Categories
Uncategorized

Misconceptions on Diet for People with Diabetes

Misconceptions on Diet for People with Diabetes

Misconceptions on Diet for People with Diabetes

Dietitian Lucas Lim
Dietitian Lucas Lim

Diabetes is a complex disease and a common health problem in Malaysia. We may have heard conflicting advice on when to eat, what not to eat, and how to manage diabetes. Sometimes, sourcing information about diabetic diet can leave us confused and misinformed. Moreover, diabetes misconceptions can lead to guilt feeling and affecting our health. So, let’s get to the truth behind some of the common food misconceptions for diabetics.

1. I seldom eat sweets or sugary foods, but yet I HAVE diabetes

According to the American Diabetes Association (ADA), sugar alone does not cause diabetes. In a healthy individual, the body breaks down foods, especially carbohydrates into glucose. A hormone called insulin produced by the pancreas will help glucose enter body cells to be used as energy. Diabetes occurs when the body cannot produce or effectively use its insulin. Because of this, glucose is not able to effectively enter the cells, causing it to accumulate in circulation. Diabetes is diagnosed when glucose (sugar) in the blood is abnormally high

There are three common types of diabetes :

  1. Type 1 diabetes (T1DM) occurs when the pancreas cannot produce insulin. This is because the insulin-producing beta-cells in the pancreas are destroyed by an auto-immune process.
  2. Type 2 diabetes (T2DM) occurs when the pancreas does not produce sufficient insulin and/or the insulin does not work properly. This is usually caused by lifestyle factors such as being obese, having poor diet (and stress) and/or genetic predisposition when the body cells are resistant to insulin action – a condition referred to as “insulin resistance”.
  3. Gestational diabetes (GDM) occurs when hormonal changes occur during pregnancy causing a rise in blood glucose level. True GDM usually resolves after birth of the child.

2. I HAVE AVOIDED carbohydrate foods, yet my blood sugar is still on the high side

Carbohydrates are the foundation of a healthy diet regardless of whether we have diabetes or not. Our body needs glucose as energy. This glucose comes from foods (mainly carbohydrates and sugars) and also from the liver. In the absence of glucose from foods, the liver will break down stored glycogen to release glucose into circulation. Liver can also convert protein and fat into glucose, if necessary. One effect of “insulin resistance” is that the liver is not responding well to insulin, continuing to produce glucose even though blood glucose level is already normal or high. As such, in diabetics, blood glucose may still be high even though patients have avoided taking carbohydrates.

Not all carbohydrates are created equal. There are whole carbohydrates and also refined (processed) carbohydrates. Whole carbohydrates such as grains, legumes, fruits, and potatoes are unprocessed and rich in vitamins, minerals, phytochemicals, and fibre that can help control blood glucose level. In contrast, refined carbohydrates such as white rice, noodles, kuey teow, sugar-sweetened beverages are processed and low in fibre and nutrients. Worse, they can cause rapid rise in blood glucose level.

Instead of avoiding carbohydrates, we should focus on choosing whole carbohydrates and control portion size. Use the “healthy-plate” concept to balance your intake of carbohydrates, vegetables, lean proteins, and healthy fats. A well- balanced diet will help maintain your blood glucose level in an optimal range and improves your overall health.

3. “I cannot eat fruits because they contain sugar that can cause my blood sugar to spike”

Fruits contain natural sugar, fibre, vitamins, and minerals. The fibre in the fruits is able to slow down absorption of sugar from the fruits, thus helping improve blood glucose level. For a diabetic, it is best to consume fresh fruit after a meal to prevent blood glucose spikes. Also remember to control its portion size

We are now clear of the facts behind the misconceptions of diabetic diet. Consult your dietitian on proper diet for you based on your food preference and lifestyle choice, to improve blood glucose control, general health, and prevent complications. Remember that false information is worse than no information. So, seek correct health information from reliable sources or from your healthcare professionals.

Categories
Uncategorized

How to Eat Healthily during the Movement Control Order (MCO)?

How to Eat Healthily during the Movement Control Order (MCO)

How to Eat Healthily during the Movement Control Order (MCO)?

Joh Ying
Joh Ying

Let’s try to make Dalgona Coffee!” “Let’s bake the trendy Basque Burnt cheesecake!” “Let’s call for food delivery!” Are you doing something similar during MCO?

Movement Control Order (MCO) has been implemented in Malaysia since March 18. Millions of people are being confined in their homes. Hence many have turned to eating, cooking, and baking as one of the many ways to cope with boredom. We know that we need to exercise but we probably end up spending more time in front of the fridge to look for food. Eating out of boredom happens typically when we’re not in the physiological need for food. Instead, we eat for the sake of psychological pleasure.

So, is boredom the culprit? Studies have shown that boredom fosters the desire to snack, especially on less healthy food.’ Dopamine is a neurotransmitter, one of the brain’s chemical messengers, used to send signals of pleasure. Dopamine makes us feel good, happy, satisfied and motivated. Ingestion of palatable food has been shown to release dopamine in the brain in proportion to the self-reported level of pleasure derived from eating the food.” Therefore, other than alcohol and drugs, food is one way to obtain that dopamine surge that we have been hoping for.

Eating out of boredom during MCO often leads to overeating, especially on high-calorie foods. Working from home may cause us to lead a less active lifestyle. Higher calorie consumption with lesser physical activity can contribute to weight gain. Hence, be mindful of the food that you put in your mouth! I am happy to share some tips on how to eat healthily during MCO.

1. Don’t skip breakfast

Studies have shown that skipping breakfast is associated with an overall less healthy diet characterized by higher daily intakes of soft drinks and salty snacks, and lower intakes of fruit, vegetables and dairy. Skipping breakfast may therefore potentially contribute to an unhealthy dietary pattern leading to overweight and obesity.

Eating breakfast helps to enhance satiety and reduce hunger throughout the morning. This may help to reduce food cravings and prevent overeating in the next meal.

a) Keep breakfast in mind when doing grocery shopping. Stock up on fruits, muesli, oatmeal, yogurt, nuts, no or low sugar soymilk or low-fat milk.

b) Make simple and convenient breakfast such as overnight oats with soymilk, fruit and nuts, or sandwich with tofu/tempeh/egg/tuna/shredded chicken, lettuce and tomatoes

2. Go easy with sugar

Craving is not hunger. It’s our brain calling for something that triggers the release of dopamine in the reward system of our brain. Highly palatable and sugary foods give us a sense of pleasure and make us going back for more even though we know they are

not good for health.

A common nutrition trap that many may fall into during the MCO is indulging in less healthy homemade comfort foods, packed with calories but little nutrients, such as homemade Dalgona coffee, burnt cheesecake, pearl milk tea, and a variety of local kuihs. In terms of sugar, a cup of Dalgona Coffee may have 4-5 teaspoons of sugar, and a slice of burnt cheesecake may contain 3-4 teaspoons of sugar. World Health Organisation recommends

reducing our daily intake of free sugars to less than 10 teaspoons. A further reduction to less than 6 teaspoons per day would provide additional health benefits.

a) Sharing is caring! Share the portion of our food or drink with our family or friends

b) Experiment with our favourite recipes with a healthy twist to create a guilt-free healthy dessert recipe such as replacing sugar with mashed bananas, unsweetened applesauce, fig puree; or simply reducing the amount of sugar used in the recipe!

c) Read the nutritional information panel and ingredient list on packaged foods and look for those with lower sugar content.

3. Cut back on salt

Canned foods are very convenient, especially when everyone is stocking up food for MCO. Most canned foods contain high amounts of salt. In Malaysia, the National Health and Morbidity Survey (NHMS) 2015 concluded that the prevalence of hypertension in adults is 30.3% (about 1 in 3 adults). High salt intake has been associated with elevated blood pressure in the PURE and INTERSALT studies 6, 7.

a) If we choose to consume canned food, it is best to drain the liquid and rinse the content to get rid of excess salt.

b) Choose minimally processed food. For example, choose air-dried vegetable chips instead of potato chips, choose unsalted nuts instead of salted nuts, use fresh beans or peas

instead of canned baked beans.

4. A moderate amount of fat and oil Roti canai is ranked No.1 on the GrabFood and FoodPanda list during this MCO period. The next terms on the list are nasi goreng kampong and nasi goreng ayam. These foods contain a high level of fat and calories. Replacing high calorie or high-fat foods with lower fat and lower calorie alternatives is an effective way to prevent excessive energy intake, which may lead to weight gain.

Use these smart substitutions to stay on our healthy eating track even when we eat out or call for food delivery.

a) Choose roasted dishes instead of fried dishes

b) Choose chapati and naan instead of roti canai

c) Choose steamed white rice (or even better, brown rice) instead

of fried rice and fragrant oily rice

5. Stay hydrated

Thirst isn’t the best indicator to probe us to drink water. When we get thirsty, we are already dehydrated. Few studies have examined how fluid reintroduction under conditions of mild dehydration may alleviate dehydration’s harmful effects on cognitive performance and mood.

a) Water is the best drink to keep us hydrated. It has zero fat, zero sugar, and zero calories!

b) Avoid high sugar fruit juice, soda, and caffeinated drinks. They tend to be high in added sugars and calories. Instead, go for low to no-calorie alternatives such as fruit-infused water, flower tea, herbal tea, sugarless sparkling water, low-fat milk, and soy milk with little or no added sugar.

c) Remembering how much water to drink daily can be a challenge. Tips: Carrying a water bottle is probably the simplest reminder to make us drink more water.

d) Stay hydrated and simply, healthy!

In summary, it is crucial to eat mindfully during the Covid-19 pandemic. Great nutrition is fundamental to support immunity and overall health!

References:

1. Moynihan Andrew B. Tilburg Wijnand A P. van, Igou Eric R, Wisman Arnaud Donnelly Alan E Mulcaire Jessie B. Eaten up by boredom: consuming food to escape awareness of the bored sell. Front Psycho, 2015, 6:369. doi: 103389/psyg 2015 00369

2. American Addiction Centers. Drug Abuse and Chemical Imbalance in the Brain Dopamine, Serotonin & More. https//americanaddictioncenters org/health-complications addiction/chemical-imbalance Accessed June 1, 2020

3. Volkow ND, Wang GJ, Baler RD Reward, dopamine, and the control of food intake: implications for obesity, Trends Cogn Sci. 2011.15(1):37-46doi: 10.1016/j.tics 2010.11001

4. E Siong Tee, Abdul Razak Nurliyana, A Karim Norimah, Hamid Jan B Jan

Mohamed, Sue Yee Tan Mahenderan Appukutly, Sinead Hopkins, Frank Thielecke, Moi Kim Ong, Celia Ning, Mohd Taib Mohd Nasir Breaklast consumption among Malaysian primary and secondary school children and relationship with body weight status – Findings from the MyBreakfast Study Asia Pac J Clin Nutr. 2018,27(2):421-43. doi: 10.6133/apjcn.062017.12.

5. WHO, WHO calls on countries to reduce sugars intake among adults and children. https://www.who.int/mediacentre/news/releases/2015/sugar-guideline/en/. Accessed May 23, 2020.

6. Intersalt an international study of electrolyte excretion and blood pressure. Results for 24-hour urinary sodium and potassium excretion. Intersalt Cooperative Research Group. BMJ. 1988,297(6644) 319-328. doi:10.1136/bmj 297 6644 319

7. Mente A. O’Donnell MJ, Rangarajan S, et al. Association of urinary sodium and potassium excretion with blood pressure. N Engl J Med 2014;371(7):601-611 doi:10.1056/NEJMoa1311989

8. Roti canai is the top MCO food. The Star https://www.thestar com my/news/ nation/2020/04/22/roti-canal-is-top-mco-lood Accessed May 26, 2020

9. Popkin BM. D’Anci KE, Rosenberg IH. Water, hydration, and health Nute Rev

2010,68(8):439-458. DOI:10.1111/11753-4887 2010.00304x

Cancellation and Refund Policy

  1. Dietitian90 Consultancy will ONLY give refunds to online nutrition course fees under the following circumstance:  – Serious illness. We will require you to produce a medical certificate as evidence. 
  2. Where online classes are cancelled by the Dietitian90 we will provide refunds except where classes are cancelled due to circumstances beyond our control (force majeure). In these cases, we will make every effort to provide alternative arrangements including make-up classes. Only where no alternative is made available will we provide refunds. 
  3. All requests for cancellation and refunds must reach us the day before the start of the class. No refunds or credits will be granted once the class has started. Approved refunds will take a minimum of 1 week to process.