Watch what you eat

Chennai: It is the meal plate that appears to upset blood sugar levels impacting overall diabetes management for many, particularly Chennaiites who just can’t do away with idlis, dosa or upma.

Breakfast options of idli, plain dosa and upma adds to more carbohydrates and steeply elevates calorie levels. Upma has the highest calories contribution to their daily calorie count. And on top of it, the lunch plate with rice, vegetable - vegetable curry, proteins byway of chicken - fish - mutton, add to carbohydrates consumed to about 75% - thus showing that Chennai has the most imbalanced meal plate, largely due to rice, as per a latest survey.

These additional carbohydrate-rich foods, over and above a regular diet that is already laden with carbs, indicate how difficult it is for Indians suffering with diabetes to manage diet properly.

“If we are what we eat, then 7 out 10 people with diabetes in urban India seem to be paying little attention to what and how much they eat,” the Abbott Food, Spikes and Diabetes survey released on Thursday said.

The survey, which covered over 4,100 people with diabetes (Type 2, diagnosed for over 18 months) between the ages of 36 – 65 years, across socio-economic classes, aimed to gain insights on what they eat, the meal plate’s role on blood sugar variability and impact on overall diabetes management.

Seven out of 10 respondents ate meals that are imbalanced in carbohydrates. The average meal plate for all respondents comprises 68% carbohydrates, significantly higher than the recommended guideline of 60% carbohydrates. While the average calories consumed per day (men - 2,534 Kcal and women - 2,634 Kcal) are generally in line with the National Institute of Nutrition (NIN) recommendation for sedentary to moderate activity, the source of the calories is a concern. Most of the calories come from simple carbohydrates that are low in fiber.

“A well balanced diet containing carbohydrates, proteins and fat is essential to maintain the health. One should avoid food that causes high glycemic index (time taken for blood sugar level to rise) and opt for a diet rich in fibre, oats, bajra, red or brown hand pound rice,” Dr R. Sundararaman, senior consultant and diabetologist.

“When the body is unable to process increased consumption of carbohydrates, the blood sugar level goes up. So, rice could be substituted with millets, as polished rice has high glycemic index. It is not difficult for south Indians to increase protein content. One should increase the intake of Sundal, kootu and poriyal and restrict the quantity of rice,” advices, Dr Vijay Viswanathan, Head and chief diabetologist, MV Hospital for Diabetes.

“In our epidemiological studies, we find that polished white rice comprises 48 % of all the calories consumed by people in Chennai and this is one of the drivers of diabetes epidemic. Controlling carbohydrate is extremely important because excess carbohydrate can lead to post-meal spikes of blood glucose. Since Indians eat carbs with every meal they get huge post-meal surge in blood glucose which abnormally increases the insulin secretion. Gradually, the insulin levels dry up due to beta cell exhaustion and severe diabetes sets in,” said Dr V. Mohan, chairman and chief diabetologist of Dr Mohan’s Diabetes Specialities Centre, here.