Eating discipline and hygiene for diabetics

 

Today diabetes is becoming such a common problem. India already has second highest diabetics in the country, and it is estimated that almost 11% of population is diabetic and another 15% is pre diabetic. The number has increased substantially by 44% over the last 4 years. In 2021 India had 74 mn diabetics which increased by 36% in 2022 to 101 mn, as per latest survey by ICMR (Indian Council of Medical Research). It is estimated that by 2045 India will be home to 125 mn diabetics however trend is moving ahead of earlier estimates. Every 6^th diabetic person in the world is Indian. Junk food, stress, lack of sleep and lack of physical activity is making every other person a diabetic in India. And I feel there is great deal of unawareness and misinformation as to eating disciplines for a diabetic. Many people stop eating fruits, then lot of people have artificial sweeteners, people try one meal a day also, avoid sugar in tea and many things. Let’s see what matters, what’s true, what is the science behind that.

Why it happens?

Its not a disease its a lifestyle disorder...!

To understand the required discipline, you need to understand a little background of diabetes. Ther are two types of diabetes ie. Type I and type II. Type I is by birth while type II, the common one, is a lifestyle disorder. In Type I diabetes pancreas don’t secret insulin at all whereas in type II insulin is getting produced but your body becomes resistant to insulin due to overuse or continuous secretion (over secretion happens due to poor eating habits and improper lifestyle). Since the body becomes resistant to insulin, it stops having the required effect on the body. Once that happens whenever you eat sugary substance it spikes sugar in your blood which is not good for your overall health. Having known about the background of diabetes, let’s see what to take care of while choosing food and what discipline to maintain.

Choose low glycemic index (GI) food: The glycemic index (GI) is a value used to measure how much specific foods increase blood sugar levels. Foods are classified as low, medium, or high glycemic foods and ranked on a scale of 0–100. The lower the GI of a specific food, the less it may affect your blood sugar level. Here are the three GI ratings: Low: 55 or less, Medium: 56–69, High: 70 or above. High GI foods will spike your blood sugar and should be avoided. Foods high in refined carbs and sugar, low on fibre, protein is digested more quickly and often have a high GI, while foods high in protein, fat, or fibre typically have a low GI. Foods that contain no carbs are not assigned a GI and include meat, fish, poultry, nuts, seeds, herbs, spices, and oils. Glucose has a GI of 100 and every other food is scored relative to that. This will help you a lot in choosing or avoiding food. So its clear now GI of food matters not whether it has sugar or not, whether it tastes sweet or not. Many fruits are sweet but not high on GI. So, its OK to have such fruits in moderation. Eg its ok to have banana, mango, dates in moderation. White rice, potatoes, maida, table sugar, jaggery, honey all are high GI food and should be avoided. Following is the list of high GI food which will help you.

• Bread: white bread, bagels, naan, pita bread, pizza base
• Rice: white rice, jasmine rice, arborio rice (Its preferable to have semi boiled rice... Semi boiled rice is medium GI)
• Cereals: instant oats, breakfast cereals, Maida, sabu dana, rawa (particularly without veggies)
• Starchy vegetables: mashed potatoes, potatoes, French fries
• Baked goods: cake, doughnuts, cookies, croissants, muffins
• Snacks: chocolate, crackers, microwave popcorn, chips, pretzels, ice creams, cake, pastries, samosa, vada pav, idlis, dosa
• Sugar-sweetened beverages: soda, fruit juice, sports drinks, colas
• Fruit Juices: Packed fruit juices or even fresh fruit juices are high GI. Fresh citrus fruit juice is OK.

 
Whenever you are in doubt google it to know its GI. In a couple of months, you will have a broad idea of GI levels of different types of food.

 Eat enough protein: Protein does not spike your blood sugar, it satisfies your hunger for longer, burns more calories in digestion and builds & repairs your muscles. Its very important to have right mix of protein in your diet. As per WHO one needs to eat a minimum of 0.8 grams of protein per kilogram of body weight. India is a protein deficient country and almost 80% of population eats lesser than required protein. Low protein intake is worse for diabetics. Normally lower protein intake results in relatively frequent hunger. It’s compensated by higher carbohydrates to satisfy the hunger. Higher carbohydrates will result in a spike in blood sugar. Low protein diet conversely means high fat and high carbohydrate diet. High carbohydrate diet will spike blood sure. Hence ensure the right protein in each meal or snack in front of you. Dairy products, lean meat, eggs, legume & pulses, nuts are protein food. You can add protein supplements also. That’s very helpful.

Eat smaller size frequent meals: Eating smaller size frequent meals is preferable in diabetes. Although scientifically it makes no difference and eating balanced nutrition with right calories is more important. But eating smaller frequent meals helps practically. If you are having larger meal you need to ensure that its not high on carbohydrates. Normally Indian meals are high on carbohydrates and low on protein and fire. Eating a large carbohydrate high meal will immediately cause a spike in blood sugar. Hence It’s helpful to eat small size meals in diabetes. Having smaller meals will have less chances of spike in blood sugar even if they lacks protein, although lack of protein has its own drawbacks. Targeting 6 smaller healthy meals is better than targeting two big meals.

Can intermittent fasting help or 1 / 2 meal in a day helpful: Intermittent fasting is healthy and can be helpful in diabetes, but it needs caution for diabetics. No#1, long hours of fasting can backfire and can result in higher blood sugar or can result even in low blood sugar. Spike in blood sugar due to fasting sounds counter intuitive, but it can happen due to rise in cortisol levels. So doing intermittent fasting in diabetes needs proper supervision and monitoring. Once one adopts to that, one can continue with the practice. 2^nd if you are having a larger meal, you need to be cautious that it should not be high on carbohydrate and it has enough protein. Sufficient protein is important in smaller sized meals also, but it becomes essential in larger meals. Smaller meals, even carbs base is less likely to spike blood sugar although low protein diet has its own drawbacks.

Eat enough fiber: Having a higher amount of fiber in food is very much required for a diabetic.  Because the body is unable to absorb and break down fibre, it doesn't cause a spike in blood sugar the way other carbohydrates can. This can help keep your blood sugar in your target range. Also, high fibre meals automatically tend to be low carbs. Those with prediabetes, type 1, or type 2 diabetes should increase their dietary fibre intakes by 15 g per day or to 35 g per day.  One practical way to increase fibre intakes is to replace refined grain products with whole grain foods. Add salad in your diet. You can add psyllium husk also in night. Brown breads, brown breads are preferable due to their higher fibre content. At the same time refined carb like maida, white bread, white rice is to be avoided because of their low fibre content.

How far artificial sweeteners help? Artificial sweeteners can be a short-term way to help some people lessen their use of sugar and lose or manage weight. In general, sugar substitutes are safe for healthy adults. But be aware of how sugar substitutes affect your food and drink choices. These ingredients may get your tastebuds used to sweetness. Products made with sugar substitutes also may give you the wrong message about processed foods. A snack labeled low sugar, or no sugar may not be the most nutritious choice. Whole foods, such as fruits and vegetables, usually have the best mix of nutrients for the body. But artificial sweeteners can help some people enjoy sweetness without excess calories. And if used in moderation, artificial sweeteners can be part of a healthy diet.

In general, it is safest to take in small amounts of sugar substitutes. And it's best to use sugar substitutes for a short time, or intermittently. So, try to cut back if you use them a few times a day. There is unproven noise around about the aftermath of sugar substitutes. People talk about cancer, liver damage, poor gut health, poor heart health or heart attack. But none of those are proven. Health agencies have clarified that sugar substitutes do not cause serious health problems.

How far jaggery or honey helps? Jaggery or honey are better options than table sugar as far as nutrition part is concerned, but they have al most similar amount of calorie and carbs content. All raises your blood sugar at almost similar pace but sugar and jaggery is little better because they content some nutrition also opposite to table sugar which absolutely have no nutrition other than simple carbs. Jaggery has good amount of iron. All have similar glycemic index. However, its better to have jaggery or honey in moderation in comparison to table sugar.

Friends’ diabetes is not any infection or disease but a lifestyle disorder. You are not eating, sleeping, exercising, drinking, and thinking well which is causing mal function in your body. I have tried to address the key things to be taken care of while eating. If you follow these disciplines, it can help you in a big way. Happy healthy living!!