Carbs: Diabetic enemy No.1?
There are no bad or good foods, just bad or good diets in diabetes.
Many diabetics think avoiding rice and sugar are the main factors in controlling their sugar level, but that’s not strictly true.
DIABETICS often find it challenging to get a completely balanced and nutritional meal. Often, they think avoiding rice is the key to controlling their sugar level.
“This is a mistake because diabetics need to have carbohydrates for energy and it is important that they segregate the carbohydrate-loading,” says Sime Darby Medical Centre, Subang Jaya, Selangor, dietetics and food services manager Nurul Aziah Musa.
“Breakfast is still the most important meal of the day and should be consumed within two hours of waking up. It’s harder to lose weight without breakfast.
“Being Malaysians, we cannot tell a patient not to eat nasi lemak or roti canai. Instead, modify these meals.
“For example, at the hospital, we serve patients nasi lemak, but substitute santan with low-fat milk.
“With it, we also include egg white and roasted peanuts, so it becomes a wholesome meal.”
She was speaking at a roundtable interview on diabetes management and education held here last month. She says, “Ideally, we emphasise healthier options such as capati or thosai.
“In urban areas, patients are more receptive to a western breakfast such as oats with chopped fruits and nuts, but it takes a lot of discipline to follow this.”
She notes that there are plenty of foods with high sugar content, and while this does not cause diabetes, these foods contain a lot of calories that contribute to weight gain.
“It’s all about portion control. Don’t overload on breakfast and spread out your meals.
“Those slightly bigger-sized should aim for a 5% to 10% weight reduction over six months,” she adds.
According to Institut Jantung Negara senior diabetes educator Siah Guan Jian, there is no such thing as a diabetic diet.
“You just have to modify your diet to control sugar levels.
“Our diabetic patients are getting younger and younger.
“Before, the diabetic age group ranged from 30 to 60 (years old), but now, we’re seeing patients in their teens with this disease.
“People are also eating out more, so we have to teach them what foods to choose without compromising their health.
“We don’t want them to end up with kidney failure or blindness in a decade,” she says.
Lack of awareness
The prevalence of type 2 diabetes is rising at an alarming rate.
Some 3.5 million or 17.5% of Malaysian adults above the age of 18 have been diagnosed with diabetes.
This figure only confirms that every Malaysian has a role to play in addressing this public health concern.
Recently, Nestle Health Science conducted a three-month nationwide Healthy Diabetes Living Starts With Breakfast initiative, where attendees were asked to complete a survey to identify breakfast trends in Malaysia.
The dipstick survey – the first of its kind locally – was carried out during a roadshow from April to June, and involved six hospitals in the Klang Valley, Perak, Penang and Johor.
The results revealed that 79% of the 694 respondents interviewed did not know what the glycaemic index (GI) was. This index is a relative ranking of carbohydrates in foods according to how they affect blood glucose levels.
Carbohydrates with a low GI value (55 or less) are more slowly digested, absorbed and metabolised, and cause a lower and slower rise in blood glucose, and therefore, insulin levels.
Further findings showed that 77.2% of the respondents did not take a special diabetic formula or oral supplementation to assist them in managing their blood sugar level.
Nestle Health Science’s country business manager Emilyn Woon says, “Not every diabetic patient needs a formula, but the results show patients had low awareness on what is GI or if they needed supplementation.
“The newly-diagnosed (diabetics) also have a stigma and fear because they’re used to eating certain kinds of food every day.
“They want convenient, tasty options and more product choices. If you start your day with breakfast, your day will usually go right.”
Nurul says, “We need to ensure the taste is palatable.
“Oral nutritional supplements come in handy, especially on a sickday diet. Patients tend to recover faster.”
Siah adds, “People think that if they don’t add sugar to their drink, then it’s healthier.
“They don’t realise how much carbs they are taking from other foods, which contribute to a high sugar level.
“We advise diabetics to change their lifestyle with three key words: diet, medicine and exercise. Don’t let diabetes control you.”
Both Siah and Nurul emphasised the importance of education in managing the disease.
“There is no good or bad food, only a good or bad diet.
“There are also a lot of myths out there. One, for example, is to overload on bitter gourd.
“While there is nothing wrong with this vegetable as it is high in fibre, there is no scientific evidence to prove that it can reduce sugar levels,” says Nurul.
Another myth is that diabetic medication will cause kidney failure.
“It’s crazy!” says Siah. “People actually stop taking their medication because of hearsay or something they’ve read on the internet.”