Be Aware – Food Choices for People with Diabetes

Diabetes Care – Educate to Protect Tomorrow

The incidence of diabetes is increasing in India and we are marching towards becoming the diabetic capital of the world. The major factors which contribute to this are a rise in sedentary lifestyles, unhealthy eating patterns, etc.

This year, the theme for World Diabetic Day is ACCESS TO DIABETIC CARE – EDUCATE TO PROTECT TOMORROW. Nutrition becomes the first and the most important step in the management of diabetes. Deviating from the balanced controlled eating patterns, we get stuck between Eastern and Western food influences, which add more stress to our system and less calorie expenditure because of a sedentary life style, all leading to metabolic disorders and DIABETES MELLITUS becomes the queen of all.

Factors contributing to good glycemic control are:

• Healthy lifestyle
• Good physical activity
• Optimum nutrition with specialized nutritional requirements
• Regular health checks
• Manage stress
• Awareness

Henceforth, we need an integrated approach by a multi-disciplinary team towards managing diabetes.

Diabetes is a metabolic disorder characterized by the presence of excessive sugar in blood and urine due to deficient action of insulin or insulin resistance. Insulin helps in glucose uptake by the levels of circulating blood sugar in the system.

From a dietician’s perspective, the general instructions are given below.

Diabetes and Food

The meals of a person with diabetes need not be very different from normal food. Your dietician can help plan your diet to suit your work routine and lifestyle. A good plan improves control and helps reduce the requirements of insulin or tablets.

Free Foods

• Salads and boiled vegetables from the group of vegetables allowed (above ground) i.e., tomato, cucumber, radish, green leafy vegetables, cabbage, capsicum, gourds, etc.
• Beverages like rasam, vegetable soup (clear), lime juice with salt, diluted butter milk and tomato juice.

Foods to Be Taken in Limited Quantity

• Vegetables like carrots, peas and beans.
• Cereals like wheat, rice and their products like refined flour, bread, pulses and gram.
• Oil allowance per day = 4-5 teaspoons, preferably PUFA.
• Fish and chicken in boiled, steamed, grilled or baked form not more than four times a week. Allowance per day is 75-100 gm.
• Egg yolk, including those used in cooking, not more than two per week. Egg white may be taken more frequently.
• Fruits like orange, sweet lime, apple, papaya and guava. Allowance – 100 gm/day.
• Whole milk intake should not exceed 300 ml per day including that used for curd, tea, coffee, paneer, etc.

Foods to Be Avoided

• Sugar, honey, glucose, jaggery, jams & jelly.
• Fats like vanaspathi, ghee, butter & coconut oil.
• Fried food items and foods cooked in a lot of oil like chips, pappad, samosa, bajji, etc.
• Bakery products like cakes, pastries, cream biscuits, etc.
• Sweets like laddu, burfi, payasam, pudding, desserts, ice creams, etc.
• Refined starch products like corn flour, commercial jelly products, custard powder and arrowroot powder, etc.
• Root vegetables like potato, yam, colocasia, tapioca, etc.
• High calorie fruits like banana, mango, grapes, pomegranate, sapota, custard apple, jack fruit, wood apple, etc.
• Dried fruits like dates, raisins, currants, etc. and nuts like almonds, cashew nuts, groundnuts, etc.
• ALL sweetened aerated drinks.
• Proprietary drinks like Horlicks, Boost, Bournvita, Complan, etc.
• Fatty meats like ham, bacon, yolk of egg, red meat, organ meat, crab, shrimp, etc.
• Pickles made in oil.
• Coconut – MINIMISE AS PER RECOMMENDATIONS AND EATING PATTERN.

Recommendations

• High fibre food items like green leafy vegetables and green salads should be taken in plenty.
• Whole grams and pulses are preferable to polished ones. They may be included in at least one meal in sprouted or raw form.
• Whole wheat beard is preferable to refined flour bread.

NOTE: Golden Rule – NO FEASTING NO FASTING

Equal spacing of the three major meals per day is very important. Free food items should be taken in between the major meals and whenever there is a feeling of hunger.

Omission of any food items from the list given above does not imply that they are freely allowed or prohibited.

If intermittent fasting is followed, do it under proper dietician supervision.

Artificial Sweeteners

Alternative sweeteners both nutritive (fructose, orbital, mannitol) or non-nutritive (saccharin, aspartame, acesulfame k, cyclamate) may be used to satisfy the need for sweetness. Nutritive sweeteners such as fructose, sorbitol and mannitol are carbohydrates and will ultimately add to your carbohydrate intake. Non-nutritive sweeteners such as saccharin, aspartame and acesulfame k are safe in moderate amounts. Sugar alcohols such as sorbitol may have a laxative effect.

Stevia – can be considered as the first preference.

Hypoglycemia or Low Blood Sugar

Low blood sugar levels occur when there is:

• Not enough food intake
• Too much insulin
• Extra exercise
• Alcohol
• A combination of the above factors

Symptoms:

Hunger, nervousness, shakiness, sweating, dizziness, headaches, blurred vision, pounding heart, unsteadiness and inability to think clearly.

What should you do?

Always take some form of sugar first such as fruit juice or glucose and then one carbohydrate choice such as a sandwich or any cereal preparation. During night time, treat as above and include some protein such as egg, meat or dhal.

Take Care on Sick Days!

Be sure to continue your diabetes medicines if you are sick. If you take insulin or pills and cannot eat your meal as planned, you may need to have carbohydrates in order to prevent low blood sugar.

Choose one of the foods from this every hour:

If you have vomiting, diarrhoea or a fever, it is important to drink 1 cup of liquid every hour.

Exercise

People on insulin may require extra carbohydrate before, during and after exercise. Follow your doctor’s advice on how much exercise is appropriate for you.

SEE YOUR DIETICIAN FOR AN INDIVIDUALISED MEAL PLAN. Oral nutritional supplement can be taken as prescribed.

KEY TAKE AWAY – CHOOSE SMART, EAT RIGHT AND STAY FIT.