1.Health Eating
HEALTHY EATING
Good nutrition is important for our mental and
physical health. This Food Fact Sheet will look at how following a healthy diet
can protect your mental health.
Guidelines
for a healthy diet in combating COVID-19.
• Cut down on simple, refined
carbohydrates
• Cut down on eating high
calorie and fried foods
• Choose
unsaturated fats oversaturated fats
• Choose less or
smaller portions of fatty or
carbohydrate heavy foods • Include plenty of fresh vegetables and also
fruit
• Reduce the
amount of processed foods in your diet • Watch the salt content.
Eat regular meals: You need to feed your brain regularly
with the right mix of nutrients for it to work properly. Unlike other organs,
your brain relies on a steady supply of glucose (ideally coming from starch
carbohydrates) as its primary fuel. Aim to eat little and often to keep your
mood at its best.
Get the right balance of fats: Our brains are made of around 50% fat, and
our cells need fats to maintain their structures, therefore an adequate supply
of fats are needed to maintain health. You can read more on how to achieve a
healthy balance of fats in your diet in BDA’s separate Food Fact Sheet on Fats,
but in summary, try to keep a moderate intake of a good balance of fats in your
diet, to ensure your brain is well nourished. Try to use olive oil or rapeseed
oil to cook with.
Add nuts and seeds, and use olive or nut oil dressings on salads. As well as
increasing unsaturated fats, try to decrease trans fats as these seem to be
harmful to brain structure and function (as well as heart health). Trans fats
are found in processed and packaged foods such as processed meats, ready meals,
pre-packed cakes and biscuits. Instead try to use fresh foods and ingredients
whenever you can.
Choose more wholegrains, fruit and vegetable foods: Wholegrain cereals, peas,
beans, lentils, nuts, seeds, fruits and vegetables are rich in a range of
vitamins and minerals that your body needs to function well. They are also
digested slowly, helping to control the rate of glucose supply to your brain and
body.
These foods are also rich in B vitamins,
(including folate) and zinc, and recent evidence suggests that these nutrients
are important in managing depression. Try to eat at least five different fruits
and vegetables daily to get all the vitamins and minerals you need.
Include some protein at every meal: Eating protein as part of a ‘“little and
often”’ eating plan also helps to keep us feeling full, which in turn, can
prevent overeating. Tryptophan is one of the building blocks of protein, and research suggests
that it may help with depression. A diet with enough protein should contain
plenty of tryptophan – good sources include fish, poultry, eggs and game, but
some green leafy vegetables (such as spinach) and seeds also provide a source.
Fresh meat, fish, shellfish, eggs, milk, low fat cheese, nuts, seeds, lentils
and beans are the best sources of protein.
Include oily fish in your diet Some
researchers think that omega 3 oils, found in oily fish, may help with
depression. Aim for a minimum of two portions of oily fish per week (NB but not
more if you are pregnant, breastfeeding or likely to become pregnant in the
future). Oily fish include salmon, mackerel, herring, sardines, pilchards and
trout.
Typical day:
• Make sure you start the day
with breakfast, for example a wholegrain cereal such as porridge with milk and
fruit, multigrain toast with a poached egg, or fruit and yoghurt and fresh
fruit juice or smoothie to drink.
• Include some starchy food
(such as boiled potatoes, rice, pasta, and granary or multigrain breads) at
lunch and dinner. If you are short of time, then go for a sandwich or jacket
potato (filled with fish or low fat cheese and salad) or even a bowl of cereal
and some fruit.
Drink enough fluid: Evidence shows that even slight dehydration may affect your mood.
Since we know that a healthy brain contains up to 78% water, it makes sense to
drink plenty. Aim for 6-8 glasses (about 1.5- 2 litres) fluid per day. Caffeine
may affect your mood and may lead to withdrawal headaches and to low or
irritable mood when the effects wear off. Drinks such as coffee, cola, energy
drinks, tea and chocolate all contain caffeine and should be limited.
• Between meals include snacks such as
fruit, vegetables, nuts, yoghurts, and oat`cakes, crackers with low fat cheese,
meat or fish.
I am gaining/losing too much weight. What should I do? First ask your doctor to
review any medicines you are taking. Some are better than others at boosting
appetite and a change may help you. If you are losing a lot of weight and are
worried, ask to see a dietitian. If you are putting on weight it may make you
feel more depressed. If you want to lose weight, try to exercise more. Also,
limit foods that are high in calories, such as pies, chips, puddings, cakes,
crisps, chocolate, sugary drinks and alcohol.
Summary: Eat regularly throughout the day,
including starch, protein and vegetables or salad at each meal to make sure
your brain has a steady supply of energy. Choose wholegrains, pulses, fresh
foods, and fruit and vegetables. Minimise processed/packaged foods to make sure
you get enough micronutrients to help your brain to function properly. Ensure
that you have a good balance of healthy fat intake to maintain the cell
structure of your brain, including oily fish (omega 3 fatty acids) in your
diet. Drink plenty of fluid (6 – 8 glasses non-caffeinated drinks) per day as
even slight dehydration can affect your mood
2.HEALTH EATING AND MOOD
HEALTHY EATING AND MOOD
COVID-19 Fact Sheet 2
Guidelines for a healthy foods and better mood in combating COVID-19.
We all have good days and bad days; we all have foods we like more, or like less. But is there a connection between feeling fine and the foods we have eaten? Do some foods make us feel grumpy? Is it possible to plan a diet for a good mood? Vitamins and Minerals When you don’t eat enough nutrient-rich foods, your body may lack vital vitamins and minerals, often affecting your energy, mood and brain function.
You should aim to get your vitamins and minerals from eating a healthy, balanced diet with plenty of fruit and vegetables but in certain circumstances or for certain people, supplements may be beneficial e.g. folic acid for all women planning pregnancy; iron supplements for people diagnosed with anaemia; vitamin D for everyone in winter months, and all pregnant and breast-feeding women, older adults, and people with dark skins.
Carbohydrate = Glucose = Brain Power The ability to concentrate and focus comes from the adequate supply of energy – from blood glucose – to the brain. In fact, the brain uses 20% of all energy needed by the body. Glucose is also vital to fuel muscles and maintain body temperature. The glucose in our blood comes from all the carbohydrates we eat – foods including fruit, vegetables, cereals, bread, rice, potatoes, sugars and lactose in milk.
Eating breakfast and regular meals containing some carbohydrate ensures you will have enough glucose in your blood. Healthier sources of carbohydrates include wholegrains, vegetables, fruits, legumes and lower fat dairy. These are an important source of nutrients as well, such as calcium and B vitamins. Not having enough glucose in the blood (hypoglycaemia) makes us feel weak, tired and ‘fuzzy minded’. This may happen when we don’t eat enough carbohydratecontaining food, and is a particular risk for people with diabetes and people doing extreme exercise. It can also happen with people following very restrictive diets or with erratic eating patterns.
Comfort eating: There is a messenger chemical in the brain called serotonin, which improves mood and how we feel. Serotonin is made with a part of protein from the diet (tryptophan), and more of this may get into the brain when carbohydrate-rich foods are eaten. This suggestion has been used to explain ‘carbohydrate craving’ – eating sweet, comfort foods to boost mood. There is not enough research to show that eating lots of tryptophan or eating a lot of carbohydrates can really support mood improvement in humans. But it may be that not consuming adequate amounts of carbohydrate (for example through a high protein/high fat diet) leads to low moods. You also may have heard the idea that eating chocolate can make you feel happier, and there are observations that people feeling depressed are more likely to eat chocolate. This is probably because of the cultural status of chocolate as a well-known reward and comfort food, rather than due to any potent physiological effects particular to cocoa.
Caffeine and the ‘drug-effect’: Caffeine, found in coffee, cola and energy drinks, is often called a ‘drug’: it acts as a stimulant and can improve the feelings of alertness, and counter the effects of fatigue. However there is also a suggestion that some of the effects of caffeine are more to ‘normalise’ the lower levels of alertness felt by regular users who have not consumed enough caffeine that day.
Too much caffeine may cause the adverse effects of irritability and headache. Such symptoms also occur with caffeine withdrawal in people used to lots of caffeine.
So does food affect mood? There are many ways that foods can affect how we feel, just as how we feel has an influence on what foods we choose. Some of the mood/food effects are due to nutrient content, but a lot of effects are due to existing associations of foods with pleasure and reward (chocolate) or diet and deprivation (plain foods). Some foods also have religious, economic and cultural significance, which will influence how we feel when eating them.
Vitamins and Minerals – effect on mood and what foods can help: When you don’t eat enough nutrient-rich foods, your body may lack vital vitamins and minerals, often affecting your energy, mood and brain function. The table below shows how missing some vitamins/minerals can affect your mood, and what you can eat to replenish your body.
Missing vitamin/mineral: Iron: this results in low levels of oxygen carrying haemoglobin in the blood, resulting in the condition anaemia.
Effect on mood: Feeling weak, tired and lethargic all the time.
Foods which can help: The risk of anaemia is reduced with adequate intakes of iron, particularly from red meat, poultry and fish, beans and pulses, fortified cereals. Avoiding drinking tea with meals may also be helpful.
Thiamin B1, Niacin B3 or Cobalamin B12 (all B vitamins): Effect on mood: Tiredness and feeling depressed or irritable.
Foods which can help: Fortified foods including wholegrain cereals, animal protein foods such as meat/fish, eggs and dairy.
Folate: Effect on mood: Increased chance of feeling depressed, particularly important in older people.
Foods which can help: Folate is found in liver, green vegetables, oranges and other citrus fruits, beans and fortified foods such as yeast extract (marmite) and fortified breakfast cereals.
Selenium:
Folate: Effect on mood: Increases the incidence of feeling depressed and other negative mood states.
Foods which can help: Brazil nuts, meat, fish, seeds and wholemeal bread.
Summary: Feeling good comes from a diet that provides adequate amounts of healthy choice carbohydrate at regular times to keep blood glucose levels stable, and eating breakfast is a sensible habit. Diets should also contain a wide variety of protein and vitamin and mineral containing foods to support the body’s functions. As a rule, plenty of fruits and vegetables and wholegrain cereal foods, with some protein foods, including oily fish, will support a good supply of nutrients for both good health and good mood.
3.DEPRESION AND DIET
DRESSION AND DIET
COVID-19 Fact Sheet 3
Depression and Poor Diet is not good for our mental and physical health. This Fats Fact Sheet will look at how preventing depression and poor diet can protect your mental health and wellbeing.
Weekly COVID-19 Fact Sheet- week-4 January 2021
Guidelines for depression and diet in combating COVID-19.
Good nutrition is important for mental and physical health. This Food Fact Sheet will look at how following a healthy diet can protect your mental health Eat regular meals- You need to feed your brain regularly with the right mix of nutrients for it to work properly. Unlike other organs, your brain relies on a steady supply of glucose (ideally coming from starch carbohydrates) as its primary fuel. Aim to eat little and often to keep your mood at its best.
Get the right balance of fats– Our brains are made of around 50% fat, and our cells need fats to maintain their structures, therefore an adequate supply of fats are needed to maintain health.
Try to keep a moderate intake of a good balance of fats in your diet, to ensure your brain is well nourished.
Try to use olive oil or rapeseed oil to cook with. Add nuts and seeds, and use olive or nut oil dressings on salads. As well as increasing unsaturated fats, try to decrease trans fats as these seem to be harmful to brain structure and function (as well as heart health).
Trans fats are found in processed and packaged foods such as processed meats, ready meals, pre-packed cakes and biscuits. Instead try to use fresh foods and ingredients whenever you can.
Choose more wholegrains, fruit and vegetable foods Wholegrain cereals, peas, beans, lentils, nuts, seeds, fruits and vegetables are rich in a range of vitamins and minerals that your body needs to function well. They are also digested slowly, helping to control the rate of glucose supply to your brain and body. These foods are also rich in B vitamins, (including folate) and zinc, and recent evidence suggests that these nutrients are important in managing depression. Try to eat at least five different fruits and vegetables daily to get all the vitamins and minerals you need.
Include some protein at every meal Eating protein as part of a ‘“little and often”’ eating plan also helps to keep us feeling full, which in turn, can prevent overeating. Tryptophan is one of the building blocks of protein, and research suggests that it may help with depression. A diet with enough protein should contain plenty of tryptophan – good sources include fish, poultry, eggs and game, but some green leafy vegetables (such as spinach) and seeds also provide a source. Fresh meat, fish, shellfish, eggs, milk, low fat cheese, nuts, seeds, lentils and beans are the best sources of protein.
Include oily fish in your diet Some researchers think that omega 3 oils, found in oily fish, may help with depression. Aim for a minimum of two portions of oily fish per week (NB but not more if you are pregnant, breastfeeding or likely to become pregnant in the future). Oily fish include salmon, mackerel, herring, sardines, pilchards and trout.
Typical day
• Make sure you start the day with breakfast, for example a wholegrain cereal such as porridge with milk and fruit, multigrain toast with a poached egg, or fruit and yoghurt and fresh fruit juice or smoothie to drink.
• Include some starchy food (such as boiled potatoes, rice, pasta, and granary or multigrain breads) at lunch and dinner. If you are short of time, then go for a sandwich or jacket potato (filled with fish or low fat cheese and salad) or even a bowl of cereal and some fruit.
• Between meals include snacks such as fruit, vegetables, nuts, yoghurts, and oatcakes, crackers with low fat cheese, meat or fish.
If you don’t like fish, you may decide to take an omega 3 supplement. If so, choose a fish body oil (these do not contain vitamin A) rather than fish liver oils. Too much vitamin A is stored in the liver and can build up to toxic levels and it can interfere with calcium metabolism. When considering how much, the Scientific Advisory Committee on Nutrition (SACN) suggests eating a minimum of 450mg per day (3g per week) of long-chain omega-3 fatty acids. Find out more in BDA’s separate Food Fact Sheet on Omega 3. Vegetarian sources of Omega 3 do not convert through to DHA and EPA (which are the forms of Omega 3 fat particularly beneficial to humans) very well. You can buy algae based supplements, but these are expensive. Alternatively, try omega 3 fortified foods such as eggs and milk.
Drink enough fluid aiming for 6-8 glasses (about 1.5- 2 litres) fluid per day. Drinks such as coffee, cola, energy drinks, tea and chocolate all contain caffeine and should be limited. Drinking too much alcohol can cause dehydration and can lead to B vitamin deficiencies, which may make you more depressed or anxious. Limit your intake to no more than two to three drinks on no more than five days per week. Alcohol also has a dehydrating effect. Drinking too much alcohol can also lead to B vitamin deficiencies, and can make you more depressed or anxious. Try to limit intake to no more than two to three drinks on no more than five days per week.
I am gaining/losing too much weight. What should I do? First ask your doctor to review any medicines you are taking. Some are better than others at boosting appetite and a change may help you. If you are losing a lot of weight and are worried, ask to see a dietitian. If you are putting on weight it may make you feel more depressed. If you want to lose weight, try to exercise more. Also, limit foods that are high in calories, such as pies, chips, puddings, cakes, crisps, chocolate, sugary drinks and alcohol.
Summary
Eat regularly throughout the day, including starch, protein and vegetables or salad at each meal to make sure your brain has a steady supply of energy. Choose wholegrains, pulses, fresh foods, and fruit and vegetables.
Minimise processed/packaged foods to make sure you get enough micronutrients to help your brain to function properly.
Ensure that you have a good balance of healthy fat intake to maintain the cell structure of your brain, including oily fish (omega 3 fatty acids) in your diet. Drink plenty of fluid (6 – 8 glasses non-caffeinated drinks) per day as even slight dehydration can affect your moo
4. COVID-19 AND HEALTHY HEARTS
Healthy Hearts
COVID-19 Fact Sheet 4
Health heart is important for our mental and physical health. This Fact Sheet will look at how a healthy heart can protect your mental and physical health.
Guidelines for a healthy heart in combating COVID-19.
Keep your heart healthy by making the right food and drink choices. Healthy lifestyle habits are important for a healthy heart such as eating a healthy diet, physical activity, stopping smoking, drinking less alcohol and maintaining a healthy weight. Looking after your heart involves preventing your risk of developing heart disease and helping protect your heart if you already have problems. A heart-healthy diet may help reduce cholesterol levels, lower blood pressure, reduce your risk of diabetes and help you maintain a healthy weight.
Enjoy a variety of fruit and vegetables: Fruit and vegetables provide vitamins, minerals, fibre and other plant nutrients such as antioxidants that help protect your heart. Fresh, frozen, tinned and dried varieties all count. Aim to include five or more portions each day. A portion (80g) is:
• three heaped tablespoons of vegetables
• a dessert bowl of salad
• two small fruits such as plums or satsumas or one larger fruit like an apple, an orange, peach or medium banana
• a handful of grapes, cherries or berries
• a 150ml glass of 100% unsweetened fruit juice
• a handful, about 30g, of dried fruit. Supplements don’t have the same benefits as eating fruit or vegetables.
Pulses (beans, peas and lentils) release their energy slowly which is thought to be good for heart health. Soya, soya products and oats are also thought to have additional benefits due to their cholesterol lowering benefits.
Eat less salt: Eating too much salt can increase your risk of developing high blood pressure and this increases your chance of developing coronary heart disease. The daily recommended maximum for an adult is 6g – about a teaspoon. Try not to add salt when you are cooking or at the table. Much of the salt we eat is hidden in foods, such as soups, ready meals, biscuits and some breads and breakfast cereal – so check how much salt is in them by looking at the label.
Understanding fats: There are several types of fats in the diet and these have different effects on the heart. Trans fats found in processed foods are associated with increased risk of heart disease. Eating less processed and takeaway foods is a good way to eat less trans fats. Cook from scratch using fresh ingredients.
Saturated fat is found mainly in animal products. Having a lot of saturated fat is linked with raised levels of harmful (LDL) cholesterol. Cut down on processed foods, eat more fruit, vegetables and starchy foods to reduce your saturated fat intake. Replacing saturated fat with moderate amounts of monounsaturated fat and polyunsaturated fat can also reduce harmful cholesterol. Food that have saturated fats are, cheese, cream, full-fat milk and fat on meat and poultry and processed foods such as burgers, sausages, pastry, pies, cakes, biscuits and rich puddings.
Polyunsaturated fats: Sunflower, corn, soya and rapeseed oils. Spreads made from these oils. Nuts and seeds.
Monounsaturated fats: Olive and rapeseed (canola) oils. Avocados. Some nuts including walnuts, almonds and pecans.
Trans fats: Processed foods (see saturated fats). Fast foods. Takeaway foods.
Plant sterols and stanols: Some foods including fat spreads, milks and yoghurts, are fortified with plant sterols and stanols (natural plant substances which reduce the absorption of cholesterol in the gut). Although the effect varies between individuals, there is evidence to show that plant sterols and stanols can help to reduce LDL cholesterol by levels up to 10-15% when 2g per day is regularly consumed as part of a healthy balanced diet.
Choose more high fibre foods: Eating more high fibre foods such as whole grains, pulses, fruits and vegetables help lower heart disease risk. They also help to fill you up which can be helpful if you are trying to lose weight. Change white breads for wholemeal or granary breads, use brown rice and wholegrain breakfast cereals Some of these foods are high in soluble fibre, which helps to lower LDL cholesterol. Good sources include oats, oat bran, and pulses such as baked beans, kidney beans, soya beans, peas, lentils and chickpeas.
Eat/drink less sugar Eat less sugary foods such as cakes, biscuits, sweets, chocolates, ice cream and sugary soft drinks to achieve a healthier weight and reduce the risk of developing heart disease. Check the sugar content on the labels and aim for no more than 30g sugar a day.
Aim for a healthy weight If you can achieve a healthier weight you can improve your blood cholesterol levels. Start by increasing your physical activity and watching your portion sizes.
Top tips for a healthy heart
•Aim for at least five portions of fruit and vegetables every day.
•Eat two portions of fish a week, one of which should be an oily fish.
•Eat more peas, beans, lentils and vegetables.
•Limit processed foods, pastries, fried and fast food – choose healthy sandwiches or rolls, a baked potato or home-cooked food.
•Cut down on fatty meat products (sausages, pies, pasties, sausage rolls and streaky bacon) – swap for unprocessed meat or fish.
•Choose plant based spreads such as olive, rapeseed or sunflower oil.
•Choose more high fibre foods – high fibre bread, breakfast cereals, oats, brown rice and pasta, plus beans, peas and lentils.
•Choose healthier snacks such as fruit, fruit loaf, crumpets, dried fruit, unsalted nuts, seeds, low fat yoghurt, high fibre cereals or oatcakes.
•Keep salt intake low by eating less processed and takeaway foods, salty snacks such as crisps and nuts; canned and packet sauces, gravy products and condiments like ketchup.
•Stick to the guidelines for alcohol limits (limit intake to no more than 14 per week for men and women spread over three or more days) and aim for two alcohol free days a week.
• Be physically active for at least 30 minutes every day.
• Do not smoke and avoid smoky environments.
Summary: If you decide to make changes, begin slowly with one or two suggestions. Remember, it is best to focus on improving your eating and exercise patterns as the main goal rather than aiming for weight loss. By eating well and being active you may or may not lose weight – but you will improve your heart health even if your weight stays the same.
Guidelines for Diabetes Type 2 in combating COVID-19 healthy outcomes. This Food Fact Sheet will look at Type 2 diabetes
What is Type 2 diabetes? Diabetes is a condition where the amount of glucose (sugar) in your blood is too high because your body cannot use it properly. In Type 2 diabetes this happens because your pancreas doesn’t produce enough of the hormome insulin (that helps glucose enter body cells) and/or the insulin that is produced does not work correctly (insulin resistance).
The importance of good blood glucose control for people with Type 2 diabetes need to control their blood glucose. It is also important to look after your heart health. Making changes to your lifestyle, diet and activity level can be key to reducing the risk of diabetes causing you problems now and in the future.
What can you eat? People with diabetes should eat a healthy diet, the same as somebody without diabetes. It should be low in saturated fat, high in fibre and include a variety of fruit and vegetables.
Top tips to help you achieve a balanced diet:
1.Eat regular meals – eating breakfast may help you to manage your hunger and avoid overeating.
2.Reduce your portion sizes to help you reduce and maintain a healthy weight. A portion is:
• a fist size of potatoes, bread, pasta or other starchy carbohydrates
• a palm size of meat/fish or poultry
• two handfuls of vegetables or salad
• a cupped-handful of fruit
• top of your thumb size of oil or fat spread. Try using a smaller plate, filling half of your plate with vegetables and avoiding second helpings
3.Carbohydrates are used for energy so include some in your diet each day. Opt for wholegrain options, fruits and vegetables, beans, pulses, low fat milk and yoghurt. Controlling or limiting portions can help reduce weight and improve diabetes control.
4.Some saturated fats are linked with increasing cholesterol. Reducing your intake of all fats can also help reduce energy intake and help weight loss. Focus should be on reducing intakes of foods such as butter, cheese, processed meat and pastries 5.5-a-day – you can have any fruit, vegetables or salad you enjoy (however, it pays to be careful with dried fruit and juices). Aim for at least 5-a-day and try to have a variety.
6.Swap meat for beans, pulses and lentils. This reduces fat and increases the fibre of your meals. Fibre helps to reduce cholesterol and prevent certain cancers. Try adding to soups, casseroles and stews.
7.Fish is a good source of low fat protein (white fish) and heart-protecting omega-3 (oily fish). Aim to eat two portions a week of fresh, canned or frozen oily fish, like mackerel, sardines or salmon. 8.Sugar can be eaten if you have diabetes but don’t overdo it. Keep foods containing sugar to small servings as an occasional treat and whenever possible choose sugar free drinks. Artificial sweeteners are safe to use.
9.Drink 8–10 glasses of fluid per day. Water is best, but tea and coffee, herbal teas, no added sugar squash and diet fizzy drinks can all contribute. You don’t have to cut out alcohol – just keep an eye on how much you are drinking. 10.Try to be more active. Diabetic foods Foods labelled ‘suitable for diabetics’ have no special benefit. They are often high in calories, may still increase your blood glucose level and may have a laxative effect! Ordinary packaged food, eaten as part of a healthy diet is suitable; just remember to consider portion sizes and how often you have them
Which foods affect your blood glucose level? All carbohydrates are broken down to provide glucose. Glucose is used by our body’s cells for energy. Starchy carbohydrates include bread, rice, pasta, breakfast cereals and potatoes. Sugary carbohydrates include biscuits, sweets, chocolate, jams, and sugary drinks. Fruit and milk also contain natural sugars, dried fruit and juices contain these in higher concentrations. All types of carbohydrate will increase your blood glucose level. Many people find it useful to spread carbohydrate throughout the day to keep their blood glucose levels stable. Whereas, other people find it helpful to reduce the quantity of carbohydrate in their diet to help control blood glucose levels. A lower carbohydrate diet could be an option for you but talk to a healthcare professional first, preferably a dietitian, as it may not be suitable or your medication may need adjusting. How much your blood glucose goes up will depend on:
• the amount of carbohydrate in your food and drink
• how active you are
• how much insulin your body still produces and how your body uses it
• your medication.
Weight loss: If you are overweight, weight loss is the most important thing you can do to help control your blood glucose levels by allowing the insulin to work more effectivelyand reducing insulin resistance. Weight loss can also help reduce your cholesterol and blood pressure. Losing weight can be difficult but evidence shows that a weight loss of just 5-10% of your current body weight can bring significant health benefits. There is also evidence emerging that weight loss of 15% (using meal replacements) can even bring diabetes into remission. If you are trying to lose weight you may need support adjusting your medication if you are making significant changes to your diet and physical activity levels, so speak to your healthcare team.
Get active: Being active is an important part of a healthy lifestyle and helps:
• control blood glucose by helping your insulin to work more effectively
• reduce heart and circulation related risk e.g. heart attacks and strokes
• manage weight. Aim for at least 30 minutes of moderate physical activity five days a week. ‘Moderate’ means breathing more deeply and feeling warmer. Focus on spending less time sitting still!
Know your condition: When you find out you have diabetes, you should see a dietitian.
Summary: Type 2 diabetes is a condition where your blood glucose is too high due to lack of insulin and/or insulin resistance. It is important to have good blood glucose control to reduce the risk of complications. If overweight, losing weight is the most important thing you can do. Working with a dietitian will help you identify the changes in lifestyle, diet and physical activity you can not only achieve but also enjoy and stick to in the long term
5. COVID-19 AND MALNUTRITION
MALNUTRITION
COVID-19 Fact Sheet 5
Malnutrition is not good for our mental and physical health. This Fats Fact Sheet will look at how preventing malnutrition can protect your mental health and wellbeing.
Guidelines for malnutrition in combating COVID-19.
Malnutrition is a condition which happens when you don’t get the correct amount of nutrients from your diet. This Fact Sheet will help you understand the signs of malnutrition and how to either stop it happening or to treat it.
Consequences of malnutrition include:
•increased risk of illness and infection
• slower wound healing
• increased risk of falls
• low mood
• reduced energy levels
• reduced muscle strength
• reduced quality of life
• reduced independence and ability to carry out daily activities
Spotting malnutrition: Malnutrition can affect anyone, but it is more common for older people and those who are socially isolated. This can be because they can’t get out much or because they have poor physical or mental health. It can happen over a long period of time which sometimes makes it difficult to spot. Common signs of malnutrition are:
• unplanned weight loss – which causes clothes, dentures, belts or jewellery to become loose
• tiredness and lethargy
• alterations in mood
• loss of appetite
• disinterest in food and/or fluids
• loss of muscle strength Stopping and treating malnutrition A balanced diet is essential for health and wellbeing.
When someone has a poor appetite and is malnourished, nutrient dense foods as well as drinks containing nutrition can help to improve energy intake without making portions too big to manage. Protein, energy (calories) and vitamins and minerals are all important for people who are malnourished. If you follow the points listed here, you can make sure you are eating well:
• Eat 2-3 portions of high protein foods every day such as meat, fish, eggs, nuts, beans, pulses, soya, tofu and other meat-free protein foods.
• Eat/drink 2-3 portions of dairy foods every day such as cheese, milk and yoghurt or non-dairy alternatives like soya, almond or coconut milk.
• Eat a serving of starchy food at each meal (e.g. bread, cereals, potatoes, pasta or rice).
• Eat some fruit and vegetables every day (fresh, frozen, tinned, dried or juiced).
• If you enjoy fish, go for oily fish such as mackerel, salmon, herring, trout, pilchards or sardines as these are rich in omega-3 fatty acids. Aim for 2 portions a week (can be tinned or frozen for convenience).
• Have at least 6-8 glasses/mugs of fluid every day, choosing drinks which contain some nutrition where possible such as milky drinks (malted drinks, hot chocolate, milky coffee, smoothies and milkshakes) which can provide energy, protein and vitamins and minerals or sugary drinks such as fruit juice, fizzy drinks or squash can provide extra energy.
The following simple ideas will help you to increase the amount of energy and protein which you eat in a day:
• Eat ‘little and often’ – try a small snack between meals and a dessert after lunch and evening meal.
• Try not to have drinks just before meals to avoid feeling too full to eat.
• Avoid low fat/diet versions of foods and drinks for example skimmed or semi-skimmed milk, low fat yoghurt, sugar free drinks etc, or watery soups.
• Choose meals that you enjoy, are easy to prepare and eat, and are high in energy and protein. Items such as tinned fish or beans are easily stored and easy to prepare. • If you are preparing food for others, remember that as we get older, our taste buds change. Older people may prefer much sweeter tastes than they used to.
• Add extra energy and protein to foods and fluid by adding high energy and protein ingredients – see above for ideas.
To make sure you are eating well, Add extra energy by adding high calorie ingredients to food and drinks.
Other high energy and protein foods include:
• cheese and crackers
• thick and creamy yoghurt
• Pot of custard or rice pudding
• nuts and seeds
• cereal bar or flapjack
• Bombay mix
• mini pork pie, sausage roll or scotch egg
• chocolate.
If there are any health concerns which have previously required you to limit fat and sugar in your diet, e.g. diabetes or high cholesterol, you should discuss whether you still need to limit these with a health professional.
Ready meals, meal delivery services and online shopping. You may find that your energy levels change throughout the week and that on some days you feel better than others. Here are some suggestions to make preparing meals easier:
• Make the most of the ‘good days’ by preparing extra meals which you can store in the fridge/freezer as individual portions for ‘bad days’.
• Buy a selection of fresh or frozen ready meals for times when you are not able to cook.
• Make use of meal home delivery services which may make shopping easier for you.
Swallowing difficulties. If you notice any of the following when eating or drinking you should seek advice from a healthcare professional such as your GP or practice nurse, who can refer you on to specialist speech and language therapist or a dietitian:
• difficulty swallowing
• choking or coughing • bringing food back up, sometimes through your nose
• a sensation that food is stuck in your throat or chest
• a change in the sound of your voice whilst/soon after eating i.e. your voice sounds ‘wet’
Other things to consider:
• Check dentures fit correctly – if not, visit your dentist.
• If you have difficulty using cutlery or with coordination, try ‘finger foods’ such as toast, sandwiches, biscuits, chunks of meat, cheese, vegetables or fruit cut into pieces etc.
• If you also suffer from constipation, try gradually increasing your fibre intake by consuming beans, lentils, fruit and vegetables and wholegrain foods whilst also increasing your fluid intake. You may need to fortify these foods as explained earlier. • Regular exercise may help increase your appetite and build up your strength – start with something easy for you and increase the intensity gradually.
• If you have vision problems or for people with dementia, try using a coloured plate so that the food stands out from the plate. Eating environment Try to make sure that where you eat is as pleasant as possible and that meals and snacks look appealing. Eating with others often helps to encourage appetite. Summary Malnutrition is a common problem and if it is not spotted or treated it can make you very ill. The simple steps outlined above should help to identify and treat the condition. If these simple steps do not seem to help, seek advice from a healthcare professional
Minimise processed/packaged foods to make sure you get enough micronutrients to help your brain to function properly.
Ensure that you have a good balance of healthy fat intake to maintain the cell structure of your brain, including oily fish (omega 3 fatty acids) in your diet. Drink plenty of fluid (6 – 8 glasses non-caffeinated drinks) per day as even slight dehydration can affect your mood.
6. COVID-19 AND DIABETES TYPE 2
Diabetes type 2
COVID-19 Fact Sheet 6
Guidelines for Diabetes Type 2 in combating COVID-19 healthy outcomes. This Food Fact Sheet will look at Type 2 diabetes
What is Type 2 diabetes? Diabetes is a condition where the amount of glucose (sugar) in your blood is too high because your body cannot use it properly. In Type 2 diabetes this happens because your pancreas doesn’t produce enough of the hormome insulin (that helps glucose enter body cells) and/or the insulin that is produced does not work correctly (insulin resistance).
The importance of good blood glucose control for people with Type 2 diabetes need to control their blood glucose. It is also important to look after your heart health. Making changes to your lifestyle, diet and activity level can be key to reducing the risk of diabetes causing you problems now and in the future.
What can you eat? People with diabetes should eat a healthy diet, the same as somebody without diabetes. It should be low in saturated fat, high in fibre and include a variety of fruit and vegetables.
Top tips to help you achieve a balanced diet:
1.Eat regular meals – eating breakfast may help you to manage your hunger and avoid overeating.
2.Reduce your portion sizes to help you reduce and maintain a healthy weight. A portion is:
• a fist size of potatoes, bread, pasta or other starchy carbohydrates
• a palm size of meat/fish or poultry
• two handfuls of vegetables or salad
• a cupped-handful of fruit
• top of your thumb size of oil or fat spread. Try using a smaller plate, filling half of your plate with vegetables and avoiding second helpings
3.Carbohydrates are used for energy so include some in your diet each day. Opt for wholegrain options, fruits and vegetables, beans, pulses, low fat milk and yoghurt. Controlling or limiting portions can help reduce weight and improve diabetes control.
4.Some saturated fats are linked with increasing cholesterol. Reducing your intake of all fats can also help reduce energy intake and help weight loss. Focus should be on reducing intakes of foods such as butter, cheese, processed meat and pastries 5.5-a-day – you can have any fruit, vegetables or salad you enjoy (however, it pays to be careful with dried fruit and juices). Aim for at least 5-a-day and try to have a variety.
6.Swap meat for beans, pulses and lentils. This reduces fat and increases the fibre of your meals. Fibre helps to reduce cholesterol and prevent certain cancers. Try adding to soups, casseroles and stews.
7.Fish is a good source of low fat protein (white fish) and heart-protecting omega-3 (oily fish). Aim to eat two portions a week of fresh, canned or frozen oily fish, like mackerel, sardines or salmon. 8.Sugar can be eaten if you have diabetes but don’t overdo it. Keep foods containing sugar to small servings as an occasional treat and whenever possible choose sugar free drinks. Artificial sweeteners are safe to use.
9.Drink 8–10 glasses of fluid per day. Water is best, but tea and coffee, herbal teas, no added sugar squash and diet fizzy drinks can all contribute. You don’t have to cut out alcohol – just keep an eye on how much you are drinking. 10.Try to be more active. Diabetic foods Foods labelled ‘suitable for diabetics’ have no special benefit. They are often high in calories, may still increase your blood glucose level and may have a laxative effect! Ordinary packaged food, eaten as part of a healthy diet is suitable; just remember to consider portion sizes and how often you have them
Which foods affect your blood glucose level? All carbohydrates are broken down to provide glucose. Glucose is used by our body’s cells for energy. Starchy carbohydrates include bread, rice, pasta, breakfast cereals and potatoes. Sugary carbohydrates include biscuits, sweets, chocolate, jams, and sugary drinks. Fruit and milk also contain natural sugars, dried fruit and juices contain these in higher concentrations. All types of carbohydrate will increase your blood glucose level. Many people find it useful to spread carbohydrate throughout the day to keep their blood glucose levels stable. Whereas, other people find it helpful to reduce the quantity of carbohydrate in their diet to help control blood glucose levels. A lower carbohydrate diet could be an option for you but talk to a healthcare professional first, preferably a dietitian, as it may not be suitable or your medication may need adjusting. How much your blood glucose goes up will depend on:
• the amount of carbohydrate in your food and drink
• how active you are
• how much insulin your body still produces and how your body uses it
• your medication.
Weight loss: If you are overweight, weight loss is the most important thing you can do to help control your blood glucose levels by allowing the insulin to work more effectivelyand reducing insulin resistance. Weight loss can also help reduce your cholesterol and blood pressure. Losing weight can be difficult but evidence shows that a weight loss of just 5-10% of your current body weight can bring significant health benefits. There is also evidence emerging that weight loss of 15% (using meal replacements) can even bring diabetes into remission. If you are trying to lose weight you may need support adjusting your medication if you are making significant changes to your diet and physical activity levels, so speak to your healthcare team.
Get active: Being active is an important part of a healthy lifestyle and helps:
• control blood glucose by helping your insulin to work more effectively
• reduce heart and circulation related risk e.g. heart attacks and strokes
• manage weight. Aim for at least 30 minutes of moderate physical activity five days a week. ‘Moderate’ means breathing more deeply and feeling warmer. Focus on spending less time sitting still!
Know your condition: When you find out you have diabetes, you should see a dietitian.
Summary: Type 2 diabetes is a condition where your blood glucose is too high due to lack of insulin and/or insulin resistance. It is important to have good blood glucose control to reduce the risk of complications. If overweight, losing weight is the most important thing you can do. Working with a dietitian will help you identify the changes in lifestyle, diet and physical activity you can not only achieve but also enjoy and stick to in the long term