MY CFRD diet - CF Buzz

Importance of diet

Diet is an extremely important factor in managing Cystic Fibrosis Related Diabetes (CFRD) in conjunction with insulin. Insulin helps your body use the carbohydrates, proteins and fats from the food you eat for energy.

There are not many foods and drinks you need to avoid and you still need a high energy and fat diet like everyone with cystic fibrosis (CF). It’s essential you balance your insulin and food intake.

Taking insulin with meals and snacks means you can eat as much as you want, and keep your blood glucose level (BGL) under control.

 

Carbohydrate Foods

Carbohydrate foods are sugars and starch and are the main source of fuel for your body.

Carbohydrates break down to sugar in the blood and have the greatest impact on your BGL. Foods that contain only protein and fat have little effect on your BGL.

You will need to eat carbohydrate foods and drinks regularly throughout the day to help keep your BGL at normal level. This means having at least one at ALL main meals and snacks.

Carbohydrate foods include:

  • Breads
  • Fruit fresh, canned or dried
  • Fruit juice
  • Rice
  • Cereals
  • Noodles
  • Potatoes in any form – hot chips, chips or sweet potato
  • Pasta
  • Lentils, legumes and baked beans
  • Corn
  • Dairy products – milk, yoghurt, ice-cream, custard
  • Cakes
  • Muesli bars
  • Biscuits – sweet and savoury

 

Understanding the GI

The Glycaemic Index (GI) ranks carbohydrates according to their effect on blood sugar levels.

HIGH GI carbohydrates are broken down and absorbed really quickly.

LOW GI carbohydrates are broken down and absorbed slowly. They are good for you and can help keep your BGL within the normal range.

The Cystic Fibrosis Related Diabetes page has more details about BGL ranges.

 

The GI and your diet

Keeping your BGL stable might feel like a bit of a challenge at times, but keeping to a low GI diet is a great help.

Aim to include one low GI food or drink at each meal and snack. You can still eat high GI foods, but it is best to eat them with low GI foods.

Food and GI content

Foods Low GI (<55) Moderate GI (55-70) High GI (>70)
Breads Multigrain, soy & linseed, fruit / raisin bread, ‘low GI’ white, sourdough, chapati, tortilla, wheat roti, rye, wholemeal Turkish, honey & oat, ‘French toast’, cheese & bacon rolls, Danish pastry Wholemeal bread, French baguette, croissant, naan, chapati, crumpet, bagel White bread, English muffin, white Turkish bread, gluten-free white
Breakfast Cereals Toasted muesli, untoasted muesli, oat porridge, All-bran, Special K, Carmen’s Clusters, Mini Wheats, Bran Buds Just right, Nutri-Grain, Sustain, Weetbix, Shredded Wheat, Honey Smacks, Sultana Bran, Froot Loops Coco Pops, Rice Bubbles, Crispix, Cornflakes, Crunchy Nut, Puffed Wheat
Muesli and Health Bars Most dried fruit and/or nut bars, fruit and yoghurt bars, Sustain bar, Carmen’s bars, Special K bar, Mother Earth® fruit-filled bars, sports/ protein bars, granola bar, choc-chip bar Rice-bubble bar Crunchy Nut bar, Just Right bar, Real Fruit® Bars, Roll-ups
Pasta All pasta, ravioli, noodles, 2-minute noodles Tin spaghetti
Rice and other grains Basmati (Indian), SunRice Doongara Clever Rice, wild, Mahatma, Uncle Ben’s, Quick rice, barley, SunRice Low GI brown Brown rice, arborio (risotto) rice, couscous, polenta Jasmine (Thai), Calrose, long grain
Legumes and Beans Legumes, baked beans, four bean mix, split peas, chickpeas, lentils Broad beans
Starchy vegetables Sweet potato, sweet corn, Carisma white potato, “New” potato, Pontiac potato, taro, French fries, wedges Canned white potato, gnocchi Other white potato, instant mash
Fruit Peach, apricot, apple, pear, plum, grapes, mango, banana, dates Sultanas, paw paw, raisins, rockmelon, pineapple, cherries Watermelon
Dairy foods Cow’s milk (all types), yoghurt, custard, ice-cream, soy milk, Up & Go, Ensure Plus, Milo, Nesquik, Le Rice, Sustagen, Ovaltine Condensed milk Rice milk
Biscuits Chocolate cookies, choc-chip cookies, Oatmeal, Full o’ Fruit, Spicy Fruit Roll, Ryvita, Vita-weat, macaroons Jatz, Arrowroot, shortbread Morning coffee, rice cakes, water crackers, Saos, wafers
Savoury Snacks Popcorn, potato chips, corn chips, Grain Waves, nuts Pretzels, Burger Rings
Sweet snacks and desserts

 

Snickers, Twix, Peanut M&Ms, cake – chocolate / banana / carrot / plain cake (incl. Iced) / sponge, apple crumble, muffins apple / blueberry / carrot / chocolate, mousse, crème fraiche, instant pudding, brownie, nougat, Bavarian dessert, Danish, banana fritter, cheesecake, scones date/fruit Pancakes, Mars Bar, Milky way, banana muffin, Pop Tarts, rice pudding, marshmallows, jelly Lollies, jelly beans, doughnut, roll-ups, lamington, plain scones, plain waffles, liquorice
Spreads and Toppings Jam, some honey (e.g. Red Box, Yellow Box, Yellow Gum, Iron Bark, Capilano Pure), peanut butter, hummus, creamy dips, Nutella Syrup, unspecified honey, sugar Glucose syrup
Mixed dishes Meat pie, pizza, sweet and sour chicken, curry and rice, fish fingers, sushi, macaroni and cheese, waffles and cream Burgers, homemade chops w/ mash potato and vegetables

Carbohydrate counting

Carbohydrate counting means matching your insulin to the carbohydrate you eat.

Each person’s insulin-to-carbohydrate ratio is different, and your CF health team will help you work out how much insulin you need for each ‘exchange’ of carbohydrate.
Exchanges are a way of measuring the amount of carbohydrate in food and drink.

1 carbohydrate exchange = approximately 15 grams of carbohydrate

It’s a good idea to record the amount of insulin you need in your CFRD health plan.

 

Counting the carbohydrate on your plate

It is important that you have plenty of carbohydrate foods at every meal and snack. It’s also important to understand how many ‘exchanges’ you have in order to work out the amount of insulin needed.

Foods without carbohydrates don’t need any insulin e.g. plain black tea, coffee, herbal tea, diet soft drink and cordial, diet jelly, sugar substitutes, herbs and spices, vinegar, green salad vegetables.

Here’s an example of a meal and the number of carbohydrates it contains

Food Number of carb serves
2 cups rice 6
Meat and vegetables 0
Sauce 1
1 cup orange juice 2
2 scoops ice-cream 1
Total number of carb exchanges 10

Reading food labels

To work out how many units of insulin to take with specific food, look at the nutrition label and remember:

one carbohydrate exchange is about 15 grams of total carbohydrate

 

Follow these steps:

  1. Look at the total carbohydrate in the per serve column
  2. Check the amount you are eating or drinking is the same as the amount the manufacturer calls a “serve”
  3. Divide the total carbohydrate by 15 to work out how many exchanges are in a serve
  4. Now multiply this number by the amount of insulin you take for each exchange

 

Example:

The food below has about 30 grams total carbohydrate per serve:

                                            30 ÷ 15 = 2

So you need to multiply the amount of insulin you take per exchange by two.

 

Alcohol and BGL

Understanding the impact of alcohol on your BGL is important. Alcohol has a different affect on our BGL and can cause a hypo. Sometimes it can be difficult for others to recognise the difference between a hypo and alcohol intoxication. It’s best to only consume alcohol with food and drink in moderation.

If you are drinking between meals, the best way to avoid a hypo is:

  • Eat food regularly, e.g. every hour: potato crisps, chips, kebabs, burgers, milk & pretzels.
  • Consume regular (not diet) soft drink, between alcoholic drinks
  • Always have a snack before going to bed e.g. toast and milk

Make sure your friends and family know the symptoms of a hypo and how to treat it.

You can read more information about the standard drink guidelines on alcohol.gov.au 



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