  • Iceberg lettuce 82
  • Raw pecans 82
  • Rocket 82
  • Brown rice 82
  • Snapper 82
  • Milk (1% fat) 81
  • Oysters 81
  • Prawn 75
  • Couscous 72
  • Clams 71
  • Raw pistachios 70
  • Unbuttered, unsalted popcorn 69
  • Canned tuna in oil,
  • drained 67
  • Monkfish fillet 64
  • Vegetarian split-pea soup mix 63
  • Instant oatmeal 61
  • Canned pineapple in juice 60
  • White rice 57
  • Sodium-free sparkling water 56
  • Milk (2% fat) 55
  • Canned kidney beans 53
  • Milk (whole) 52
  • Scallops 51
  • Pasta 50
  • Canned peas 49
  • Prunes 45
  • Vanilla yoghurt 43
  • Orange juice 39
  • Skinless chicken breasts 39
  • Canned peaches in light Syrup 37
  • Lobster 36
  • Flank steak (beef) 34
  • Dried apples 34
  • Tomato juice 32
  • Condensed split-pea soup
  • with ham 32
  • Minced sirloin 30
  • Tomato juice 32
  • Condensed split-pea soup
  • with ham 32
  • Minced sirloin 30
  • Chicken drumstick 30
  • Enriched white bread 29


  • Whole chicken with skin 28
  • Leg of lamb 28
  • Ham (whole) 27
  • Raisins 26
  • Hamburger (75% lean) 25
  • Apple chips 24
  • Coconut 24
  • Green olives 24
  • Pork baby back ribs 24
  • Bagel 23
  • Condensed tomato soup 23
  • Peanut butter 23
  • Sherbet 23
  • Reduced-fat sour cream 22
  • Condensed cream of
  • broccoli soup 21
  • Salted, dry-roasted peanuts 21
  • Instant chocolate pudding 20
  • Fried egg 18
  • Swiss cheese 17
  • Diet fizzy drinks 15
  • Non-streaky bacon 13
  • Pretzel sticks 11
  • Dark chocolate 10
  • White bread 9
  • Salami 7
  • Hot dog 5
  • Cheese puffs 4
  • Milk chocolate 3
  • Apple pie 2
  • Crackers 2
  • Fizzy drinks 1
  • Popsicle 1


Help from other organisations & websites