Most
people with diabetes or impaired glucose tolerance or impaired
fasting glucose have similar nutritional needs as everyone else. So
when you are on a 'diabetic diet', it is fundamentally a balanced,
and healthy diet - high in complex carbohydrates and dietary fiber;
low in fat, sugar and salt; comprising a wide variety of foods.
What
Sweet Foods ?
Probably
one of the more exciting trends of nutrition management for diabetes
in recent years is that it is all right to include your favorite
sweetener or sweet food (small quantities of sugar, honey, golden
syrup, jam) to make meals more palatable, and pleasurable. With
recent documentation of the glycaemic index theory, the glycaemic
effect of carbohydrate foods are no longer predicted by their
structure. Thus dispelling the myth that 'all sugars are more
rapidly digested, and absorbed than starches, and thus aggravate
hyperglycemia (high blood sugar levels).
Research
has shown the use of simple sugars such as table sugar (sucrose),
jams and honey when taken as part of the meal plan, does not impair
blood glucose control in individuals with Type 1 or Type 2 diabetes.
Note the phrase 'as part of the meal plan'. This means that the
sucrose, and sucrose-containing foods must be substituted for other
carbohydrates, and not simply added to the meal plan. It musts also
be remembered that sugar is energy-dense - providing only energy,
and minimum nutrients. Such excess intake will be converted to fat
stores if not utilized, resulting in unwarranted weight gain.
This
trend is also consistent with the Healthy Diet Pyramid model which
also recommends that foods containing high proportions of added
sugars should be used sparingly in the context of a healthful diet
(not to the drastic extent of abstinence). Avoiding simple sugars
would be ideal, but there are alternative sweeteners to cater for
people with diabetes, and those wanting to reduce their sugar intake
(thus energy intake) for weight reduction / maintenance. Avoid the
three-in-one coffee mixes, and make your own, 'whitened' with skim
milk powder, and sweetened with artificial sweeteners. When drinking
fizzy beverages, opt for the 'diet' version that is sweetened with
intense sweeteners such as aspartame, and acesulfame-K. Freshen your
mouth with sugar-free mint drops. More restaurants, and coffee bars
are also offering such sweeteners in order to meet consumer demand.
Desserts (and all things sweet) are often
laden with sugar during food preparation. This will be a bit more tricky
because the current sweeteners available in the market are not suitable
for baking Unless you are unable to make do with a limit on the amount
of sugar used or have access to some form of sweetener in the
heat-protective encapsulated version, it may be better to eat less of
the 'original' cake. However, one must remember that such sugar replaces
may have reduced-energy but are not energy-free. They generally do not
promote dental caries but excess consumption may have a laxative effect.
As it does not significantly increase blood glucose, and insulin levels,
it will not help restore blood glucose levels when experiencing
hypoglycemia. In general, if you are unable to alter the quality of the
dish for the dinner, then reduce the quantity for consumption, and eat
at regular meal times.
What Fatty Foods ?
In
general, for people with diabetes, research has shown that the fat
you eat impacts on :
- you
weight
- the amount of
cholesterol in your body, and
- Influences how well your body
uses insulin.
These 3 factors play major roles in the
development of heart disease, stroke and hardening of the arteries.
People with diabetes are more susceptible to these medical problems, and
are advised to pay more attention to reducing their overall fat intake.
Diabetic Foods ?
Imported products such as Diabetic
Chocolate or Sugar-free Wafers found in local pharmacies are usually
made with fructose (fruit sugars). Do not be deceived by the claim that
it is, 'suitable for diabetes'. Fructose has a higher sweetness than
sucrose thus less is required to sweeten the product. When compared with
the regular chocolate from the local supermarkets, the diabetic version
may be lower in carbohydrates, but higher in energy, fat and protein,
and there is always the price tag to think about.
Nutrition Supplements ?
Currently, there is no scientific reports
to indicate that people with diabetes have a lower nutritional status
than people without diabetes. Nor has there been much evidence to
indicate any drastic nutrient-drug interaction that warrants 'extra'
nutrition. One must remember that the liquid nutrition supplements
advertised for people with diabetes are also complete and balanced
liquid nutrition. They could be used occasionally as a meal replacements
or when one is unable to consume adequate nutrients and energy through
oral food intake.
Following the Healthy Diet Pyramid, and
attending diabetes education classes on diet are good starting points.
The Healthy Diet Pyramid is an easy model to emphasize an overall
healthy diet with food choices to be coordinated to achieve variety,
proportion, and balance. Provided your blood glucose levels are under
control (by regular home blood glucose monitoring), and your weight is
maintained at the desirable level, adhering to the qualitative eat-more
/ eat-less concept of the Healthy Diet Pyramid may be sufficient.
However, depending on the diabetes
aetiology, and medical treatment (which could be a combination of
insulin injections, oral medication, and diet or just diet alone), some
individuals will eventually require more quantitative, and intensive
dietary advice from the dietitian. Take the initiative to make yourself,
and the people responsible for preparing your meals to see the
dietician. You will then be able to gauge your own nutrition management
for self-management. Depending on the medical condition, the 'diabetic
diet' may need to be individualized, and 'fine-tuned' with the help of
the dietitian. Ultimately, you must be disciplined, and be in control of
the type, and amount of food that you eat. Long-term changes to your
diet, and activity with behavior modification remains the best strategy
for diabetes management.
