FOOD AND NUTRITION

  • What is nutrition therapy and how it helps in managing diabetes?
  • What is a diabetic diet?
  • Does diabetic diet means totally avoiding sugar and sweets?
  • Can diabetics have honey and jaggery?
  • Are artificial sweeteners good for diabetics?
  • Is it advisable to snack in between meals for people with diabetes?
  • What are the healthier snacks a person with diabetes can have?
  • What non-vegetarian food items can a person with diabetes include in the diet?
  • Which is the best oil and how much one should consume?
  • What are the healthy beverages options for people with diabetes?
  • Which fruits a person with diabetes can eat and in how much quantity? And, which fruits one should avoid?
  • Is it true that home or kitchen remedies helps in lowering blood sugar levels?
  • What are major nutrients required by the body and why?
  • What are carbohydrates and how it impact blood sugar levels?
  • What are complex carbs and why they are better than refined carbs?
  • What is fiber ? In what quantity it should be consumed ?
  • What are the soluble and insoluble fiber and their sources?
  • What are proteins? How are they important for the body?
  • What are fats? Why are they important for the body?
  • What are unhealthy fats? What are their sources?
  • What are healthy fats? What are their sources?
  • How are vitamins and minerals important for the body?
  • What are the common vitamins and their sources?
  • What are the common minerals? What are the sources of minerals?
  • What are antioxidants and why they required by our body?
  • How can a person with diabetes ensure that he/she is having a balanced diet?
  • How one can follow portion control in their diet?
  • What is Glycemic Index and how one can choose their food according to that to maintain better blood sugars?
  • If someone with diabetes is not able to lose weight, is it that when they follow a crash diet, they lose weight quickly?
What is nutrition therapy and how it helps in managing diabetes?

For people with diabetes, the most challenging part of the treatment plan is determining what to eat. This question can be solved with the help of nutritional therapy which help people with diabetes learn how to make appropriate choices that will have a positive impact in preventing diabetes, managing existing diabetes, and preventing, or at least slowing, the rate of development of diabetes complications. That’s why proper nutrition is important at all levels of diabetes prevention.

As, there is not a one-size-fits-all for people with diabetes. That’s why it’s strongly recommend individuals with diabetes should receive individualized nutrition counselling, preferably provided by a trained nutritionist or diabetes educator who is knowledgeable and skilled in providing nutritional guidelines according to the disease condition.

What is a diabetic diet?

There is nothing like a diabetic diet. Diet for diabetes is a healthy diet containing food from all food groups in a balanced proportion according to personal need, preferences and condition.

Does diabetic diet means totally avoiding sugar and sweets?

Sugar and sweets are basically refined carbohydrates which are easily converted into glucose and raise blood glucose levels. It is advisable to limit their intake as much as possible. However, type, frequency and portion should be customised by nutritional professional.

Can diabetics have honey and jaggery?

Generally, there’s no advantage of substituting honey or jaggery for sugar in a diabetes eating plan. Both honey or jaggery and sugar will affect your blood sugar level in a similar way. In fact, honey actually has slightly more carbohydrates and more calories per teaspoon than does granulated sugar.

But if someone prefer the taste of honey or jaggery, then can go ahead and use it — but only in moderation. One can add 1/4th tsp honey in some preparation or a small piece of jaggery (size of a candy or thumb) can be taken once in a while not frequently.

Are artificial sweeteners good for diabetics?

In general, it is not a good idea to depend upon artificial sweeteners too much as they won’t give any nutritional value just will add taste. But – It is easier said than done. So a few tablets or drops (2-3 in a day) wouldn’t harm. Just don’t be an addict! And, use artificial sweeteners as sparingly as possible.

Is it advisable to snack in between meals for people with diabetes?

People with diabetes are always advised to have “small and frequent meal pattern” to avoid any fluctuations (sudden “spike” or “low”) in blood sugar profile. So, rather than having a three major meals, one should divide their meals into smaller parts which may also include 2-3 small snacks to prevent any low sugars or hypoglycemia between meals. This healthy snacking helps in reducing the amount of food intake in the major meal. So the person eats fewer calories which can be well handled by the body metabolism.

What are the healthier snacks a person with diabetes can have?

Healthy snacking is an essential part for people with diabetes to keep blood sugar levels steady and avoid overeating at mealtime. Snack should be a combination of complex carbs and protein. Some good options include fresh fruit, almonds, walnuts, buttermilk (chaach), roasted channa, whole wheat vegetable sandwich, sprouts, paneer or tofu with some sautéed veggies or a besan cheela etc.

What non-vegetarian food items can a person with diabetes include in the diet?

One should prefer lean meats including fish, chicken and egg whites which are healthier options. Have them in grilled, roasted or boiled form rather than frying them. Avoid red meats like mutton, pork and sausages as they are high in cholesterol.

Which is the best oil and how much one should consume?

No single oil is considered as the best oil. Instead it is advised to use blends or combination of different oils to include all the essential and healthy in the diet. A good example is olive or canola oil with soybean, rice-bran or mustard oil. General recommended allowance of cooking oil for an adult is 300-400 ml oil per month OR 3-4 tsp oil; per person; per day

What are the healthy beverages options for people with diabetes?

Water is the best drink one can have and at least 8-10 glasses of water in a day is required to stay hydrated. Other preferable beverage options are double toned milk with cardamom or kesar, buttermilk (chach), light tea, hot or cold coffee, green tea, lemon water, coconut water and homemade vegetable soups.

Which fruits a person with diabetes can eat and in how much quantity? And, which fruits one should avoid?

Fruit contains natural sugar but also contain a good mix of vitamins, minerals, and fiber. One can eat fruit in moderation i.e. 70-100 gm or 1 medium fruit at a time as snack option not along with a meal. One can eat 1-2 serving of fruit in a day. Some of the good choices are apple, melon, pear, peach, plums, berries, jamun, papaya, orange, mousambi or guava.

As far as fruits like mango, banana, chiku, grapes, custard apple etc. are concerned one can eat a little portion (e.g. 1-2 small pieces of mango or chiku rather than eating complete fruit or few pieces of grapes or 1 small banana at a time) once in a while (if sugars are controlled) but not regularly. However, it is important to remember you can eat whole fruits but avoid all kind of fruit juices (whether fresh or packed) as it requires several fruits to make small serving of juice and juices are devoid of fiber that’s why can increase your sugars rapidly.

Is it true that home or kitchen remedies helps in lowering blood sugar levels?

Yes, some Indian home remedies are found to help in managing sugar levels like fenugreek seeds (methi dana), cinnamon, bitter gourd (karela), bottle gourd (ghiya/laukey), jamun. These can be taken in natural form in reasonable quantities. However, healthcare provider should be informed and medications should not be altered or stopped without doctor’s advice. And following a healthy lifestyle still remain essential to manage diabetes in a long run.

What are major nutrients required by the body and why?

The food we eat contains nutrients that the body needs. It is important for us to consume these essential nutrients on a daily basis for the body to function properly. Deficiencies, excesses and imbalances in diet can produce negative impacts on health. There are three main nutrients also called macronutrients (needed in large amounts) that make up food and contribute calories are: carbohydrate, protein and fat. Whereas, vitamins and minerals often called micronutrients as the body needs in small amounts to work and perform properly.

What are carbohydrates and how it impact blood sugar levels?

Carbohydrate foods play an important role in our diet. Carbohydrates or carb are digested in the body to form glucose in the blood which is a major source of energy, which provides 4 kcal for each gram of carb. They provide energy in the form of calories that the body needs to be able to work, and to support other functions. Carbohydrates should supply 40 to 60 percent of the average person’s caloric intake.

Carbohydrate is the nutrient that will have the biggest impact on the blood glucose levels. The effect of carbohydrate will depend on i) the amount of carbohydrate you eat and ii) the type of carbohydrate you eat. Cereal and grains, fruits and vegetables, starchy vegetables, milk and milk products and sugar or sugar containing food are the sources of carbohydrate in the diet.

What are complex carbs and why they are better than refined carbs?

Complex carbohydrates are made up of sugar molecules that are strung together in long, complex chains. As compared to simple or refined carbs people with diabetes are advised to prefer or eat complex carbs as they digest and absorb slowly and prevent a sudden spike in blood glucose levels. The common sources of complex carbohydrate in foods are whole grains like whole wheat, oats, barley, quinoa, sorghum, rye, nuts, and in fruits, vegetables, legumes, and pulses.

What is fiber ? In what quantity it should be consumed ?

Dietary fiber or roughage is not a ‘nutrient’ it is nevertheless an important component of our diets that cannot be digested or absorbed in the small intestine and passes into the large intestine intact. Dietary fiber comprises the edible parts of plant is a type of carbohydrate. Since it is not broken down by the human body, it does not contribute any calories. For adults the recommendation is 25 to 40 grams of fiber every day. One should increase the amount of fiber slowly in the diet and drink plenty of fluids to avoid discomfort and gas.

What are the soluble and insoluble fiber and their sources?

There are two types of fiber. Soluble fiber is the soft fiber that helps to control weight by increasing satiety (feeling of fullness), control blood glucose (sugar) and blood pressure and reduces cholesterol.

Whereas, insoluble fiber is the bulky fiber that helps to prevent constipation by regulating bowel movement. It also helps to prevent some types of cancers. Many foods contain both soluble and insoluble fiber.

Important sources: Dietary fiber is found in fruits (e.g. apple, pears, strawberries, blackberries, raspberries, currants, oranges etc.), vegetable (e.g. brussel sprouts, green leafy vegetables, artichoke, onion, garlic, corn, peas, green beans, broccoli etc.), pulses (like lentils, chickpeas, beans) and whole grain cereals (e.g. wheat, maize, data, bajra, ragi, oats, brown rice, quinoa).

What are proteins? How are they important for the body?

Proteins are the major structural components of cells (consisting of one or more long chains of amino acid) and they are responsible for the building and repair of body tissues. One gram of protein provides 4 kcal and contributes 10%-20% of daily energy intake. Protein does not break down into glucose, so it does not directly raise blood glucose levels. However, there are some protein foods which also contain carbohydrate which will have an effect on blood glucose levels.

Dietary Sources: Animal sources of protein constitutes meat, poultry, fish or other animal products like milk and dairy food are complete proteins which contain all the amino acids your body needs for normal functioning. Whereas plant sources only contain incomplete proteins, meaning some amino acids are missing. For people who are vegetarian and doesn’t eat animal protein should eat a variety of protein-rich plant foods such as beans, nuts and combination of cereals and pulses or milk protein to ensure an optimal combination of amino acids.

What are fats? Why are they important for the body?

Fats and oils are concentrated sources of energy, which provides 9 kcal for each gram of fat. They are considered as dietary enemies, but they are as necessary to the body’s normal functioning as the other essential nutrients. Dietary fat helps the absorption of vitamins, supports cell membrane health and helps maintain the immune system.

Not all fats are equal, it depends on type and amount of fat you are eating. Excess fat intake can make you put on weight, which may make it more difficult to manage your diabetes and has been also linked to other major health problems, including an increased risk of heart disease, hypertension and certain types of cancers. Our bodies need some fat for good health but the type of fat you choose is important and quantity also matters.

What are unhealthy fats? What are their sources?

Unhealthy fats like saturated fat, trans fat and cholesterol are usually solid at cool temperatures. These fats are tend to raise blood cholesterol and bad or LDL cholesterol, which can adversely affect cardiovascular health.

Saturated fat is found in animal foods like red and high-fat meat (e.g. beef, pork, bacon, sausages etc.), poultry (chicken and turkey skin) full-fat dairy food like milk, cheese and cream. Cooking oils like palm and coconut and solid fat which are solid like butter, ghee, lard, cream sauce and products containing these fats. The goal for people with and without diabetes is to eat less than 7% of calories from saturated fat. Read nutritional labels before choosing, Foods with 1 gram or less saturated fat per serving are considered low in saturated fat.

Trans-fats: are produced when liquid oil is made into a solid fat by the process of hydrogenation. For healthy heart eat as little trans-fat as possible by avoiding all foods that contain it by reading food labels. Look for words like hydrogenated oil or partially hydrogenated oil. However, if there is not at least 0.5 grams or more of trans-fat in a food, the label can claim 0 grams.

Sources of trans-fat include processed foods like snacks (crackers and chips) and baked goods made of hydrogenated oil like muffin, cookies and cakes, margarine, shortening, fast food items like french fries.

Cholesterol: isn’t a fat rather it’s a waxy fat-like substance. Your body makes some of the cholesterol and rest comes from foods you eat. Cholesterol is vital because, among other important functions, it helps build to body’s cells and produces certain hormones. But the body makes enough cholesterol to meet its needs — one doesn’t need extra dietary cholesterol. Excessive cholesterol in the diet can increase the unhealthy LDL cholesterol level like saturated fat. So it’s a good idea to eat less than 300 mg per day (for people with diabetes and heart disease <200mg/day). Foods from animals are sources of dietary cholesterol.

Sources of cholesterol include high-fat dairy products (whole or full-cream milk, cream, ice cream, full-fat cheese), egg yolks, liver and other organ meats and high-fat meat and poultry skin.

What are healthy fats? What are their sources?

They are usually liquid at room temperature. These types of fats are healthy fats. They are further divided into two categories:

Monounsaturated fats (MUFA) and oils – are called “good or healthy” fats because they can lower the bad (LDL) cholesterol. It found in canola or olive oil, and in avocados, nuts like almonds, cashews, pecans, and peanuts and sesame seeds peanut butter and peanut oil.

Polyunsaturated fats (PUFA) and oils – are also “healthy” fats, found in polyunsaturated margarine (check the label), sunflower, safflower, soybean, corn, cottonseed, grapeseed and sesame oils, also in pumpkin or sunflower seeds.

They help to reduce LDL-cholesterol but also lower HDL-cholesterol; so it should only be present in up to 10% of total fat intake.

Essential fatty acids are unsaturated fats including omega-3 and omega-6 fats, make the cell membranes more flexible, lower blood pressure and cholesterol, and reduce morality from heart disease. They are also required for the production of certain hormones that are essential for blood clotting, eye and brain function. Omega-3 fatty acids help prevent clogging of the arteries. Some types of fish are high in omega-3 fatty acids (e.g. cold water fish like salmon). The ADA recommends eating non-fried fish 2 or 3 portions/week.

Animal sources include:

Albacore tuna, herring, mackerel, rainbow trout, sardines, salmon

Some plant foods are also sources of omega-3 fatty acids. Sources include:

Tofu and other soybean products, walnuts, flaxseed and flaxseed oil, canola

How are vitamins and minerals important for the body?

Vitamins and minerals often called micronutrients as your body needs in small amounts to work properly and are essential as perform hundreds of roles in the body. They help shore up bones, heal wounds, and bolster your immune system. They also convert food into energy, and repair cellular damage. Eating a healthy diet is the best way to get sufficient amounts of the vitamins and minerals you need.

What are the common vitamins and their sources?

There are two types of vitamins: fat-soluble and water-soluble.

Fat-soluble vitamins are found mainly in fatty foods and animal products, such as vegetable oils, milk and dairy foods, eggs, liver, oily fish and butter. While your body needs these vitamins every day to work properly, you don’t need to eat foods containing them every day. This is because your body stores these vitamins in your liver and fatty tissues for future use. However, if you have much more than you need, fat-soluble vitamins can be harmful. Vitamin A, vitamin D, vitamin E and vitamin K are fat-soluble vitamin.

Whereas, water-soluble vitamins are packed into the watery portions of the foods you eat. They are absorbed directly into the bloodstream as food is broken down during digestion. They don’t store in the body, so you need to have them more frequently. If you have more than you need, your body gets rid of the extra vitamins through urinating. However, this doesn’t mean that all large amounts are necessarily harmless.

Water-soluble vitamins are found in a wide range of foods, including fruit, vegetables, potatoes, grains, milk and dairy foods. Unlike fat-soluble vitamins, they can be destroyed by heat or being exposed to the air. They can also be lost in water used for cooking. Vitamin C, the B vitamins are water soluble vitamins.

What are the common minerals? What are the sources of minerals?

Minerals are necessary for our body, they help in building strong bones and teeth, controlling body fluids inside and outside cells turning the food you eat into energy. Minerals are found in foods such as meat, cereals (including cereal products such as bread), fish, milk and dairy foods, vegetables, fruit (especially dried fruit) and nuts.

Calcium, chloride, magnesium, phosphorus, potassium, sodium and sulfur are examples of major minerals. One of the key tasks of major minerals is to maintain the proper balance of water in the body. Sodium, chloride, and potassium take the lead in doing this. Three other major minerals—calcium, phosphorus, and magnesium—are important for healthy bones. Sulfur helps stabilize protein structures, including some of those that make up hair, skin, and nails

There are some trace elements which are also essential nutrients that your body needs to work properly, but in much smaller amounts than vitamins and minerals. Trace elements are found in small amounts in a variety of foods such as meat, fish, cereals, milk and dairy foods, vegetables and nuts.

Examples of trace elements are chromium, copper, fluoride, iodine, iron, manganese, molybdenum, selenium and zinc.

What are antioxidants and why they required by our body?

As the name implies, antioxidants are substances that are capable of counteracting the damaging, but normal, effects of the physiological process of oxidation in our body. Antioxidants are nutrients (vitamins and minerals) as well as enzymes. Although antioxidants aren’t proven to treat any conditions, but research has shown that antioxidants have also been implicated in the prevention of a number of degenerative, age-related disease chronic diseases such as cancer, heart disease, stroke, Alzheimer’s disease, Rheumatoid arthritis, and cataracts. Much interest has been sparked in the role of antioxidants and diabetes, as diabetes has been noted to be a state of oxidative stress.

High blood sugar increases oxidative stress, which contributes to the impairment of the main processes that fail during diabetes, insulin action and insulin secretion. In addition, antioxidant mechanisms are diminished in diabetic patients, which may further increase oxidative stress.

Common food sources of antioxidants are: colourful fruits (like citrus fruits and berries) and vegetables (like pumpkin, carrots, spinach, capsicum, leafy veggies and herbs), onion, garlic, seafood, milk, soybean, tofu, lentils, peas, seeds and nuts etc.

How can a person with diabetes ensure that he/she is having a balanced diet?

Often, when someone is diagnosed with diabetes, they don’t know where to begin. One way is to change the amount of food you are already eating. Creating the plate is an easy way to get started and way to have a balanced meal. It’s also a simple and effective tool for both managing diabetes and losing weight.

Steps for Creating a Balanced Plate

  • Use a 9-inch plate and fill half of the plate with green and non-starchy veggies like cabbage, broccoli, carrots, mushrooms, tomatoes, cauliflower, spinach, peppers or salad greens.
  • Now in one of the small sections (one-fourth), put whole cereals/grains and less of starchy foods e.g. whole wheat bread, oats, roti, dalia, high fiber cereal, brown rice etc.
  • And then in the other small section, put lean protein e.g. whole pulses, legumes, chicken, tofu, egg, low-fat fish or seafood.
  • To complete the meal, add a low-calorie dairy product like a small bowl of plain curd.
  • Choose healthy fats and oils in small amounts. For cooking, use vegetable oils (like olive, canola, rice-bran, mustard or sunflower). For salads use lemon or vinegar dressing.
How one can follow portion control in their diet?

Over the past 20 years, our food portions have increased drastically and today many can only be described as “supersized”. However, to maintain a healthy balanced diet, and weight it is important to know what a healthy food portion is. One easy method to estimate food portions is the Hand Jive, which uses your hands as a guide.

One can use their Hands to Plan Proper Meal Portions

  • Your both hands together determines your veggie portions.
  • Your cupped hand determines your carbohydrate and fruit portion.
  • Your palm determines your protein portions.
  • Your thumb determines your fat portions.
What is Glycemic Index and how one can choose their food according to that to maintain better blood sugars?

The Glycemic Index (GI) is a scale which ranks carbohydrates containing food by their glycemic response: the amount and speed at which they raise blood sugar levels, 2 hours after eating which is compared to the reference food either glucose or white bread. The lower the glycemic index, the lower the rise in blood sugar. Glycemic Index is an important tool, used in deciding which carbohydrate foods to include in an individual’s diet.

Food with low glycemic index (<55) are whole cereals (like unprocessed oats, barley, quinoa), whole pulses (like Green gram, black-eyed bean, rajma, soybean, chickpea, kidney bean), green leafy veggies, eggplant, green beans, cauliflower, carrot, cucumber, tomato, broccoli, low-fat milk and milk-products, nuts and seeds, seafood and eggs.

Some examples of food with medium glycemic index (55-69) are whole wheat, rye, muesli, brown or basmati rice, peas, yam, sweet potato etc.

Whereas, food with high glycemic index (>70) are usually refined or processed white rice or bread, puffed rice, refined flour (maida), instant oats, cornflakes, cake and cookies, pumpkin, white potato, energy drink, pizza, fast foods, sugar and sugar containing products.

One should opt for food with low glycemic index, but also take care of portion sizes for managing blood glucose and for losing or maintaining weight. The GI of a food is different when eaten alone than it is when combined with other foods. When eating a high GI food, one can combine it with other low GI foods to balance out the effect on blood glucose levels. Many nutritious foods have a higher GI than foods with little nutritional value. For example, oatmeal has a higher GI than chocolate. Use of the GI needs to be balanced with basic nutrition principles of variety for healthful foods and moderation of foods with few nutrients.

If someone with diabetes is not able to lose weight, is it that when they follow a crash diet, they lose weight quickly?

People with diabetes often find it challenging to lose weight and turn towards some crash or fad diet. Fad diets provide temporary weight loss but long term weight maintenance has been found to be unsatisfactory. As soon as you are off the fad diet, you are most likely to regain all the lost weight. It is difficult to comply with fad diets over long periods due to severe restrictions on certain foods or food groups. These diets can also have bad impact on the health of people with diabetes and may lead to serious conditions like ketosis, kidney problems, hypoglycemia and nutritional deficiencies.

So, rather than relying on fad diets, it is important to make long-term lifestyle changes, practice portion control and have regular meal timings. Changing unhealthy eating habits, following healthier lifestyle e.g. exercise regularly, manage stress, better sleep etc. should be the goal to achieve optimum health.


ALCOHOL AND DIABETES


  • Can someone with diabetes, drink alcohol?
  • What happens when you drink?
  • How alcohol can affect the body?
  • How much a person with diabetes can drink?
  • Is moderate amount of alcohol good for the heart?
  • Is red wine better for the heart than other alcoholic drinks?
  • If someone don’t drink should start drinking to reduce the risk of heart disease?
Can someone with diabetes, drink alcohol?

Most people who are managing their diabetes well can safely drink alcohol but in moderation. However people who have or are at risk of complications should be particularly cautious because alcohol can make complications of diabetes worse. However, it’s best to check first with your healthcare provider whether alcohol is safe for you and also discuss side-effects and precautions.

What happens when you drink?

After you drink alcohol, your liver starts clearing the alcohol from your blood quickly as its first priority. It will not release more glucose into the bloodstream until it has detoxified all the alcohol from the system may eventually lead to low blood sugars or hypoglycemia even after 12 hours of consumption.

How alcohol can affect the body?

Someone with diabetes, drinking alcohol may cause the blood sugar to either rise or fall. Plus, alcohol has a lot of empty calories without any nutritive value. Here are some other ways that alcohol can affect diabetes:

  • provide extra calories that can make weight and sugar management difficult
  • increase blood pressure and triglycerides (cholesterol)
  • worsen eye disease and inflammation of the pancreas
  • contribute to sexual difficulties
  • damage your brain, nerves and your liver over time
  • dehydrate the body, which is very dangerous for someone with high blood glucose
  • increase the risk of various cancers over time
  • increase the risk of depression or aggression
  • affect judgment, attention or skill
How much a person with diabetes can drink?

If someone chose to drink it’s important to limit the alcohol intake. Current guidelines recommend women can consume at most one drink per day, and men a maximum of two drinks per day. But these are general recommendations, for specific guidelines, tips and precautions one need to consult their diabetes care team. Who can guide according to the person’s specific condition, current sugar control, medical history and complications.

Is moderate amount of alcohol good for the heart?

Yes. Studies have shown that a small amount of alcohol (no more than one standard drink) may decrease the risk of heart disease in people over the age of 40 but might increase the risk of other complications. More studies are needed to show whether it has the same protective effect at a younger age.

Is red wine better for the heart than other alcoholic drinks?

Whilst red wine does contain some antioxidants, it is not the best choice for preventing coronary artery disease or maintaining heart health. Antioxidants are best consumed by eating at least five servings of vegetables and two servings of fruit per day. It is the amount of alcohol consumed (rather than type) that has the biggest impact on health.

If someone don’t drink should start drinking to reduce the risk of heart disease?

No, there is no evidence to suggest that non-drinkers should start to drink. Other lifestyle factors such as a healthy eating plan and regular physical activity are far more important.

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