Diabetes Dialogue, Autumn 2012 issue
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Your mother was right: A smart start to the day includes a nutritious breakfast. This is true for everyone, but it’s especially important for people with diabetes, says Bozica Popovic, pharmacy manager at Loblaws’ Princess Street store in Kingston, Ont. “A person with diabetes who misses breakfast can end up with higher blood glucose as the morning progresses. The levels can remain that way all day, and people who are using insulin may require a higher dose. On the other hand, those on oral medications who miss breakfast can experience dangerously low blood glucose levels,” explains Popovic, a certified diabetes educator.
Lingering over a leisurely breakfast sounds like a lovely treat, but it isn’t a weekday option for most of us. Rather, we’re often busy and time-crunched, and looking for breakfast ideas that are quick and easy. Few breakfast foods are speedier to fix than a bowl of cereal, but have you looked at your supermarket’s cereal aisle lately? Most offer a bewildering range of products.
When it comes to choosing a nutritious breakfast in a box, Popovic’s top pick is unsweetened cereal that contains complex carbohydrates such as whole grains, and at least five grams of fibre per serving. Why unsweetened? “You can always sweeten it to taste,” she explains, “but you can’t take away sweetener that has already been added.”
It’s always a good idea to check the labels on any packaged food you buy, but in the cereal aisle—with its wealth of choice—reading nutrition labels is a must-do. Look for the words “whole grain” (e.g., whole oats) on cereal labels, and opt for products where whole grains appear near the top of the ingredient list. Beware of products masquerading as whole grain—red flags include the words “cracked wheat” or “multi-grain”—as they’re less nutritious than whole-grain cereals.
Shannon Richter is a registered dietitian at Loblaws’ Midland Avenue and Princess Street stores in Kingston, Ont., who conducts store tours for people with conditions such as diabetes. During the tours, she shows her customers how to read labels, what to look for, and other tips on choosing healthful products.
In the cereal aisle, Richter guides customers with diabetes toward products that are low on the glycemic index (GI), such as oatmeal and some bran-based cereals. By contrast, high-GI cereals include cornflakes and crisped rice cereal. Low-GI foods raise blood glucose levels less than high-GI foods, and they do so more slowly.
As well as watching for sweetened cereals, it’s best to avoid those with added dried fruit. “We advise limiting the amount of dried fruit you eat if you have diabetes,” says Richter, “as it’s very high in carbohydrate.” Better to add a little fresh fruit if you want some natural sweetness in your cereal, she suggests.
One of the packaged cereals that contains the most dried fruit is granola, a product that may seem a nutritious choice, but one that Richter advises people with diabetes to avoid. “Granola is very dense and concentrated,” she explains. “If you read the label, you’ll find the suggested serving size is small and likely won’t satisfy you like a larger bowl of less dense cereal.” But, Richter concedes, granola can be a good topping to sprinkle sparingly on a bowl of yogurt.
Your mother wasn’t right only about breakfast, she was on the button about oatmeal, too. Oatmeal is a nutritional powerhouse that’s very high in fibre, along with B vitamins, vitamin E, minerals, and healthy fats.
Oatmeal comes in various forms, from the least-processed steel-cut oatmeal to regular, quick-cook, and instant. Richter advises that less processing equals more nutrition. “Check the cooking instructions to figure out how processed an oatmeal is. The faster it cooks, the more processing it’s had,” says Richter.
Steel-cut oatmeal is the healthiest choice (see recipe below), but if you’re short of time and would prefer to fix instant oatmeal in the mornings, read the labels and choose the one with the lowest sugar and sodium content.
Think outside the (cereal) box
In addition to oatmeal, try other whole grains for breakfast, such as quinoa, barley, or wheat berries. Most are quick to prep (just follow directions on the package) and can be ritzed up with any of the toppings listed in “All Dressed”.
Choose low-fat milk or milk alternatives; if using the latter, opt for unflavoured varieties (you can always add a dash of vanilla), and select soy milk over an almond or rice beverage since it’s higher in protein. What about granola bars for the mornings when you’re really rushed? Richter warns that some, especially those with chocolate, are more candy bar than breakfast. A healthier option, she says, is to put some cereal in a Baggie and tote it with a small container of milk. Alternatively, team a small unsweetened yogurt with one or two of the toppings listed in “All Dressed” (below) for a nutritious grab-and-go breakfast.
And if you just aren’t a cereal fan, here is a breakfast suggestion that meets the Canadian Diabetes Association’s 2008 Clinical Practice Guidelines for a well-balanced breakfast that includes about 45 to 60 per cent carbohydrate, less than 35 per cent fat, and 15 to 20 per cent protein:
1 slice whole-grain toast
1 tbsp (15 mL) peanut butter
1 boiled egg
I sliced orange
1 cup (250 mL) skim milk
In her book Healthy Starts Here! (Whitecap, 2011), Mairlyn Smith shows just how easy it is to fix nutritious food. Here’s what she has to say about this
good-for-you breakfast: “If you don’t think you have
time to make oatmeal from scratch every morning,
this recipe will prove you wrong. The nutty, chewy
goodness of cooked steel-cut oats can be in your bowl
in about 10 minutes.” We’ve adapted the recipe to
keep the carbohydrates to 25 grams per serving.
¼ cup (50 mL) Irish, Scottish or steel-cut oats
¼ cup (50 mL) oat bran
¼ cup (50 mL) dried blueberries
½ cup (125 mL) skim milk
or fortified organic soy beverage
Generous sprinkle of cinnamon
Honey or your choice of sweetener to taste (optional)
The night before, a couple of hours before you get ready for bed, bring 1¼ cups (300 mL) water to a boil in a medium microwaveable bowl. When the water boils, stir in oats, cover, and let sit for 30 minutes, then put the bowl in the fridge. (If you don’t have a microwave, just boil the water in a saucepan, then stir the oats and boiling water together in a medium bowl.)
As soon as you get up the next morning, scrape the contents of the bowl into a small saucepan and stir well. If the oatmeal looks really thick, add a little more water. Bring to a boil over medium heat. Stir in oat bran and blueberries, and simmer for 5 minutes, stirring occasionally.
Remove saucepan from heat and stir oatmeal. Spoon it into 3 bowls and add milk, dividing evenly. Sprinkle with cinnamon and, if you like, sweeten to taste with honey or a sweetener of your choice.
Makes three scant ½-cup (110 mL) servings
Nutritional breakdown per serving:
25 g carbohydrate, 5 g protein, 1.3 g total fat, 0.3 g saturated fat, 3 g fibre, 24 mg sodium, 9 g sugars, 125 calories
Whatever cereal you choose to start your day, you can amp up its nutrient quotient by sprinkling on these healthy add-ins. If choosing nuts or seeds, make sure they’re processed without any oil or salt, and limit the amount to about one tablespoonful (15 mL):
- chopped unsalted nuts (walnuts and almonds are great choices)
- ground flaxseeds (grind whole flaxseeds in a coffee grinder and store them in the freezer)
- oat bran
- chia seeds
- unsalted pumpkin or sunflower seeds
- fresh fruit (limit it to ½ cup/125 mL chopped fruit or 1 fist-size piece of fresh fruit)
- a sprinkling of cinnamon or finely grated lemon or orange zest