In this weeks episode Charlotte catches up with our diabetes specialist dietician ,Isi and we look at our top five nutrition tips

Missed anything in todays diabetic and healthy podcast? View the podcast transcript below to get the full show notes.

Life with diabetes has some highs and lows, but just like in a normal life, you can make choices which help to make your life easier, improve your health and wellbeing. In the Diabetic and Healthy podcast, we show you how to do just that. We’re here to help you put your diabetes worries behind, so that you can start enjoying life with a sky high smile on your face. So, let’s meet our host for today’s show, here’s Charlotte.

Charlotte:

Hello, and welcome to another episode of the Diabetic and Healthy podcast. Once again, thank you so much for listening. I really do hope you are enjoying all the episodes so far. If you are enjoying it, please do hit subscribe, so that you never miss a show. Today, I’m going to be talking to Isi. Isi is actually one of a diabetic and healthy team and she is a diabetes specialist dietician.

Now, don’t worry if you’re not sure exactly what that is because Isi is going to explain it all to us. She has a wealth of experience and knowledge and, what I would say, is a very refreshing approach to nutrition. Stay tuned, because if you’re expecting to hear all about how we should all just be munching on salads, then I think you’re going to be pleasantly surprised. We’re going to be talking about everything from the most common diet misconceptions to how our relationship with food can affect our diet, and then in turn our blood sugar control is.

Isi is also going to be sharing her top five nutrition tips with us. We’re going to be covering lots of specific nutrition and food relationship subjects with Isi in future podcast. But, for now, this is me asking Isi the answers to a few questions that I know many people who have diabetes would probably like to know. Hi Isi, how are you?

Isi:

I’m very well, thank you Charlotte. How are you?

Charlotte:

I am good, thank you. So, you are a diabetes specialist dietician.

Isi:

I am.

Charlotte:

For anybody that doesn’t know, what exactly does that mean?

Isi:

It’s a fair question, because there is a lot of different titles out there. There’s nutritionist, nutrition therapists, dieticians, all sorts. So, a dietician is a protected title. It’s the only one that is. It means that I have to have done a certain level of qualification and I have to be registered with the Health Care Professions Council. I have to maintain my registration by showing that I’m continuing to stay relevant and practicing in an evidence-based way.

Isi:

As a dietician, I am all about nutrition. I studied nutrition and the science around nutrition and how to apply it to health. As a diabetes specialist, that means I’ve worked with diabetes, I’ve done extra study in diabetes and that’s the area I work in. So, personally, I’ve been a dietician since 2004 and I’ve been working in diabetes since 2007. I don’t have diabetes myself, so I don’t live with diabetes and that is a whole level of experience in itself. We have to account for that. I don’t pretend that I do have diabetes and that I know everything about it, but I have been working with people with diabetes for many, many years now. So I’ve accrued quite a bit of experience from that side.

Charlotte:

Okay, fab. Well, really interesting what you were saying about your qualifications because I know there’s so many kind of different places you can get information and especially online, where people are looking. You don’t always know who that information is coming from and whether they’re qualified and things like that. But, from what you’re saying, if it’s from a dietician, you know that that should be pretty solid information that you’re getting.

Isi:

It should be. Also, it means that you can hold that person to account because we are registered with the HCPC. It means that people can complain about us. Hopefully, they won’t have a need to. But, anyone can set themselves up as a nutritionist and there’s no way you could hold that person to account. They can say whatever they like-

Charlotte:

Ah, right.

Isi:

… and, that’s entirely up to them.

Charlotte:

That’s kind of their opinion that they’re putting out there as a fact.

Isi:

Yeah. I would say there are lots of really good nutritionists out there. So, it’s not that everyone who isn’t a dietician can’t give good advice, but you just haven’t got that security that you have with the titled dietician, and the training would tend to be slightly different. So, as a dietician we just have that slightly more solid qualification and council registration behind us.

Charlotte:

Oh, okay. That’s really interesting. Why did you want to specialize in diabetes? You say you’re not diabetic yourself, but obviously, the interest was there for you to want to specialize. So, why did you decide diabetes?

Isi:

Well, I didn’t actually decide it. I didn’t sort of have an actual decision moment.

Charlotte:

You didn’t have a moment?

Isi:

No. When I first qualified, I worked in all areas, in 2004. So, I spent two years working in various different areas. As a newly qualified dietician, you would usually do that to try out different areas and see which one appeals to you most. One of the ones I did was diabetes, and a job opportunity came up in there. This was when I lived back in Suffolk. I started working with a really supportive team in West Suffolk Hospital who really fired up my interest. They wanted to do things, they wanted to be changing things, moving with the times to help people with diabetes as much as possible. I really enjoyed that job, and I really felt I could be good at it. So, that’s the area I then stayed in and got promoted within.

Isi:

And then, I moved down to Dorset about five years ago. Yeah, and definitely wanted to stay with diabetes because it’s an area I’d found a real passion for. I’m really, really interested in finding out more about nutrition so that we can let people know about that, so their lives will be easier. That’s really my whole reason for being a dietician, is to try and make people with diabetes life easier. So-

Charlotte:

That’s what we want.

Isi:

Yes. Like you said, there’s so much confusing information out there. It’s my full-time job, and I’m busy doing that. So when-

Charlotte:

I suppose you’re battling against all those, “Oh, I’ve read this and I’ve read that, and I’ve read this. So-and-so says this.”

Isi:

Yeah. I just don’t think there’s any way that anyone with diabetes can keep abreast of everything, because diabetes isn’t their job. They’ve got a job, they’ve got a family, they’ve got everything else. The diabetes is an additional thing they have to fit in. So, I feel it’s my job to do that reading and studying and networking to find out. And then, to speak to someone to find out which bits that I know are going to be most useful to that person, so that I can pick that knowledge and pass it on to them, rather than them having to spend all that time wading through all the random stuff to get to the bit that’s going to be most useful for them.

Charlotte:

Every diabetic needs an Isi?

Isi:

Well, yes. That would be good.

Charlotte:

What kind of people do you work with?

Isi:

I will work with anyone with diabetes. Obviously, this podcast is targeted mostly at people with type 1 diabetes. I’ve done a lot of work with people in type 1 including pumps, Libre, all sorts. I’ve done gestational diabetes clinic, which is where I met you.

Charlotte:

Yeah.

Isi:

I’m doing a lot of work at the moment in my NHS role, with people with type 2 diabetes and some pre-diabetes as well. I’ve had a little experience with the genetic, some of the rarer genetic forms of diabetes, but they tend to go to specialist centers. So, I haven’t done so much work with those, but all areas. People who’ve had it for years, people who are brand new and they’ve just been diagnosed. I’ve done some work with pediatrics as well, so children who’ve just been diagnosed or dealing with all the different stages as well.

Isi:

So yeah, all sorts of diabetes.

Charlotte:

Interesting lot.

Isi:

Yes, I think so.

Charlotte:

What is the most common question that you get asked? Is there a kind of question that stands out?

Isi:

Yes. The most common question I get asked is, “Can I eat?”

And then, a food is named.

Charlotte:

Chocolate?

Isi:

Yeah. Or, should I eat, and then a food is named. That is usually the question that pretty much routinely gets asked. It’s a very interesting one, because it tells me that that person is trying to manage their diabetes with an expectation that there is a list of foods that they can eat  and a list of foods that they can’t eat. That’s not actually how I would suggest someone tries to manage their diabetes. It’s the old fashioned way.

Isi:

So, it’s the way some people were told to do it and it was thought to be best at the time. We can’t change that. But, it’s also the general perception by the public as well. People who don’t have diabetes think that if someone with diabetes eats a cake that … something dreadful is going to happen, or-

Charlotte:

Honestly, I wish I had a pound every time I heard, “Should you be eating that?”

Isi:

Mm-hmm (affirmative), yeah.

Charlotte:

“Why, is it poisonous?” Like, “Well, why should I not be eating that?”

Isi:

Absolutely.

Isi:

Yeah, the most common question I’m asked is, “Can I eat?” My question is, or my response rather is always, “I don’t know, can you?”

Charlotte:

Let’s see.

Isi:

It depends, because I’m never going to give someone the answer of, “Yes, you can”, or “No, you can’t”-

… because that’s not how it works. But, yeah, that is the most common question I get asked.

Charlotte:

I suppose this might kind of be the same. I was going to ask what’s the most common kind of diet misconception, but maybe that’s it.

Isi:
That is definitely, yeah.

Charlotte:
yes foods or no foods.

Isi:
Food has sort of a single purpose, and the food is either good or bad. So, there’s this perception that a food is either one thing or another and no food is. All food has a number of roles for us. With regards to physical health, there’s a number of different nutrients that make up any food and those nutrients will each offer something different, some of which may be beneficial, some of which may be less healthy. But, as the food is a combination of those, no particular food sits solely in the good or bad box. That’s just a perception that the general public has about food. So even if I’m not talking to someone about diabetes, there’s still this, “Is this food good or bad?”

Charlotte:
Obviously as a PT, I get a lot of the same. People, they come to me and they say, “Well, I know you’re going to tell me must eat this. I know you’re going to tell me I mustn’t eat that.” I’m like, “No, I’m not.”

Isi:
One of the most common misconceptions, not about diet, but about dietitians, is that that’s what I will do. People either don’t want to come and see me because they already have assumed what I’m going to tell them or they come to me with that assumption that I’m going to give them a sheet that says, “Eat this, eat broccoli, cabbage, mung beans, I don’t know, and a random selection of foods. Don’t eat anything that tastes nice.” That’s going to be my advice. It really, really isn’t. It ties in a bit with another misconception, is that food is moral and it isn’t. The attachment of good and bad to foods has a whole-

Charlotte:
It’s definitely got a connection around eating, and-

Isi:
Yeah. A donut has no soul. It is not really trying to tempt you. It is just sitting there and whether or not you eat it and what it does to your body is not any reflection of you as a human being, or you as a person. But, there is this perception that good people eat good diets and if you eat a bad diet, you’re a bad person.

Charlotte:
There’s been loads of it. I’ve seen a lot on social media quite recently, actually, about food shaming. It used to be all about body shaming, and now there’s this food shaming. It’s exactly what you said. It’s being judged by what you’re seen to be eating.

Isi:
Yeah, massively. I feel it as well, because as a dietician, if I bump into any clients in the supermarket, one of the first thing they do is look in my trolley-

Charlotte:
I’m the same. When I had a lot of PT clients and that was my full-time thing, yeah, I’d get that. You’d almost want to shop somewhere else, because you think, “They know I’m a PT and now look at them looking in my trolley’

Isi:
But, what you would never understand from any person is their diet as a whole from a snapshot, and that-

Charlotte:
Yeah, from a basket of things.

Isi:
Yeah, going back to the misconception that I started with there, that there are foods that are good or bad. It’s because what affects you is what you do overall. So, even if I bump into a client at the supermarket and my basket happens to be full of vegetables, I might have cupboards at home full of completely different foods. Or, if I bump into someone, and it happens to be time of the month and I’ve got a basket in front of chocolates, because that’s the only thing that I’m going to cope with. Exactly, that’s what my body is telling me it needs right now, that doesn’t mean that I’m doing that every day of the month.
It might just be that that day is a day when I happened to want some chocolate. A snapshot, a single food, a single day, a single meal is not enough to judge somebody on, but there is massive judgment on them. Massive judgment on what people eat.

Charlotte:
Yeah, definitely. Definitely.

How much impact would you say that nutrition in general has on someone’s diabetes control or their blood sugar level control?

Isi:
I would say it is big. It has a big impact, in particular the carbs, because the balance between carbs and insulin is going to have a big and immediate effect on blood glucose levels. So, if you’re not able to take that into account, then your ability to keep your blood glucose levels managed is going to be quite reduced.

Isi:
There’s lots of other things nutritionally to take into account as well. The impact of the other nutrients, glycemic index, how it balances with activity, and all the other things you do in your life as well. So, on a very simple term, it’s the carbs and insulin balance. On a wider picture, nutrition in many ways can have quite an impact too.

Charlotte:
Yeah. Is there such thing as a diabetic diet?

Isi:
No, absolutely not. It is one of the phrases that I really get on a soapbox about. There is no such thing as a diabetic diet. People with diabetes can and should be eating similar to anyone else in the population. They would just need to have that extra awareness so that they can be dosing their insulin accordingly, and making choices in relation to their health the same as anybody else should. Anyone without diabetes can think about their diet in relation to their health, and people with diabetes are just the same.

Isi:
There is no diet that they should be following. I don’t really believe in diet plans that have to be followed too closely because I just don’t think they’re suitable for life. They’re not flexible enough for real life, so we need to have something that’s a bit more able to adjust day to day, week to week, year to year, decade to decade, depending on what somebody’s got to deal with in their life.

Charlotte:
Yeah. It still makes me laugh if you, say you book in a holiday online and it comes up with the meal options for on the plane and one of the options is diabetic meal. Sometimes, I’m tempted to click it just to see.

Isi:
I would like to write exactly and say “Exactly what does that involve?”

Charlotte:
“What’s in your diabetic meal?” Yeah, and I’ve never opted for a diabetic meal funny enough. I kind of wish I had, just to see what they think a diabetic meal consists of.

Isi:
I mean, presumably, it’s a reduced sugar meal or it might be a low carb meal, but then they should call it a reduced sugar, or a low carb-

Charlotte:
A reduced sugar, or a low carb, yeah.

Isi:
… meal, because being diabetic doesn’t mean that you are following a reduced sugar or low carb. If that’s how you’re choosing to manage your diabetes, then that information would be helpful to you.

Charlotte:
How would you describe healthy eating?

Isi:
Healthy eating is a balanced diet, and actually it won’t necessarily be the same for everybody. There are some general guidelines that should suit the majority of the population, but there are lots of people for whom there would need to be adaptations, depending on their own health conditions. So, healthy eating for an absolute nutshell would just be a really good varied diet, because your body needs a whole range of nutrients and different foods provide a different balance of those nutrients.

Isi:
So, the more different foods you eat, the more likely you are to get in all the nutrients that your body needs. If you restrict your diet in certain ways, then there’s chances that you might be missing out on some things. Hopefully, most people are aware that vegetables are good for you. But, even within vegetables, no one vegetable will give your body everything. It needs all the vitamins and minerals. Different vegetables will provide different ones. So, the more different veg you eat, the more likely you are to get all the different vitamins and minerals that veg can offer. The same goes for all the other foods as well.

Isi:
So, a healthy diet is one that is varied and balanced, so that it contains some of everything. Some of your macronutrients, so proteins, fats, and carbohydrates, fiber, fluid. And then, also the micronutrients, all the vitamins and minerals as well. A healthy diet gives you a balance of all of those, hopefully through the day. But if not, through the week and through the month. You wouldn’t necessarily get everything every day you’d have to try really hard to do that.

Charlotte:
That would be quite impressive.

Isi:
Yeah, yeah.

Charlotte:
If someone has diabetes and they’re planning a meal, what’s the main thing they need to take into account? The carbohydrate content?

Isi:
Yeah, if for someone with diabetes, the extra thing that they would have to take into account that someone who didn’t have diabetes wouldn’t need to, would be mostly the carbohydrate content. Therefore, what that’s going to do to their blood glucose levels and how they would balance their insulin to accommodate that. Like I’ve said before, there’s various complexities you can go into with glycemic index, glycemic load, the balance with the other nutrients in there, but that would be the main thing that someone with diabetes would just need to be aware of the carbohydrate in that-

Charlotte:
I say they, we. I’m Diabetic. What’s your opinion on diet or low fat food? So, you’re in the supermarket and something says diet on it or there’s a low fat option. What’s your opinion on those kinds of foods?

Isi:
My opinion on those, is that they have a role and it’s up to the individual to decide if that is something that they want to make use of. For example, if something’s labeled as low fat, then you know it’s not going to be giving you an awful lot of fat, and if you are looking to keep the fat in your diet low or if, for example, you feel you’ve eaten a lot of fat already that day and so you don’t want to be having more fat-

Charlotte:
You just want to kind of balance it out a bit, why not?

Isi:
Yeah, then you might choose a low fat option. If you haven’t had a lot of fat in your day, then you might feel you don’t need the low fat option at that time. So, I would say it’s a food by food decision rather than it always being a good thing or always being something you should avoid.

Isi:
The other thing is making sure you’re interpreting the labels correctly, which is something that we can go into it quite a bit more because… So, reduced for example, that just means there’s less than the original, so…

Charlotte:
But, it could be a very minimal difference.

Isi:
Absolutely. Well, and it depends how much was in the original. If the original was really high fat [crosstalk 00:20:02], then the reduced fat could still be much higher fat than a standard product which maybe wasn’t high fat to start with. So, you can choose differently rather than necessarily choosing the low fat option. Labeling you need to interpret, because you have to make sure you’re clear on what that label is telling you.

Isi:
But, diet foods and low fat foods have a role if you are wanting to have a product, but you feel that the nutrients in the original product are more than you want, usually it would be fat and sugar or calories that they’re focusing on. If you feel you don’t want to take in the amount that’s in the normal product and there is a reduced or a lower or a diet version available, then that’s something worth looking for. I mean the main one for diabetes would be the diet drinks. So, if you really like fizzy drinks, the amount of sugar in a fizzy drink and the GI-

Charlotte:
Is a hypo fix.

Isi:
Yeah, exactly. There’s a lot of sugar and it’s really quick acting, so it’s something which is difficult for the body to cope with unless it’s needing it to treat a hypo. So, diet drinks for people with diabetes do tend to be a helpful option. They’re not necessary, so if you can go without fizzy drinks at all, then that’s an option as well. But, if you like them and you want to have them in your diet, but you don’t want to go for the full sugar ones, then the diet fizzies offer you an alternative.

Charlotte:
Yeah. They do zero now, which-

Isi:
Yeah.

Charlotte:
It tastes like the real thing. Well, I was going to talk a bit about sweeteners. Would you say they’re a good alternative? Are sweeteners a good alternative? Or, is this-

Isi:
I would hesitate to use the word good.

Charlotte:
… is this a whole can worms that we’re opening now.

Isi:
Just because nothing’s good or bad really, so sugar can be included if you are happy to have sugar in your diet. It can be included in a way that shouldn’t force your blood glucose levels up in a way that the insulin couldn’t cope with. It depends on your insulin dosing and what foods you’re combining it with. However, added sugar doesn’t have any special nutritional benefit. Where I said most foods give you a range of nutrition, added sugar is the only one that doesn’t. It only provides you with calories, only provides you with energy.

Isi:
If you’re not looking to get more pure energy in your diet, then it’s a good one to cut down on, so that you get your energy from foods that will bring you other nutrient benefits. So, the foods that would bring you vitamins and minerals and fiber as well. Sugar is one that you can certainly reduce without your body suffering too much. Sweeteners is a way to do that. Some people find that they’re wanting to keep their insulin doses down just for convenience, so they don’t have to wind up with big doses or because the extra insulin leads them to gain weight. So, they’re wanting to get their doses down for that reason. Or, maybe because they’re wanting to have a carb free meal so that they don’t have to jab at all.

Charlotte:
Yeah, always a bonus side.

Isi:
So, there’s many reasons why someone might want to go without sugar and in which case sweeteners are a safe alternative. There was a scare that they weren’t very safe, but at the current time all the evidence shows that unless you’re consuming them in very large volumes, they are safe to include in your diet and offer an alternative to sugar.

Charlotte:
Mm-hmm (affirmative), if you have a sweet tooth.

Isi:
Yeah.

Charlotte:
I have come across quite a lot of people, during doing my personal training, and just speaking to people with diabetes and some of them are concerned about eating fruit because of their sugar content.

Isi:
Yes, that’s quite a common one.

Charlotte:
Yeah?

Isi:
Yeah, it’s those mixed messages out there. Sugar’s got quite a bad reputation at the moment. It’s had a lot of focus and there’s been a lot in the news about how bad sugar is for our health.

Charlotte:
Yeah, sugar’s the killer.

Isi:
Yeah, absolutely. Fruit does contain sugar, but there’s a confusion between added sugar and natural sugars. Again, where I was saying before about how foods will often give you a range of nutrients, but added sugar doesn’t. It just gives you the calories. Whereas, the sugar in fruit comes with all the added benefit that the fruit brings, the fiber, the vitamins, the minerals. All of those kinds of things, which we know are good for health.

Isi:
Also, the sugar bound up within the fruit is released at a slower rate than if you are having that sugar on its own.

Charlotte:
So refined sugar.

Isi:
Yeah. So that’s why fruit juice, which has been removed from the fruit, has a faster effect and would potentially be a good hypo treatment is much better than if you were, say eating the orange. You’d have to eat quite a few oranges to get the same amount to the fruit juice and it would be much slower releasing. So, all sugars aren’t equal. It’s been oversimplified really into just sugars are bad and then, people think, “But fruit’s got sugar in it, so that’s bad.”

Charlotte:
They don’t talk about glucose and fructose and yeah.

Isi:
Exactly. That’s where I would never say people need to avoid fruit. Definitely not. They might want to adjust the amounts they eat or the timings they eat or it might be a case of just making sure that they’re accounting for it in their insulin dose. But, there’s absolutely no reason to avoid fruit.

Isi:
But, you just need to be aware that it does contain some natural sugar and that will need to be balanced with insulin or activity or whichever way you are managing it.

Charlotte:
That’s good news.

Isi:
Yes.

Charlotte:
I love fruit.

Isi:
Yes, it’s good for you.

Charlotte:
What advice would you give to someone who wants to improve their diet, that they’re literally… We were saying there’s all these mixed messages, they literally just don’t know where to start. Obviously, even come to us.

Isi:
Yes, yes. Obviously, come for a one-to-one consultation, and I will find out where the right place is to start for you. My advice would be, first of all, is just to sit down and think about it. Because, if you’re looking to change your diet, the most likely way you are to be successful is to find the changes that suit you best. Someone else might say, “Oh, I did this and it really worked for me.” But, they’ve got a completely different lifestyle, they have different food preferences, and so on. Personally, I hate bananas. There’s nothing I can do about that.

Charlotte:
No.

Isi:
I just hate bananas.

Charlotte:
I think I’m eating enough for the both of us. So-

Isi:
So, that’s all.

Charlotte:
… we’re all good.

Isi:
If you said to me, “I’ve got this brilliant diet plan, Isi. You need to eat a banana for breakfast, lunch, and dinner.” I just wouldn’t follow that plan, Charlotte.

Charlotte:
You just wouldn’t.

Isi:
I’m sorry. I just wouldn’t do it.

Charlotte:
That’s exactly what I was going to suggest, my banana diet.

Isi:
So, thinking about actually what’s important to you in your diet? What would you really struggle to change? Telling a chocoholic to give up chocolate-

Charlotte:
It’s not going to work.

Isi:
It’s not going to work. There’s a small number for whom it will work, because they need that shock, sort of cold turkey situation. But, for the majority of people that won’t work. It won’t stick. So, working out what is important to you in your diet, what do you think maybe you could change about your diet, and then starting small and building up from there.

Isi:
It would be thinking about the balance, is your diet balanced? Sit down, think about what you eat. Is it balanced? Are you getting a good variety of foods, and are those foods bringing the different nutrients into your diet? If they’re not, which foods could you eat less of? Which foods could you eat more of, and start creeping those in. I wouldn’t usually advise people to start following anything in particular.

Charlotte:
Start Googling.

Isi:
Yeah, yeah.

Charlotte:
Lastly, again, this is something that I’ve come across quite a lot and have quite a lot of personal experience with, which I’ll definitely be discussing in future episodes. Do you think a lot of people with diabetes have kind of a bad relationship with food?

Isi:
I do.

Charlotte:
Or, an emotional, not necessarily bad and more of an emotional relationship with food, maybe?

Isi:
I do, definitely. It’s quite a big factor in what I do for my work, because telling somebody about the nutrients in food is one thing. The emotional side and the psychological side is vital, if someone’s actually going to make a change that works for them. So, most people don’t think about food. People without diabetes or various other health conditions that mean they have to, they just don’t think about food. They reach for something and eat it when they feel like it. They don’t have to consider what time it is, what they’re eating, what that’s going to do to them, et cetera, et cetera.

Isi:
So, that extra burden for people with diabetes can make food the enemy, because it’s stressful. Also-

Charlotte:
You think about it all the time. It’s like you said, if you have diabetes, you can’t avoid that thought process. You have to think about it. I think, especially if you’re trying to control how you eat and have this healthy, varied diet, it’s hard when all you think about is food.

Isi:
Yeah. That thought becomes annoying, because you don’t want to have it, but you have to. So then, it becomes a negative situation when you have to think about it. A bit like when you’ve got a toddler who keeps asking, “Why?”

Charlotte:
Yeah.

Isi:
The first couple of times it’s all right, and then, “Why, why?” And then, you start to get a bit ratty and a bit fed up with it. With diabetes, if you’ve been 10 years, 20 years, and every time you eat you’re having to think about it, not out of choice, but because it’s a chore and you have to, you can become very tired of it and you can become really ratty with it.

Charlotte:
Yeah, yeah.

Isi:
and that’s been a bit of a bad relationship with food because you’re thinking negatively or it brings negative emotions. It’s not that you’re thinking negatively about it, but it is an annoyance. That can be quite difficult to handle. I don’t think it’s helped by the way that we used to teach children as well and people when they’re newly diagnosed, but particularly children, because sugar wasn’t allowed. So, sweets were naughty. If you were a child and you was like-

Charlotte:
Rebelling.

Isi:
Yeah, and you ate sweets, you would be told off. If you had a high blood-

Charlotte:
you have this guilt linked with those kind of foods.

Isi:
When you had a high blood glucose level, did they accuse you of eating-

Charlotte:
Oh, yeah.

Isi:
Yeah. Well, and you might not have-

Charlotte:
It doesn’t matter if you have or you haven’t

Isi:
But, they were like, “What have you eaten? You must’ve eaten something naughty.”

Charlotte:
Yeah, yeah.

Isi:
Then, food becomes something you’re told off for. So you think, “Well, I might as well have eaten it, whatever it was.”

Charlotte:
Because, it is spiking anyway, they thin.

Isi:
Yeah, they’re telling me off, so I might as well do it.

Charlotte:
Yeah, and I suppose it puts you back into that childlike state, you’re being told off for something.

Isi:
The way we used to teach, it was definitely there were good and bad foods. That you were meant to follow a regime. People may have been given lines to count, so you’re only allowed to have a certain amount. So, if you wanted to vary from that, then you were rebelling and you were naughty. The human mindset is to go, “Well, blow it. I might as well-”

Charlotte:
“Well, they think I’m doing that anyway.”

Isi:
Exactly, or I’ve tried it and it doesn’t work, so I might as well give up completely because it’s never going to work for me. There’s all these reasons why food then becomes the enemy, or too difficult to manage, or people just give up. Because, it’s not working and then that persists. It then can become quite a barrier to making changes in the future, because there’s already this expectation that it won’t work. That’s what’s meant to happen, but it just doesn’t work for me.

Isi:
And food, yeah. Lots of people just ignore it, because they think, “It’s too much. I can’t deal with it. I don’t have the space in my life to be thinking about food all the time, so I’ll just ignore it. There’s nothing I can do.” People feel quite helpless. So, there’s all kinds of things in there that mean the relationship with food becomes damaged and a barrier to good self-care. It’s not just that people don’t know what to eat. It’s actually very difficult for some people to change what they’re eating. I can spend quite a lot of time talking to people about that and helping them to work out how their relationship with food is and how we can move that on.

Charlotte:
Well, I definitely want to do an episode purely on that.

Isi:
No problem. Yeah.

Charlotte:
I feel like we could actually talk about that for hours.

Isi:
Yeah, there’s loads we can talk about there.

Charlotte:
But yeah, when I said from a personal side of things, I definitely relate to all of that, and…

Isi:
Yeah, I know it’d be lovely to hear listener’s comments as well-

Charlotte:
Oh, absolutely.

Isi:
… if listeners get in touch to let us know what their experiences-

Charlotte:
People’s stories and … Definitely like you were saying about whether it’s a consultant or a nurse or whoever looking at a spike and saying, “Oh you’ve eaten something like…” Yeah, definitely want to hear about that kind of thing.

Isi:
Yeah, the judgment around food and diabetes is just massive. We’ve got to unpick it and help people to be able to move on from that space where they can enjoy food again.

Charlotte:
Yes. So, we’re just going to finish off with, if you could give us your top five tips. I know this probably isn’t an easy question, because there’s so much you could tell us, but if you had to give us top five nutrition tips, what would they be?

Isi:
Okay, so the top five nutrition tips from me would be, number one is eat a variety of foods. Number two, would be pay attention to your carbs. And no, I’m saying pay attention. I’m not saying you have to do anything in particular, but just pay attention to them. Number-

Charlotte:
Not eat them or don’t eat them.

Isi:
Yeah. Number three, would be to look for patterns. So, look for patterns in your eating and your blood glucose levels. But, just look for them. Don’t jump to make judgements about them, because that’s something that can sometimes lead you down the wrong path number. Number, oh what number was that? Three.

Charlotte:
That was number three.

Isi:
Number four, is eat more fruit and veg. That’s a good thing for health, whether you’ve got diabetes or not. But, it’s something which, as we were talking about earlier with the fruit, people with diabetes can find difficult-

Charlotte:
They’re almost be a bit scared.

Isi:
… because they worry about the sugar, but definitely eat more fruit and veg. But, be aware of the carbs in fruit and build that in. And then, the last one is when it comes to nutrition, be kind to yourself. Don’t judge yourself, don’t listen to other people’s judging you. Make sure that you are able to enjoy your food and enjoy what you’re choosing to eat.

Charlotte:
Love that one.

Isi:
Me too. I’d follow it.

Charlotte:
Well, thank you so much.

Isi:
You’re welcome.

Charlotte:
It’s been amazing. Got loads of useful information.

Isi:
Thanks for having me along.

Charlotte:
Oh, you’re very welcome. Like I said, we could probably talk for hours about nutrition and diabetes, so yeah, look forward to doing another episode soon.

Isi:
Hopefully, see you soon. Thank you.

Charlotte:
I really hope everyone enjoyed that, and found lots of that information really interesting. I know I did. As I said, we’re going to be homing in on some more specific areas of nutrition and talking about kind of relationships with food and things like that in future shows, as there’s just so much kind of surrounding nutrition that we can talk about. Please do get in touch with any feedback you have on the show so far, and let me know if there’s something specific that you would like me to cover. So, that does bring us to the end of the show. Thank you so much again for listening and until next time, have a happy and healthy time.

The Podcast Outro

This episode has ended, but your journey towards a healthy and happy life continues. Head on over to diabeticandhealthy.com, and join the conversation with other diabetics and their families. All the information in this episode is not designed to replace the advice from the health professional team looking after you and your diabetes. Before making any significant lifestyle changes, do consult them with your doctor.

How to get in contact:

Isi Hooley
Isi HooleyDiabetes Dietician
One of a diabetic and healthy team and she is a diabetes specialist dietician