World Diabetes Day: Healthy living prevents diabetes and obesity
By Shobha Shukla
Feature Article | Fri, 13 Nov 2009
Feature Article | Fri, 13 Nov 2009
AUTHOR: Shobha Shukla
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Today is World Diabetes Day – a day to reflect upon why India has become the diabetic capital of the world with 50.8 million (7.1%) of its people suffering from diabetes. It is high tim
e we prepared to combat this menace and curb its spread. As the new President of IDF has rightly remarked that either we turn off the diabetes tap or else spend our lives mopping the floor.
We Indians are genetically more prone to diabetes. On top of this, a rapid shift in our dietary habits and life styles is resulting in a rapid rise in obesity, diabetes, metabolic syndrome and heart disease. Hence a proper and healthy diet remains the cornerstone of prevention and management of these diseases.
Perhaps the most important reason for increasing prevalence of diabetes, obesity and hypertension is the rapidly changing imbalanced dietary habits, both in rural and urban areas, due to several factors – easy availability of convenience foods, frequent snacking on energy dense fast foods, high consumption of packaged food in place of traditional home made food, etc. This transition has resulted in excess consumption of calories, saturated fats, trans fatty acids, simple sugars, salt and a low fibre intake.
This has necessitated a revision in the existing dietary guidelines prepared 10 years a go by the National Institute of Nutrition, Hyderabad, which was predominantly rural centric. So, more than 100 renowned experts, belonging to varied disciplines of health and nutrition, have got together under the aegis of Science For Equity and Empowerment Division (SEED), Ministry Of Science and Technology, Govt Of India and Diabetes Foundation (India), to formulate a "National Consensus on Dietary Guidelines for Adult Asian Indians for Healthy Living and Prevention of Obesity & Diabetes". They have incorporated worldwide research and opinions in nutrition modulated to India specific data. They are simple, easy to understand by doctors and common public alike, and provision of standard diet charts catering to different regions of India will help people from all parts of India.
According to Mrs. Rekha Sharma, former chief dietician AIIMS, New Delhi, “Researches done on the nutritional health of the Indian Population indicate a rampant increase in obesity and other NCDs, like diabetes, primarily due to faulty eating and sedentary life style. Hence, to keep up with the changing scenario of health, we need new scientific broad based dietary guidelines, tailor made to the eating pattern of the Indian population.”
Dr Anoop Misra, director, Diabetes, Obesity and Metabolism, Diabetes Federation Of India, strongly feels that the application of these guidelines will significantly help in preventing and halting diabetes and obesity epidemic in India.
Countrywide adaptation of these guidelines is likely to have a significant impact on prevalence and management of more than 25 diseases, including diabetes and diabetes related diseases.
What are these dietary guidelines for healthy living and prevention of diabetes and obesity?
The energy requirement must be calculated on the basis of height, weight and activity level – a medium frame Indian male of 165cm height should weigh 62 kg, and if sedentary, would require 1850 K cal to maintain healthy weight.
The daily carbohydrate intake, derived from whole wheat, unpolished rice, barley, buckwheat, oats, millet, whole pulses, legumes, and whole fruits like guava/apple etc, should be around 50-60% of total calorie intake, that is 250-300 gm/day.
The total daily dietary fibre should be 25-40 gm. Hence high fibre food items like cereal, pulses, vegetables, salads, guava, amla, apple, pears, peaches etc should be eaten. In fact, 4 to 5 servings of fruits and vegetables per day are recommended.
Visible fat (oil, butter, ghee) and invisible fat (from cereals and pulses), together should be less than 30% of total energy. This can be got by consuming 4 to 5 teaspoonfuls of a combination of two or more vegetable oils. Correct cooking methods like boiling, steaming, roasting, grilling etc, instead of frying can minimize the visible fat intake.
Trans fatty acids should be less than 1% of the total energy. These are found abundantly in bakery products, ready to use soups and gravies and foods prepared in margarine and vanaspati ghee. Hence it is best to avoid these products.
Ideal protein intake is 1gm/day for every one kilo of body weight. Thus for the average Indian male, this could be obtained from two bowls of cooked pulses, or 2 pieces of lean chicken/fish meat, or 500ml of double toned milk, or 9 servings of wheat flour. This much of protein will provide 10-15% of the total calories.
Salt intake should be less than 5gm per day. So, we Indians need to drastically curtail the ever so popular consumption of salted potato chips (a big favourite of children), pickles, and salty fried snacks.
Sugar in very small amounts and water in excess (about 8-10 glasses) every day, should cap it all.
Apart from this, it is important to take small frequent meals at intervals of 3-4 hours. While eating out (which has become increasingly popular, even in small towns in India), one should choose small portion sizes of healthy snacks. Beverages like buttermilk, coconut water, and fresh lime with water are excellent substitutes for aerated and high calorie drinks.
If adopted, these guidelines can, perhaps, have a significant impact on prevalence and management of obesity, diabetes and heart diseases, and save the native Asian Indian race from the ravages of non-communicable diseases (NCDs).
A persistent and prolonged intensive lifestyle intervention could be the most effective tool to combat diabetes. At the same time, more effective drugs (and not glamorous pharmaceutical manipulations) are needed for those who cannot follow intensive life style therapy due to infirmity. Continued
Source: Shobha Shukla
e we prepared to combat this menace and curb its spread. As the new President of IDF has rightly remarked that either we turn off the diabetes tap or else spend our lives mopping the floor.
Perhaps the most important reason for increasing prevalence of diabetes, obesity and hypertension is the rapidly changing imbalanced dietary habits, both in rural and urban areas, due to several factors – easy availability of convenience foods, frequent snacking on energy dense fast foods, high consumption of packaged food in place of traditional home made food, etc. This transition has resulted in excess consumption of calories, saturated fats, trans fatty acids, simple sugars, salt and a low fibre intake.
This has necessitated a revision in the existing dietary guidelines prepared 10 years a go by the National Institute of Nutrition, Hyderabad, which was predominantly rural centric. So, more than 100 renowned experts, belonging to varied disciplines of health and nutrition, have got together under the aegis of Science For Equity and Empowerment Division (SEED), Ministry Of Science and Technology, Govt Of India and Diabetes Foundation (India), to formulate a "National Consensus on Dietary Guidelines for Adult Asian Indians for Healthy Living and Prevention of Obesity & Diabetes". They have incorporated worldwide research and opinions in nutrition modulated to India specific data. They are simple, easy to understand by doctors and common public alike, and provision of standard diet charts catering to different regions of India will help people from all parts of India.
According to Mrs. Rekha Sharma, former chief dietician AIIMS, New Delhi, “Researches done on the nutritional health of the Indian Population indicate a rampant increase in obesity and other NCDs, like diabetes, primarily due to faulty eating and sedentary life style. Hence, to keep up with the changing scenario of health, we need new scientific broad based dietary guidelines, tailor made to the eating pattern of the Indian population.”
Dr Anoop Misra, director, Diabetes, Obesity and Metabolism, Diabetes Federation Of India, strongly feels that the application of these guidelines will significantly help in preventing and halting diabetes and obesity epidemic in India.
Countrywide adaptation of these guidelines is likely to have a significant impact on prevalence and management of more than 25 diseases, including diabetes and diabetes related diseases.
What are these dietary guidelines for healthy living and prevention of diabetes and obesity?
The energy requirement must be calculated on the basis of height, weight and activity level – a medium frame Indian male of 165cm height should weigh 62 kg, and if sedentary, would require 1850 K cal to maintain healthy weight.
The daily carbohydrate intake, derived from whole wheat, unpolished rice, barley, buckwheat, oats, millet, whole pulses, legumes, and whole fruits like guava/apple etc, should be around 50-60% of total calorie intake, that is 250-300 gm/day.
The total daily dietary fibre should be 25-40 gm. Hence high fibre food items like cereal, pulses, vegetables, salads, guava, amla, apple, pears, peaches etc should be eaten. In fact, 4 to 5 servings of fruits and vegetables per day are recommended.
Visible fat (oil, butter, ghee) and invisible fat (from cereals and pulses), together should be less than 30% of total energy. This can be got by consuming 4 to 5 teaspoonfuls of a combination of two or more vegetable oils. Correct cooking methods like boiling, steaming, roasting, grilling etc, instead of frying can minimize the visible fat intake.
Trans fatty acids should be less than 1% of the total energy. These are found abundantly in bakery products, ready to use soups and gravies and foods prepared in margarine and vanaspati ghee. Hence it is best to avoid these products.
Ideal protein intake is 1gm/day for every one kilo of body weight. Thus for the average Indian male, this could be obtained from two bowls of cooked pulses, or 2 pieces of lean chicken/fish meat, or 500ml of double toned milk, or 9 servings of wheat flour. This much of protein will provide 10-15% of the total calories.
Salt intake should be less than 5gm per day. So, we Indians need to drastically curtail the ever so popular consumption of salted potato chips (a big favourite of children), pickles, and salty fried snacks.
Sugar in very small amounts and water in excess (about 8-10 glasses) every day, should cap it all.
Apart from this, it is important to take small frequent meals at intervals of 3-4 hours. While eating out (which has become increasingly popular, even in small towns in India), one should choose small portion sizes of healthy snacks. Beverages like buttermilk, coconut water, and fresh lime with water are excellent substitutes for aerated and high calorie drinks.
If adopted, these guidelines can, perhaps, have a significant impact on prevalence and management of obesity, diabetes and heart diseases, and save the native Asian Indian race from the ravages of non-communicable diseases (NCDs).
A persistent and prolonged intensive lifestyle intervention could be the most effective tool to combat diabetes. At the same time, more effective drugs (and not glamorous pharmaceutical manipulations) are needed for those who cannot follow intensive life style therapy due to infirmity. Continued
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