Hello readers am glad to bring to you today my exclusive interview with a professional in the field on the topic DIABETES. This interview is to celebrate the world diabetes day and also enlighten every reader especially those from this part of the world on what diabetes really mean.
Grab a bottle of apple and pineapple smoothie as you get informed.
Welcome to Dietherapy247,Tell us about yourself, background and Career?
Hello, I am Nitya Hullur – a certified Nutritionist, with bachelors in applied nutrition from SNDT- Mumbai, India. Post which I have finished an intensive masters course in global health and management from the University of Aberdeen, Scotland. In our field, it always about updating your knowledge and keeping up with the times-so I have successfully completed my Diploma in paleo nutrition and a certificate course that qualifies me to be diabetic educator. Most of all everyone who knows me knows my passion for food and human body- which keeps me inspired everyday to learn more and achieve more.
For how long have you been practicing?
It has officially been 6 years since I have been in this field. I think to be a well informed nutritionist- it is very important to get the ground work right. So I started of as an intensive public health researcher which took me to various organizations including World Health Organization (WHO), Geneva, MRC/Wits Rural Public Health and Health Transitions Research Unit, University of the Witwatersrand (Wits),South Africa, InternationalCentre for Sustainable International Development, University of Aberdeen, Scotland andCentre for Public Policy Alternatives, Lagos. The main aim to work across various work cultures was to understand their interpretation of nutrition and community health. Understanding health from the grass root level is the only way health can be improved on sustainable grounds for all.
As a registered dietitian with so many years in practice, our readers will
like to know all about diabetes?How do I know if I have diabetes?
Diabetes is an epidemic taking over the world like wild fire. Statistics suggest that one in every 11 individuals around the world is suffering from Diabetes today– this rate is shown to quadruple by the year 2040. In the African region alone- 14.2 million individuals are diabetic and are dealing with the associated complications.
There are so many factors including our current lifestyle, wrong food choices, sedentary activity levels and genetics that play a role in being diabetic. Diabetes mellitus is a group of diseases characterized by high blood glucose concentrations (hyperglycemia) resulting from defects in the insulin secretion, insulin action or both. Staying in a constant state of hyperglycemia can eventually lead to serious complications and premature death. There are various types of diabetes and pre-diabetes according to which the insulin dose has to adjusted and taken to ensure steady blood glucose concentrations.
The easiest ways to come to know if you are diabetic or not is through
- Testing your sugar levels: If your fasting sugar levels are higher than 120 mm/hg and random sugar levels are higher than 200 mm/hg – please book your appointment with a endocrinologist today!
- If you are experiencing symptoms such as excessive thirst (Polydipsia), excessive urination, especially during night time (Polyuria) or go through dips in glucose levels due to which you suddenly feel like you have lost all your energy- please get yourself a glucometer and keep a close check.
I always tell my clients that a “healthy body” is only possible when you have “happy hormones”. This means that for each and every part of your body to function well – your hormones need to be well balanced to ensure all the vital functions in the body are being properly executed. So never take any risk with your health and hormones- if you are in doubt, go now!
What does diabetes have to do with Diet or the importance of diet in
Diabetics?
Diabetes management requires awareness. Understanding the day-to-day factors that fluctuate your sugar levels is the key to making peace with it. People forget that insulin is not the cure to diabetes, it is a treatment. Ultimately it all depends on the type and composition of meals you consume to which your sugars respond with a spike or a dip. Diabetic diets need to be carefully balanced with good fats, complex carbs and rich proteins to ensure the client has stable sugar levels throughout the day and does not enter a hypo or hyper glycemia phase. “Your sugar levels are a reflection of your food”- I have seen my clients reduce their insulin doses greatly, having constant energy levels with a better quality of life with small tweaks in their food level- so its never to late to change how your plate looks.
Does diabetes require I stop eating so many foods?
No. That is a big, fat myth that a diabetic diet is boring. Diabetics can eat everything but in moderation. Insulin is triggered by a high carbohydrate or a high protein meal- because of which each meal that is given to a diabetic should have some good fats and soluble fibre which can regulate the spike in sugars that is caused by proteins and carbs. Eliminating foods is not the solution; working around them to come up with macronutrient balanced meals is what we need to be looking at.An ideal diabetic plate should have 2 portions of green vegetables for vitamins and fibre, with a portion of high protein source and a small portion of alkaline carbs- like sweet potato or rice.
Is there a cure for diabetes?
This depends on the type of diabetes one has. Currently there is no cure for type 1 a diabetic (which is an auto immune condition) – it requires insulin administration through pump or injections to balance the sugar levels which need to be coupled with a balanced diet, regular exercise and aware choices. This may seem overwhelming at times but trust me seeing clients transform their lives and making diabetes their strength, a reason to lead a healthy life rather than weakness is inspiring. As for type 2 diabetes- loosing weight in many cases has shown to reverse diabetes completely. Loosing fat- improves their insulin sensitivity and glucose control and gradually the excess fat is drained out of the pancreas which allows them to functions like before. There have be scientific studies that suggest that 150 minutes of exercise a day with 1200 kcal of daily food intake has reversed diabetes in 10% of the diabetic population in an year. This shows the importance of diet and exercise in those with diabetes. For diabetic clients their weight goals should be 5-10% weight loss in the span of 6 months- and this weight loss should be from “fat” not “muscle”. The total fat % in your body should not exceed 23%, in addition having a good muscle profile (ideal 25%-30%) makes it easier to deal with glucose response in the body.
Can Diabetes be prevented?
Type 1 diabetes cannot be prevented. However it has been estimated that 58% of the type 2 diabetes cases can be prevented by simply making healthy choices, weight management and including exercise everyday. Some causative factors like ethnic background and family history cannot be controlled predisposing individuals to the diabetes threat.
I have seen some diabetic patients tell me their dietitian said he/she
needs to lose some weight. So I ask what has overweight /obesity has to do
with diabetes?
Among diabetics loosing a little weight can make them gain a lot of control. Studies have shown that overweight women with a BMI higher than 30 kg/m2 have a 12 fold higher chance of being diabetic rather than those in the healthy weight range. Bearing the extra weight in diabetics predisposes them to various other complications including high blood pressure and coronary heart disease. Even if you loose 5% of your body weight – the body is able to use the insulin more efficiently, your cholesterol levels decreases, your risk to heart disease decreases and gradually you will observe a spike in your productivity levels throughout the day. However to achieve these results in a short span of time some clients go on crash diets or salad diets which is the BIGGEST BLUNDER, they fail to understand that the body is complex and requires the right amount of fat, protein, carbs with minerals and vitamins for smooth functioning. On these FAD diets they loose weight but the results are not sustainable, something we nutritionists call “yo-yo dieting” – the weight bounces back and gets more difficult to loose it this time. Hence a golden rule for weight loss- Please never take short cuts, your body deserves more.
If am diabetic, does it mean my children will be diabetic too?
If anyone in the immediate family (brother, sister or parent) has type 1 diabetes, then the chances that the child has type 1 diabetes is 10-20 times higher than the general population. Among type 2 diabetics- if it “runs in your family” there are chances you may be predisposed to this condition. This risk is further exacerbated depending on your race and ethnicity- the risk of diabetes is higher in Asians, Hispanics and blacks as compared to whites. So it is clear that – genes and the environment you are living in play are key role when we talk about diabetes.
Our readers will like you to share with us those foods that are good for
diabetics?
When it comes to diabetic friendly food- always remember to look at the following
- Fibre
- Glycemic load (Glycemic Index * carbohydrates per portion/100)
So all the options you pick should be high on fibre and low on glycemic load to prevent sugar spikes. So understanding this one at a time, soluble fibre in the food manages your blood sugar levels, has a favourable effect on your cholesterol and increases your satiety
(a feeling of fullness after you consume the meal). My top choices include oats, oat bran, fruits, legumes and partially refined pulses. Second factor- glycemic index, it is a value assigned to the food depending on how quickly it rises your sugar levels, however I believe glycemic index only tells you half the story. It is very important to understand how much glucose enters your blood stream and how quickly your levels rise- this can only be determined by the carb content in the food which is why glycemic load makes more sense and provides a deeper understanding of the carbohydrate impact on your sugar levels. So the thumb rule here is – foods with a glycemic load below 10 are safe while those above 20 should be avoided.
A classic example that I always quote is of watermelon, the glycemic index is around 80, the carb content in a slice of watermelon is so less (6 gm) that the glycemic load comes upto 5 – which safe for consumption , but don’t ever over do it.
Here in Nigeria there is this practice that individuals with diabetes
eat mostly wheat instead of the usual cassava. As a practicing Dietitian
what do you have to say about that? Does it mean that wheat is better than
cassava?
No- this is not 100% true. That’s where the problem lies, Nigeria has so much goodness in its food but still tries to ape the west which not only affects local health but also the production of local food. I strongly believe that there is not food better than local food, and it’s a fact that cassava has been considered as one of the super foods around the world to reduce the incidence of diabetes. This is not me saying it, its all backed up by science and studies. Cassava has a lower glycemic index and load as compared to wheat. Did you know that wheat consists of anti- nutrient called gluten which gradually damages our gut eventually leading to inflammation and indigestion. Cassava on the other hand is free from all anti-nutrients, its pure health with very less quantities of salt, sugar and refined carbohydrates. Personally I believe diabetics should always work to achieve a balance, there is no problem in having cassava provided the portion sizes are controlled and it is should be combined with Egusi soup and a fillet of fish. That’s makes your plate macro and micro balanced.
Why is artificial sweeteners not prescribed for diabetics since they have
zero calories?
I absolutely love to answer this question. Adding a sugar free tablet to your tea or coffee does not support your health in any means instead you’re deteriorating your health with every tablet. So this is a classic example of marketing gimmicks- so sugar free does not mean fat free and low calories, start reading and understanding food labels- these sweeteners come with loads of side effects from hallucinations, seizers, skin rashes and are proven to increase your appetite that makes you eat more junk and puts you on a higher number on the scales. Classic example- Splenda uses sucralose that is proven to give you tummy pain, head aches, diarrhoea and even bladder issues. The golden rule here is anything synthetic, anything processed is not for health. So I choose honey, maple syrup, agave nectar, and molasses over the above in limited quantities to add to my client’s dishes if required.
What are your final words and advice to people living with diabetes in
Nigeria and all over the world?
Diabetes is the most common endocrine disorder in Nigeria, estimates suggests that the number affected will rise to 15 million by 2025. So why is this? Blame the healthcare quality? Stress?Living conditions?
It’s a combination of all- but lets work on what’s in our hands, our health. I have come across so many clients who are hypertensive and are unable to control their glucose levels, please moderate your food, set your goals and make exercise compulsory to see positive changes.
Nitya is based in Lagos, so if you want to reach out to her to understand your metabolism, bring down your weight, set your hormones right and most importantly live a healthier life – get in touch with her on:
Mobile: 08133352331.
Facebook: Nitya Hullur
Instagram: Nitya Hullurl
| Feel free to drop your questions in the comment box |
Very educative! I enjoyed reading it😀
You are welcome, Naza