A plea from a diabetes specialist dietitian

Throughout my experience as a dietitian, I have had many people walk through my door who are in an absolute panic and are feeling completely overwhelmed following their diagnosis of type 2 diabetes. They are already feeling unsure and anxious but a particular trigger, I have realised, is someone telling them they cannot eat a particular food (white bread, grapes, bananas etc. usually get the blame!).

This advice may come from anyone, including a practice nurse, a GP, a friend or family member. Although it comes from a good place and is usually fair advice, unfortunately the delivery can cause quite a negative impact on how a person copes and goes on to manage their diabetes. The time period following diagnosis is critical and we all need to get it right to support that person to achieve self-management.

By starting off by telling someone what they cannot eat, this causes a reaction in which the individual then wonders what else they cannot eat; as a result they cut out almost everything in the diet just to be safe. The problem with this is that at no point did anyone mention what they could eat so the diet is very restricted, unsustainable and they are most likely subconsciously eating to compensate. At some point (after a period of waiting) they arrive in my (virtual) clinic with a list of foods, asking which ones are good and which ones are bad. The damage is done. I find myself then trying to pick up the pieces and start from scratch, sometimes asking the person to forget everything they have been told or read online until now.  I have met patients who were told they could not eat fruit 20 years ago and still will not touch it, despite it being a very important part of the diet for a range of reasons. Also, if you cannot eat fruit as a snack, what do you eat instead and is that healthier for you?

The moral of the story is that there is no food you cannot eat! Just ones you may have less frequently and in smaller portions now. Instead you will fill your plate with other things. Start with what you are already eating and chop and change it gradually. There is no such thing as a “perfect” diet or a “bad” food. Why not try some new foods and experiment? Please never tell someone to stop eating something, instead discuss with them what other options there are which they could switch to most of the time, or could they reduce the portion? Do not start them on a journey of reliance on someone else to tell them what they are allowed to eat.

Nicola Clarke BSc RD

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