New Delhi: November 14 is being observed as the World Diabetes Day mainly to raise awareness on diabetes mellitus ---- a chronic disease caused by inherited and/or acquired deficiency in the production of insulin by the pancreas.

On this occasion, MyNation reached out to dietician, Dr Pavithra N Raj of Columbia Asia Referral Hospital in Bengaluru to have some insight about the diet, which should be maintained by a diabetic patient.

Here are some important points made by Dr Pavithra:

1.    Can a diabetic patient consume carbohydrates? If yes, which carbohydrates should he or she use?

Dr Pavithra: All the food that we eat has carbohydrates in them. However, the patient should keep in mind that complex carbohydrates, like wheat, ragi, jowar, millets, oats, quinoa etc, are good as they contain a lot of fibre. When these items are consumed, the digestion process takes a long time and the release of carbohydrate is slow.

2.    Do I have to cut down on sugar altogether?

Dr Pavithra: We need to cut down on simple sugar, which the body absorbs faster. For example sugar, jaggery, honey and date syrups.

3. How much fat should I get in my diet?

Dr Pavithra: Five hundred mililitre per person per month is the visible fat recommended (15gms/ day or 3 tsps. /day)

4. How will alcohol consumption affect my diabetes? 

Dr Pavithra: One gram of alcohol gives 7 kcal. For example, if a person is taking 50 g of alcohol, the amount of energy you will get is 350 kcal.

If a person’s total daily intake of food is 1,200 kcal (when divided to three major meals it will be 350 X 3 = 1,050 kcal and two snacks of 75 x 2 = 150 kcal).

Consumption of even 50 g alcohol will give extra calories for a person. So the body has to produce more insulin to convert the extra calories. Physical activity plays an important role to burn the extra calories. Every gram of consumption of alcohol will add extra calories to the body.

5. How much of alcohol am I permitted to have?

Dr Pavithra: A maximum of 60 ml in 15 days along with a healthy diet, which has high fibre (like salads). Make sure you do not include fried and oily products, which will again increase calories.

6. In an Indian household, what are the foods I can include as a diabetic patient?

Dr Pavithra: •    Cereals - One serving per day (30gms) of wheat, ragi, jowar, millets, oats, quinoa, unpolished rice 
•    All dals, pulses and sprouts.
•    Include high fibre vegetables. Avoid starchy vegetables like potato, beetroot, carrot and yam
•   Fruits like apple, pear, pineapple, orange, papaya, guava, sweet-lime, one slice of muskmelon (one cup of cut fruits if the fasting sugar is less than 100 and only in the first half of the day. Don’t eat fruits with meals. Eat them preferably midmorning)
•    Milk /curds / buttermilk – low fat 400ml /day
•    Non veg food – Two eggs per day, two pieces (100gm) of fish/ chicken in the form of steam, boiled or grilled weekly once and only during lunch time. Do not consume any mutton.
•    Five hundred millilitres per person per month is the visible fat recommended (15gms/ day Or 3 tsps /day)
•    Nuts – Almonds (4 nuts/day) and walnuts(1 nut/day) , flax seeds (2tsp)
•    Salt – 5gm/day (one tsp)
•    Fluid – 2.5 to 3 lt/day (include soups/ buttermilk/lime juice with no sugar)
(No fruit juice, tender coconut water/ cane juice /aerated drinks/ health drinks with sugar)

7. Does the cooking oil I use matter? Which oil is best for cooking food for a diabetic patient?

Dr Pavithra: For cooking use ricebran oil, canola oil, groundnut oil, mustard oil, sunflower oil and olive oil.

Different oils can be used for different dishes. However, the blending of oil is not safe since the smoking temperature of each oil is different and it can lead to the formation of trans fats.

8. Will the consumption of tea or coffee affect my diabetes in any way? 

Dr Pavithra: Caffeine and tannic inhibits the absorption of nutrition from food and too much coffee and tea along with diabetic medication may again inhibit absorption.

However, anaemia is caused by drinking too much tea because of tannic acid present in tea.

9. What are the foods I should completely avoid?

Dr Pavithra: •    All sweets and sweetened products like sugar, honey, jaggery, cakes, pastries etc have to be avoided.
•    Avoid sweetened fruit juice, high-calorie fruits or overripe fruits like mango, banana, sapota, seethapala, jackfruit, grapes and pomegranate.
•    Avoid roots & tubers such as potato, sweet potato, beetroot, yam, tapioca.
•    Avoid aerated and caffeinated drinks such as Pepsi, Coke, Fanta, diet coke, soda etc.
•    Avoid dry fruits such as raisins, dates, figs, prunes, plums, cashew & pasta.
•    Strictly avoid health drinks, like Horlicks, Boost, Complan etc.
10. 72 million cases of diabetes recorded in 2017. Why do you think diabetes is so prevalent in India? 
Dr Pavithra: Firstly, diabetes is so prevalent because of our sedentary lifestyle, stress and lack of physical activity.

Any person who is eating a limited amount of food will also consume 1,200 kcal/day. So the person needs to burn 500 kcal/day for which one hour of physical activity is needed.

Also, one should keep in mind that fat starts burning after 40 minutes of physical activity.
To keep diabetes at the bay one should follow these steps

•    Optimise nutrition: Eat mostly plant foods, cut back on refined carbs and sugary drinks, and choose healthy fats, keep regular meal and snack times (do not starve, do not feast). Add roughage or bulk to your diet fruits, vegetables, whole grains, beans, nuts and seeds. In general, the more natural and unprocessed the food, the better. Instead of frying, choose to grill, boil, bake, or stir-fry.
•    Balance your hormones: Sleep on time, get up early, meditate, smile
•    Boost energy metabolism: Exercise, exercise, exercise
•    Calm your mind: Relax, breathe