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People with Type 2 diabetes should follow general healthy eating advice. This means eating a balanced diet that is:
We often read in newspapers or on the Internet about how certain foods or diets can improve particular medical conditions. There has been some research into the health benefits of individual foods, but in general we need to eat a variety of food types to make sure we're getting the range of nutrients our bodies need. Most people should eat a balanced diet, which means one that is rich in starchy foods (such as bread, pasta and rice) and we should choose wholegrain varieties where possible. We should also be eating:
For osteoarthritis, prevention is key. The best thing you can do is maintain a healthy weight by eating a varied and balanced diet and keeping physically active. The aim should be to eat a diet that is rich in starchy foods, such as wholegrain rice and bread, and moderate amounts of meat and dairy products, with at least five portions of a variety of fruit and vegetables every day. It is also important to eat two portions of fish a week. One of these should be oily fish, such as salmon, mackerel or sardines. This may help people who suffer from rheumatoid arthritis because the fats found in oily fish may have an anti-inflammatory effect. When someone has osteoarthritis, the smooth cartilage that takes the strain in a normal joint becomes rough, brittle and weak. To make up for this, the bone beneath thickens and spreads out, forming knobbly outgrowths. This causes stiffness and pain. This form of arthritis is most common in older people and is very rare in people under the age of 40. Women are more likely to suffer from it than men, and people who are overweight or obese are more at risk from the disease, especially in their knees. Joints that have suffered injury are also more susceptible to osteoarthritis. There has been research into the use of fish oil supplements in treating various forms of arthritis, although the focus is generally on rheumatoid arthritis as opposed to osteoarthritis. Rheumatoid arthritis is caused by the body's immune system attacking the joints and causing inflammation. Fats are involved in this inflammation and it is thought that those found in fish can affect the process and help reduce inflammation. Some studies testing this theory on people with rheumatoid arthritis have shown benefits, while other studies have shown no benefit at all. Research is continuing. Some research suggests that having more than an average of 1.5mg per day of vitamin A over many years may affect our bones and make them more likely to fracture when we're older. This is in addition to the risk of osteoporosis that older people, particularly women, face. Fish liver oil supplements (as well as many multivitamins) are high in vitamin A. So if you take supplements containing vitamin A, make sure you don't have more than a total of 1.5mg per day from your food and supplements. If you eat liver or liver products such as pâtè every week, you should avoid taking any supplements that contain vitamin A, because liver is very rich in vitamin A. Women who have been through the menopause and older men, who are more at risk of osteoporosis, should avoid eating liver or liver products more than once a week, or eat only small portions of liver. People at risk of osteoporosis who eat liver or liver products such as pâtè every week, should also avoid taking supplements containing vitamin A, and this includes fish liver oils. So if you want to take a fish supplement, you might want to choose to take fish oil supplements rather than cod liver oil or other fish liver oil supplements.
There are a number of ways you can find a qualified professional to advise you about your diet. You could consult either a dietitian or a nutritionist, depending on the kind of advice you want. Registered dietitians (RDs) are experts in diet and nutrition, so they can provide advice on all aspects of eating and diet, including special diets for medical conditions. The title 'dietitian' is protected by the Health Professionals Council (HPC). This means that someone can't call themselves a dietitian unless they are suitably qualified and registered with the HPC. Registered dietitians are regulated by the Government. The professional association for dietitians is the British Dietetic Association. You can contact a registered dietitian through your local hospital or GP surgery. You can also search online for a dietitian at Dietitians Unlimited, which is run by the Freelance Dietitians Group of the British Dietetic Association. The HPC publishes its register online, so you can check on its website to see if a dietitian is registered. Nutritionists are qualified to provide information about food and healthy eating, but not about special therapeutic diets. The Nutrition Society has a register of nutritionists (R Nutr), associate nutritionists (A Nutr) and public health nutritionists (R PH Nutr). The purpose of this register is to provide a list of nutritionists who have received an approved level of training. A list of registered nutritionists can be found on the Nutrition Society website.
Diet is very important for keeping our bones healthy, and so is doing enough physical activity. Weight-bearing exercise is particularly important for keeping our bones strong, for example, walking, climbing stairs, running and playing football. Bones are complicated living organs that are constantly changing and repairing. Most people know that bones need calcium. Milk and milk products are the best source of calcium. Soya beans, tofu and fish where you eat the bones (such as sardines, whitebait and pilchards) are other good sources. But we also need vitamin D for the calcium to be absorbed into the bones to make them strong. We get most of our vitamin D from the action of sunlight on our skin. So it's important to spend some time outdoors (taking care not to get sunburnt). We get the rest of our vitamin D from food. It's found in oily fish such as salmon, mackerel and sardines, and in eggs, some breakfast cereals and margarines. Some research suggests that having more than an average of 1.5mg per day of vitamin A over many years may affect our bones and make them more likely to fracture when we're older. If you eat liver (which is a very rich source of vitamin A) or liver products such as pâtè every week, you are likely to be having, on average, 1.5mg of vitamin A per day. If you aren't getting enough vitamin D, you might be more at risk of the harmful effects of too much vitamin A. People who may be particularly short of vitamin D include women of Asian origin, if you always cover up all your skin when you're outside and older people who rarely get outdoors, or people who eat no meat or oily fish. So if you're short of vitamin D it might be a good idea to boost the amount you're getting. You might want to think about taking a 10 microgram supplement of vitamin D each day. There are also many other nutrients that are thought to be important for healthy bones. Lots of these are found in fruit and vegetables. So, to keep your bones healthy, the best advice is to get active outdoors and eat a balanced diet, including at least five portions of a variety of fruit and vegetables every day, a moderate amount of milk and dairy products, and at least two portions of fish (one of which should be oily fish) every week.
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