| Diet in diabetes
|What food can we eat to keep the blood sugars
No other area
causes as much confusion as the "diet" in diabetes. There
are as many theories as there are doctors and nutrition experts!
The only thing one needs to remember is that there are no absolute
Dos and Donts. All types of food can and should be tried and had,
the only variation is in how much and how often. If you arm yourself
with some basic nutrition facts, choosing a heathy, tasty meal is
Also, nutrition in diabetes is not
only about controlling blood sugars - it also needs to be low in
fat, and high in fiber and protein, and we should be able to get
adequate vitamins and minerals from it.
|Some basic facts about nutrition
We need food
mainly for the energy our body derives from it. This is the main
difference between plants and animals - the former can make their
own food, while we depend on plants and other animals.
|The Big Three
Your body is
like a car. It's a finely tuned machine, which requires good care
so it runs well. There are three main parts of the car's care, or
rather three kinds of nutrients that you need to have : carbohydrates,
protein, and fat. ALL foods contain all 3 items along with vitamins
and minerals. The amount of each contained by each food item determines
if they are called carbohydrates, fats or proteins.
| Eating carbohydrates is like putting
petrol or diesel in your car. It is the fastest source of energy.
Carbohydrates are the body's main source of fuel. Carbohydrates are
found in almost everything we eat. What we need to realise and remember
is that everything we eat has carbohydrates, including vegetables.
Some foods have only or mainly carbohydrates (like rice, wheat etc),
while others (like egg, fruits, vegetables etc have limited amount
of carbohydrates. Sugar is also a carbohydrate (as are honey, jaggery,
and other sweeteners). Carbohydrate is the food that most immediately
influences blood glucose levels, so most of our dietary advice focuses
| Proteins act like the tools a car
mechanic uses. They repair and build tissue in your body. Proteins
can also be used for fuel, but it takes double the time to change
proteins to sugar. We get protein in meat, milk, nuts, and some kinds
| Fats are reserve fuel, like keeping
an extra can of petrol in the car for emergencies. They also help
you absorb certain vitamins and help the cells send signals to the
rest of her body. Fat is basically concentrated energy. It has double
the calories of carbohydrates or proteins. Too much can make you overweight.
Fat is found in all foods (including rice), but some foods contain
a large amount of fat - butter, oils, most meats, eggs, whole milk,
chocolate, and any foods cooked in butter or oil. Fts are an essential
part of any diet.
|Don't Forget About Your Vitamins & Minerals
So you're thinking,
"What about vitamins and minerals?" Vitamins and minerals
are substances your body needs to keep working well. They're mostly
in carbohydrate and protein foods. The best way for you to get all
the different vitamins you need every day is to have different kinds
of foods, especially different kinds of fruits and vegetables.
|Timing of meals
For people with
diabetes, when they eat is nearly as important as what they eat.
Having small regular meals is the easiest on the body, but most
of us do not have the luxury of doing this on a regular basis. One
thing to definitely plan is to make sure that you eat within 20
minutes of taking any tablet or insulin for diabetes. This is essential,
as otherwise the medicine starts working at a time when the blood
sugars have not started to go up. This is can cause low blood sugars,
a most unpleasant feeling. Make sure you are prepared for emergencies
- you may be out at a meeting or at a function, or even in your
doctor's office getting delayed. If it looks like your meal timing
is going to be delayed - have a fruit or a healthy snack - peanuts,
or even a snack bar. These things keep for a long time, so having
small readymade packets of these in easy reach is essential.
|Sugar & Sugar Substitutes
For many years,
people with diabetes were told to avoid sugar at all costs. It was
thought that sugar would pass into the bloodstream faster and easier
and would cause blood glucose levels to rise too quickly. More recent
research has shown that all carbohydrates affect blood glucose levels
the same way. A potato and a chocolate bar, if they have the same
number of carbohydrates, have about the same affect on blood glucose
In terms of blood glucose control,
all that matters is the number of carbohydrates in a food item.
However, many sugary foods have a very high concentration of carbohydrates
in a relatively small portion size. Look at the example of a potato
versus the chocolate. The chocolate contains a lot of sugar, so
it doesn't take a very big piece to equal the same number of carbohydrates
as a fairly large potato.
One option for enjoying more sweet
foods is the use of sugar substitutes. Calorie-free sugar substitutes
do not contain carbohydrates, so you can eat them without raising
your blood glucose. However, some sugar substitutes do contain calories
and carbohydrates. When choosing products with sugar substitutes,
read the label. Even products labeled "sugar-free" can
contain fats, carbohydrates, and proteins, which can affect blood
glucose levels. Also, keep in mind that "fat-free" and
"low-fat" products sometimes have a higher sugar content
or special carbohydrates used as bulking agents. Always check the
labels of products before you buy.
There is no reason, however, for you
to avoid all sugary foods. In the context of a healthy diet, an
occasional cup of ice cream should cause no problems for diabetes
You may run into people who still
think that people with diabetes can't eat sugar. There is also a
myth that a person can "bring on" diabetes by eating too
much sugar. This is not true. Diabetes is brought on by a complex
interplay of several factors - including getiing older, having certain
genes, being overweight (particularly around the tummy) and not
|What can I eat?
Now that you
have some basic nutrition facts, remember to plan all meals around
the dictum "No added sugar, low fat and high protein and fiber".
Please do not feel that having diabetes
means a "life sentence" in terms of food choices. We can
certainly choose healthy, tasty food. One should be aware as to
why certain food choices are advised in diabetes and not blindly
follow a "diet chart". The main aim of the food choices
are to ensure that
Blood sugars are kept under control.
no extreme fluctuations in blood glucose levels through the day
- meaning there is no extreme of high or low blood sugars.
is kept under control. Excess weight leads to poor blood sugar
control, and increases risk of high blood pressure and high cholesterol.
Please use the following information
to make your own choices in food.
Avoiding added sugar in food is important
for 2 reasons - avoiding a blood sugar spike, and to avoid excess
calories that can lead to weight gain. Remember that cutting out
sugar on a daily basis in your diet can save you 2 kg of weight
every year. Try and avoid sugar in your tea and coffee, sweets,
chocolates, icecream, cool drinks, jams, cakes, biscuits. Honey
and jaggery also contain sugar - so it is better had in moderation
as everything else. So called health drinks may also contain sugar
- please look at the label - if it containes sucrose or fructose,
it may spike your sugar levels.
This again helps to reduce weight, and to reduce
cholesterol levels to some extent. Avoid or minimise deep fried
items like pooris, vadais, bondas, bajjis, chips, samosas and
snacks like murrukku etc. Also be careful about the amount of
ghee in food. Cheese alos contains a large amount of fat, so needs
to be restricted.
Fiber is an important, and often neglected, part
of our diet. The fiber found in fruits and veg is needed to control
weight and blood sugars. Please have at least 1-2 fruits and 3-4
cups of vegetables daily. The following fruits are generally preferred
in diabetes as they contain relatively less sugar: Apple, orange,
musambi, guava, papaya (1 cup), pomegranate (1/2 cup seeds). The
following fruits are higher in sugar, so should be taken rarely:
mango, banana, sapota, watermelon, jackfruit, grapes. All vegetables
are fine, again beetroot nd cooked carrots probably push up sugars
faster. Potatoes - baked, not fried, has actually been found to
be good for preventing a sudden rise in blood sugars.
at least 1-2 glasses of low fat milk and 1 cup of curd daily in
few nuts daily (3-4 pieces of badam / pista / walnuts).
raisins are higher in sugars, try to have it less frequently.
You can instead try prunes or apricots.
fruit juices contain concentrated sugar, even when it says "no
added sugar". Try and have home-made fruit juice as much
as possible, or dilute the store brought fruit juice with water
Choose sensibly when eating out. Have limited quantity
of the carbohydrate (rice or chappati or bread), avoid deep fried
things, have plenty of salads, dal, curd. Avoid dessert, go for
the fruits. Avoid the juices and limit alcohol.
| Self monitoring of blood glucose:
If you have the time, means and the will meaning the glucometer, you
can plot your blood sugars based on what you eat all through the day.
You may find that certain foods push up the blood sugars more thn
expected, and that others are not as bad.