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    THE BEST FOOD FOR DIABETES – A COMPREHENSIVE GUIDE.

    We often think of diabetes as a disease that just happens to us with age. Sometimes, we take it for granted that we inherit it through our genes. However, diabetes is not a problem of faulty genes, but of epigenetics (the impact of our environment on our genes).

    Secondly, we tend to believe that diabetes is a problem of high sugar. Therefore, we must take medicines to keep our blood sugar levels in check. However, the fact is that the ‘cause’ of diabetes is insulin resistance which leads to high insulin and glucose in the blood. High sugar is the ‘effect’ of diabetes.

    Due to the vast quantum of misinformation around diabetes, the disease has blown out of proportions and has become a global epidemic. But the good news is that diabetes is reversible. What we need is the right knowledge, starting with the fact that the best doctor uses the least medicine.

    DIET AND DIABETES

    Experts attribute much of the rise in the incidence of diabetes to the change in our food over the last few decades. The Green Revolution was started with the objective of increasing food productivity. 

    It introduced hybrid seeds and pesticides. Similarly, the White Revolution introduced chemicals into the dairy sector. As a result of these measures, our food productivity has increased and is now sufficient to cater to the growing world population. 

    But in the bargain, it has created another mammoth problem – nutrient deficient, chemicals and pesticide laden food.

    In the process of ultra-processing, food loses its essential nutrients and fibers. Such food usually contains a high level of sugar, fat and salt compared to unprocessed or minimally processed foods. 

    It is usually hyper palatable and consuming it gives us a high dopamine rush, making it addictive in the long-run. It is therefore vital in our day and age, to know the art of eating right. Because that is the only way to prevent, treat or reverse chronic diseases, as most of them are rooted in insulin resistance, among other factors.

    In order to understand what ‘eating right’ is all about, we must first understand some important factors associated with foods. 

    WHAT IS GLYCAEMIC INDEX AND GLYCAEMIC LOAD?

    Glycaemic Index (GI): The Glycaemic Index (GI) is a rating system for foods containing carbohydrates. It assigns a numeric value to foods to show how quickly that food can raise your blood sugar level after consumption. 

    On the basis of their Glycaemic Index, foods are classified into low, medium and high GI groups.

    • Low GI = Less than 55
    • Medium GI = 56 to 69
    • High GI = 70 and above

    The lower a food’s GI, the slower it raises our blood sugar after we eat it. In general, processed foods have higher GI and foods containing fiber and healthy fats have lower GI.

    Glycaemic Load (GL): Glycaemic Load (GI) tells us how much our blood sugar can increase after we eat a particular food. It takes into account both Glycaemic Index and the amount of carbohydrate in the portion size. 

    Hence, it is a much more reliable indicator than the Glycaemic Index. For instance, watermelon has a high GI of around 80. So you might think you should avoid it. But a serving of watermelon has a very low GL of 5.

    Calculation of Glycaemic Load:

    Glycaemic Load = Glycaemic index * grams of available carbohydrate / 100 

    Foods can be categorised into low, medium and high GL groups depending upon their Glycaemic Load. 

    • Low GL = 10 or less
    • Medium GL = 11 to 19
    • High GL = 20 and above

    How should diabetics choose their foods based on GI and GL?

    It is important for diabetics to avoid blood sugar spikes. Eating anything with high GI and GL will put you at that risk. Therefore, a diabetic diet should consist of low GI and GL foods.

    All naturally available foods (particularly traditional grains, lentils and pulses) belong to low or medium GL and GI groups. Complex carbs (carbs that have fibers) are healthy foods for diabetics. On the other hand, simple carbs and ultra-processed foods should not be part of a diabetic diet as they belong to the high GL and GI groups due to their low fiber and high sugar content. 

    Note: If the carb content is the same in an ultra-processed and a minimally processed food, ultra processed food will cause insulin secretion of 150 units per day as opposed to the normal insulin secretion of 40 units.

    WHAT ARE MACRONUTRIENTS AND WHAT IS THEIR ROLE IN DIABETES MANAGEMENT?

    Macronutrients are the nutrients that our body needs in large quantities. They give us the energy we need to perform our day-to-day activities and maintain the body systems and structure. These macronutrients are:

    • Carbohydrates: These are of two types; simple and complex carbs. Complex carbs (carbs that come with fibers) are food good for diabetes. Such carbs have a shielding effect in regulating blood sugar levels. For diabetics, the quantity of starch or complex carbs doesn’t really matter, but consuming unprocessed or minimally processed carbs is recommended for better metabolism.
    • Proteins: Proteins are the building blocks of the body. They are therefore especially important in a diabetic diet as diabetics are nutritionally deficient. They make up about 20-25% of the human body and are present in every cell. The Indian diet is quite low on protein. 

    A diabetic diet should consist of at least 1 gram of protein for every kg of our body weight for the optimal functioning of our body. At present, we are generally short on protein by around 50 to 75% at any time of the day, the shortage being worse in the case of vegetarians. 

    While non-vegetarian foods are a combination of high fats and moderate protein, vegetarians need to ensure optimal protein consumption by eating foods like A2 paneer, tofu or tempeh, sprouts, pulses, lentils, nuts, seeds, or even hydrolysed protein in external form. All of these are healthy foods for diabetes.

    • Fats: There are basically two types of fats; saturated and unsaturated. Fats are important in a diabetic diet for the management of diabetes, as insulin receptors require essential fatty acids and cholesterol for proper functioning. 

    There is no general recommendation for the consumption of fats on a daily basis as fats are a stored form of energy. As and when the body requires, it can utilize the stored fats depending upon the hormone-metabolic status. 

    However, because fatty acids cannot be produced by the body, they should be supplemented. These essential fatty acids are Omega 3 and Omega 6. The problem with our food system is that we have more Omega 6 and very less Omega 3. 

    The ratio is almost 15 or 20 to 1, while the ideal ratio of Omega 6 to Omega 3 should be less than 2 to 1. Due to this, the balance between inflammation (Omega 6) and anti-inflammatory (Omega 3) is disturbed, thus resulting in chronic inflammation. 

    Therefore it is advisable to take 2 spoons of desi ghee with your lunch and dinner and also eat fat foods such as avocado, coconut oil, flaxseed, nuts and seeds as part of our diabetes diet.

    WHAT ARE THE BEST FOODS TO CONTROL DIABETES?

    Before making a list of food for diabetic, we should bear in mind that a good diabetes diet should have both macronutrients and micronutrients in balanced proportions. 

    While macronutrients consist of complex carbs, high quality fats and valuable proteins, micronutrients are basically vitamins and minerals which are required by the body in smaller quantities. 

    So let’s see what is on the list of foods for diabetic and what to eat in a diabetes diet.

    • Whole grains: Ultra-processed food is a major factor in the causation of chronic diseases. Our body is evolutionarily designed for whole foods. Starches are complex carbs which contain fiber. 

    This fiber not only slows down the absorption of glucose into the intestine, but also nourishes (prebiotics) our gut microbiome which in turn mediates several immunological and metabolic reactions. Traditional grains such as organic rice (brown, red, black rice and certain varieties of traditional white rice such as Thooyamalli etc) and millets are good sources of complex carbs. 

    They not only give us energy but also contain micronutrients such as minerals, vitamins, antioxidants and polyphenols. Such traditional grains are native to our bodies and are good food for diabetics. 

    Hybridized rice and wheat on the other hand, contain high amounts of gluten and can spike your blood sugar level and are not healthy foods for diabetics.

    • Fruits and vegetables: Fruits are a good source of micronutrients. However, hybrid varieties that taste like honey contain a high amount of fructose. Opposed to these, wild fruits that taste tarty are low in fructose and high in micronutrients. Hence, they are healthy for diabetes. 

    Moreover, natural fruits are available during the summer and fall, not throughout the year. This is attributed to the process of evolution wherein animals hibernate in the winter. Therefore, consuming fruits throughout the year is not a healthy practice. 

    One should consume seasonal and low glycaemic fruits for better metabolism. Also, fruits should be eaten alone or 90-120 minutes after eating cooked food to prevent fermentation. 

    All types of berries, cherries, semi-ripe guavas and papaya, green apple, lemon, lime and oranges, pomegranate, olives, avocados, pears and peaches, and dragon fruit are some fruits high in micronutrients and relatively low in sugar. 

    All types of vegetables (especially green, leafy vegetables) are good for diabetics. Avoid potatoes, sweet corn, tubers, GMO and hybrid varieties. Local and seasonal vegetables should be preferred. The portion of vegetables should ideally be equal to or more than the carbs in any meal.

    • Lean proteins: It is a common misconception that lean proteins free of fats are healthy. We must understand the basic concept that most non-vegetarian food sources contain a combination of high fats and moderate proteins.

     Healthy fats should not be feared. When consumed along with proteins, fats increase the bioavailability and utilization of protein. Hence, non-vegetarian foods like fresh water sea foods, poultry and meat, and vegetarian foods such as dairy, pulses, lentils, nuts and seeds are among the best foods for diabetics as they are the best sources of protein. It is noteworthy here that in terms of nutrition, eggs (including its yolk) are considered a complete food all by itself and a good food for diabetics.

    • Healthy fats: Fats are a clean source of energy. They function as store houses of energy and as shock absorbers. Saturated fats are especially beneficial to the body. We should include saturated fats such as animal sourced foods, coconut, butter made from A2 milk and A2 ghee in our diabetes diet. 

    Monounsaturated fatty acids (MUFA) like coconut oil should be preferred over polyunsaturated fatty acids (PUFA) like refined and seed oils. PUFA are more prone to oxidation and can form toxic aldehydes and other metabolites. 

    It impairs the function of the mitochondria by lipid peroxidation. In short, PUFA is toxic for our system and not among the best diabetic foods.

    • Dairy: Indians are generally lactose intolerant. Hence, it is better to consume fermented dairy products such as curd, buttermilk and ghee. Paneer is an excellent source of fats and protein. 

    A diabetes diet should have A2 milk rather than A1. A1 milk and hybridized wheat have gluten and sugars in high amounts and are responsible for most allergies and inflammation. However, it is best for the majority of the population to avoid drinking milk after 3-4 years of age. 

    WHAT FOODS TO AVOID WITH DIABETES?

    A diabetes diet should generally avoid sugary foods and beverages, refined carbs, processed and red meats, trans fats and refined oils, white rice, wheat, milk, high sodium foods (that are salt processed, come in cans, packages and are frozen) and high GI fruits (ripe bananas, red apples, chikoo, mango, grapes, melons etc.). 

    These are not good foods for diabetics. White salt should also be replaced with Himalayan pink or rock salt in a diabetic diet. Refined and seed oils should be avoided in a diabetic diet. This includes seed oils like groundnut, sunflower, mustard, sesame, rice bran and vanaspati oil etc.

    HOW TO MAKE A HEALTHY MEAL PLAN?

    A healthy meal plan should consider the following:

    • What to eat and when: The right order to eat your meals is vegetables first, followed by protein and fats. Carbs and starch should be eaten last of all. This is because when you eat your food in this order, you effectively reduce the glucose spike of the meal by up to 73% and insulin spike by about 48%.
    • Portion control: Many people find the idea of portion control appealing. However, it never really works. So instead of portion control, the basic mantra should be to stop eating when you feel you are 80% full.
    • Balanced meals: The important thing to note is that we should take the amount of macronutrients into account on a per day basis, not for every meal.
    • Consistent meal time: Our body has a sensor for nutrients and energy. So it is good to eat only when hungry. However, having breakfast by 9-10 am and dinner before 7-8 pm is advisable as it synchronizes with the circadian rhythm.
    • Meal planning and preparation tips: Focus on one macronutrient at a given meal so that it balances out when you consider all three meals of the day. Always soak traditional grams, pulses and nuts for at least 10-12 hours before cooking or eating so that the anti-nutrients are eliminated. Do not use the same soaked water for cooking, as it is toxic. Drain the rice after cooking so that the excess starch is removed, thus reducing the glycaemic load. 

    BEST DIABETIC FOODS, MEAL PLANS, AND RECIPES

    So now the question is – what food is good for diabetics? Or what to eat with diabetes? Given below are some recommendations for breakfast, lunch, dinner and snacks that are considered the best foods for diabetics.

    • Breakfast: Avoid carbs. Eat a high protein and fat rich breakfast and never skip this meal. Your breakfast ought to be a king size meal, but in terms of the richness of the food consumed, not the quantity. 

    As the body’s digestive fire is the highest in the morning, it can easily break down the protein and fat which is required for metabolism and functioning. 2-3 boiled eggs or omelettes cooked in A2 ghee, cooked sprouts (green gram, red gram or chickpeas) with salt, pepper or lime are the best foods for diabetics. 

    For vegetarians, Moong dal chilla/ pesarattu/ besan chilla loaded with greens and vegetables sautéed in virgin coconut oil would be the best diabetic foods. A healthy protein shake with fats (avocado, flaxsees), nuts and seeds is also a good breakfast for diabetics.

    • Lunch: Lunch should ideally be a mix of protein + fat and complex carbs (minus the sugars). Thooyamali (or red / brown) rice with soaked pulses, 1 cup green leafy veg and 1 cup cooked vegetables + dal or rasam are healthy foods for diabetics.

    Non-vegetarians can have baked lean organic meat / wild salmon / sardines / herring / mackerel with vegetables and olive / avocado oil dressing. Broccoli, mushroom and spring onions are also foods good for diabetes.

    • Dinner: The goal should be to keep this meal light so that there is less load on the gut as the body goes into repair mode during sleep. Dinner can be a mix of protein + fat and a small portion of complex carbs.

    Millets can also be cooked like rice and consumed with dal and vegetables or made into a khichdi as these are foods diabetics can eat. Upma / idli / dosa made from millets or even moong dal or besan chilla is a good option. Or even a good vegetable soup or chicken broth should suffice.

    • Snacks: Snacks should be avoided as they aren’t the best food for diabetics. But if you feel too hungry, you can have a handful of soaked nuts / roasted makhana / roasted chana.

    CONCLUSION

    Our health is a reflection of our food and lifestyle. What we put into our bodies is what will manifest itself in our being. Hence it is important to watch what we eat, have a meal plan and focus on balancing our daily diet. 

    In this blog, we have elaborated on what comprises a good meal plan and a balanced diet and best diabetes foods in general. However, there may be some specific requirements depending on individual conditions.

    Wellfinity has a comprehensive team of research experts, physicians and nutritionists who work in tandem to design customized dietary guidelines and meal plans to suit your individual preference and needs for best results. 

    We also advise certain superfoods for healing individual organ systems, as required. So whether you are suffering from a chronic ailment and looking for help regarding your diet, or you are perfectly healthy and wish to maintain your health with a good diet plan, you can always look us up.

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