MANAGING DIABETES DURING RAMAZAN

Ramzan is the most awaited time for people belonging to muslim community. It is a lunar based holy month, duration of which varies between 29-30 days and involves fasting for more than 18 hours a day. Those who fast abstain from eating, drinking and use of oral medications from pre-dawn to after sunset, which is not intended to create hardship on an individual as per the religious tenets. Fasting for so many hours with diabetes (especially with type-I diabetes) is a medical challenge for an individual itself and their health care providers.

This blog brings to you simple yet effective measures of managing diabetes during this holy period.

Anticipatory health check

Visit your diabetes consultant at the start of ramzan with specific attention to glycaemic control, steady blood pressure levels and lipid profile. For those with diabetes type – I, a closer contact with the physician and dietitian is advisable.

Begin ‘Roza’ the right away

‘Sehri’ or the ‘pre-dawn’ meal after which fast begins should be based on ‘Indian-thali’ concept; whole grains, whole pulses, cooked/raw vegetables and curds..., non-veg. recipies should be included in grilled, roasted, curry or baked forms. Any form of deep fried dishes should be avoided. The ideal time to take pre-dawn meal would be just before the start of daily fast.

Calling it off even better

‘Iftaari’ or the ‘after-sunset’ meal should ideally be kept light..., like a commonly taken breakfast. The traditionally consumed dates and fresh fruits can be coupled with some cereal and milk serving to initiate on a steady glycaemic control. It also helps to avoid gastrointestinal symptoms like bloating, hyperacidity and heart burn which one typically experiences after a heavy meal.

Exercise pattern

Excessive strenuous activity may lead to hypoglycaemia. Moderate activity, however, may be planned. Repeated cycles of kneeling, rising and bowing during prayers should be considered as part of daily exercise program. Young adults with diabetes type-I who follow a regular exercise pattern can plan it post the after-sunset meal, with at least one and half hour difference between the meal and exercise.

Fluid intake

A daily fluid intake of 2 litres including tea, coffee, milk, buttermilk etc. should be maintained. Inadequate fluid intake during prolonged fasting, is a cause of dehydration. This dehydration can be severe due to excessive perspiration in hot and humid climate and in those who perform hard physical labour. Taking fluids intermittently between meals after the fast is called off, for every half an hour can help maintain fluid balance and prevent dehydration.

Identifying and managing symptoms

One should be educated to identify symptoms of hypo and hyperglycaemia. Fast should be called off immediately in case of hypoglycaemia that is blood sugar level reaches <60mg/dl or <70mg/dl in first few hours as well as in case of hyperglycaemia when it reaches >300mg/dl. Blood glucose values should be checked frequently to avoid any emergency situation.

A patients’ decision to fast should be made after a detailed discussion with the health care provider. The ones who insist on fasting must undergo proper assessment and receive adequate education and instructions regarding menu planning, glucose monitoring, timing of medications and managing acute glycaemic responses. Any day..., a patients’ individual awareness and willingness to maintain a sound health status while practising religious beliefs holds utmost importance. 

By Pooja Lakhani Health Coach at LiveNutriFit

MEET THE 7 HAPPY FOODS

“One of those bad days”.. Ah..!! We all have said this to ourselves some day or the other. Sometimes, we experience depression or mood swings due to inadequate sleep,fatigue or over thinking. If you’re feeling dull or blue, there are some foods to alleviate your mood and make you feel better irrespective of the reason for your sad mood. The following foods may help ease anxiety, fight depression and reduce stress.

·       Chocolate, all eyes wide open & mouth filled with gushes of water!! Yes, guess we all know or have heard that eating dark chocolate (of course in limited quantity) reduces stress. Just be careful with the quantity consumed else, you’ll be stressed with the weighing scale showing unhappy results.

·       Green Leafy Vegetables, include this bundle of anti-depressants into salads, soups & sandwiches or stir fry. Eating these would not only keep calories at bay but also help reduce depression.

·       Green Tea, being rich in anti-oxidants, drinking green tea can lower level of stress thereby making you feel better.

·       Walnuts & Flaxseed, toss them into salads/ smoothies or into breakfast cereal/ granola to get your omega 3, which would keep you hail & hearty and always on the go.

·       Berries, mornings or evenings..who doesn’t like to indulge into berries, either throw in a handful into morning cereal or snack on them fresh or frozen. It be blueberry,strawberry,raspberry, they help reduce stress & when eaten before bed induce sound sleep.

·       Salmon & Oily fish, try to indulge in a preparation of salmon or trout fish to get your daily dose of omega 3, known to boost mood & memory.

·       Fruits & Vegetables, if consumed in limited quantity would surely help reduce depression & uplifting mood. By consuming vegetables & fruits, you not only feel contented naturally but also feel happy.

By Aditi Shrishrimal Health Coach at LNF

READ BEFORE YOU EAT !!!!!!

How often do we find ourselves reading labels of the very attractive #healthy#diet foods before buying them....?

6-7 out of 10 people feel happy they do.... but how many of those who do... really understand it...?

Well... the figures might not really please you!

In the next five minutes of this read.... you will find yourself  “smart enough to decode” these fascinating claims of nutrition facts mentioned on your favourite food items

Serving Size

First step in label reading is checking the serving size. The amount for which the label claims the product to be ‘fat free/low fat/zero trans fat’..etc. might not match the amount you actually eat

Serving size for favourite chips (as can be seen in this label) to be fat free is 15 chips...!! How many of us actually satisfy eating 15 slices of yummy fried potatoes...?

Calories (and calories from fat/sugars)

Calories help us count the amount of energy we get from serving size of any food. Mostly we eat more calories than required while lacking other nutrient requirements.

This food label of packaged meat has serving size of 56g... ideally a medium size chunk of meat. Total calories provided are 60 out of which 20 calories are from fat that is almost 1/3^rd of these calories would come from fat.

Remember...as many servings you consume is the total amount calories you actually eat.

Note the calories for one serving and the number of servings in every container. Be careful about the portion size that you eat and “do the math” to decide on the number of portions you can eat...!

Percent daily values (%DV)

[Recommendations as per the FDA guidelines]

Mostly.., the nutrient label shows ‘percent daily value’ (%DV) supplied by a serving, that is how much of the recommended daily requirement can be supplied by one portion of that product.

 DVs are based on a 2000 calorie diet. (as metioned in the above label)

Considering the average height of Indians (5’2” -5’6” feet) and increasing prevalence of overweight and obesity...... your calorie requirement would be lower than 2000 kcal/day and so will be the %DV.

Interpret the Percent Daily Value...

Nutrients with %DV of 5 or less are considered “low”... those with  %DV of 10-19 are considered “good sources” while the %DV of 20 or more are considered “high or rich sources”.

The nutrients:watch your priority

Limit these

Includes fats, saturated fats, trans fats, cholesterol, sugar and sodium as these increase the risk of certain chronic diseases of liver, affect your heart health, lead to a few types of cancers and make you gain those extra kilos of weight..!

Recommendation is to consume them in amounts as low as possible.

Get enough of these

Eating sufficient of these improves overall health and helps reduce risk of certain diseases. For example, taking enough calcium reduces the risk of osteoporosis and eating sufficient amount of dietary fiber promotes healthy bowel function.

                     

                              Lastly...., Always remember to review the ingredient list. Ingredients are sequenced in the orer of maximum to minimum content. Pay particular attention to the top five items listed. Ingredients containing sugars often end in –ose. Term hydrogenated signals that processed, trans or saturated fats may have been used. Sodium containing additives may be present in multiple forms. In an effort to lower the amount of heavily processed food consumed, look for ingredient containing more nutrient-dense food items and fewer additives.

BY POOJA LAKHANI HEALTH COACH AT LNF