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Managing Diabetes Magazine - diabetes

Diet Tips for South Asians with Diabetes
How to modify the traditional cuisine

More than two million Canadians have diabetes. Another million have it unknowingly, with this number expected to triple by the end of the decade. The diagnosis of Canadians with type 2 diabetes is rising dramatically as our population ages, obesity rates increase, and we continue to be inactive.

Type 2 diabetes is the result of both genetics and lifestyle. Kids as young as ten are now being diagnosed with type 2 diabetes. Seventy-seven per cent of new Canadians are at higher risk for this type of diabetes, including those of Hispanic, Asian, South Asian or African descent. Newly arrived South Asians can be at particular risk for diabetes. It can be difficult for those new to North America to give up their tasty traditional foods. In India, the excess weight that comes with eating food rich in fat and sugar is a sign of affluence.

While butter, sugar and milk are more affordable in the western world, we are not as physically active. In rural India, physical labour such as cutting grass for animals, irrigating wells and building houses is done by hand. Daily housework, including washing clothes, dishes and floors, is also done manually. In contrast, Canadians have tools to help make our lives easier and more efficient. We use cars and appliances to do the work for us, and it shows in our weight.

Often, those newly diagnosed with diabetes ask whether a special diet will be necessary. However, diabetes diagnosis is not a life sentence to a rigid menu plan (the myth of the ‘diabetic diet’). Instead, maintaining good nutrition with diabetes involves a lifestyle change balancing moderation and healthy food choices.

When food is eaten, the pancreas releases insulin. If you have diabetes, either your body does not produce enough insulin or you cannot use the insulin that is released. Taking medication or insulin helps your body use the carbohydrate that you eat as fuel. Managing diabetes well involves gaining good blood glucose control over the long term. Keeping control of blood pressure, cholesterol and weight are important, as is eating a well balanced diet. Testing blood glucose levels at different times of the day shows how what you eat and do affects your blood glucose. Exercise and regular appointments with your diabetes care provider are also necessary. Together, these self-care steps help you reduce the chance of complications and lead a normal healthy life.

There are many myths about which foods actually increase blood glucose levels. It is important to realize that all foods can be part of healthy eating – whether you have diabetes or not. It’s just that some foods should only be eaten occasionally or in moderation.

The food we eat contain different nutrients, including carbohydrates, proteins, fats, vitamins, minerals and water. Glucose, the body’s main source of energy, is the end product of carbohydrate breakdown. Protein, found in meats, eggs, milk, beans, lentils, tofu, nuts and seeds, breaks down very slowly. Eating protein together with carbohydrates slows the breakdown to glucose. Fats, the most concentrated source of energy, also break down slowly. A balanced meal consists of carbohydrate, protein and fat.

So what foods contain carbohydrates? Grain products, vegetables, fruits and dairy products all have natural sugars and affect blood glucose levels. Eating reasonable serving sizes is important. Research shows that high fibre, vegetarian diets contribute significantly to diabetes control and prevention, while reducing the risk of other problems related to diabetes.

Here are some general guidelines you can follow. For more specifics, it is best to talk to a diabetes educator or dietitian.

Always eat three meals each day, including breakfast, with no more than four to six hours between meals. This prevents your blood glucose levels from falling too low, and is particularly important if you are on diabetes medication.

Eat balanced meals by choosing high-fibre grain products such as 100 per cent whole wheat bread, roti, and pasta, brown rice or cereal with at least four grams of fibre and no more than five grams of sugar per serving. Vegetables such as spinach, saag, lettuce, eggplant, peppers, zucchini, cucumbers, and celery can be eaten in larger portions, as they have very little carbohydrate content. Eat starchy vegetables such as turnip, potatoes and fruits in smaller amounts. Include protein foods such as lentils, eggs, peanut butter, cheese, tofu and meats at each meal. Protein foods and those high in fibre will slow the breakdown of the meal. This keeps your blood glucose levels from rising and falling too quickly. Fibre also helps with regular bowel movements, maintains a sense of fullness and keeps colon cancer risk low.

A serving of grain, about 30 grams, is contained in each of the following choices: two slices of bread, one paratha, two small rotis, or half a cup of cooked basmati or brown rice or pasta. A serving of vegetable or fruit is the size of a tennis ball or your fist. Green leafy vegetables and the ones mentioned above can be eaten more freely. Fruits and the vegetables that grow underground should be eaten in moderation.

Drink plenty of water or other sugar-free beverages. Have whole fruit rather than fruit juices.

Check with your diabetes health care provider about snacking. Some people, especially those using insulin, may require an evening snack.

Many sugar substitutes are available if you enjoy sweetener in your chai or coffee, or if you want to bake. An example of a sweetener is sucralose (for example, Splenda™). Since sucralose is not broken down, it has no calories and the body does not recognize it as a carbohydrate. It does not have any aftertaste and can be used in the same amounts as with sugar. Many products on the market are now made with this sweetener, including Source yogurt, cranberry cocktail, syrups, and jams. You can also find other sweeteners and products containing them on the market. Remember, a diet product made with a sweetener (including sucralose) still has calories and must be counted in your meal plan.

Be careful when choosing sugary foods such as candies, jams, jellies, regular soft drinks, chocolate, iced cookies and Indian sweets like barfi, jalebi, and ladoo. They are very concentrated sources of sugar and fat. Although people with diabetes can enjoy any types of food, sweets like this should be eaten in very limited amounts.

Limit fats by choosing lean meats, fish and poultry, and low fat dairy products. Hidden sources of fat include baked goods, fried foods like pakoras, and snack foods like chips and gathia, and chevdo. Healthy sources include canola oil, olive oil, soft non-hydrogenated margarines, and nuts and seeds in small amounts. Try baking, steaming, broiling and barbecuing rather than frying.

Use only small amounts of salt and limit your use of processed and fast foods.

You can learn more about nutrition by attending classes at your local diabetes education center or meeting with a registered dietitian. Consider asking your local Safeway Pharmacy if grocery store tours are offered. The diabetes way of eating and living is quite healthy and can be followed by the whole family.

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While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physican promptly. Copyright 2012, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 0S1  [DI_MDc05]