What to eat

Current advice is that, of the total calories eaten, 55 per cent should be carbohydrate, less than 30-35 per cent should be fat, and 10-15 per cent should be protein (Fig. 5.1). Most people have no idea what this actually looks like on a plate. Fat supplies about twice the calories (9 kcal/g) as the same weight of protein (4 kcal/g) or carbohydrate (3.8 kcal/g). Food also contains water, fibre, and inedible waste such as orange peel. If a man working as a builder eats about 3000 kcal a day he may have 1000 kcal for his evening meal. Table 5.1 shows how this is translated into real food.

The builder's helpings of beans and vegetables are large, those of chicken, custard, and pie are small. This size of meal is only appropriate for an energetic young man. It would constitute the food for an entire day for an overweight person on a 1000 calorie diet. Forty per cent of the calories are in the sweet pudding in which a lot of fat is concealed in the pastry which also greatly increases the carbohydrate intake. For someone with diabetes it would have been better to have fruit alone. There is plenty of fibre in this meal—in the baked beans, potatoes, cabbage, and apple.

It took me some time to calculate this example and it is clearly unrealistic to expect our builder to sit down with the calculator and weighing scales before he tucks into his well-earned dinner. The simplest option is to encourage people with diabetes to learn about the different types of food. They should eat as much as they want of low-calorie foods such as green vegetables, large helpings of starchy, high-fibre carbohydrate foods, tiny helpings of fat, and moderate helpings of protein. Sugar and salt should be treated as rare treats or avoided. 'Made-up foods' not produced at home to a diabetes recipe should be viewed with suspicion as they often contain a lot of hidden sugar and fat (e.g. pies, sausages, cakes). The total amount eaten can be adjusted by the number of meals and snacks and the size of helpings—our builder could serve his food with a tablespoon and eat three big meals and three snacks a day, an overweight

100 CALORIES

100 CALORIES

typist could serve her food with a teaspoon and eat three small meals a day, with a bedtime snack if on insulin.

Table 5.1 The builder's meal (calculated from figures in the Manual of nutrition, 1989)

Food

Weight

kcal

Protein

Fat

Carbohydrate

(g)

(g)

(g)

(g)

Tomato soup

200

110

1.6

6.6

11.8

Roast chicken (meat)

100

148

24.8

5.4

0

Cabbage

200

30

3.4

0

4.6

Baked beans

200

162

9.6

1.2

30.2

Boiled potato

200

152

3.6

0.2

36.0

Apple pie

100

369

4.3

15.5

56.7

Custard*

30

35

1.1

1.3

144.3

Total

1030

1006

48.4

30.2

144.3

kcal

1006

193

272

541

Percent of total kcal

100%

19%

27%

54%

* Made with sugar; full-fat milk in the custard. He drank mineral water with the meal.

* Made with sugar; full-fat milk in the custard. He drank mineral water with the meal.

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