World Diabetes Day

It's that time of the year when firecrackers and good food reign. But even as the city celebrates Deepavali with much gusto and a few bangs, diabetologists are gearing up to mark World Diabetes Day, which falls on November 14.

Diabetes, a condition in which blood sugar levels are not under control, is a silent killer and affects the eyes, the kidneys and the heart. Despite the multitude of campaigns organised every year, the incidence of the disease is rising, and dangerously so — a possible indicator that awareness is still low. Each of the diabetology departments in the three major tertiary care government hospitals in the city receives around 800 to 1,000 patients every day. Around 98 per cent of patients have type-2 diabetes, a condition that is associated with lifestyle. 

PREVENTING DIABETES is within your own managed.

What you need to know about diabetes and diet

Eating right is vital if you're trying to prevent or control diabetes. While exercise is also important, what you eat has the biggest impact when it comes to weight loss. But what does eating right for diabetes mean? You may be surprised to hear that your nutritional needs are virtually the same everyone else: no special foods or complicated diets are necessary.

A diabetes diet is simply a healthy eating plan that is high in nutrients, low in fat, and moderate in calories. It is a healthy diet for anyone! The only difference is that you need to pay more attention to some of your food choices—most notably the carbohydrates you eat.

Myths and facts about diabetes and diet

MYTH: You must avoid sugar at all costs. 
Fact:  The good news is that you can enjoy your favourite treats as long as you plan properly. Dessert doesn't have to be off limits, as long as it's a part of a healthy meal plan or combined with exercise.

MYTH: A high-protein diet is best. 
Fact:  Studies have shown that eating too much protein, especially animal protein, may actually cause insulin resistance, a key factor in diabetes. A healthy diet includes protein, carbohydrates, and fats. Our bodies need all three to function properly. The key is a balanced diet.

MYTH: You have to cut way down on carbs. 
Fact:  Again, the key is to eat a balanced diet. The serving size and the type of carbohydrates you eat are especially important. Focus on whole grain carbs since they are a good source of fiber and they are digested slowly, keeping blood sugar levels more even.

MYTH: You'll no longer be able to eat normally. You need special diabetic meals. 
Fact:  The principles of healthy eating are the same—whether or not you're trying to prevent or control diabetes. Expensive diabetic foods generally offer no special benefit. You can easily eat with your family and friends if you eat in moderation.

Diabetes and diet tip 1: Choose high-fiber, slow-release carbs

Carbohydrates have a big impact on your blood sugar levels—more so than fats and proteins—but you don't have to avoid them. You just need to be smart about what types of carbs you eat.

In general, it's best to limit highly refined carbohydrates like white bread, pasta, and rice, as well as soda, candy, and snack foods. Focus instead on high-fiber complex carbohydrates—also known as slow-release carbs. Slow-release carbs help keep blood sugar levels even because they are digested more slowly, thus preventing your body from producing too much insulin. They also provide lasting energy and help you stay full longer.

Choosing carbs that are packed with fiber (and don't spike your blood sugar)
Instead of…	Try these high-fiber options…
White rice	Brown rice or wild rice
White potatoes (including fries and mashed potatoes)	Sweet potatoes, yams, winter squash, cauliflower mash
Regular pasta	Whole-wheat pasta
White bread	Whole-wheat or whole-grain bread
Sugary breakfast cereal	High-fiber breakfast cereal (Raisin Bran, etc.)
Instant oatmeal	Steel-cut oats or rolled oats
Croissant or pastry	Bran muffin

Making the glycemic index easy

What foods are slow-release? Several tools have been designed to help answer this question. The glycemic index (GI) tells you how quickly a food turns into sugar in your system. Glycemic load, a newer term, looks at both the glycemic index and the amount of carbohydrate in a food, giving you a more accurate idea of how a food may affect your blood sugar level. High GI foods spike your blood sugar rapidly, while low GI foods have the least effect.

You can find glycemic index and glycemic load tables online, but you don't have to rely on food charts in order to make smart choices. Australian chef Michael Moore has come up with an easier way to regulate the carbs you eat. He classifies foods into three broad categories: fire, water, and coal. The harder your body needs to work to break food down, the better.

§ Fire foods  have a high GI, and are low in fiber and protein. They include "white foods" (white rice, white pasta, white bread, potatoes, most baked goods), sweets, chips, and many processed foods. They should be limited in your diet.

§ Water foods  are free foods—meaning you can eat as many as you like. They include all vegetables and most types of fruit (fruit juice, dried fruit, and canned fruit packed in syrup spike blood sugar quickly and are not considered water foods).

§ Coal foods  have a low GI and are high in fiber and protein. They include nuts and seeds, lean meats, seafood, whole grains, and beans. They also include "white food" replacements such as brown rice, whole-wheat bread, and whole-wheat pasta.

8 principles of low-glycemic eating

1. Eat a lot of non-starchy vegetables, beans, and fruits  such as apples, pears, peaches, and berries. Even tropical fruits like bananas, mangoes, and papayas tend to have a lower glycemic index than typical desserts.

2. Eat grains in the least-processed state possible:  "unbroken," such as whole-kernel bread, brown rice, and whole barley, millet, and wheat berries; or traditionally processed, such as stone-ground bread, steel-cut oats, and natural granola or muesli breakfast cereals.

3. Limit white potatoes and refined grain products  such as white breads and white pasta to small side dishes.

4. Limit concentrated sweets —including high-calorie foods with a low glycemic index, such as ice cream— to occasional treats. Reduce fruit juice to no more than one cup a day. Completely eliminate sugar-sweetened drinks.

5. Eat a healthful type of protein at most meals,  such as beans, fish, or skinless chicken.

6. Choose foods with healthful fats,  such as olive oil, nuts (almonds, walnuts, pecans), and avocados. Limit saturated fats from dairy and other animal products. Completely eliminate partially hydrogenated fats (trans fats), which are in fast food and many packaged foods.

7. Have three meals and one or two snacks each day,  and don't skip breakfast.

8. Eat slowly and stop when full.

Diabetes and diet tip 2: Be smart about sweets

Eating for diabetes doesn't mean eliminating sugar. If you have diabetes, you can still enjoy a small serving of your favorite dessert now and then. The key is moderation.

But maybe you have a sweet tooth and the thought of cutting back on sweets sounds almost as bad as cutting them out altogether. The good news is that cravings do go away and preferences change. As your eating habits become healthier, foods that you used to love may seem too rich or too sweet, and you may find yourself craving healthier options.

How to include sweets in a diabetes-friendly diet

§ Hold the bread (or rice or pasta) if you want dessert.  Eating sweets at a meal adds extra carbohydrates. Because of this it is best to cut back on the other carb-containing foods at the same meal.

§ Add some healthy fat to your dessert.  It may seem counterintuitive to pass over the low-fat or fat-free desserts in favor of their higher-fat counterparts. But fat slows down the digestive process, meaning blood sugar levels don't spike as quickly. That doesn't mean, however, that you should reach for the donuts. Think healthy fats, such as peanut butter, ricotta cheese, yogurt, or some nuts.

§ Eat sweets with a meal, rather than as a stand-alone snack.  When eaten on their own, sweets and desserts cause your blood sugar to spike. But if you eat them along with other healthy foods as part of your meal, your blood sugar won't rise as rapidly.

§ When you eat dessert, truly savor each bite.  How many times have you mindlessly eaten your way through a bag of cookies or a huge piece of cake. Can you really say that you enjoyed each bite? Make your indulgence count by eating slowly and paying attention to the flavors and textures. You'll enjoy it more, plus you're less likely to overeat.

Tricks for cutting down on sugar

§ Reduce how much soda and juice you drink.  If you miss your carbonation kick, try sparkling water either plain or with a little juice mixed in.

§ Reduce the amount of sugar in recipes  by ¼ to ⅓. If a recipe calls for 1 cup of sugar, for example, use ⅔ or ¾ cup instead. You can also boost sweetness with cinnamon, nutmeg, or vanilla extract.

§ Find healthy ways to satisfy your sweet tooth.  Instead of ice cream, blend up frozen bananas for a creamy, frozen treat. Or enjoy a small chunk of dark chocolate, rather than your usual milk chocolate bar.

§ Start with half of the dessert you normally eat,  and replace the other half with fruit.

Proceed with caution when it comes to alcohol

It's easy to underestimate the amount of calories and carbs in alcoholic drinks, including beer and wine. And cocktails mixed with soda and juice can be loaded with sugar. If you're going to drink, do so in moderation (no more than 1 drink per day for women; 2 for men), choose calorie-free drink mixers, and drink only with food. If you're diabetic, always monitor your blood glucose, as alcohol can interfere with diabetes medication and insulin.

Diabetes and your diet tip 3: Choose fats wisely

Fats can be either helpful or harmful in your diet. People with diabetes are at higher risk for heart disease, so it is even more important to be smart about fats. Some fats are unhealthy and others have enormous health benefits. But all fats are high in calories, so you should always watch your portion sizes.

§ Unhealthy fats  – The two most damaging fats are saturated fats and trans fats. Saturated fats are found mainly in animal products such as red meat, whole milk dairy products, and eggs. Trans fats, also called partially hydrogenated oils, are created by adding hydrogen to liquid vegetable oils to make them more solid and less likely to spoil—which is very good for food manufacturers, and very bad for you.

§ Healthy fats  – The best fats are unsaturated fats, which come from plant and fish sources and are liquid at room temperature. Primary sources include olive oil, canola oil, nuts, and avocados. Also focus on omega-3 fatty acids, which fight inflammation and support brain and heart health. Good sources include salmon, tuna, and flaxseeds.

Ways to reduce unhealthy fats and add healthy fats:

§ Cook with olive oil instead of butter or vegetable oil.

§ Trim any visible fat off of meat before cooking and remove the skin before cooking chicken and turkey.

§ Instead of chips or crackers, try snacking on nuts or seeds. Add them to your morning cereal or have a little handful for a filling snack. Nut butters are also very satisfying and full of healthy fats.

§ Instead of frying, choose to grill, broil, bake, or stir-fry.

§ Serve fish 2 or 3 times week instead of red meat.

§ Add avocado to your sandwiches instead of cheese. This will keep the creamy texture, but improve the health factor.

§ When baking, use canola oil or applesauce instead of shortening or butter.

§ Rather than using heavy cream, make your soups creamy by adding low-fat milk thickened with flour, pureed potatoes, or reduced-fat sour cream.

Diabetes and diet tip 4: Eat regularly and keep a food diary

If you're overweight, you may be encouraged to note that you only have to lose 7% of your body weight to cut your risk of diabetes in half. And you don't have to obsessively count calories or starve yourself to do it.

When it comes to successful weight loss, research shows that the two most helpful strategies involve following a regular eating schedule and recording what you eat.

Eat at regularly set times

Your body is better able to regulate blood sugar levels—and your weight—when you maintain a regular meal schedule. Aim for moderate and consistent portion sizes for each meal or snack.

§ Don't skip breakfast.  Start your day off with a good breakfast. Eating breakfast every day will help you have energy as well as steady blood sugar levels.

§ Eat regular small meals—up to 6 per day.  People tend to eat larger portions when they are overly hungry, so eating regularly will help you keep your portions in check.

§ Keep calorie intake the same.  Regulating the amount of calories you eat on a day-to-day basis has an impact on the regularity of your blood sugar levels. Try to eat roughly the same amount of calories every day, rather than overeating one day or at one meal, and then skimping on the next.

Keep a food diary

Research shows that people who keep a food diary are more likely to lose weight and keep it off. In fact, a recent study found that people who kept a food diary lost twice as much weight as those who didn't.

Why does writing down what you eat and drink help you drop pounds? For one, it helps you identify problem areas—such as your afternoon snack or your morning latte—where you're getting a lot more calories than you realized. It also increases your awareness of what, why, and how much you're eating, which helps you cut back on mindless snacking and emotional eating.

What about exercise?

When it comes to preventing, controlling, or reversing diabetes, you can't afford to overlook exercise. Exercise  can help your weight loss efforts, and is especially important in maintaining weight loss. There is also evidence that regular exercise can improve your insulin sensitivity even if you don't lose weight.

You don't have to become a gym rat or adopt a gruelling fitness regimen. One of the easiest ways is to start walking for 30 minutes five or more times a week. You can also try swimming, biking, or any other moderate-intensity activities—meaning you work up a light sweat and start to breathe harder. Even house and yard work counts.

Regards,

ChandraSekhar