The National Health Morbidity Survey (NHMS) 2019 revealed an alarming statistic: 1 in 5 Malaysian adults, aged 18 and above, have diabetes. That means 3.9 million Malaysians are now diabetic. The prevalence of diabetes by age group shows that it is much more common among those aged 50 and above.
Diabetes is a type of chronic disease where the pancreas produces insufficient insulin or when the body cannot effectively use the insulin it produces.
Insulin is an important hormone that regulates the body’s blood sugar levels and it is responsible for converting blood glucose into energy our body needs. Any interruption to how the body produces or uses insulin can lead to significant health problems over time, including lasting damage to the body’s regulatory systems.
There are two categories of diabetes: type 1 and type 2. Type 1 diabetes is when your body does not produce insulin. It is usually diagnosed in children, teenagers and young adults. Type 2 diabetes is when your body is unable to utilise insulin properly. It is also the most common form of diabetes and is mainly diagnosed in adults.
Given Malaysia’s reputation as a food haven, both locally and internationally, it can be difficult to resist eating your favourite foods. However, if you or your loved one is diabetic, putting food over your health can have a detrimental effect on your health in the long term. It is very important that you monitor your health at all times to prevent unwanted medical complications.
Food & Diabetes
A recent new article mentioned that a majority of Malaysians do not actually fully understand diabetes and its associated health complications.
“More than half (52%) of respondents revealed that they do not know that diabetes cannot be cured, while 51% think that diabetes is not difficult to manage. What’s more startling is that about 1 in 3 respondents (37%) with diabetes do not know what the abnormal blood sugar level readings are.”
Of particular note is the assumption Malaysians have that a high-calorie diet, among other factors, is one of the leading reasons that cause diabetes.
As mentioned earlier, a lack of insulin will cause a rise in your blood glucose level, leading to hyperglycemia. Glucose comes from foods that we eat and come in varying quantities. Even when we are fasting, the liver produces glucose to maintain optimal levels within our bodies. When this process is disrupted, hyperglycemia is one of many health complications that will manifest, causing undesirable effects on our bodies.
To manage the complications of diabetes, doctors usually recommend patients adhere to a well-balanced and nutritious diet. It will take into account the required calorie intake, having regular meal times in a day, and eating food in moderation. Regular physical activity is also highly recommended to help you lose weight, reduce your blood glucose, and even boost your sensitivity to insulin.
This does not mean you have to permanently abstain from enjoying your favourite foods. You can still do so, but you should limit portion sizes or the frequency of eating them.
Generally, you may be asked to monitor your carbohydrate intake when you eat. Carbohydrates have the most profound impact on your blood glucose levels, as they are broken down into glucose for the body to use. Some food and drink can raise your blood glucose quickly, while some others do not; fruit juice, for example, can raise your blood glucose faster than if you had a whole fruit instead.
It is absolutely essential to keep track of your diabetes at all times. In doing so, you are taking charge of your overall well being, and the feeling of success at managing your diabetes can be a rewarding experience. However, if you feel frustrated by your condition or have lost any interest in regulating your blood glucose, you may be going through diabetes burnout. Be sure to take care of your physical and mental health; seek help from family, friends or licensed medical professionals if you feel burned out.
Source: The Star Malaysia
What is a Balanced Diet?
You may have seen a picture of the food pyramid before. It provides a clear picture of the ideal servings you should have in a day. While its suggestions apply to everyone, this is especially important for diabetics.
A balanced diet for diabetics usually consists of foods that are rich in complex carbohydrates, such as:
- Whole grains
- Fruits; vegetables
- Milk and dairy products
- Protein-rich foods, such as fish and lean meats
- Regular glasses of water
You should reduce the number of fats, oils, sugars and salts, as well as keep track of your daily calorie intake.
Regular meal intervals and portion control help out with managing what you should have on a daily basis. With regular meals, you will reduce unnecessary food intake that can drive up your calorie and/or blood glucose count. It also helps you to regulate your appetite and help with managing your weight.
Do you find yourself eating in excess when served with more food on your plate? Portion control becomes important to control the amount of food you consume; this includes refraining from having seconds or extra snacks if you do not have a meal schedule set. This will help you to further manage your blood glucose as well.
Source: Four Arrows Regional Health Authority
In the case of the Malaysian Healthy Plate recommendation, you should have one-quarter of the plate for carbohydrates (e.g. rice, bread), one-quarter with proteins (e.g. fish, meat, tofu), and half of the plate for vegetables. A serving of fruit should be no larger than a cup, or the size of a small rice bowl.
Every individual is different, and your loved one has care needs that are unique. Engaging a caregiver for your loved one with diabetes not only encourages better care; it also helps build strong emotional support for your loved one.
To give your loved one the best care he/she deserves, we provide a free care consultation for you and your loved one, to ensure that they get a Care Professional that best suits their needs.
Food to Avoid
You will need to reduce your intake of the following Malaysian foods if you want to start taking charge of your overall health. Note that you do not have to completely abstain from them. You can still eat them, but have smaller quantities or on a less regular schedule. Take heed of the BMV rule: be Balanced, practise Moderation, and choose Variety
Kuih-muih
Occasionally, one of your colleagues at the office will bring back small bags full of assorted kuih-muih from the nearby roadside stall, from onde onde to kuih keria and a few other favourites. Because of their small sizes, you may indulge in more than a few pieces.
If you are diabetic, kuih-muih (in all its varieties) is going to be one snack that you will have to abstain from. Most sellers tend to make them using a lot of sugar and other sweeteners. Given the simple carb content that is easily broken down into glucose, this will not do any favours to your blood glucose level.
Keropok
The same applies to keropok lekor and other fried goodies, such as goreng pisang, which are usually served together with kuih-muih. The process of making keropok tends to involve a significant amount of oil to deep fry them into their familiar crispy or crunchy texture. This snack is also not recommended for diabetics.
Teh tarik
Essentially tea mixed with sugar and condensed milk, this is a staple drink at any mamak restaurant. While it is a delicious beverage, it is also high on the calorie and sugar count to get the sweetness that Malaysians love.
Roti canai
Another staple dish at the mamak, roti canai also contains a lot of oil to make it delicious. Having it with the various types of curry, which are also rich in oil, sugar and salt, can easily make it an unhealthy dish to have.
White rice
It may be surprising, but white rice has a high glycemic index that can raise your blood glucose levels significantly. A study found that people who ate a lot of white rice have a 27 per cent higher risk of diabetes type 2. Moreover, white rice is not rich in nutrients like fibre or magnesium, unlike brown or whole grain rice.
Candy
This should be something to avoid in the long term. A lot of commercial sweets contain a high sugar content, and sometimes the exact type of sugar is not explicitly stated in the nutrition guide of the product. Consider sweets that use sugar substitutes, or artificial sweeteners that have no extra carbs or calories, if you wish to satisfy your sweet tooth.
Sweetened coffee
Coffee is actually beneficial to health since they contain polyphenols that have antioxidant properties that are good for you. However, coffee served at restaurants and cafes tend to have a high ratio of sugar or sweetener to reduce the bitterness of the drink. These additives will only exacerbate your blood glucose and may even adversely affect your body’s sensitivity to insulin.
What You Should Have
Consider the following alternatives for healthy and delicious meals.
Fruits
Photo by Magda Ehlers from Pexels
As per the food pyramid, 2 servings of fruit are a much better alternative than fruit juice. Fruits are a much healthier sweet snack to have in place of sweets or even fruit juice.
Have more whole fruits as snacks instead of junk food to stave off the hunger pangs after meals. Make sure you keep track of your fruit consumption so that it is in line with your daily calorie/carb count.
Brown/whole grain rice
Brown rice and whole-grain rice are healthier alternatives to white rice. White rice is mainly derived from the starchy endosperm that contains no nutrient value. In contrast, the whole grain contains the nutrient-rich germ and bran layers of the grain, which contain all the nutritional value that white rice lacks. The nutritional benefits of eating brown/whole grain rice make for an excellent replacement to white rice.
One cup of brown rice contains a good amount of required nutrients, including magnesium, fibre, proteins, zinc and other minerals and vitamins.
Basmati rice is also another type of rice you can switch to. It is fragrant and just as nutritious as brown rice, as well as having a lower glycemic index than white rice.
Whole grain bread
Similar factors apply to whole grain bread. Coarsely ground grains found in whole-grain bread (and even in oats) take longer to digest, so there is a slower release of nutrients into the body. White bread tends to contain mostly starch and little else in nutritional content.
Capati is also an example of a type of whole grain meal. It is a better alternative to roti canai, and you can still enjoy it with your favourite curry dips.
Vegetables
This is undoubtedly an important part of healthy eating. Greens are a rich source of essential vitamins and minerals; they are also a good source of fibre, which helps regulate your blood glucose while keeping you feeling full for longer. Make vegetables a daily staple and go with the suggested portions.
Plain yoghurt
While there are fruit-flavoured yoghurts, they are usually made from non/low-fat milk that is high on carbs and sugar. Choose plain, whole milk yoghurt instead, and add small fruit slices into your yoghurt for a healthier and equally delicious dessert.
Unsweetened tea
Photo by John Diez from Pexels
Tea has many beneficial properties that make it good for your health; tea is an antioxidant, as well as being able to reduce the risk of cancer.
Various studies have shown that tea is very effective at reducing the risk of diabetes. If you plan to have tea, it is best to have it unsweetened. Most teas served at coffee shops tend to overload with sugar or other sweeteners, so have a smaller serving or ask for no sugar at all.
If you would like to learn more about keeping your diabetes in check, we spoke to pharmacist Gina Koay on how medications and dietary habits can help with diabetes management.
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