February 07, 2022

ROLE OF NUTRITION AND LIFESTYLE IN DIABETES

Is the thought of managing diabetes overwhelming you? Do you think diabetes means giving up all the food you love? If yes, you need to rethink.

Diabetes is a condition in which the blood sugar levels remain high. This happens because either the body cannot produce any insulin or cannot use the insulin produced effectively because of too much fat deposition (1). Insulin is the key to let the glucose from the food we eat enter into the cells of the body for energy. When insulin is not enough or is not being used by the body, blood sugar level remains high which can be harmful to the body.

But does that mean this is the end of enjoying all your favorite foods? No! the good news is that whether you are newly diagnosed or have had diabetes for several years, you can lead a healthy, complication-free, good quality life by making simple lifestyle changes like following a healthy diet, exercising regularly, saying no to smoking and monitoring the blood glucose levels regularly (2).

 The Diet Dilemma 

When you are diagnosed with diabetes the first thing that comes to your mind is that I cannot eat my favorite foods now. Do I have to give up on rice, potato, chocolates, sweets and live a boring restricted life? If this is what you are thinking, you may be in for a surprise.

Diet is one of the main pillars of diabetes management as what, when, and how much we eat has a major impact on our blood glucose levels, weight and cholesterol levels. The carbohydrates from the food get converted to glucose in the body and they impact the blood glucose level, so you need to watch the food you eat. Healthy eating in diabetes includes a balanced, wholesome diet with emphasis on complex carbohydrates, adequate-protein, healthy fats, and high fiber with good hydration (2). 

Good carbs v/s Bad carbs

It is recommended to choose low glycemic index carbohydrate sources (2) such as whole grains like unpolished rice, millets, rolled/steel cut oats, barley, whole wheat flour, legumes, vegetables, fresh, seasonal, whole fruits, and sweet potato. Being rich in fiber, they are digested slowly and lower post-meal blood glucose levels. Fiber also helps to stay full for a longer time and thereby reduces hunger pangs and helps in weight loss.

Avoid refined carbohydrate sources like refined sugar, refined flour, and its products which are devoid of fiber are digested quickly and cause blood glucose levels to spike (2).

Pump up the protein

Meet your protein requirements by incorporating protein-rich foods such as eggs, curd, buttermilk, paneer, sprouts, dal, soybean, soy chunks, soy granules, lean meat, fish, nuts, etc. in your meals. Adding protein and fiber to a meal helps blunt the post-meal response as well as provides the much-needed satiety (3).  

In case you find it challenging to meet your protein and fiber requirements through diet alone, supplements containing protein and soluble fiber can be taken like Horlicks Diabetes Plus. It is a dual blend high fiber supplement (nutriose and fibersol) * that helps to manage weight and blood glucose levels. It contains soluble fibers like nutriose and fibersol which form a viscous gel in the stomach, delay passage of food to the intestine, help feel full for a longer time, release glucose slowly from food leading to delays in the absorption of blood glucose and therefore better glucose control. It is a supplement that fulfills 26% of your fiber requirement. 

Choose the fat wisely

Choose healthy fats like nuts and seeds. Rotate oils or use commercially available blended oils to get maximum health benefits. Foods rich in omega 3 fatty acids, such as fatty fish, nuts, and seeds like walnuts and flaxseeds are recommended. Avoid consumption of foods high in saturated fat such as butter, margarine, etc (2). Look for words such as "shortening", "partially hydrogenated vegetable oil" or "hydrogenated vegetable oil" in the ingredients. These are sources of trans-fats that are harmful to health. Reheating and refrying of cooking oils should be avoided.

Watch your portions

Maintain portion control by choosing a 9" plate

instead of a 12" plate. (6) Fill half the plate with non-starchy vegetables and salads. Fill 1/4th of the plate with unpolished cereals, millets, and starchy vegetables and the remaining 1/4th plate with protein-rich food sources. Start your meal with a vegetable (salad) and protein source followed by carbohydrate-containing foods to blunt the post-meal blood glucose spike (4). Stay hydrated by drinking adequate water unless advised against by your physician.  Alcohol intake must be restricted and smoking or tobacco intake must be stopped.

Walk your way to good health: 

Exercise plays a vital role in diabetes management along with healthy eating. Aim for at least 30 minutes of moderate-to-vigorous intensity aerobic exercise like brisk walking, bicycling, dancing, swimming etc. at least 5 days a week or a total of 150 minutes per week.

It is also recommended to include strength training at least two times a week in addition to aerobic activity (5). However, it is very important to consult your doctor before you start any exercise regime and get a fitness consent. Working out helps to keep the blood glucose levels in control and is a great stress buster too (5). Find opportunities to be less sedentary and more active throughout the day. You can walk when talking on the phone, take five-minute activity breaks between work, take the stairs instead of the elevator, play with children, walk the dog or do some household chores.

Self -Check

In addition to a balanced diet and exercise, regular blood glucose monitoring at different times of the day and night will help you understand how well your diet, exercise, or medication are working or if you need to make changes.

 It helps your healthcare provider to make informed decisions and suggest appropriate treatment. Make a lifestyle change that is simple, sustainable, and economical to follow in the long run. If you follow a healthy lifestyle by eating a healthy balanced diet, doing physical activity regularly, you can enjoy the ride of life with diabetes.

REFERENCES:

  1. NIN ICMR 2020 guidelines
  2. Lifestyle Management: Standards of Medical Care in Diabetes—2019. Diabetes Care. 2018;42(Supplement 1):S46-S60. doi:10.2337/dc19-s005. 
  3. Imai, S., Fukui, M., & Kajiyama, S. (2014). Effect of eating vegetables before carbohydrates on glucose excursions in patients with type 2 diabetes. Journal of clinical biochemistry and nutrition, 54(1), 7–11. 
  4. Alpana P. Shukla et.al, Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels, Diabetes Care 2015 Jul; 38(7): e98-e99.
  5. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association Sheri R. Colberg, Ronald J. Sigal, Jane E. Yardley, Michael C. Riddell, David W. Dunstan, Paddy C. Dempsey, Edward S. Horton, Kristin Castorino, Deborah F. Tate Diabetes Care Nov 2016, 39 (11) 2065-2079; DOI: 10.2337/dc16-1728.
  6. American Diabetes Association. 5. Facilitating Behavior Change and Well-being to Improve Health Outcomes: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020;43(Suppl 1):S48-S65. doi:10.2337/dc20-S005
Disclaimers
*Journal of Diabetes and Metabolism; 2020 Feb; 11(2): 841.
NUTRIOSE® is a registered trademark of Roquette Frères
^Nutriose® and Fibersol -2 are trade names for Wheat fibre dextrin & Corn fibre dextrin respectively.
Horlicks Diabetes Plus is not intended to replace any existing medication. It is a nutritional beverage to be consumed as a part of balanced daily diet and exercise.