MISCONCEPTIONS CORRECTED

“Many people think that when you have diabetes you need to avoid sugar, while others believe it requires a strict way of eating that controls glucose. Both are not quite right,” said Sarah Shamila, a Manager at Mount Alvernia Hospital’s Nutrition and Dietitics Services.

Managing carbohydrate intake remains the mainstay in diabetes management. Carbohydrate is our body’s preferred source of energy in the diet. Common foods containing carbohydrates are rice, noodles, cereals, breads, pasta, beans and pulses, as well as all fruit, some vegetables such as potatoes, lotus root and yam, and dairy products like milk and yoghurt. 

“Since carbohydrates are broken down into glucose, which is essential fuel for the body, especially the brain, any reduction in carbohydrates should to be undertaken with the supervision of a dietitian,” said Sarah.

Sarah advised that saturated fat and trans fat can raise blood cholesterol, increasing your risk for heart attack or stroke, and should be consumed sparingly or not at all. Some sources of saturated fat include butter-rich pastries and cakes, poultry with skin, red meat, full cream milk, yoghurt and cheese. Trans fat is found in some hard margarines, snack foods and fast foods. Look out for the Healthier Choice Symbol when choosing foods.

People with diabetes should cut back on their sodium intake since they are more likely to have high blood pressure, a leading cause of heart disease, than the general population. High-sodium foods include canned foods like luncheon meat, 

salted vegetables, salted fish, salted eggs and cold cuts like ham.

GLYCEMIC INDEX EXPLAINED

There is some evidence to suggest that the way carbohydrate foods digest in the body may affect blood sugar levels. The glycemic index, or GI, measures how a carbohydrate-containing food raises blood glucose. Foods are ranked based on how they compare to a reference food — either glucose or white bread. A food with a high GI raises blood glucose more than a food with a medium or low GI. 

Carbohydrate-containing foods with a low GI include brown rice, wholegrain breads and cereals (like whole wheat bread, rye bread, oats and all-bran cereal), all non-starchy vegetables, some starchy vegetables like sweet potatoes, most fruit, and many dried beans and legumes (like kidney beans and lentils). 

Meats and fats don’t have a GI because they do not contain carbohydrate. 

There are several factors that can affect the GI of a food. These factors include:

Cooking method — how long a food is cooked (al dente pasta has a lower GI than soft-cooked pasta)

Ripeness and storage time — the riper a fruit or vegetable, the higher the GI

Processing — juice has a higher GI than whole fruit, mashed potato has a higher GI than a whole baked potato, stone ground wholewheat bread has a lower GI than wholewheat bread, and so on

Variety — converted long-grain white rice has a lower GI than brown rice but short-grain white rice has a higher GI than brown rice

“The GI of a food is different when eaten alone than it is when combined with other foods. When eating a high-GI food, you can combine it with other low GI foods to balance out the effect on blood glucose levels,” advised Sarah.

BAD NEWS AND GOOD NEWS

There is strong evidence to suggest that medical nutrition therapy is effective in managing blood glucose levels. A sedentary lifestyle coupled with excessive food intake predisposes an individual not only to diabetes, but also to obesity and other chronic diseases.

If not managed properly, diabetes can lead to many complications including cardiovascular disease, blindness, kidney failure, and lower limb amputation.

However, if managed properly, people with diabetes can enjoy a great quality of life with excellent health. That’s a pretty good prognosis, whichever way you look at it!

With thanks to our contributor:

Sarah Shamila

Manager, Nutrition and Dietitics Services

Mount Alvernia Hospital