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Are smoothies really good for you?

Drinking your fruit may not be the healthiest move
Viewpoint

By Alyssa Schwartz

They are full of fruit and wholesome ingredients such as protein, grains, and seeds; and are typically low in saturated fat and sodium. Plus, smoothies are available in ready-to-go formats. For all of these reasons, they might seem like a great option, especially when you consider that 60 per cent of Canadians have fewer than five servings per day of fruits and vegetables (Canada’s Food Guide recommends at least seven servings per day for women and eight for men).

“Smoothies offer convenience and portability,” says Stephanie Boutette, a registered dietitian and education coordinator with the Canadian Diabetes Association (CDA). “They’re typically advertised as containing servings of fruits and vegetables in a delicious form.”

However, she says, “many smoothies are made with juice or fruit purée as the first ingredient, which means the sugar content is often high.” For a person with diabetes, she explains, this can lead to a quick increase in blood sugar [glucose]. As well, “compared to eating a piece of fruit, drinking a smoothie may not be as satisfying. If you don’t feel as full, that can lead you to consume more calories later in the day, which can make weight control more difficult.”

Plus, some ready-made smoothies may not provide the benefits of whole fruits, such as fibre. For example, Oasis smoothies, which are available at grocery stores, have two servings of fruit in a one-cup serving, but offer just one gram of fibre. Bolthouse Farms Berry Boost smoothie claims 3.75 servings of fruit per bottle (including 2.5 apples, a third of a banana, and 61 berries), but there is not a single gram of fibre in a serving. Consuming these fruits in their whole form would provide about 20 grams of fibre, a significant proportion of the 25 to 50 grams of fibre recommended by the CDA every day to help control blood sugar and reduce cholesterol. Tim Hortons’ Mixed Berry Smoothie (with or without yogurt) also contains just one gram of fibre per serving. Products that contain whole fruit (look for the name of the fruit without the words “concentrate” or “purée” on the ingredient list) are a better option.

Smoothie success

One easy way to ensure you are getting all of the nutrients of actual fruit is to make your own smoothies—but even then, it is important to be cautious about calories, especially if you use several different fruits and popular ingredients such as yogurt, honey, or chia seeds. “When you’re adding so many ingredients to the blender, it can be easy to lose track of how many calories you’re consuming,” Boutette says. Here are four tips to help.

Read the label If you’re buying a ready-made smoothie, look for options that include the whole fruit, not juices or purées. Use the Nutrition Facts Table to compare products for fibre (the more, the better when it comes to controlling blood sugar and reducing cholesterol), and sugars and calories (the less, the better for these two).

Water it down If you add liquid, opt for water, low-fat milk, or unsweetened nut milks, which can help you achieve the desired consistency without a lot of added sugar (from products such as juice, and sweetened almond or sweetened soy milk.)

Add your own protein Nut butter, Greek yogurt, whey protein, or even tofu can provide the protein necessary to make your smoothie a meal.

Have your protein on the side Eating some low-fat cheese or an egg can help balance the reduced feeling of fullness that comes from drinking your meal.

Did You Know?

Eating the skins and seeds of fruits and vegetables is one way to increase your fibre intake. For more tips, visit “Fibre” now.

Receive a great diabetes-friendly recipe every month when you subscribe to Diabetes Current, the CDA’s monthly e-newsletter. Sign up for your free subscription here




What to do when there’s no nutrition info label at the deli?

What to do when there’s no nutrition info label at the deli?
On the Shelf

By Alyssa Schwartz

Information is power, especially when it comes to eating well. For people living with diabetes (and those who are not), nutrition information is an important tool that can help you make the best decision about what to eat for your health. This means choosing foods that are higher in fibre and other important nutrients, and lower in calories, saturated fat, or sodium.

According to one study from Drexel University School of Public Health, people who had nutrition information on restaurant menus consumed, on average, 151 fewer calories, 224 fewer milligrams of sodium, and 3.7 grams less saturated fat than those who did not have this information available. In other words, the information helped to change their behaviour in a good way.

If you are shopping for packaged foods at the grocery store, finding nutrition information is easy: Health Canada requires information to appear in a standardized format on most food labels. But if you are shopping at the prepared food or deli counter, the facts may not be as easy to find.

“According to Health Canada, foods prepared or processed at the store—including bakery items, salads, cooked items, and more—are not required to have the Nutrition Facts table,” says Stephanie Boutette, a registered dietitian and education coordinator with the Canadian Diabetes Association (CDA). “This can make it more difficult to make comparisons between products, which you could easily do if you had two packaged goods in front of you.”

However, given that prepared foods can be a good way to eat a healthy meal when you do not have time to cook at home, what should you do?

How to be a food detective

The lack of detailed information does not mean the prepared food counter is a no-go zone, but it is important to make choices based on factors that go beyond what looks good.

The first thing Boutette recommends: Ask for more information. “Sometimes there are ingredient lists or other nutrition information behind the counter,” she says. Ingredients such as added salt, sugars, and fats can be a sign that a food might be less healthy; vegetables, pulses, whole-grain whole-wheat flour and other nutrient-filled ingredients may be healthier options.

If the ingredient list is not available, ask how an item was prepared. “Whether a food is baked, steamed, broiled, or fried can tell you about the nutritional value of a food,” Boutette says, who suggests staying away from fried foods on most occasions. At the deli counter, words such as “smoked” or “cured” can also indicate which meats are processed. These are often higher in sodium and saturated fat, and have been linked to an increased risk of colon cancer, she says.

Eyeballing dishes can also be a good indicator. “If they’re breaded, loaded with gravy or creamy dressing, or drenched in oil, those may be items you want to have less often,” Boutette says.

Bottom line? When chosen carefully, prepared foods can be a good way to add fresh, healthy ingredients—beans, legumes, fresh vegetables, or lean proteins such as chicken or fish—to your meals. “[The lack of readily available information] doesn’t mean these products aren’t good choices,” Boutette says. “It’s often just a matter of looking more closely and digging for more information.”

Did You Know?

Whether at restaurants, takeout counters, vending machines, or corner stores, making healthy choices is possible and important. For tips to help you enjoy healthy meals wherever you are, visit “Eating from Home”.

Receive a great diabetes-friendly recipe every month when you subscribe to Diabetes Current, the CDA’s monthly e-newsletter. Sign up for your free subscription here.




The nutritional benefits of soup

The nutritional benefits of soup
On the Shelf

By Alyssa Schwartz

From vivid green asparagus soup in spring, to cool and spicy gazpacho in the summer or a comforting bowl of chicken noodle as the weather gets cold, soup is versatile and tasty year-round. But more than just a delicious way to start your meal (or sometimes a satisfying meal in itself), soup can offer some important nutritional benefits…if you fill your bowl right.

“Soup is a great way to get a boost of key nutrients while helping you to control your appetite,” says Stephanie Boutette, a registered dietitian and education coordinator with the Canadian Diabetes Association (CDA). “In addition to helping you get more vegetables in your diet, you could end up eating less if you have soup, which is a low-calorie, high-volume food.”

There are many different soup preparations and varieties available on grocery store shelves, from powdered mixes or soup-and-noodles in a cup, to canned varieties. No matter which you choose, preparation is a breeze: For some, you add just boiling water or milk, while others come ready to eat. Many grocery stores also offer fresh prepared soups in the deli section.

Whatever option you choose, it is important to read the product’s nutrition facts table to understand its benefits and drawbacks. “Often, with packaged foods, salt is used to maintain safety and freshness,” Boutette says, “which is why packaged soups can be high in sodium.”

While people generally should avoid too much dietary sodium, this is even more important for people with diabetes, who have an increased risk of heart disease. Some soups, particularly creamy options, can also be higher in saturated fat, which the CDA also recommends limiting.

“In general, if a nutrient, like sodium, has a per cent daily value [%DV] of less than five per cent, it means that there’s little of it in the product, while 15 per cent means there’s a lot of it in the food,” Boutette says. Her rule of thumb: Stick to the lower %DV ranges for nutrients like sodium and saturated fat.

She also cautions that people are sometimes fooled by claims on the front of the can. “If it says ‘sodium reduced,’ that means the soup contains 25 per cent less sodium  compared to the original product,” she says. “But if the original product has a lot of sodium, the reduced product still might have a lot.” This is why it is important to check the nutrition facts table.

A 2014 study published by the U.S. National Center for Biotechnology Information found that soup eaters had better overall diets than non-soup eaters. Research has also shown that people who eat soup consume fewer calories and have lower body weights, in part because soup makes you feel full compared to other foods. This means that if you eat soup—whether before a meal or as a meal in itself—you are likely to eat less of other, less healthy foods.

“Between vegetables, meat and alternatives, and whole grains, you can get nutrients such as vitamins A, C and K; B vitamins; antioxidants; iron; and lots of fibre [in soup],” Boutette says. “In general, it is recommended to have at least three of the four key food groups at every meal—fruits and vegetables, meat and alternatives, starches, and milk and alternatives. Soup can often fit that standard. If you choose or make a soup with lots of vegetables; a lean protein such as beans, lentils, or chicken; and a whole grain such as barley, quinoa, or brown rice; you’re getting three of the four food groups.” Even if your soup does not contain all of the food groups, it is easy to top it up with veggies or a lean protein to make it a complete meal.

“Broth-based and tomato soups can be a great way to get nutrients and increase the amount of vegetables you’re eating,” Boutette says. “But try to eat creamy and higher-sodium canned soups less often.”

Vegetarian hot and sour soup

Traditional hot and sour soup is meat-based, but this vegetarian version gets its protein boost from tofu and eggs. This recipe, from canolainfo.org, appeared in the Canadian Diabetes Association’s 2015 Healthy Living Calendar. For more recipes, visit diabetes.ca/recipes.

4 dried Chinese black (shiitake) mushrooms
2 tsp (10 mL) canola oil
1 carrot, peeled and julienned
5 cups (1.25 L) vegetable broth
¼ cup (50 mL) canned bamboo shoots, drained and julienned
3 tbsp (45 mL) cornstarch, dissolved in ¼ cup (50 mL) cold water
3 tbsp (45 mL) low-sodium soy sauce
1/3 cup (75 mL) plain rice vinegar
¾ tsp (4 mL) ground white pepper
6 oz. (170 g) savoury baked or firm tofu, julienned
2 eggs, lightly beaten
2 stalks green onion, thinly sliced

In a small bowl, soak dried mushrooms in hot water for 20 minutes or until softened. Cut off stems and any hard areas, and discard. Cut caps into thin slices. Set aside.

In stock pot, heat canola oil over medium-high heat. Add mushrooms and carrots, and cook for about 2 minutes. Add broth and bamboo shoots; bring to a boil. Add cornstarch mixture and stir until soup thickens, about 2 minutes. Add soy sauce, rice vinegar, and white pepper. Stir.

Add tofu and bring soup back to a boil. While stirring soup in circular motion in one direction, pour eggs in thin stream into soup. Remove soup from heat. Stir in green onions. Adjust flavour to taste. Serve immediately.

Makes 8 servings (each 1 cup/250 mL)

Nutritional breakdown per serving: 8 g carbohydrate, 4 g protein, 3.5 g total fat, 0 g saturated fat, 2 g fibre, 450 mg sodium, 80 calories

How do these soups measure up?

Brand (serving size) Calories Total fat (g) Saturated fat (g) Sugars (g) Protein (g) Sodium (mg) Fibre (g) Carbohydrates (g)
Campbell’s Condensed 50% Less Sodium Tomato Soup (250 mL prepared) 80 0 0 14 2 360 2 19
Baxter’s Carrot and Butter Bean Soup (250 mL) 100 4.5 0.4 1 2 600 2 17
Primo Lentil Soup (250 mL) 150 1.5 0.2 2 9 360 8 23
Knorr Dry Soups Tomato Vegetable (250 mL prepared) 60 1.0 0 3 2 480 0 11
Amy’s Organic Light in Sodium Split Pea Soup (250 mL) 100 0 0 4 7 330 6 19

Tips

“Check the ingredients for celery salt, garlic salt or onion salt, soy sauce, monosodium glutamate [MSG] and sodium nitrate, which are some other ways of saying salt.” – Stephanie Boutette, registered dietitian and education coordinator with the Canadian Diabetes Association (CDA)

“If you’re making your own soup, puréeing beans or lentils can give a creamy texture without the saturated fat.” – Stephanie Boutette, registered dietitian and education coordinator with the Canadian Diabetes Association (CDA)


Did You Know?

Herbs, spices, lemon, and vinegar can be great ways to add flavour to soups and other foods without adding sodium. Read more on reducing your salt intake.




International-style pizza

International-Style Pizza
On the Shelf

By Alyssa Schwartz

When it comes to family dinners, who doesn’t love pizza? It is tasty and convenient, and can be an easy way to satisfy a variety of tastes. A hot slice fresh from the oven, with cheese and other toppings, might sound tempting. But with many frozen and delivery options clocking in with high fat and sodium levels, is it a healthy choice for people with diabetes?

“Depending on what [toppings and crust you use], pizza can be a nutritious choice that can be enjoyed by everyone,” says Stephanie Boutette, registered dietitian and education coordinator with the Canadian Diabetes Association (CDA). But before you place your order, you should know that making your own pizza is the best option.

“It’s hard to control what is on a ready-made pizza compared to when you make it yourself,” Boutette says. “Ready-made pizzas may be loaded with cheese, and not have much in the way of vegetables per slice. When you make your own, you get to have control. You can pick the crust and its thickness, the amount of vegetables, as well as the type and amount of cheese and meat.”

But you do not need to make everything from scratch. International cuisines offer lots of options if you want an easy, ready-made pizza base, from Middle Eastern pitas and Turkish pide, to naan and tortillas (see “Flatbread Finder” (below) for some ideas). “The different types of crusts offer variety in terms of your base, but some may be better options than others,” Boutette says. She recommends reading the product’s Nutrition Facts table and ingredients list (look for whole grains as the first ingredient) when considering different types of international breads for your base, and checking the serving size.

“There’s no reason you need to limit how often you have homemade pizza, but you also don’t want to eat the entire pizza. Have a slice or two with a side salad or raw vegetables to make it a more nutritious meal.” – Stephanie Boutette registered dietitian and education coordinator, Canadian Diabetes Association

Flatbread finder

A pizza crust by any other name is just as delicious. Try these international flatbreads as the base for your pie:

Arepa Colombia; Venezuela
Pita: Mediterranean and Middle East
Roti: Central and South Asia; Caribbean
Tortilla: Mexico; Central and South America Venezuela
Barbari bred: Iran
Lavash: Armenia
Naan: Central and South Asia
Pide: Turkey

“Making the crust whole grain, adding lots of vegetables, and limiting high-fat, high-calorie meats are all good adjustments if you’re making pizza at home.” – Stephanie Boutette, registered dietitian and education coordinator, Canadian Diabetes Association

The tops in toppings

Whether you are using an Armenian lavash or Italian focaccia, what you put over top also makes a big difference. “Depending on the toppings, pizza can be packed with foods from all four food groups,” Boutette says. (The food groups are fruits and vegetables, meat and alternatives, grain products, and milk and alternatives.) Vegetables or fruits such as pineapple, which is popular on Hawaiian-style pizzas, get the green light, while Boutette advises proceeding with caution when it comes to cheeses and meats.

“For a meat lover, I would recommend sliced chicken or lean ground meat over salty, fatty choices such as bacon, pepperoni, and sausage,” she says. “And although cheese is a great source of calcium, it adds calories and fat. Mozzarella, which is most commonly used in pizza, has less fat than cheddar or Swiss, making it a better choice. Feta and goat cheese contain similar amounts of fat as mozzarella, but feta can be higher in sodium—one option would be to mix it with mozzarella.” Fish lovers might even want to try adding tuna or shrimp—though, again, keep an eye on sodium, particularly if you like cured fish such as smoked salmon.

Sauces can also add sodium and fat—but that does not mean you should forgo them, as the right choice can increase the health benefits of your pizza. “Tomato-based sauce contains antioxidants, such as lycopene and other nutrients,” Boutette says. But some store-bought varieties contain a fair bit of salt, so she recommends homemade tomato sauce or using crushed fresh tomatoes with no salt added. Alternative sauces, such as pesto, Alfredo and barbecue varieties, or even butter chicken sauce, may contain unwanted salt or fats—choose less often or add sparingly.

“Making pizza can be a great way to have fun with your dinner, and with the right fixings, it can be nutritious, too,” Boutette says. “People with diabetes shouldn’t feel limited in what they can or can’t eat. By making small changes, they often are able to enjoy all the same foods as someone without diabetes—and pizza can be one of those. Be aware that pizza may affect people’s blood sugar levels differently. You can talk to your health-care professional for individual recommendations.”

Try sprinkling the cheese on top of your other pizza toppings rather than as the first layer—you tend to use less that way.” – Stephanie Boutette, registered dietitian and education coordinator, Canadian Diabetes Association

Chicken Fiesta Pizza

With its Tex-Mex flair and just a little bit of heat, this pizza delivers fun for family movie night or a kids’ sleepover. This pizza has a lot of toppings, so it takes longer to cook. Adapted from Fan Fare! Best of Bridge Cookbook by The Best of Bridge © 2011 www.bestofbridge.com. Reprinted with permission. Available where books are sold.

1 clove garlic, minced
½ tsp (2 mL) ground cumin
½ tsp 2 mL) salt
¼ tsp (1 mL) cayenne pepper
2 tbsp (25 mL) olive oil, divided
1 red bell pepper, thinly sliced
½ large red onion, thinly sliced
1 cup (250 mL) frozen corn kernels (no need to thaw)
1–2 tbsp (15–25 mL) cold water (if needed)
1 large boneless skinless chicken breast, about 250 g (8 oz.), thinly sliced
1 pizza crust, tortilla or other flatbread base, 12–14 inch/30–35 cm
½ cup (125 mL) salsa
½ cup (125 mL) drained sliced pickled
jalapeño peppers (optional)
1 cup (250 mL) shredded part-skim mozzarella

Preheat oven to 400°F (200°C). Lightly oil a 12- or 14-inch (30 or 35 cm) pizza pan. In a small bowl, combine garlic, cumin, salt, and cayenne. Set aside. In a large non-stick skillet, heat 1 tbsp (15 mL) oil over medium heat. Add red pepper, red onion, and corn; cook, stirring occasionally, for 5 to 7 minutes or until vegetables are softened and lightly browned. If vegetables start to stick, add cold water as needed. Transfer to a bowl and set aside.

Wipe out skillet with paper towels. Add remaining oil to skillet and heat over medium heat. Sauté chicken for about 5 minutes or until browned on all sides and no longer pink inside. Add garlic mixture and cook, stirring, for about 30 seconds or until chicken is coated and fragrant. Stir chicken into bowl with vegetables. Let cool for 15 minutes.

Place pizza crust on prepared pan. Spread salsa evenly over crust. Top with chicken mixture. Sprinkle with jalapeños, if using. Top with mozzarella. Bake for 12 to 14 minutes or until crust is browned and slightly puffed and cheese is bubbly.

Makes 8 servings


Did You Know?

Reduce fat without sacrificing flavour by using smaller amounts of stronger cheese instead of more of a milder option. Read more from “Top 10 Tips for Tasty & Healthy Meals.”




Muffins for breakfast?

Muffins for Breakfast?
On the Shelf

By Alyssa Schwartz

You have probably heard this message before: Breakfast is the most important meal of the day. But it is important to understand why, especially if you live with diabetes. “Starting your day off with breakfast fuels your body and helps you meet your nutritional requirements for the whole day,” says Stephanie Boutette, a registered dietitian and education coordinator with the Canadian Diabetes Association (CDA).

“Skipping breakfast can cause you to overeat at lunchtime, or lead you to eat those less healthy food cravings mid-morning. For people with diabetes, it’s really important to have consistent meals to help regulate blood sugar.”

Reviews of observational studies found that adults who skip breakfast are more likely to have a higher BMI or to be overweight or obese than adults who eat breakfast. Consuming breakfast is also associated with a lower degree of weight gain over time.

The Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada (CDA Guidelines): recommend that breakfast (or any meal) should include foods from any three out of the four food groups in Canada’s Food Guide—vegetables and fruit, cereals and grains, milk and alternatives, and meat and alternatives. “The body needs an adequate amount of carbohydrates, fibre, healthy fat, protein, vitamins, and minerals,” says Boutette. “You can get that by making sure to incorporate a variety of foods.”

“For a balanced breakfast that includes a muffin, have it with an apple and some cheese, or some nut butter and a glass of milk.” – Stephanie Boutette, registered dietitian and education coordinator, Canadian Diabetes Association

Make it whole grain

When it comes to easy, healthful, and tasty options, how do muffins—with their crunchy baked tops and sweet, fluffy interiors—measure up? On their own, they do not provide a balanced breakfast, but they can play an important role. “Your muffin would be considered your grain or your starch. You can complete it with a source of protein and a fruit or dairy product,” Boutette says. She adds that muffins made with ingredients such as whole-grain flour can provide a good amount of fibre, which helps you feel full and regulates blood glucose (sugar). Most Canadians do not get enough fibre daily, which is an important part of a healthful diet.

“If you’re looking at an ingredients list, ensure that whole-grain whole wheat is the first ingredient,” Boutette says. “Try to avoid muffins made with refined flour. If the list includes ‘enriched flours,’ that means some of the vitamins and minerals lost during processing were added back, but they’re still missing some of the nutrients and fibre you find in whole grains.”

“Breakfast can help keep you satisfied and on track for the day.” – Stephanie Boutette, registered dietitian and education coordinator, Canadian Diabetes Association

Comparison shopping

When you are comparing muffins, compare their Nutrition Facts tables and choose one with at least two grams of fibre, though options with four to six grams are a better choice.

Fibre is not the only thing you should consider. “If you’re looking at a chocolate chip muffin with white flour and high amounts of sugar and fat, there’s not a whole lot of difference between it and a cupcake. It’s essentially just a cupcake without icing,” Boutette says.

“In the case of many commercially produced foods, saturated fats and sodium may be present in higher levels than in foods you make at home,” adds Boutette. “If possible, look for options with less than five per cent of the daily value for these two nutrients on the Nutrition Facts table.” She also suggests keeping the portion size in mind. Many storebought products are a lot larger than they used to be, and larger portions mean more calories.

The problem is that depending on where you buy your muffins, nutrition information may be limited. “When you buy muffins in a package at the grocery store, the Nutrition Facts table will be on the label. That can help you decide whether one muffin is a better choice than another,” says Boutette. “If you go to a bakery or a coffee shop, you can’t always make that decision, although some places may provide the nutritional information online or in a pamphlet. Look at that information in advance or while you’re waiting in line. You can then make a more informed choice. It may not always be easy, especially if you’re buying a muffin on a whim or if the information is not readily available. Ask questions if you cannot find the information on your own.”

The bottom line? “Read labels and ask questions,” Boutette says. “And if you can, make your muffins at home so you can control the portions and ingredients. There’s a lot of variety in muffins and some are better than others. Information can help you decide whether a particular muffin is a good option for you.”

How do these store-bought* muffins stack up?

Brand/serving size Calories Total fat (g) Saturated fat (g) Sugars (g) Protein (g) Sodium (mg) Fibre (g) Carbohydrates (g)
Irresistables Life Smart Cranberry Orange Bran (½ of package, prepared according to instructions) 140 1.0 0.2 10 8 240 7 33
Quaker Low Fat Bran Muffin (¼ cup dry mix, about one muffin) 150 3.0 1.0 12 3 260 3 28
Vitamuffins CranBran (1 muffin/55 g) 100 0.5 0 7 5 125 11 26
Udi’s Gluten Free Blueberry Muffins (1 muffin/85 g) 250 9.0 2.5 21 3 260 1 40
U-Be-Livin-Smart Belgian Chocolate with Banana Muffins (1 muffin/78 g) 140 4.0 2.0 9 9 180 4 20
Tim Hortons’ Whole Grain Carrot Orange Muffin (1 muffin/115 g) 350 11.0 1.5 26 5 360 6 59
Starbucks’ Raisin Bran Muffin (1 muffin) 320 12.0 N/A N/A 6 N/A 6 54

*Items 1 and 2 are mixes, 3 is frozen, and 4 and 5 can be found in the bakery section.

In the mix

Muffins can help you meet your target for daily fibre consumption. To do that effectively,

  • Choose muffins made with whole grains and ingredients such as vegetables.
  • Choose muffins with at least two grams of fibre.

How much fibre is enough?

The Canadian Diabetes Association recommends people with diabetes have more fibre than the general population because of the beneficial effects. It recommends that adults get between 25 and 50 grams of fibre every day.

Did You Know?

Fibre offers a number of important health benefits, including controlling blood sugar, managing blood pressure, reducing blood cholesterol, and increasing the feeling of being full. For more information, visit diabetes.ca/fibre.




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