It is a welcome change in the climate after months of scorching heat in the middle East. This might last for a couple of months before the scorching heat picks up again. It is the time for outdoor partying, smell of inviting barbeques and probably increase in bad cholesterol levels !!!!! It is also the time for contracting viral fevers. Have you had your annual flu shot? The Flu Vaccine at least helps against many of the strains of virus which are getting more complex with each passing year.
Losing weight is something the doctor always stresses on. Interestingly, you might notice that the males are generally reluctant to address the obesity as well as their female counterparts. Moreover, weight loss is slower among those with diabetes due to the medicines they are on and also due to diabetic dysregulation. But , that cannot be used as an excuse for losing weight or even trying to.!!!! There is always a weight loss plateau that is to be expected and that should not deter yourself from continuing, but will need a self assessment as how to overcome the plateau.
Many now blame the cold weather and cold breeze and wish to remain cuddled under the blankets or remain indoors and try eating more to keep the body heat.
Impulsive eating can occur when stressed ( positive stress is during a vacation and negative stress during a personal tragedy) , when angry, when depressed or when worried about an upcoming event or even when stewing over a conflict at office or work. This often leads to impulsive eating followed by the guilt and again feeling low followed by eating again which gets you nowhere healthy !!!
Bed time snacking
People might keep on snacking to give them the so called energy while staying up awake while working late hours. There are certain occasions when you are allowed to snack especially when having an early light dinner and sleeping late. But, there are certain things to be known while snacking.
Warm milk contains tryptophan and helps in sleep
A bowl of cereal with milk or a glass of labaan( butter milk) , crackers or bread and cheese all can cause sleep due to the carbohydrate content.
Sources of hidden caffeine and fatty food such as burgers can impair with sleep.
Alcohol ( nightcap) might cause nightmares, frequent awakening, night sweats and headache for some which can impair with sleep. Drink plenty of water after the sleep.
Protein rich and high fat food will cause problems in digestion which can impair sleep.
Spicy food and smoking can impair with digestion.
So make healthy choices while snacking. Snack is just a small meal and not another meal.
The winter months are a cause for celebrations and family outings . The smell of barbeque fills the air after the sun sets. People might eat more of meat and prawns which might increase the cholesterol levels. You can however go a walk outside as the climate is much better than the hot humid summer climate.
Generally sugar levels and cholesterol levels rise with the increased food and alcohol consumption during the winter months.
You can safely exercise indoors if the weather outside is not to your liking. Tai Chi, Pilates, using the Hula Hoop, dancing to music, yoga, skipping rope or just spot jumping helps burn calories. Zumba or kick boxing are options that needs a trainer to help you out. For the fitness freaks who like to sweat it out in a gym, try something new at the gym or use resistance bands. You can swim or do any exercise in the pool as water is kind to the joints. Aqua aerobics is catching up in a big way as it is entertaining and kind on the joints as well. One can enjoy shopping by walking in the malls and doing window shopping !!!! Walking is still a good exercise. Take care of your footwear and use proper clothing if walking outdoors. Cover your head and neck if very chilly. The new form of play station using the X box helps you engage in interactive games and helps you combine entertainment with exercise and it can be enjoyable when performed with either family of friends.
For those who are interested in resistance training using small weights, remember to always warm up, stretch and do repetitions of ten to twelve in a smooth controlled motion. The muscles might ache at the beginning, Give a rest in a between and try these on alternate days to help the muscles to recover.
How to overcome barriers to exercise?
Break the times of exercise to smaller periods if it not practical to spend 30 minutes a day for five days a week.
Identify causes of waste of time such as watching the television, lying on the sofa. See if these can be overcome.
Reframe the concept of exercise such as walking the dog or taking the kids for playing, playing ball on the beach or even dancing, walking in a mall, walking around a large airport terminal while waiting for the flight.
Join a group who can motivate you.
Watch the television or listen to music while exercising.
Take stairs instead of the lift or escalators.
When ill, do not exercise.
There are numerous apps which can be downloaded from the app store if you have a smartphone. These can monitor the progress and can even motivate you to get moving.
Ask yourself why you want to lose weight:
Feel comfortable in clothes
Improve self image and confidence
Improve physical stamina
Improve energy levels
Be a role model for my family
Improve the blood pressure, cholesterol and diabetes
Reduce joint pain
Improve life expectancy
You might want to add more…..such as want to look good at a function or don those clothes which you outsized and so on…..
Write down the challenges and obstacles you face towards achieving the goals. The more honest you are with yourself, both in recognizing the obstacles and coming up with realistic strategies, greater are your chances at succeeding. Let that be your New Year resolution.
Diabetes is on the rise the world over. Just about anybody can become a diabetic whether you are rich or poor or a male or female or whether your parents are diabetic or not. It is largely attributed to the disordered lifestyle habits and increased stress levels in day to day life that has caused this to blow out of proportion.
People turn to shortcuts such as the great number of diets available each one claiming superiority over the others, a great number of holistic medications or alternate medicines and of course, sugar free substitutes. It has taken the markets by storm and you have so many available in the market today which has been incorporated into carbonated soft drinks, chewing gums, baked goods, cakes, fruit juices, candies, ice cream and even yogurt.
There are natural sweeteners such as Agave nectar, date sugar, fruit juice concentrate, honey, maple syrup and molasses which are available in the market.
The artificial sweeteners are always artificial though some products such as those containing stevia are claiming themselves to be natural. But it has to be either refined or processed to be marketed. These are intensely sweet and are many times sweeter than natural sugar. All the sweeteners leave an aftertaste.
There are different types of sweeteners such as :
Low calorie or no calorie sweeteners
Non nutritive sweeteners
Reduced calorie sweeteners
Some of the sweeteners can be used for either baking or cooking as well. These can come in different forms such as tablets, or sachets containing powder or in liquid forms.
Sugar alcohols do not contain alcohol and do not contain ethanol which is seen in alcoholic drinks. These are naturally seen in certain vegetables and fruits, but can also be manufactured. These help to increase the bulk and improve texture when added during cooking or baking. These are seen in toothpastes, mouthwashes, chewing gums, frozen desserts, fruit spreads and chocolate. It is labeled as Xylitol or sugar alcohol in the nutrition labels.
When consumed in large quantities the use of sugar alcohols can cause a bloated up feeling, loose stools and abdominal fullness
I have seen many people who had a craving for sweets after consumption of the artificial sweeteners which in turn, causes the sugar levels to fluctuate. This in turn, leads to an increase in either the doses of medicines or injectables with the hope to control sugar levels. Just being off the artificial sweeteners bring about so many changes and reduces the cravings as well.
Some of the common brands available in the market are:
Sweet N low® contains sachharin
Equal® contains aspartame
Sweet one® contains Acesulfame potassium
Splenda® contains Sucralose
Fruit juice concentrates contain Neotame
How sweet are these artificial sweeteners?
Sachharin is 300 times sweeter than sugar, aspartame is 180 times sweeter, acesulfame is 200 times sweeter, sucarlose is 300 times sweeter and Neotame is 7000 times sweeter than sugar.
Whenartificial sweeteners are used there are some health concerns to be careful of- these can attribute to weight gain, tooth decay, probable increase in incidence of diabetes, cancer and troublesome numbness of the hands and feet, muscle spasms, giddiness and cramps. Generally people who are diabetic or those at risk to develop diabetes tend to rely more on ingestion of the so called sugar free containing food items. Besides having a lot of artificial sweeteners, the rest of the ingredients are the same which do add to the calories. Also it is worth bearing in mind that the taste has to be modified to enhance the flavor and also help it being sold off the racks at the supermarkets. The enhancement of flavor is done with the help of adding more hydrogenated oils or butter or fats which leave an excellent buttery taste and can help increase cholesterol levels !!!! People in this mad frenzy, tend to overeat their portions because of the false security given by the artificial sweeteners.
Being a diabetic does not mean you should be off sugar in totality. Your body needs a balance of sugar, salt, fats, carbohydrates, proteins and fat to make a complete meal which can be taken as small frequent meals to prevent cravings later on. Combine this with adequate physical activity and all will be well.
The solution to sugar needs:
You can substitute the white sugar with brown sugar or cane sugar which is the unrefined version of sugar. It is extremely hygroscopic and hence absorbs water from the atmosphere once the cover if opened. Store this in air tight containers. Roughly 3 spoons of brown sugar equals one spoon of white sugar.
Remember that people of the previous generation did not rely on artificial sweeteners.
Checking the blood sugar is as common as checking ones blood pressure these days, but is not done as frequently though. There may be no symptoms at all related to high blood pressure or there maybe headache, giddiness or even shortness of breath. Some may present with severe headache or paralysis of one side of the body with a slurred speech or chest pain as part of a massive heart attack.
Having high blood pressure undetected and untreated over a long period of time, can put a strain on the important organs such as the heart, kidney, brain and eyes.
Blood pressure, diabetes mellitus and high cholesterol levels are like close friends. These all are affecting the blood vessels and having one can put you at risk for developing the other two.
Blood pressure is the pressure of the blood in the blood vessels which help propel the blood forward from the heart to different parts of the body carrying oxygen where needed and also carrying away the waste products from the kidneys and liver.
Blood pressure is recorded by a machine called sphygmomanometer in which a mercury expansion is measured. This is operated only by health care professionals as you have to hear the sounds to decide the blood pressure.
Now-a -days, digital blood pressure machines are available. The ones measuring the blood pressure by inflating the cuff around the arms is preferred. The ones measuring around the wrist is not reliable. The digital machines can be battery operated and or AC/DC operated. The batteries have to be removed after each check to prevent the leak of the batteries while kept inside for indefinite periods of time. There are two readings for the blood pressure, called systolic for the top reading and diastolic for the lower reading. So if the doctor tells your blood pressure is 130/80 mm it means, 130mm is the systolic and 80 mm is the diastolic reading.
The blood pressure can vary with the position, posture, soon after exercise, soon after driving, and even for some when they come to the hospital or clinic due to anxiety. It is wise to check the blood pressure after relaxing for some time. For those where anxiety visiting the hospital causes high readings, it is wise to have the blood pressure recorded at home with a machine and make a set of readings for a week and have the doctor analyse that. There is a devise which can be connected to the upper arm for 24 hours ( 24 Hour ambulatory Blood pressure monitoring) which will measure the blood pressure every 20 minutes even during sleep and activity and have the data downloaded. Keep the arms straight while the cuff is inflating to avoid errors in the machine reading. For some, the blood pressure is highest while at work, for some it is highest at night. Mental and physical stress plays a major role in fluctuations of blood pressure levels.
Pregnant women may get high blood pressure readings which are treated with some specific medicines as they will not cause harm to the growing baby. The blood pressure spike is usually associated with swelling of the feet and proteins in the urine. Some even get blurred vision.
Normally a doctor will not start medications for blood pressure based on one reading. An average of readings which show a persistent set of high levels will decide. The blood pressure can be high even for children in those having some diseases of the kidney. The cuff diameter is different while measuring the blood pressure for children and for those who are obese. The normal blood pressure readings are between 120-140 systolic and 70-90 diastolic. Generally the elasticity of the blood vessels is lost as one advance in age and so the blood pressure can be slightly high for the elderly and hence a level of 140/90 mm Hg is normal for the elderly.
What can be done from your side:
Avoid stressful situations as much as possible. Learn relaxing techniques such as doing something you like or meditation or just relaxing on a rocking chair, or listening to songs or reading a book or enjoying a swim or watching a movie.
Incorporate a healthy lifestyle which includes at least 150 minutes of physical activity a week and a diet in which salt consumption is reduced. Sausages, sauces, tinned vegetables , olives soaked in brine, potato fries all come with salt. Use of rock salt is better or low sodium salt is another option. One can use lemon or vinegar to add a salty taste without actually adding salt. Among the exercises, Tai Chi, Yoga, swimming, skipping rope, aerobics, walking, cycling, golf, playing shuttle badminton or tennis if it is okay , are good options. Enjoy the exercises sessions.
Avoiding spicy and oily food helps.
Take plenty of vegetables, fruits depending on diabetes levels, non roasted and non salted nuts, fish and chicken and lean meats.
Avoid too much of caffeine
Maintaining a normal weight is equally important.
Limit alcohol consumption- for males 21 units a week and for women 14 units a week ( one unit is half a pint of beer, a glass of wine or a single measure of spirits)
Cigarette smoking is another thing to be careful of. Smoking can make the blood cells stick together which can help form blocks and also increase the chances for a block in the blood vessels. There are ways to stop smoking by using various nicotine replacement techniques such as nicotine chewing gum, lozenges or patches.
Be regular in your visits to the doctor.
If there is a history of high blood pressure running in the close family ( parents or uncle and aunt), have the blood pressure monitored. If your parents have had either a stroke ( paralysis of one side of the body) or a heart attack at an earlier age ( below the age of 50) you have to be careful.
If you are overweight or obese ( having a body mass index of more than 25) or having diabetes, you have to check the blood pressure.
This involves the basic essentials such as reducing stress levels, stop smoking and alcohol consumption, reducing excess salt intake, maintaining a healthy diet, exercising regularly and having a check up on time.
When the above measures do not work or if you develop some complications such as problems with the kidneys, heart or brain, medicines are prescribed.
The eye doctor looks into the eye and checks for early changes in the blood vessels on the retina which needs you to be starting treatment soon to prevent further damage to the eyes.
There are certain basic tests which are necessary such as checking the haemoglobin, sugar, cholesterol, kidney, liver, urine for leak of proteins, ECG and ECHO for the heart, an eye check up and further tests if anything is amiss and needs further evaluation. Some need a scan of the brain if there has been a stroke.
Some people need one medicine and some need more than one medicine. There are different medicines coming in different strengths. The number of mg of each tablet does not reflect upon the severity of the blood pressure. The doctors decide which medicine based upon the kind of protection needed. Some need to have additional protection to the heart and kidney, some need to have their heart rates reduced, some need to have their feet swelling reduced, some need to have the pressure in their kidney reduced and so forth. The aim is to bring down the blood pressure to normal without causing further damage.
As with all tablets, there are some side effects with the medicines for blood pressure. Some may cause slow heart rate, some cause swelling of the feet, some cause coughing and throat irritation, some cause electrolyte disturbances and some medicines are not tolerated well. The dose of medicines has to be adjusted based on individual needs. Generally, once you are on medicines it must be continued for life. But, having a metabolic surgery ( bariatric surgery) can help avoid the need for a medication. This will help control the diabetes, blood pressure as well as your weight. If the blood pressure is solely due to increased stress levels, change of job or relocation will help cure the blood pressure as well.
Many people delay the initiation of treatment despite the medical advice. This is putting your life in danger as changes once they occur, in important organs, are difficult to reverse. It is much better to control the blood pressure than having a massive heart attack or a stroke and put your family or yourself at risk.
Eating less salt can substantially reduce the risk of health problems associated with high blood pressure, which is a risk factor for heart disease and stroke — a cause of death for more than 2 out of every 3 people with diabetes
Select fresh fruit or vegetables.
Avoid creamy soups .
Stay away from bread and rolls with salty, buttery crusts.
This is one area many are still unsure of. It is generally assumed cutting down the carbohydrate intake to as low as possible when one is a diabetic helps in control of diabetes.
” Gastronomic voyeurs have long proposed that eating is a holistic form of exercise involving various muscles necessary for scooping up the food, chewing it and getting the food to the mouth.”
Restaurants and supermarkets have taken marketing to whole new level. Terms such as biggies, jumbos, king size, grand,supreme and prompts such as all-you-can-eat -buffets and two-for-one -specials are enough to lure the unwary.
A good diet should contain 50% carbohydrate, 30% fat and 20% protein according to the American Diabetic association. One should aim for a weight loss of 5-7 % of the body weight. Most of the diets turn out to be failures as they are not practical or planned to give drastic results. Normally diabetics find it difficult to reduce weight and maintain weight loss when compared to a non diabetic. Some of the medicines taken for diabetes treatment also can cause weight gain.
Generally pregnant women and growing up children need more calories.
Culture or “habits” may have taught many of us to eat in response to any triggers such as stress, boredom, and guilt. We may multitask and eat and then wonder,” How on earth did I manage to eat that whole bag of chips or that large burger?”
Food , as a four letter word, is both a necessity as well as a burden when taken in excessive amounts. You must be familiar with the age old saying, “Eat to live and not live to eat”.
As one ages, the body weight may increase as you may be consuming more calories than needed. This coupled with the decreased physical activity and excuses such as “too tired from work”, “I just need to sleep for some time” ,” I shall grab a bite and then start”, and sink into the cozy sofa to seal the fate.
The daily need of calories depend on the following:
• The body size
• The age
• The height and weight.
• Level of activity
• Gender- whether male or female
• If pregnant.
Levels of activity
A person is labelled non active if the person is doing just normal activities such as going to work, shopping and going to school.
If the person does some physical activity such as walking for 2-4 kms daily or some form of exercise besides regular activity, the person is labelled moderately active.
If the person does heavy workouts like a gym workout, good games of squash, tennis or badminton or swimming, cycling, or walking more than 4 kms a day, the person is labelled very active.
One kilogram of body weight will equal 7700 calories. To reduce one kilogram over a week, one will have reduce 1100 calories daily. This may sound impossible. But, reducing the sugar intake by just one spoon daily can reduce the calorie intake by 500 calories. That is not a big burden, is it ?
The table given below will show the caloric needs based on age, gender and level of activity
If one observes the above table carefully, the calorie intake for both gender groups is maximum between the ages 18-25 . Thereafter the recommended caloric intake comes down to that of a 10-15 year old irrespective of your level of activity. Well, that is something to seriously think about.
A healthy breakfast will include whole grains, lean protein such as peanut butter, lean meat, fish, poultry and hard boiled eggs, low fat dairy such as yoghurt, cheese and milk and a portion of fruits and vegetables.
Know the food
Starches are bread, grains, cereal, pasta, and starchy vegetables like corn and potatoes. They provide carbohydrate, vitamins, minerals, and fiber. Whole grain starches are healthier because they have more vitamins, minerals, and fiber.
Eat some starches at each meal. Eating starches is healthy for everyone, including people with diabetes.
Examples of starches are bread , pasta, corn, potatoes, rice, cereals, beans, lentils, yam
What are healthy ways to eat starches?
• Buy whole grain breads and cereals.
• Avoid fried and high-fat starches such as regular tortilla chips and potato chips, french fries, pastries, or biscuits. Try fat-free popcorn, baked or potato chips, baked potatoes, or low-fat muffins.
• Use low-fat or fat-free plain yogurt or fat-free sour cream instead of regular sour cream on a baked potato.
• Use mustard instead of mayonnaise on a sandwich.
• Use low-fat or fat-free substitutes such as low-fat mayonnaise or light margarine on bread, rolls, or toast.
• Eat cereal with fat-free (skim) or low-fat (1%) milk
Vegetables provide vitamins, minerals, and fiber. They are low in carbohydrate. Examples of vegetables are lettuce , broccoli, vegetable juice, spinach, peppers, carrots, tomatoes, Celery, cabbage, greens. What are healthy ways to eat vegetables?
• Eat raw and cooked vegetables with little or no fat, sauces, or dressings.
• Try low-fat or fat-free salad dressing on raw vegetables or salads.
• Steam vegetables using water
• Mix in some chopped onion or garlic.
• Use a little vinegar or some lemon or lime juice.
• Add a small piece of lean ham or smoked turkey instead of fat to vegetables when cooking.
• Sprinkle with herbs and spices.
If you do use a small amount of fat, use canola oil, olive oil, or soft margarines (liquid or tub types) instead of fat from meat, butter, or shortening.
There are two types of vegetables- the starchy and non starchy. The starchy vegetables can increase the sugar levels- potatoes, corn and peas are included. Non starchy vegetables include broccoli, cabbage, sprouts, carrots, cucumber green, egg plants, ladies fingers (Okra), mushrooms, bell peppers, iceberg lettuce, tomatoes to name a few. These help in adding fiber and also keep the stomach full without increasing the sugar levels. Fruits
Fruits provide carbohydrate, vitamins, minerals, and fiber.
What are healthy ways to eat fruits?
• Eat fruits raw or cooked, as juice with no sugar added, canned in their own juice, or dried.
• Buy smaller pieces of fruit.
• Choose pieces of fruit more often than fruit juice. Whole fruit is more filling and has more fiber.
• Save high-sugar and high-fat fruit desserts such as peach cobbler or cherry pie for special occasions.
• Feel the fruits before purchasing them. If fruits are very soft, they are sweeter.
• Generally speaking bananas from the Philippines, grapes, dates, mangoes, water melon, cherries and pineapple are very sweet
Milk provides carbohydrate, protein, calcium, vitamins, and minerals.
What are healthy ways to have milk?
• Drink fat-free (skim) or low-fat (1%) milk.
• Eat low-fat or fat-free fruit yogurt sweetened with a low-calorie sweetener.
• Use low-fat plain yogurt as a substitute for sour cream.
Meat and Meat Substitutes
Meat and meat substitutes provide protein, vitamins, and minerals.
Examples of meat and meat substitutes include chicken , fish, eggs, peanut butter
What are healthy ways to eat meat and meat substitutes?
• Eat chicken or turkey without the skin.
• Cook meat and meat substitutes in low-fat ways: broil , grill, stir fry, roast, steam and micro wave
• To add more flavor, use vinegars, lemon juice, soy sauce, salsa, ketchup, barbecue sauce, herbs, and spices.
• Cook eggs using cooking spray or a non-stick pan.
• Check food labels. Choose low-fat or fat-free cheese.
Fiber diet can slow the gastric emptying and slow down the rate of glucose absorption from the intestine. Water soluble fiber includes oats and bran. Men need 38 g of fiber day and women need 25 g a day.
But, do remember………
This does not mean one should avoid carbohydrates in total. Please be reminded that carbohydrates are needed for setting up the energy levels during the day.
One should have a hearty breakfast, a moderate lunch and a light dinner.
It will be worthwhile to have an approximate 45 grams carbohydrate inclusion with each of the main meals ( Normally a healthy person has 3 main meals and snacks in between).
Spread the carbohydrate intake during the day to help one curb hunger and thereby prevent overeating.
A toast of bread with an egg will fill you longer than a couple of toasts with jam.
Please be reminded that fish, chicken, Turkey Ham, eggs do not have carbohydrate.
But, addition of cheese or cream or milk while beating the gees to make them creamier, can shoot up the carbohydrate content.
Addition of bread crumbs and other coverings such as chick pea flour or corn flour can also send the sugar levels high.
All vegetables growing below the ground do contain some amount of carbohydrate and so excess consumption of the same can upset the sugar levels.
Those who are on insulin roughly need a unit of insulin for every 12-15 grams of carbohydrates taken.
Given below are 3 options for a meal containing 45 grams of carbohydrates
One cup of cooked oatmeal - 32 gram carbohydrate
Half medium sized banana - 13 grams of carbohydrate
A Hard boiled egg and some black coffee – no carbohydrate
2 scrambled eggs - no carbohydrate
A slice whole wheat bread – 15 grams
An orange - 18 grams
A cup of low fat milk - 14 grams
3 Rye bread pieces – 24 grams
Half cup non fat cheese – 5 grams
One cup blueberries - 15 grams
Avoid fizzy carbonated drinks and sugar free items as one may compensate by eating or drinking more.
Some tips for breakfast:
Those who eat a healthy and balanced breakfast regularly manage their body weight better as well as have better concentration. The breakfast is what sets the tempo and energy levels for the day.
• Turkey sandwiches are a good option.
• Smoothies with berries and low fat yoghurt are another good option
• Whole grain oat meal with fruits or nuts
• Making a French toast with whole grain bread dipped in batter made from egg white, cinnamon powder, salt to taste and vanilla essence makes a delicious dish. This can be topped with thinly sliced apples , berries or bananas.
• Do not watch television or use the computer while eating as many studies show an increased consumption of food and improper chewing of the food as well.
• Mid day snacks can be either fruits, low energy granola bars, non salted or non sweetened nuts comprising pistachios, walnuts, almonds, pecan , pine nuts and hazel nuts.
• 2 tablespoonfuls of olive oil is enough a day. Light olive oil is more processed than either the virgin or extra virgin olive oil. The light olive oil is lighter in color, but not lighter in calories or fat. Even too much of olive oil is not healthy.
• Having a bowl of salads is a healthy low calorie option ( of course without the rich creamy sauce or dressing).
• Base meals on starchy foods such as potatoes, bread, rice and pasta, choosing wholegrain where possible.
• Eat plenty of fiber-rich foods – such as oats, beans, peas, lentils, grains, seeds, fruit and vegetables, as well as wholegrain bread and brown rice and pasta.
• Eat at least five portions of a variety of fruit and vegetables each day, in place of foods higher in fat and calories.
• Eat a low-fat diet and avoid increasing your fat and/or calorie intake.
• Eat as little as possible of: fried foods, fizzy drinks and confectionery high in added sugars
• Eat breakfast.
• Watch the portion size of meals and snacks, and how often you are eating.
• For adults, minimize the calories you take in from alcohol.
• Chew food thoroughly rather than gulping down the food.
• A small gesture such as cutting back on a spoon of sugar a day or even using the salad dressings or mayonnaise as dips rather than mix with the salads can cut back on calories.
Try having food on a 9 inch plate with half the plate comprising non starchy vegetables, the other quarter comprising one half of starchy vegetables or grains and the other quarter with protein. The tendency to have plate of 12 inches is quite common these days to get value for money.
Some dairy product can be added such as glass of low fat milk or low fat yoghurt. No second helpings! Food must not be more than an inch deep in plate ………!
Eat slowly, chew well. It gives enough time for the brain to register the stomach is full.
If you feel hungry after meals, try brushing your teeth or drinking water or having non starchy vegetables.
Eat more of vegetables which are non starchy ( those grown below the ground contain more starch)
Choose whole grains instead of processed grains
Use liquid oils rather than solid fats (solid fats contain high amounts of saturated fats which have high calories)
Use non fat or low fat dairy products
Drink water in plenty. Use less of fruits juices, cocktails, alcoholic beverages.
Lentils and kidney beans have more proteins and less fat
Beware of high calorie snacks which taste good
Beware of junk food.
Some of the commonly used items and their caloric values: Item Quantity Calories
Canned beans ½ cup 127
Bread One loaf 70
Normal butter ( salted) Big spoon 102
Non fat creamy cheese 28.35 g 23
Low fat cheddar cheese 28.35 g 79
Half fat creamy cheese 2 big spoons 64
Full fat mozzarella 28.35 g 90
Non fat yoghurt Cup 137
Flavored non fat yoghurt Cup 162
Low fat yoghurt Cup 155
Flavored low fat yoghurt Cup 250
Full fat yoghurt Cup 150
Flavored full fat yoghurt Cup 292
Non fat milk Cup 86
Full fat milk Cup 150
Boiled egg One 66
Egg mixed with oil fried 2 197
Fried falafel 28.35 g 111
Dried dates 5 114
Fried potatoes ½ cup 87
Fruit juice Cup 117
Beef 85.05 g 176
Roasted beef 85.05 g 211
White rice ½ cup 103
Brown rice ½ cup 108
Spaghetti macaroni Cup 197
Nuts ¼ cup 161
Peanut ¼ cup 212
Almonds ¼ cup 211
All oils One big spoon 120
Mushroom Cup 18
Mixed vegetables 1 cup 38
Ice cream 10-12% fat ½ cup 143
Fruit salad ½ cup 47
Chicken 28.35 g 56 Cereals:
Some have cereals with milk or some just put in a handful or two into their mouth and chew on them. The market is flooded with innovative labels and cereal boxes have attractive packs to lure the people. Most of the cereals are made targeting the kids and so they are rich in sugar.
• Go for the ones made for adults
• Read the nutrition labels well
• If sugar is written near the top half of the label, it means the sugar content is more.
• High fructose corn syrup, honey coated cereals, dextrose are all forms of sugar.
• Look for serving size- some may have one cup, some half a cup
• Look for calories per serving- Go for the ones which have < 160 cals per serving.
Go for adequate portions of vitamins and minerals, have some fruits and vegetables and limit trans fats, saturated fats. Did you know?
• Stress levels and infections can increase the sugar levels.
• Sports drinks contain as much sugar as in a fizzy drink
• Dried fruits contain more carbohydrates
• Birth control pills can increase the sugar levels.
• Prolonged moderate intensity exercise can predispose to low sugar during or after the exercise
• High intensity exercise for a short time can lead to high sugars!
• Cold temperatures and high altitude can increase the risk of low sugars
• Repeated episodes of low sugar can reduce the body`s ability to recognize low sugar. The counter regulatory response by the body is also blunted in such patients.
Is this the shape of things to come?
This is an interesting concept to follow:
To get the maximum of the food one has try these tips:
Pick food from different groups such as using fruits, vegetables, low fat milk, yoghurt, whole grain bread, pasta, brown rice, lean meat, fish, poultry and eggs.
Fasting from dawn to dusk in the holy month of Ramadan for healthy adult Muslims has been ordained and physically sick Muslims are exempt from it. However many Muslims with mild to moderate Diabetes, Hypertension and other medical conditions do want to fast.
The purpose of this presentation is make some recommendations how one can fast safely in light of research on fasting. Many are concerned they cannot fast when they have diabetes mellitus . Please consult with your doctor.
Some people may need some tests to be done to assess fitness for fasting. The salient features of fasting are :
It is a voluntary undertaking rather than being ordered by a physician
There is no selective food intake i.e. protein only, juice only, fruit only , water only etc
There is no total calorie malnutrition i.e. it not a semi starvation diet.
An exercise in self discipline i.e. from constant nibbling , drinking, smoking etc
Psychological effect on the body and additional prayer give additional peace. People who should ideally not fast, but can fast under supervision
Diabetes Mellitus Type 1
Those who get recurrent low sugar levels.
Chronic Renal Failure including Renal Transplant
Severe heart and lung conditions
Physically sick ( Quran 2: 184-185)
Traveler on a journey
Women during menstruation
Pregnant and lactating women
pre pubertal children
Do you know?
Blood glucose and Insulin levels will fall during the fast.
The first few days will take some adjustment. If in doubt( headache, sweating, dizziness) check sugar or blood pressure. What to do during the fasting:
Beware the sweets and the fried food.
Remember that by eating throughout the night will not help one tide over the next day. Instead indigestion and gas related problems may set in.
Fluid intake must be adequate during the night to make up for the reduced intake during the day
Having too much of sweets or fried food during the Sahoor can lead to dryness of the mouth which can be a cause of concern during the fast. Points to remember while breaking the fast at Ifthaar:
Drink enough water, butter milk or juice. A glass of water melon juice, butter milk or tender coconut water will be a good option to break the fast. One need not add glucose. Water melon juice is sweet by itself and usually people add more sugar. Water melon has a higher glycemic index.
Try to be careful with the fried and sweet food. Take them in moderation.
Have a good Ifthaar or Isha meal. Have your prayers and then go for a walk to allow digestion.
Have some fruit at about midnight if need be. Have a good Sahoor of needed.
Avoid too salty food at Sahoor as that can make the mouth dry forcing more fluid intake.
Check the sugar level 2 hours after Ifthaar to decide whether any additional dose of medicines is needed.
Exercise and Ramadhaan
One can exercise during the month. Please check the sugar before exercise. One can exercise lightly before Isha or after the heavy meal.
Try to avoid strenuous workouts as the body may be tired due to the lengthy fast.
Those who want to exercise before Iftaar should check their sugar before exercise. If sugar is below 100mg(5.5 mmol/L) avoid exercising.
Those with type 1 diabetes are exempt from fasting as their sugar levels are dependant on insulin. However, there are some who do fasting alternate days only. This is depending on your health status.
Some more tips
Check sugar levels just before Ifthaar and before the Sahoor meal.
One can check the sugar levels at 7 am before going to work. If the sugar levels are either too low or too high, it is wise to seek medical advice immediately. You may be advised to forego the fast that day.
Time your medicines between Iftaar and 1am.
If on long acting insulin such as Glargine or detemir, it is advised to take 20% less either at Ifthaar or Sahoor time
Normally the doses of most of the medicines could be reduced during the month.
The medicines have to be tailored in such a way that there is no hypoglycemia
Be careful of sulphonyl ureas and rapid acting insulin
Among the sulphonyl ureas, gliclazide is safe in that the chances of hypoglycemia is lesser and the weight gain is minimal.
Intermediate acting insulin are avoided during the month due to the 10-12 hour action which can go into the period of fasting
The essence of Ramadhaan is the same all over the world, but the flavors may differ.
It is of a major concern that the increased consumption of sugar sweetened beverages has been linked to the development of the dangerous chronic illnesses such as diabetes type 2, hypertension and coronary heart disease.
The increased consumption has been a potential contributor to the pandemic of obesity.
Unlike carbohydrates which have a high fiber content, the sugar sweetened beverages are nutrient poor and are often accompanied by intake of salty fast food as well. High levels of fructose corn syrup promote insulin resistance as well as fatty liver which can lead on to diabetes type 2.
The pictures given below show the amount of sugar in some of the commonly used things. It is eye popping. Out here in the Middle East, Coca Cola and Mountain Dew are considered like the national drinks and no party is complete without a similar beverage.
Normally during the cold winter months, the levels of HbA1C, the 3 month average of sugar, can be higher due to higher food quantity consumed to combat the cold, the frequent outdoor barbeques and probably excess liquor consumption with the co incident Christmas and New Year festivities. People spend more time indoors in places where the weather is extreme. Lack of adequate physical activity and excess sleeping hours cuddled up under the warm blankets add more insult. It is quite natural to gain 5-6 kilos during the winter.
Blood Sugar Testing
The finger tips may be cold and so warm them by rubbing them together or wrapping them around a hot mug before pricking the finger for testing. In places where it snows, the glucometer kit has to be kept warm in covered bags so that errors do not come in the readings
It is difficult to work up a sweat while exercising during this time and one may feel cold after the exercise due to the evaporation. Remember to dress adequately while going for outdoor exercises. Hydration with adequate amounts of fluids is still important even in the colder months. Dehydration can increase the sugar levels.
Exercise such as skipping rope, doing the Hula Hoop, aerobics, dancing, yoga, swimming in thermal controlled swimming pools or working out in an indoor gymnasium do wonders. The benefits of exercise are the same whether done during winter or summer!!
Some blame the cold for exercising outdoors, but then they also blame the summer heat and humidity when that sets in.
Care of Skin
It is important to take good care of the skin as it can dry quite fast. Adequate and generous application of moisturising creams, and sunscreen if going to winter sports such as skiing or snow surfing or those just trekking in the snow laden mountains are very important. Adequate hydration keeps the skin shining and hydrated.
Those with neuropathy ( where the nerves of the feet are not working properly) may have difficulty in gauging the heat of water used for bathing.
Take care of the feet. Do not use hot water bags to keep yourself warm. Use multiple layers of clothing or socks at night to the feet. In some countries warm fireplaces keep the rooms warm, but beware the carbon monoxide accumulation.
Food & Beverages
Alcohol may cause a sense of warmth caused by dilatation of blood vessels, but the same may be lost after some time. Manage the consumption of alcohol wisely. Try to take hot beverages and easily digestible food such as soups, oats, porridge, steamed food and some fruits. Black tea with crushed ginger and black pepper is a good drink to even soothe the throat. Remember that excess red meat consumption can lead to high cholesterol levels in some races. The temperature can get quite low at night and it is natural people may eat more to raise their body temperature. Remember you do not need that much food at dinner whether it is summer or winter. It is healthier to sleep on a lighter stomach.
Frequent respiratory infections , mostly viral, are quite common. It is wise to have a Flu vaccine taken once a year rather than have to take multiple courses of antibiotics and medications to combat the infection. The elder adults should have a shot of pneumococcal vaccine once in their life.
It is also quite common to get infections due to food poisoning from eating out .
Use tissues, frequent washing of hands using soap and water or sanitizers especially before shaking hands with others help to prevent transmission.
Gargling of the throat with warm saline helps. So also does steam inhalation.
Fizzy cool sugary drinks do not help whether it is summer or winter.
Enjoy the winter because you will wish it was like this when summer blasts in.
Though essential, there are many bad effects with salt when taken in large amounts over a long period of time. The kidneys cannot get rid of this in time which leads to water retention, hypertension ( raised blood pressure) and studies have shown this is also important in development of osteoporosis among women even with normal calcium levels.
Processed or canned food contain salt in plenty. These may not taste salty. Fat free or low fat food usually have high sodium content.
Tricks to give a salty taste without really adding salt are to use vinegar or to squeeze lemon on to the dish.
Rock salt gives the taste of salt but is very low on sodium content.
Sodium content in some commonly used foodstuff:
A teaspoon of light soya sauce has 365 mg salt.
Dark soya sauce has 200 mg in a teaspoon
Reduced salt soya sauce has 185 mg in a teaspoon.
A small cup of French fries has between 200 to 400 mg salt.
Chicken rice has a whooping 1290 mg salt !!
A glass of milk (250 ml) has 80-120 mg salt.
Did you know?
One level teaspoon of salt is the equivalent of 2300 mg of sodium
Reducing the salt by 3000 mg a day can reduce the risk of developing a heart event , stroke and death by any cause by phenomenal percentages.
Salt is seen in these forms. Look for these on the nutrition labels.:
• Monosodium glutamate
• Disodium phosphate
• Sodium citrate
• Sodium nitrite
• Sodium nitrate
• Sodium benzoate
• Sodium ascorbate
• Baking powder
• Baking soda
These are salty…….
Salt and seasoned salt (or salt seasonings)
Boxed mixes of potatoes, rice, or pasta
Canned soups and vegetables (with salt)
Cured or processed foods
Ketchup, mustard, salad dressings, other spreads and canned sauces
Packaged soups, gravies, or sauces
Processed meats: lunch meat, sausage, bacon, and ham