• Carbohydrate foods (Carbs)
• Glycaemic index (GI)
• Protein foods
• Types of fat
• Cholesterol
• Enjoying healthy fats 

Carbohydrates 

Carbohydrate foods play an important role in our diet. They are the preferred energy source for your body, especially your brain.  

When carbohydrates are digested they break down to form glucose and are absorbed into the bloodstream. Insulin allows the glucose to enter the cells of the body where it is used to provide energy. Most carbohydrate containing foods are also very good sources of fibre, vitamins and minerals which keep our body and bowels healthy. 

Of the three key nutrients in our food – fat, protein and carbohydrate – carbohydrate is the nutrient that will have the biggest impact on your blood glucose levels. The effect of carbohydrate will depend on 1) the amount of carbohydrate you eat and 2) the type of carbohydrate you eat. 

Everyone’s carbohydrate needs are different depending on your gender, how active you are, your age and your body weight. Anyone with diabetes should see an accredited practising dietitian to work out the amount of carbohydrate to eat at each meal and snack. 

For some people, a lower carbohydrate diet may help with diabetes management. If you are considering reducing the carbohydrate content of your diet, consult your healthcare team for individualised advice. You can read our position statement on low carbohydrate eating for people with diabetes.  

If you eat regular meals and spread your carbohydrate foods evenly throughout the day, you will help maintain your energy levels without causing large rises in your blood glucose levels. If you take insulin or diabetes tablets, you may need to have between meal snacks. Discuss this with your doctor, dietitian or credentialled diabetes educator. 

If you believe it is valuable to learn to carb count you may be interested in the carbohydrate counting fact sheet, Carb Counting online program, CarbSmart program or, if you have type 1 diabetes, the OzDAFNE program. Find out more about our programs and events.  

Glycaemic index (GI) 

Glycaemic index (GI) is a simple way of rating how quickly carbohydrate foods are digested into glucose and absorbed into the bloodstream. 

Low GI carbohydrate foods take longer to break down into glucose, enter the blood stream slowly and have less of an impact on blood glucose levels. These foods can help manage blood glucose levels, cholesterol and make you feel fuller for longer. Examples of low GI foods include traditional rolled oats, dense wholegrain breads, lentils and legumes, sweet corn, milk, yoghurt, pasta cooked till al dente, and most types of fresh fruit.  

High GI carbohydrate foods break down into glucose and are absorbed into the bloodstream quickly, which means a higher and faster rise in blood glucose levels after eating.  

The type of carbohydrate you eat is very important as some can cause higher blood glucose after eating. The best combination is to eat moderate amounts of high fibre low GI carbohydrates. 

GI numbers are to be used as a guide only as individual foods do not have the same response in all people with diabetes. 

• Low GI foods are foods with a GI less than 55 
• Intermediate GI foods are foods with a GI between 55 and 70 
• High GI foods are foods with a GI greater than 70

When it comes to GI, include one or more low GI foods in every meal or snack. 

Things to consider:  

• GI only applies to carbohydrate containing foods, however the presence of protein and fat in carbohydrate foods and meals does affect the GI as they slow digestion 
• Eating large amounts of low GI foods will still affect blood glucose levels, so it’s important to watch portion sizes   
• Low GI foods are not always healthy and can still be high in saturated fat and sugar (e.g. chocolate)

For more information see the Glycaemic Index factsheet or visit the Glycemic Index and GI Database and our Diabetes Low GI Guide. 

Protein 

Protein foods are needed by the body for growth and repair. Protein does not generally break down into glucose, although research is starting to show that both fat and protein can cause blood glucose levels to rise in three to five hours after a meal, however, this is only of major significance for particular meals that are large in portion size or that also contain large volumes of fat and protein. These factors are of more consideration to you if you are living with type 1 diabetes. The main protein foods are: 

• Meats, chicken, fish, tofu and tempeh 
• Eggs 
• Nuts and seeds 
• Cheese 

There are some protein foods which also contain carbohydrate such as milk, yoghurt, lentils and legumes which will have an effect on blood glucose levels but these should still be included as part of a healthy diet. 

Types of fats 

Fats have the highest energy (kilojoule or calorie) content of all foods. Eating too much fat can make you put on weight, which may make it more difficult to manage blood glucose levels. Our bodies need some fat for good health but the type of fat you choose is important. 

Saturated fat 

It is important to limit saturated fat because it raises your LDL (‘bad’) cholesterol levels. Saturated fat is found in animal fats and tropical oils so, to reduce your saturated fat intake: 

• Choose reduced or low-fat milk, yoghurt, cheese, ice-cream and custard 
• Choose lean meat and trim any fat off before cooking 
• Remove the skin from chicken, duck and other poultry (where possible, before cooking) 
• Avoid using butter, lard, dripping, cream, sour cream, coconut oil, copha, coconut milk, coconut cream and hard cooking margarines 
• Limit pastries, cakes, puddings, chocolate and cream biscuits to special occasions 
• Limit pre-packaged biscuits, savoury packet snacks, cakes, frozen and convenience meals 
• Limit the use of processed deli meats (devon/polony/fritz/luncheon meat, chicken loaf, salami, etc) and sausages 
• Avoid fried takeaway foods such as chips, fried chicken and battered fish and choose BBQ chicken (without the skin) and grilled fish instead 
• Avoid pies, sausage rolls and pastries 
• Rather than creamy sauces or dressings, choose those that are based on tomato, soy or other low-fat ingredients 
• Limit creamy style soups 

Polyunsaturated and monounsaturated fats 

Eating small amounts of polyunsaturated and monounsaturated fats can help ensure you get the essential fatty acids and vitamins your body needs. 

Polyunsaturated fats include: 

• Polyunsaturated margarines (check the label for the word ‘polyunsaturated’) 
• Sunflower, safflower, soybean, corn, cottonseed, grapeseed and sesame oils 
• The fat found in oily fish such as herring, mackerel, sardine, salmon and tuna

Monounsaturated fats include: 

• Canola and olive oils 
• Some margarines 
• Avocado

Seeds, nuts, nut spreads and peanut oil contain a combination of polyunsaturated and monounsaturated fat. 

Cholesterol 

Cholesterol is a type of fat in the blood. Healthy cholesterol levels are important for the body. There are two main types of cholesterol, HDL, or high-density lipoprotein (good cholesterol) and LDL, or low-density lipoprotein (bad cholesterol). Triglycerides are another type of fat in the blood, which if too high, can be bad for your health.  

People with diabetes and high levels of bad cholesterol are at a higher risk of having a heart attack or stroke. By lowering your bad cholesterol, you can significantly reduce your risk.  Having higher levels of good cholesterol can help protect you from heart disease.  

Diabetes & cholesterol 

High blood glucose levels can result in the bad cholesterol staying in the blood stream for longer. Too much bad cholesterol and triglycerides in the blood causes fatty material to build up in the blood vessels, making them narrower. Narrow blood vessels can lead to blockages causing heart attacks, strokes, and circulation problems.   

Improving Blood Cholesterol 

Knowing your cholesterol numbers will help you to know if you are on track.  For most people with diabetes it is recommended to aim for the following numbers: 

• Total Cholesterol < 4.0 mmol/L 
• Triglycerides < 2.0 mmol/L 
• HDL > 1.0 mmol/L 
• LDL < 2.0 mmol/L 

Please talk to your doctor or healthcare professional to find out what numbers you should aim for. 

You can improve your cholesterol levels and reduce your risk of a heart attack or stroke. You can try and do this by: 

• Eating a healthy balanced diet
• Eating less saturated fat 
• Aiming for at least two to three serves of oily fish a week  
• Getting more active
• Limiting alcohol to no more than 10 standard drinks per week and no more than four standard drinks on any one day.  
• Stopping smoking  
• Maintaining a healthy body weight for you 
• Taking cholesterol lowering medication prescribed by your doctor.

Foods to improve Cholesterol 

In Australia, eating less saturated fat is one of the most practical ways to lower cholesterol. You should focus on eating less saturated fat rather than eating less cholesterol. Saturated fat has more of an impact on your blood cholesterol levels.  

Omega 3 fats helps to decrease triglycerides. Omega-3 fats can be found in oily fish such as: 

• herring,  
• mackerel,  
• sardine,  
• salmon and  
• tuna

They are also found in certain nuts and seeds and products made from these, such as flaxseed, canola, walnut, wheat germ and soybean oils and margarines.  

Increasing fibre in your diet from wholegrains, lentils and legumes, fruit and vegetables can help improve your cholesterol. Soluble fibre (a type of fibre) helps to reduce the absorption of sugar and fats from your intestines.  

Ideas for enjoying healthy fats 

• Stir-fry meat and vegetables in a little olive or canola oil (or oil spray) with garlic or chilli 
• Dress a salad or steamed vegetables with a little olive oil and lemon juice or vinegar 
• Sprinkle sesame seeds on steamed vegetables 
• Use linseed and soy bread and top with a little peanut butter 
• Snack on a handful of unsalted nuts, or add some to a stir-fry or salad 
• Spread avocado on sandwiches and toast, or add to a salad 
• Eat more fish (two to three times a week) as it contains a type of fat (omega-3) that is good for your heart 
• Include one or two meat free meals each week, choose eggs, legumes, tofu or nuts and seeds 
• Do more dry roasting, grilling, microwaving and stir-frying in a non-stick pan 
• Avoid deep fried, battered and crumbed foods