Publication: Malaysia Star
Author: Dr Farid Amir Isahak
Date: December 3rd 2006
THE World Health Organization has warned of an impending diabetes pandemic in Asia, and Malaysia will not be spared. Already about 10% of adult Malaysians are diabetic, and the prevalence is increasing. The situation is not much better in developed countries.
Globally, the trend is the same. This is attributed to the affluent modern lifestyle synonymous with an unhealthy diet, overweight/obesity and lack of physical activity/exercise.
In Malaysia, about 20% of us are overweight and another 10% are obese (grossly overweight). We also do not exercise enough
Diabetes can result in many complications, chief of which are heart disease, stroke, eye problems, kidney disease, foot ulcers, frequent and recalcitrant infections and abscesses, and impotence in men. It is the leading cause of eye disease, kidney failure, leg amputations and erectile dysfunction.
While we know what causes diabetes, unfortunately, the prevention and treatment aspects still need to be improved. Type 1 diabetes (due to lack of insulin production) is genetic and becomes apparent early, before adulthood. Type 2 diabetes (due to insulin resistance), which affects 90% of the patients, also has a familial risk factor (higher risk if there is a family history), but all the other risk factors are related to diet and lifestyle, and are therefore modifiable.
The key is prevention
Doctors and scientists have devoted much effort in trying to address the problem of diabetes. Sadly, many diabetics who are undergoing treatment still end up with the various complications that make their lives miserable, affect their work and finances, and shorten their life-spans. Only those who are perfectly controlled, with blood sugar levels normal all the time, can expect reasonably normal lives.
Unfortunately, this is rarely achieved. More worrying is that probably a third of diabetics don’t even know of their diabetic condition.
To avoid being a victim of this scourge, the smart solution is prevention. As mentioned above, the only un-modifiable risk factor is the genes you carry. Everything else depends on your commitment to your health.
Obesity is the mother of many diseases. Obesity is strongly linked to diabetes, such that a new term, diabesity, has been coined to denote those cases where diabetes is directly linked to obesity. There have been many cases of morbidly obese diabetic patients who became non-diabetic after losing weight. In such cases, the diabetes was cured!
So the first preventive and therapeutic strategy is to lose weight if you are obese, and to maintain a healthy normal weight if you are not. If you are overweight or obese, reducing your weight will also help normalise your lipids, and lower your risk of hypertension, heart disease, stroke, joint problems, and possibly even cancer.
However, only 20% of diabetics are obese. Which means that the other risk factors are also significant.
If you are already diabetic, you can certainly expect improvement in your condition if you exercise enough. The benefits of regular exercise go beyond feeling fresh and energetic.
There are very few muscular diabetics. Firstly, if you build muscles, it means you do lots of exercise, and have improved your cardiovascular health, apart from many other benefits. You also reduce your body fat and improve your carbohydrate metabolism. Muscles burn glucose efficiently and therefore help maintain normal glucose levels, and prevent excess fat deposition.
Regular exercise and building muscles are therefore important components of my prevention and treatment for diabetics.
The anti-diabetic diet
My diet prescription is simple – take lots of fresh, raw veggies (of many varieties, but minimising the starchy ones like potatoes); take lots of different fruits (restrict to one or two slices or portions per fruit if you are diabetic); add healthy fats (olive oil, avocado, or supplements), nuts, legumes, and some whole grains and there will be no more room for the unhealthy food to fit in your stomach.
If you must have meat, choose fish over chicken, beef or mutton, in that order. You can have enough calories, carbohydrates, fats, and even proteins, plus tons of antioxidants, vitamins, minerals, phytonutrients, enzymes, co-enzymes, fibre, and food for your friendly gut bacteria if you take lots of fresh fruits and veggies.
The nutrient-dense fruit and veggie diet is applicable to all who want to be healthy. It will be beneficial in maintaining good health and fighting against health problems like heart disease, cancers and diabetes. There are only minor adjustments for the diabetic patient.
Begin your meal with the fruits and veggies. This will ensure that the food enzymes will assist in the digestion of whatever else you take afterwards. It is sad that some diabetics are advised to avoid fruits by their doctors or dieticians.
In my opinion, the nutrients in fruits are essential for diabetics, and the sugar content is permissible, provided you restrict the amount of each fruit. Go for variety, which will provide a wider range of healing nutrients. If you know the glycaemic index of your food choices, that is even better. Go for the lower ones.
There is no restriction for veggies (except the starchy ones). Go for a variety of dark-coloured leafy veggies – the more, the better.
Load yourself with nutrients
The problem with diabetes is not just the high blood glucose level, but also the lack of sufficient nutrients to protect the cells and organs from damage, and to re-sensitise the cells to insulin.
To prevent and treat diabetes, you will need loads of antioxidants, vitamins, minerals, enzymes, co-enzymes, phytonutrients, fibre and probiotics (friendly bacteria).
If your diet is nutrient dense, you will already have much of these. If not, you will have to rely on supplements to provide these healing nutrients.
Antioxidants, vitamins and minerals together protect the cells from free radicals and other elements prevalent in the diabetic patient. Free radicals are the main culprit in diabetic complications, by causing cellular injury, and gradual closure of the micro-circulation (the smallest blood vessels – arterioles, capillaries and venules).
As a result, nerves malfunction, healing and immune mechanisms are thwarted, clogging of arteries by cholesterol plaques become rampant, and the whole body suffers.
My prescription includes taking as many of the antioxidant cascade as possible, with other important vitamins and minerals. Fibre helps regulate glucose absorption, apart from ensuring a healthy bowel.
Probiotics is a major component in my fight against infections in diabetics (and non-diabetics). The role of probiotics in helping diabetics is only now being slowly realised. They also improve many other aspects of health. For insurance, I insist diabetics take these in supplements to ensure they get sufficient amounts, especially if their diet is not perfect (which is the usual case anyway).
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