<p>Sugar is something that we all love. No matter what form it comes in, we consume it, often in excess, without thinking about the risk of diabetes. <br /><br /></p>.<p>A fast growing epidemic in India, the ailment has affected the lives of over 62 million individuals. According to the World Health Organisation (WHO), it is estimated that the prevalence of diabetes will double globally from 171 million in 2000 to 366 million in 2030 with a maximum increase in India. <br /><br />While the numbers are grave, identifying potential hazards can delay the progress of the disease. Reducing weight, particularly around the abdomen, with regular exercise can cut down diabetes risk. Simultaneously consuming a balanced and planned diet will help. <br /><br />Reduce the dependence<br /><br />Refined sugar is the worst. Bakery products, cakes, candies, cola, soda and sweetened beverages are full of it and can contribute to obesity, impaired insulin levels and gradual progression towards diabetes and other metabolic disorders. The Dietary Guidelines for 2015 - 2020 recommend consumption of less than 10% of calories per day from added sugars. So, how does one reduce sugar in the diet?<br /><br /> Here are a few ways:<br /><br />Replace simple sugar with natural sweetness of fruit.<br />Replace sugary drinks like cola with fresh, unstrained juices, coconut water or barley water.<br /><br />Have small and frequent meals spread out throughout the day to avoid overload and excess calories. This prevents storage of fats.<br /><br />Restrict the consumption of foods rich in carbohydrates (complex sugar) like chapati, rice, breads and pasta to five servings per day.<br /><br />Cereals can be replaced with millets with low glycaemic index like jowar, <br />bajra, ragi and pearl millet as they enable slow release of sugar into the blood stream.<br /><br />Regular physical activity will increase insulin production and lead to better sugar control.<br /><br />Complement every meal with raw cucumber, tomatoes, lettuce and cabbage. The serving size of fibres should be twice as that of cereal.<br /><br />Consume unpolished pulses and cereals, as bran is a good source of vitamin B complex and fibre.<br /><br />Include functional foods like fenugreek seeds, oats, soybean and pectin in your daily meal.<br /><br />While eating out, choose healthy alternatives. Instead of ice cream and dessert, go for plain yogurt or low-fat cream with fresh fruits.<br /><br />Glycaemic index (GI) quantifies the blood sugar response after eating a specific food item. Foods with high glycaemic index are readily absorbed and raise blood glucose quickly. <br /><br />Low glycaemic index foods are digested and absorbed slowly and hence, raise blood glucose levels gradually. Lower GI foods include oats, pulses, peas, beans, legumes, raw fruits, milk and plain yogurt. <br /><br />Some moderate GI foods are rice, rye bread, muesli and fresh potatoes. High GI foods include white and whole wheat bread, wheat and corn-based breakfast cereals, old potatoes, strained fruit juices, honey, sugar and jaggery. <br /><br />Other sugar substitutes<br /><br />The Food and Drug Association (FDA) has approved the use of six artificial sweeteners and their acceptable daily intake (ADI). Generally recognised as safe (GRAS) notices have been submitted to the FDA for two types of sweeteners — stevia plant and extracts obtained from Siraitia grosvenorii or swingle fruit (also known as luo han guo or monk fruit). Here are some of the approved alternatives to refined sugar:<br /><br />Acesulfame K: It is 200 times sweeter than refined sugar. It is heat stable and can be used in baking and is often used in products which require a longer shelf life. It is mostly used in combination with aspartame in diet drinks and sodas. Patients with kidney disease should limit its intake as this substitute has 10 mg of potassium per packet. Its acceptable daily intake is 15 mg per kg body weight per day.<br /><br />Sucralose: It is 600 times sweeter than sucrose. It is heat stable and it can be used for baking and to sweeten commercial foods, which are often labelled ‘sugar-free’ or ‘no added sugar’. Its acceptable daily intake is 5 mg per kg of body weight per day.<br /><br />Saccharin: It is 300-700 times sweeter than regular sugar. It is recommended for use in cooking and baking. It has an aftertaste that makes it a little less palatable. Saccharin is not recommended for pregnant women as it can cross the placenta and interfere with the growth of the foetus. Its acceptable daily intake is 15 mg per kg body weight per day. <br /><br />Aspartame: It is 200 times sweeter than sugar. It is not recommended for persons with phenylketonuria (an inherited disorder that increases the levels of the amino acid phenylalanine in the blood). It is not recommended for cooking as it is not heat stable. However, it can be used as a table-top sweetener. It provides 4 kcal per gram but the calorific value per packet is insignificant due to concentrated sweetness and the quantity used. Its acceptable daily intake is 5 mg per kg body weight per day. <br /><br />Stevia: It is a plant-based sweetener. It is 200-300 times sweeter than sugar. It is mostly used as a food additive. Its acceptable daily Intake is 4 mg per kg body weight per day.<br /><br />With so many alternatives to choose from, saying goodbye to sugar may not be that hard. Start today and make a change to keep diabetes at bay.<br /><br /><em>(The author is chief dietician, NephroPlus Dialysis Centres)</em></p>
<p>Sugar is something that we all love. No matter what form it comes in, we consume it, often in excess, without thinking about the risk of diabetes. <br /><br /></p>.<p>A fast growing epidemic in India, the ailment has affected the lives of over 62 million individuals. According to the World Health Organisation (WHO), it is estimated that the prevalence of diabetes will double globally from 171 million in 2000 to 366 million in 2030 with a maximum increase in India. <br /><br />While the numbers are grave, identifying potential hazards can delay the progress of the disease. Reducing weight, particularly around the abdomen, with regular exercise can cut down diabetes risk. Simultaneously consuming a balanced and planned diet will help. <br /><br />Reduce the dependence<br /><br />Refined sugar is the worst. Bakery products, cakes, candies, cola, soda and sweetened beverages are full of it and can contribute to obesity, impaired insulin levels and gradual progression towards diabetes and other metabolic disorders. The Dietary Guidelines for 2015 - 2020 recommend consumption of less than 10% of calories per day from added sugars. So, how does one reduce sugar in the diet?<br /><br /> Here are a few ways:<br /><br />Replace simple sugar with natural sweetness of fruit.<br />Replace sugary drinks like cola with fresh, unstrained juices, coconut water or barley water.<br /><br />Have small and frequent meals spread out throughout the day to avoid overload and excess calories. This prevents storage of fats.<br /><br />Restrict the consumption of foods rich in carbohydrates (complex sugar) like chapati, rice, breads and pasta to five servings per day.<br /><br />Cereals can be replaced with millets with low glycaemic index like jowar, <br />bajra, ragi and pearl millet as they enable slow release of sugar into the blood stream.<br /><br />Regular physical activity will increase insulin production and lead to better sugar control.<br /><br />Complement every meal with raw cucumber, tomatoes, lettuce and cabbage. The serving size of fibres should be twice as that of cereal.<br /><br />Consume unpolished pulses and cereals, as bran is a good source of vitamin B complex and fibre.<br /><br />Include functional foods like fenugreek seeds, oats, soybean and pectin in your daily meal.<br /><br />While eating out, choose healthy alternatives. Instead of ice cream and dessert, go for plain yogurt or low-fat cream with fresh fruits.<br /><br />Glycaemic index (GI) quantifies the blood sugar response after eating a specific food item. Foods with high glycaemic index are readily absorbed and raise blood glucose quickly. <br /><br />Low glycaemic index foods are digested and absorbed slowly and hence, raise blood glucose levels gradually. Lower GI foods include oats, pulses, peas, beans, legumes, raw fruits, milk and plain yogurt. <br /><br />Some moderate GI foods are rice, rye bread, muesli and fresh potatoes. High GI foods include white and whole wheat bread, wheat and corn-based breakfast cereals, old potatoes, strained fruit juices, honey, sugar and jaggery. <br /><br />Other sugar substitutes<br /><br />The Food and Drug Association (FDA) has approved the use of six artificial sweeteners and their acceptable daily intake (ADI). Generally recognised as safe (GRAS) notices have been submitted to the FDA for two types of sweeteners — stevia plant and extracts obtained from Siraitia grosvenorii or swingle fruit (also known as luo han guo or monk fruit). Here are some of the approved alternatives to refined sugar:<br /><br />Acesulfame K: It is 200 times sweeter than refined sugar. It is heat stable and can be used in baking and is often used in products which require a longer shelf life. It is mostly used in combination with aspartame in diet drinks and sodas. Patients with kidney disease should limit its intake as this substitute has 10 mg of potassium per packet. Its acceptable daily intake is 15 mg per kg body weight per day.<br /><br />Sucralose: It is 600 times sweeter than sucrose. It is heat stable and it can be used for baking and to sweeten commercial foods, which are often labelled ‘sugar-free’ or ‘no added sugar’. Its acceptable daily intake is 5 mg per kg of body weight per day.<br /><br />Saccharin: It is 300-700 times sweeter than regular sugar. It is recommended for use in cooking and baking. It has an aftertaste that makes it a little less palatable. Saccharin is not recommended for pregnant women as it can cross the placenta and interfere with the growth of the foetus. Its acceptable daily intake is 15 mg per kg body weight per day. <br /><br />Aspartame: It is 200 times sweeter than sugar. It is not recommended for persons with phenylketonuria (an inherited disorder that increases the levels of the amino acid phenylalanine in the blood). It is not recommended for cooking as it is not heat stable. However, it can be used as a table-top sweetener. It provides 4 kcal per gram but the calorific value per packet is insignificant due to concentrated sweetness and the quantity used. Its acceptable daily intake is 5 mg per kg body weight per day. <br /><br />Stevia: It is a plant-based sweetener. It is 200-300 times sweeter than sugar. It is mostly used as a food additive. Its acceptable daily Intake is 4 mg per kg body weight per day.<br /><br />With so many alternatives to choose from, saying goodbye to sugar may not be that hard. Start today and make a change to keep diabetes at bay.<br /><br /><em>(The author is chief dietician, NephroPlus Dialysis Centres)</em></p>
