Preventing type 2 diabetes - The Mediterranean way

A snap from my time in Greece in 2014

As we discussed here yesterday, living a healthy lifestyle and maintaining your healthiest weight can prevent or delay the onset of type 2 diabetes. This is great news right!

The problem is, with the co-existence of the weight loss industry promoting every fad under the sun, and an obesogenic environment placing convenient food options at an arms reach, the meaning of living a healthy lifestyle is often blurred. As a dietitian helping people to eat for health, I do not recommend ‘diets’ or restrictive eating behaviours. Instead, I help people find their own healthy balance that eventually becomes a lifestyle that they can sustain and enjoy. I also consider the evidence around different eating patterns and how they help different population groups. I try and integrate this evidence wherever possible and appropriate. If we look at an eating pattern that is leading the way to help lower diabetes incidence, manage a healthy weight and reduce cardiovascular disease, there is no doubt that the Mediterranean way is winning.

So lets take a look at some key components of the Mediterranean eating pattern and enjoy some pic's from our recent trip to Italy and Greece.

A photo taken while completing 'The Walk of the Gods,' on the Amalfi Coast, Italy in 2014 - Just STUNNING!

An Extra Drizzle of Olive Oil Please

Sorry coconut oil lovers but when we look at the evidence, nobody can argue that olive oil is winning the race for the healthiest daily oil to use. NOBODY. 

The Mediterranean way is not consistent with the outdated approach of low fat eating, as it boasts a good intake of foods rich in healthy fats such as nuts, oily fish and an extra drizzle of olive oil with most meals. These fats are protective against cardiovascular disease, a strong risk factor for type 2 diabetes. Meals higher in healthy fats can also keep us feeling full and satisfied, helping to manage food portion sizes and reduce that urge for nutritionally poor snacks between meals. 

Hold the Red Meat

Red meat appears on plates just every 'now and then' in the Mediterranean region. Instead of red meat, the predominant protein sources are legumes, eggs, fish, shellfish, white meats such as chicken and turkey and a bit of yoghurt and cheese each day. Replacing red meat with these alternatives (majority of the time) may help to lower the unhealthy, saturated fat in your diet and prevent type 2 diabetes.

Lots of legumes

Legumes are a main feature in the Mediterranean diet. Whether canned or dried, legumes such as lentils, kidney beans and chickpeas really are natures own ‘super food’ as these little beans are loaded with various nutrients such as protein, protective fibre, healthy fats and low glycemic index (GI) carbohydrates. Even better, all of these nutrients are delivered at a low cost and can be served as a source of protein in replace of meat. It is recommended to enjoy these little gems at least 2-3 times a week.

Fill up on vegetables

Every healthy way of eating includes plenty of vegetables, including the Mediterranean way, which is a very plant-based way of eating. Filling up on non-starchy vegetables with most meals (not just dinner) will only provide you with the goodness of fibre, vitamins and minerals without the extra energy you may not require. Starchy carbohydrates such as potato, sweet potato and corn are also important, however if your energy requirements do not call for a large serve just allocate these vegetable to one quarter of your plate, just enough to keep you satisfied.

Nuts About nuts

The Mediterranean’s are just nuts about nuts and so are we. If you attempt to follow a ‘low fat’ diet you would automatically put the nuts back on the shelf after carefully reviewing the nutrition information panel. This is because nuts possess a large amount of fat. But this fat is GOOD and can keep our blood vessels healthy. Furthermore, nuts are jam packed with nutrients such as vitamin E (an antioxidant), zinc, B vitamins and fibre just to name a few. Although they are high in fat, there is evidence to show that enjoying a small handful a day (about 30-40 grams) can assist with weight loss, potentially due to the ability of nuts to keep us satisfied in a small dose. Any tree nut is a healthy choice, so whether is it macadamias, pistachio’s, almonds or cashews, just hold the salt, and you have yourself a perfect healthy snack.

Just like every healthy way of eating, the Med's way is about the whole eating pattern and lifestyle and not just about one food group or nutrient in particular (e.g. quitting sugar). This way of life also involves sharing and celebrating food with loved ones. So take a leaf out of the med’s book and sit down with your loved ones and share some of these beautiful foods - and enjoy every moment. 

Here are some snaps from my holiday in Italy and Greece last year - these give some beautiful insight into the Mediterranean way.

Delicious sardines, lightly fried in olive oil and drizzled with lemon 

Fried zucchini with a garlicy yoghurt sauce

Traditional Greek salad drizzled with olive oil

Santorini fava - made with yellow split peas (legumes)

A picture says a thousand words...

Amazing mussels and squid matched with a Greek salad - loaded with healthy fats and full of goodness

Grow your own and eat fresh and seasonal 

Berries at the Venice Farmers Markets

Exercise is a key component of the Meds way and a key factor in reducing your risk of type 2 diabetes

Fuelling the football finals

So this week is FINALS week! My husband’s team will take on Brisbane Roar at Adelaide Oval on Friday night for the semi-finals of the A-league.

I often get asked what Nigel likes to eat before games and during a  training week. You just have to look at Instagram to know this one, and many people close to us know how much I dislike spaghetti bolognese after 10 years of having this the night before a game! But I did get asked if this had changed being such a big week, so I thought that I would share.

When I was planning our evening meals for the week, I did have FINALS WEEK in the back of my mind. I wanted to make sure that every night we had good quality protein (and a good variety of sources), lots of vegetables for immune support, healthy fats and carbohydrates at every meal. This is pretty standard, although I often ask Nige which nights we need more carbier meals and what nights we can go easy (this depends on his training load).

This week, being a heavy week and nearing the end of the season when fatigue starts to set in, I made sure every meal had a decent amount of carbs.

So this was our weekly menu:

Sunday night

• Vegetable soup for entree
• Spiced lamb back-strap with a zucchini, pomegranate and almond couscous salad for main
• Honey and cinnamon baked pears with ricotta and pistachios for dessert

Monday night

• Baked eggs in a kidney bean and vegetable mix served with zesty guacamole and corn wraps

Tuesday night

• Cumin spiced salmon with sweet potato chips and stir-fried greens

Wednesday night 

• Chicken and vegetable curry with brown rice for main
• Baked pears for dessert

Thursday night (you guessed it)

• Spaghetti Bolognese (I’m having leftover curry) for main
• Ice-cream for dessert (part of the tradition)

There is also lots of weet-bix, fruit, sandwiches, yoghurt and a couple of pasta lunches to fill in the gaps.

GOOD LUCK BOYS!

What is your favourite pre-game / competition meal?

Healthy school snacks

Are you in the process of getting your kids ready to go back to school?

No doubt you are busy getting books, bags and shoes organised...but what about healthy lunch box and after school snacks?

Kids require adequate fuel to get them through a busy and active day at school. They also require nutrients to optimise their growth and development. Snacks are a fantastic opportunity to help meet these requirements, but one of the most common questions I get asked is: “What makes a healthy snack?”

Foods coming from our core food groups almost always make a healthy snack. This includes fruit, vegetables, dairy, grain foods and lean meats and alternatives. If these foods are presented in a minimally processed way, they are one step closer to a healthy snack.

I think one of the most important aspects to consider when organising healthy snacks for kids is to make them interesting and fun. Getting them involved in the preparation process and asking them what they like and what they think is healthy also helps ensure that they don’t swap, or throw out their intended healthy snacks.

Lets take a look at how we can use our core food groups in an appealing way to minimise the number of packaged or processed snacks for kids. Not only will this help to improve your child’s health, but reduce your family’s carbon footprint.

1.  Fruit and vegetables

Fruit and vegetable based snacks can provide fibre, water, phytochemicals and a range of vitamins and minerals. Snacks may include:

• Frozen fruit such as frozen berries mixed through natural yoghurt

• Small portions of dried apricots mixed with cubes of cheese or seeds such as sunflower or pumpkin seeds

• Tinned fruit in natural juices

• Savoury wholemeal flour or quinoa muffins with grated vegetables

• Corn fritters

• Fruit salad OR

• Veggie sticks with a nutritious dip such as hommous or tazziki – why not make your own?

2.  Dairy foods

Dairy based snacks can help to provide protein, low glycemic index (GI) carbohydrates, calcium, vitamin D, B vitamins and zinc. Snacks may include:

• A container holding a mix of cherry bocconcini and cherry tomatoes

• Tubs of natural, Greek or flavoured yoghurt –freeze tubs of yoghurt (or small containers of yoghurt) before putting in your child’s lunch box to keep them cold

• Small portions of flavoured or plain milk (including soy milk) OR

• A slice of low fat cheddar cheese on wholegrain crisp breads.

3.  Lean meats and alternatives

Lean meat and alterative based snacks provide protein, iron, zinc and B12. Snacks may include:

• Roasted chickpeas (a nice replacement for chips) – roast canned chickpeas with a sprinkle of paprika and cumin for about one hour on ~150 degrees (fan forced oven)

• Hard-boiled eggs

• Felafels

• Tinned bean mixes and fish OR

• Mini vegetable frittatas.

4.  Grain foods

Grain foods will provide fibre, carbohydrate, B vitamins, zinc, vitamin E, magnesium, iron and phosphorus. Snacks may include:

• Wholemeal lavish bread with a nutritious dip such as beetroot

• Wholemeal savoury or fruit pikelets

• Homemade muesli bars OR

• Dried cereal such as weetbix biscuits topped with cheese and a thin scrape of vegemite or peanut butter.

Choosing a healthy muesli bar

I often get asked about choosing healthy muesli bars, which can be a great convenient snack, especially for active kids.

My recommendations are to always try and choose the muesli bar that is highest in fibre, lowest in sodium and lowest in saturated fat per 100g. Most will have a little bit of added sugar to increase the palatability of the product without displacing key nutrients, however some bars marketed at children can have way too much sugar than required.

Unfortunately, reading sugar on the nutrition information panel is not always the best indication of a healthier option as the presence of natural sugars such as fruit or yoghurt will be listed under ‘sugars’ on the nutrition information panel. These natural sources of sugar are nutrient dense.

The ingredients list can help you identify added sugars. Look for sucrose, cane sugar, raw sugar, dextrose, glucose, honey, brown sugar, malt syrup, fructose, lactose, molasses, barley malt and caramel. If one of these ingredients is high on the list, this means that there is likely a large quantity of it in the product.

More infomration on this can be found here.

After school snacks

Feeding hungry kids after school can be challenging, especially when trying to find something that is fun, nutritious and easy to prepare. Try:

• Fruit skewers by using small cookie cutters to make different shapes (see picture above)
• These mango and strawberry yoghurt cups
• This choc, blueberry and beet cake

• Mini ‘pizzas’ with wholegrain English muffins topped with ‘no added salt’ tomato paste (or homemade tomato sauce), tomato, pineapple and cheese and placed under the grill
• Freezing any left over fruit to make smoothies – use frozen fruit such as as banana and strawberries and blend with yoghurt and milk

• Celery filled with your child’s favourite nut butter and a sprinkle of sultanas

• Baked bean filled toasties OR

• A platter filled with cubed cheddar cheese, sushi, rice crackers, lavish bread, dried fruit and a nutritious dip.

Fuelling Active Kids

Over the last few weeks I have had the opportunity to help educate many kids about general nutrition and nutrition in sport. I was also lucky enough to attend the Sports Dietitian’s Australia conference in Melbourne, which was insightful and inspiring. Each of these experiences has taught me a great deal. In particular I have learnt that kids are active! Even though our statistics tell us that there is a decrease in the activity levels of many children living in Australia, there are still many kids that are active who need good quality fuel in order to keep them going.

When I talk to kids about nutrition I always relate our body back to a car. If you put the good quality petrol in, the car will drive better compared with if we put the cheap, crappy petrol in. Not only will good nutrition help to maintain adequate energy and concentration levels required to enjoy sport and general activity, it will support a child’s overall health, growth and development.

How to fuel active kids?

Active kids need to eat regularly in order to refuel their energy levels, with the preferred fuel source being carbohydrates. A regular day for an active kid can often be a busy one, especially when they are training before or after an already active day at school. To ensure that kids get the good quality fuel they require, use the following tips:

1.  Organise to have nourishing meals and snacks on hand to enjoy at home, school, during sport or on the run.

2.  Encourage your child to start the day with a nourishing breakfast such as baked beans on toast, a fruit smoothie, toast or a high fibre breakfast cereal topped with fruit.

3.  Have some carbohydrate based meals or snacks available to enjoy before, during and after training and sport. Convenient snacks may include tinned, dried or fresh fruit, yoghurt, custard,  french toast with ricotta, raison bread topped with ricotta and fruit, flavoured milk, pasta or rice salad, wholegrain English muffins topped with honey, nut butter or vegemite, homemade fruit muffins, sandwiches, smoothies or liquid meals such as Sustagen Sport or an Up and Go.

4.  Pack a drink bottle and encourage kids to drink well at school (water being the preferred choice) and during sport to help avoid dehydration. There is a place for sports drinks around sport to help assist with hydration, especially during prolonged or higher intensity sport.

The right meal

To make sure a tired child tops up their fuel tank at the end of the day it is important that fluid is encouraged and a nutrient dense meal is available.

A nutrient dense meal is one that has some carbohydrates for energy (including potato, sweet potato, pasta, noodles, rice or quinoa), protein for recovery and muscle maintenance (including eggs, fish, chicken, legumes or beef), salads and vegetables to help meet fibre, vitamin and mineral requirements and a low fat dessert based on fruit or dairy to enjoy. This can be very challenging, especially when parents and carers are also busy with work, study or their own sport.

To help to ensure a meal is on hand in times of need try some of the following tips:

5.  Be organised and plan the meals and snacks for the week.

6.  Create a shopping list and get the groceries for the busy week ahead.

7.  Plan for meals that are quick and easy to prepare such as stir frys with chicken, vegetables and noodles, fish with vegetables and rice, burritos with minced meat and salad, a tuna and vegetable pasta bake and hamburgers made with lean mince or a vegetable pattie and served with salad on high fibre rolls.

8.  Use a mix of fresh, frozen and canned foods such as frozen vegetables, canned legumes (beans) and tinned fruit.

9.  Dedicate an afternoon to preparing some meals and snacks that can be frozen and reheated.

10.  Put a slow cook meal on in the morning before work so a tasty and healthy meal is ready for when everyone gets home.