Healthy Eating-Healthy Living

Healthy eating for people with diabetes is no different from what is recommended for everyone else. By choosing healthy foods and being active you will help manage your blood glucose (sugar) levels, avoid diabetes complications and control your weight.Needless to say, every treatment works better and longer with good dietary poractices,

There is no need to prepare separate meals or buy special foods, so relax and enjoy healthy eating along with the whole family!

What should I eat?
To help manage your diabetes, your meals need to be:
->Regular and spread evenly throughout the day.Say every 4 Hours.
->Portions should be nearly equal in 3-4 divided meals
->Lower in fat, particularly saturated fat and avoid refined carbohydrates -starches by all means.That means things like polished white rice, Maida, Sooji,cookies,candies, crunchy snacks/bites are all to be avoided.
->Diet must be based on high fibre (complex)carbohydrate foods such as wholegrain breads and cereals,beans, lentils, vegetables and fruits. An optimum mix of All The “Colours In Nature”  including Red. White, Green, Yellow etc has to be there.Remember more you process ,roast,fry or cook a food item less useful it becomes in a Diabetic’s diet.Stay close to nature !

Along with healthy eating, regular physical activity can help you to manage your blood glucose levels, reduce your blood fats (cholesterol and triglycerides) and maintain a healthy weight.Each Kilo of Your Body weight adds work for your ailing pancreas-to produce more Insulin!

Facts about fat

Fats have the highest energy (kilo joule or calorie) content of all foods. Eating too much fat can put on weight which in the long run may make it more difficult to manage your blood glucose levels. On the other hand small amounts of healthier fats add flavour to your food, may improve your health and reduce your risk of heart disease. Therefore, the type of fat you eat is important, as well as the amount.

Saturated fat

It is important to only eat saturated fats in small amounts because it raises your LDL (‘bad’) cholesterol levels . Saturated fat is found in meat fat, mainly processed meat, cream, butter, full fat milk and dairy foods, coconut milk/cream, palm oil (pastries, chocolate and deep fried foods), dripping, lard and ghee. Never more than 7-8% of total fat allowance should be as Saturated Fat.Please note saturated fats from natural foods is found to be less harmful though as compared to Vanaspati Ghee.

Polyunsaturated and monounsaturated fat

Some fat is important for good health. Eat a variety of polyunsaturated and monounsaturated sparingly in place of saturated fats.

Polyunsaturated fats include:

->Polyunsaturated margarines (check the label for the word ‘polyunsaturated’).
->Sunflower, safflower, soybean, corn, cottonseed, grapeseed and sesame oils.
->The fat found in oily fish such as herring, mackerel, sardine, salmon and tuna.
->Walnuts, pinenuts and brazil nuts.
->PUFA Rich Seed Oil if taken in excess or as sole fat being used in your cooking , as being advertised on Electronic and Print media can actually BE HARMFUL!!

->Monounsaturated fats sources include:
->Canola and olive margarines.
->Canola ,Mustard and olive oil.
->Peanuts, almonds, pecans and hazelnuts.
->Nut spreads and peanut oil contain a combination of polyunsaturated and monounsaturated fat.
->More amounts of MUFA can be taken if you can replace any other fat from your Diet BUT a 1:1:1 Mix of Saturated: Polyunsaturated: Monounsaturated ration is best to have.
->Main cooking in Mustard/Soya/Rice Bran oil, little frying in mustard oil and a dash of Desi ghee just to add flavor to your Daal OR Tadka to your Dal should be fine and will make provision for all the healthy combinations. Total half Kg per person per month of Desi Ghee is the best idea for most Indian Kitchens.

Saturated fats 6-10 percent are present even in seed oils so in fact it is not  mandatory to add some Desi Ghee ,as is suggested by some dietitians!

About Trans Fat
There are four kinds of fats: monounsaturated fat, polyunsaturated fat, saturated fat, and trans fat. Monounsaturated fat and polyunsaturated fat are the “good” fats. It is generally accepted that consumption of saturated fat should be kept low, especially for adults.

Trans fat (which means trans fatty acids) is the worst kind of fat, far worse than saturated fat.It Increases Bad Cholesterol and Reduces Good Cholesterol.
Partial hydrogenation is an industrial process used to make a perfectly good oil, such as soybean oil, into a perfectly bad oil. The process is used to make an oil more solid; to improve shelf-life of products;to provide longer fry-life for cooking oils, and to provide a certain kind of texture or “mouthfeel.” The big problem is that partially hydrogenated oil is laden with lethal Trans fat.
It is only the trans fat created by the partial hydrogenation of vegetable oils that we are concerned about and that should be eliminated completely from your diet. We are not much concerned with the kind of naturally occurring trans fat, found in small amounts even in pomegranates, cabbage, peas, or the type found in the meat and milk of cows, sheep and goats.Even with Desi Ghee ,the quanity should be a bigger concern than the quality of trans fats in it.
Partially hydrogenated oils are commonly found in processed foods like commercial fried or baked products such as snacks, cookies, cakes and crackers, and even in bread. They are also used as cooking oils (called “liquid shortening”) for frying in restaurants.
Top nutritionists at Harvard have stated as follows:
“By our most conservative estimate, replacement of partially hydrogenated fat in the U.S. diet with natural un-hydrogenated vegetable oils, would prevent approximately 30,000 premature coronary deaths per year, and epidemiologic evidence suggests this number is closer to 100,000 premature deaths annually.”30,000 to 100,000 premature deaths each year means between 82 and 274 each day!

The Trans fatty acid molecule- Everyone is worried about-Let us explore what it is ?

If you are interested in the science, here is a brief explanation.

In the illustration above, the light grey rounded areas are hydrogen atoms and the dark grey areas are carbon atoms. Note the different positioning of the hydrogen atoms in the middle which is caused by partial hydrogenation. The hydrogen atoms in the middle are in a “trans” position which makes this a “trans” fatty acid. The effect is to straighten out the molecules so they can pack together more closely and make the oil less liquid and more solid.

Health effects

Trans fats cause significant and serious lowering of HDL (good) cholesterol and a significant and serious increase in LDL (bad) cholesterol; make the arteries more rigid; cause major clogging of arteries; cause insulin resistance; cause or contribute to type 2 diabetes; and cause or contribute to other serious health problems.

Trans versus Saturated fat

Here are some of the differences between MUFA, PUFA and saturated fat.
contents of common oils

The saturated fat molecules CANNOT BEND

When we compare the biological effects of the trans fatty acids versus the saturated fatty acids, we see that
(1) saturated fatty acids raise HDL cholesterol, the so-called good cholesterol, whereas the trans fatty acids lower HDL cholesterol;
(2) saturated fatty acids lower the blood levels of the atherogenic lipoprotein [a], whereas trans fatty acids raise the blood levels of lipoprotein a [Lp(a)];
(3) saturated fatty acids conserve the good omega-3 fatty acids, whereas trans fatty acids cause the tissues to lose these omega-3 fatty acids;
(4) saturated fatty acids do not inhibit insulin binding, whereas trans fatty acids do inhibit insulin binding (see our page on diabetes);
(5) saturated fatty acids do not increase C-reactive protein, but trans fatty acids do increase C-reactive protein causing arterial inflammation;
(6) saturated fatty acids are the normal fatty acids made by the body, and they do not interfere with enzyme functions such as the delta-6-desaturase, whereas trans fatty acids are not made by the body, and they interfere with many enzyme functions such as delta-6-desaturase; and
(7) some saturated fatty acids are used by the body to fight viruses, bacteria, and protozoa, and they support the immune system, whereas trans fatty acids interfere with the function of the immune system.

CONCLUSION: Trans fats are WORST FATS, while  some little saturated fat in Diet can be allowed , rather has to be there!

Facts about carbohydrate

Carbohydrate foods are the best energy source for your body. When they are digested they break down to form glucose in the bloodstream. If you eat regular meals and spread your carbohydrate foods evenly throughout the day, you will help maintain your energy levels without causing large rises in your blood glucose levels.

All carbohydrate foods are digested to produce glucose but they do so at different rates – some slow, some fast. The Glycemic Index or GI is a way of describing how a carbohydrate containing food affects blood glucose levels. Foods with a low GI raise blood glucose more slowly than foods with a high GI. Including at least three low GI foods throughout the day, ideally one at each meal, can help with blood glucose management.

Not to forget Total Glycemic Load ,that means amount of prescribed ration in terms of quantity ,for the day and per meals ,should not exceed the prescribed limits.

Facts about sugar

Table sugar has a moderate GI similar to that of tropical fruits and whole meal bread. Therefore, a healthy eating plan for diabetes can include some sugar. However, it is still important to consider the nutritional value of the foods you eat.

Added sugars in nutritious foods such as breakfast cereals or low fat dairy products are preferable to food or drinks such as sweets, candies, waffles, lollies and soft drinks, which contain little else other than kilojoules. Some sugar may also be used in cooking and many recipes can be modified to use less than the amount stated. Select recipes that are low in fat (particularly saturated fat) and contain some fibre. 1/2 a teaspoon of sugar in cup of tea taken twice a day is OK!

Juices increase Free Fatty Acids-so, eat full fruit with pulp-fibre !
Alternative sweeteners-are not 100% safe
While it is no longer necessary to always use alternative sweeteners instead of sugar, there is still a place for artificially sweetened products, particularly those that may be consumed in large amounts such as cordials and soft drinks.

Facts about protein

Choose protein foods that are also low in fat. This will help to reduce the amount of saturated fat you eat. Protein foods include lean meat, poultry without the skin, seafood, eggs (not fried), unsalted nuts, soy products such as tofu and pulses (dried beans and lentils).

KFC and all those grilled chicken dishes mostly use Chicken with Skin and skin is rich in fat !

Other foods, condiments and drinks

You can use these foods to add flavour and variety to your meals:
Herbs, spices, garlic, chilli, lemon juice, vinegar and other seasonings.
Products labelled ‘low calorie’ e.g: low calorie/diet soft drinks, low cal jelly.
Tea, coffee, herbal tea, water, soda water, plain mineral water.

Facts about alcohol

If you enjoy alcohol, it is generally acceptable to have one standard drink a day if you are a woman and between one to two  a day if you are a man. It’s best to drink alcohol with a meal or some carbohydrate containing food.
One standard drink is equal to:
100 mL wine,
285 mL regular beer,
30 mL spirits,
60 mL fortified wine,
35- 40 ml of Whisky/Gin/Vodka/Rum
375 mL low-alcohol beer (less than 3% alcohol).

It is important to remember:
->To discuss alcohol with your diabetes educator or dietitian.
->To aim for at least two alcohol free days each week.
->That all alcoholic drinks are high in kilojoules (calories). Each Gm gives you 7 Cal. One 30 ml whisky equals One chapati extra ! Count this.
->That low alcohol or ‘lite’ beers are a better choice than regular or diet beers because they are lower in alcohol.
->When mixing drinks use low calorie/diet mixers such as diet cola, diet ginger ale, diet tonic water.
->That drinking a lot of alcohol can cause hypoglycaemia if you are taking insulin or certain diabetes tablets.
->Drink slowly, keep snacking with drink.

Weight management

Being overweight, especially around your waistline, makes it more difficult to manage your diabetes and increases your risk of heart disease. It is not essential to reach your ideal weight as a small weight loss (5-10% of body weight) can make a big difference to your health.

Measuring your waistline is another great way of checking your weight along with by weighing yourself regularly. In general,Indian  women need to aim for a waist measurement of less than 80 cm and men less than 90 cm.

If you are carrying excess weight around the middle, try to lose some of it by:
Following a diet plan lower in calories or kilo joules and total fat (particularly saturated fat).
Doing regular physical activity such as walking, dancing, aerobics, riding a bike or swimming.
Ask your doctor for safe and elaborate exercise plan for you!

IMP: A word about Non Veg. choices:
Chicken without skin has approximately 45 -48 mg of Cholesterol per 100 Gms
Lean Mutton without fat and Blood has 54-56  mgs of Cholesterol per 100 Gms.
Many of us, while avoiding Red Meat , do not bother to check how much white meat they are eating! Therefore if taken excessively than there is no advantage left for not consuming red meat ! For example If you consume Half Tandoori Chicken you consume More Cholesterol then when you consume two Mutton Seekh Kebabs,which by weight, contain more of Herbs and Gram Flour !

It is also important to note that Dietary Cholesterol in reality Not as Bad as has been projected by media and lay press

So it is clear that correct choice and quantity you eat is much more important then simply avoiding Red Meat !

Moreover,Research has shown that – Diet restrictions can change your Lipids Only by 10 % which might not be having much health impact.

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