Indians and Diabetes
Healthy Living

Indians and Diabetes

Authored by DesiMD Doctor on 19 Mar 2013 - 15:00

Diabetes Mellitus is a metabolic disease which is characterized by a deranged carbohydrate metabolism due to either deficiency or diminished effectiveness of insulin hormone. It is usually manifested as high blood sugar levels and presence of sugar in urine.

In type 1 diabetes or Insulin Dependent Diabetes Mellitus (IDDM) no insulin is produced by the pancreas, whereas in type 2  diabetes or Non-Insulin Diabetes Mellitus (NIDM), either the production of insulin is reduced or the body cells are less responsive to the reaction of insulin, also known as insulin resistance.

 

An increased body mass index or BMI of greater than 25 increases the likelihood of diabetes in individuals with genetic predisposition. Type 2 diabetes more commonly occurs in obese individuals. Moreover, physical inactivity is an important risk factor in NIDM.

The cases of diabetes have been increasing at an alarming rate in India. This is in part due to better diagnostic facilities but increased incidence of obesity and inactive lifestyle has also played a major role.

Nutrition plays an important role in the management of diabetes both type 1 and type 2. In fact a patient with mild disease can manage his condition by changing his diet alone. However, dietary control and regulation is required and recommended in all types of diabetes whether treated with an oral hypoglycaemic drug or insulin.

 

The basis of dietary management in diabetes is to provide only that many calories to the patient that are needed to maintain his body’s daily calorie requirement. Thus total calories have to be adjusted in each individual patient according to his body’s needs.  For example, an obese diabetic will be put on a lower calorie diet to assist in simultaneous weight loss in comparison to an underweight diabetic who will require a high calorie diet.Before recommending any dietary changes, it is imperative to determine an individual’s normal eating habits. Dietary modifications should be advised in a manner so that there are no drastic changes in a patient’s normal meal pattern.

An approximate calorie recommendation for various groups of diabetic patients is:
1. A middle-aged or elderly patient who is obese and is suffering from mild diabetes: 1000-1600 kcal/day.
2. A normal weight elderly patient with diabetes: 1400-1800 kcal/day.
3. A young patient with diabetes who is active physically: 1800-3000 kcal/day.

General principles which are followed while planning a diabetic diet are:

  • 55% of the total calorie intake should be in the form of carbohydrates; 20% simple and 35% complex carbohydrates. Carbohydrate intake should be evenly spaced and consistent which can be accomplished by the use of carbohydrate exchange lists.
  • 30% of total calorie intake should be in the form of fats; 25% from saturated fats, 50% from monounsaturated fats and 25% from polyunsaturated fats (nuts, olive oil and fish). Cholesterol should be limited to 150 mg per day.
  • 10 to 20% of total calorie intake should be in the form of proteins; however, the quantity should be reduced in diabetic nephropathy. Majority of proteins should be in the form of lean meat, poultry, fish, beans and lentils.
  • At least 20-35 g of fibre should be consumed daily. Foods rich in fibre are fruits, legumes, lentils, roots, tubers, oats and oat-bran.
  • Salt intake should be limited, especially in individuals who suffer from associated hypertension, nephropathy and congestive heart failure.

(Image depicting Diabetics need to eat less carbohydrates (Rice) (Image modified from original work of Parvathisri))

List of foods which can be eaten by a diabetic according to region

What types of foods a South Indian diabetic patient can include in his diet?
South Indians eat more of rice and rice based dishes which form the major source of carbohydrates in their diet. It is important to eat a well balanced diet at each meal specific to your body’s daily requirement. To achieve this, eating your meal in appropriate portion is very important. Moreover, you can substitute white rice with brown rice as it is healthier. Coconut oil can be substituted with vegetable oils such as olive oil and canola oil.

Foods a South Indian Diabetic can include in his diet more often:

  • Starches: Idlis which are steamed and low in fat; Dosas which are prepared using minimum oil; Upma made from cracked wheat; Plain Brown rice.
  • Meat and other form of protein foods: Dal; Dal adais prepared using minimum oil; fish; chicken cooked in minimum oil
  • Vegetables: Stir fried green vegetables such as cabbage prepared using minimum oil; mixed veg kottu with minimum coconut.
  • Dairy: Buttermilk prepared from skimmed and low fat milk; pal koottu or majjige pulusu prepared with low fat curd.
  • Fruits: All fresh fruit.
  • Fats: Vegetable oils in minimum amounts.

Foods which a South Indian Diabetic should avoid or eat less often:

  • Starches: Idlis: Fried or made with a lot of oil and ghee; Dosas prepared using extra oil or butter; Upma cooked with extra amounts of oil or ghee.
  • Meat and other form of protein foods: Dal prepared with cream or excessive amounts of ghee or butter; dal adais prepared with extra oil; fried chicken, fried fish prepared in coconut sauce.
  • Vegetables: Aviyal with excess coconut; Fried potatoes; potato roasted curry with excessive oil.
  • Dairy: Buttermilk prepared from full fat milk; pachadi (raita) prepared with cream and fried bundi.
  • Fruit: Canned fruits; Banana pachadi with jaggery and nuts; chakkapradaman with nuts.

What types of foods a North Indian diabetic patient can include in his diet?

North Indian meals usually contain high amounts of fats and carbohydrates. If you suffer from diabetes then it is important to restrict the carbohydrate and fat content of each meal according to your body’s dietary requirements. It is beneficial to eat balanced meal of roti, dal, meat (if you are a non-vegetarian), vegetables and fresh salad. Eat each food in appropriate portion size so that actual carbohydrate intake can be determined at each meal.

Following is  a list of foods you should eat more often:

  • Starches: Chapatti, Boiled rice, potatoes cooked in minimum oil.
  • Fruits: All fresh fruits in moderation; portion size of fruits should be monitored.
  • Vegetables: All vegetables prepared using minimum amount of oil.
  • Meat and other form of protein foods: Dal, chicken and fish prepared using minimum amount of oil. Focus should be on lean meats and fish.
  • Dairy: Low fat paneer, skimmed and low fat milk, fat free curd and buttermilk.
  • Fats: Vegetable oils in specified amounts; dry fruits such as almonds, peanuts and walnuts in limited amounts.

Foods which should be eaten less often or should be avoided:

  • Starches: Paratha, puri, naan, kachori, samosa, pulao, biryani, French fries or potatoes in fried form.
  • Fruits: Canned fruits.
  • Vegetables: Fried vegetables and vegetables cooked in cream and ghee.
  • Meat and other form of protein foods: Dal or meat which is fried and cooked in cream.
  • Dairy: Full fat milk and milk products should be avoided.
  • Fats: Butter, ghee, cream, coconut oil.

Apart from the various regional differences there are certain common points which should be followed by all diabetic patients while planning their meals. Some of these are:

  • It is better to maintain a record of the foods you eat at each meal with their approximate amounts initially till you have a good knowledge about them.
  • Substitute saturated fats in your meal with heart healthy oils such as olive oil and canola oil. If you use ghee or coconut oil, use it occasionally and in minimum amounts and take care to count them in your total daily fat allowance.
  • Include generous amounts of fresh or cooked vegetables in your diet. Use minimum oil while cooking them; 1-2 teaspoons of oil is recommended to cook 3-4 cups of vegetables. Instead of using fats or oils, add more spices, garlic, onion and fresh herbs such as basil, coriander etc to impart flavor to vegetables.
  • Refrain from both fasting and feasting.
  • Get adequate water to maintain hydration. It is best to drink at least 8 glasses of water every day. Avoid soda, cola or fruit juices as they increase the total calorie count without providing any nutrients.
  • Avoid use of excessive salt.
  • Include a regular exercise program in your daily routine after consulting your health care provider.

Calories of some of the common foods
Vegetables (per 100 grams) Calories

Vegetables (per   100 grams)

Calories

Cabbage

46

Carrot

49

Cauliflower

31

Corn (baked)

85

Cucumber

11

Eggplant (Fresh)

25

Eggplant (Cooked)

68

Fenugreek (methi)

48

French Beans

25

Lettuce

22

Onion

51

Peas

92

Potato

96

Potato (fried- 1 cup)

451

Potato (baked- 1 cup)

101

Potato (mashed- 1 cup)

244

Potato (boiled- 1 cup)

84

Pumpkin (cooked)

32

Spinach

25

Tomato (fresh)

20

Tomato (stuffed and baked)

57

Tomato (baked)

38

Fruits (Per 100 grams)

 

Apple

55

Banana

152

Black Grapes

46

Chickoo

93

Cherries

71

Dates

280

Guava

65

Litchies

60

Mango

71

Melon

73

Orange

52

Papaya

31

Peach

51

Pears

50

Pineapple

45

Plums

55

Pomegranate

78

Watermelon

15

Cereals per 100 grams

 

Bajra

361

Maize flour

354

Rice

324

Wheat flour

340

Breads (per slice)

 

Chapati (wheat bread) (medium)

118

White bread

61

Paratha (not stuffed)

281

Deserts (per 100 grams)

 

Biscuits

398

Boondi ladoo

151

Cake (with icing)

301

Cake (without icing)

217

Cookies (butter cookies)

481

Custard

204

Fruit pie

235

Fruit salad

81

Gujia

500

Gulab Jamun

386

Halwa (atta)

262

Halwa (rawa)

180

Halwa (sohan halwa)

398

Jalebi

495

Jelly

64

Kheer (rice)

140

Kheer (rice-carrot)

225

Maalpua

326

Sandesh

56

Dairy (per cup)

 

Buffalo milk

114

Butter (100gms.)

751

Buttermilk

18

Cheese

316

Cow milk

101

Cream (100gms)

211

Ghee (100gms)

911

Skimmed milk

46

Miscellaneous

 

Coconut water (100 ml)

26

Coffee

41

Honey (1 tbsp)

91

Orange juice (100 ml)

48

Sugar (1 tbsp)

49

Tea

31

Tomato juice (100ml)

23

 

 

*Disclaimer: This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.