A recent five-year data analysis of 2.9 lakh patients by a leading national laboratory found one in three people in Mumbai is prediabetic. In 2019, a similar analysis of 5.3 lakh patients by another laboratory in Mumbai found 25% were suffering from poor blood glucose control. Prediabetes is a condition marked by high blood glucose levels but not high enough to qualify as diabetes. It is the precursor to diabetes type 2, which is one of the major non-communicable diseases and caused 4.2 million deaths worldwide in the year 2019. According to the National Urban Diabetes Survey, 14% of Indians were living with prediabetes in 2018.
Why is the number increasing in Mumbai?
One can find the answer by looking at the city’s lifestyle. Mumbai is famous for its street food with countless roadside carts selling delectable items like vada pav, samosa, chaat, pani puri, and more. At the same time, there is no shortage of western fast-food joints selling burgers, pizza, fries, etc. The city is always working, always rushing with little or no time for daily physical activity, relaxation, managing stress, or getting good sleep.
Apart from genetic predisposition, eating junk food combined with lack of physical activity could be a possible reason behind the city’s diabetes and prediabetes number. The risk of prediabetes can also be influenced by other factors such as age, ethnicity, waist circumference, body weight, tobacco use, and certain medical conditions. Fortunately, prediabetes can be reversed by lifestyle modifications like eating healthy, regular physical activity, reducing stress and getting quality sleep.
Weight loss is the first step
If you are overweight or living with obesity, losing weight is the most important step to reverse prediabetes. The Center for Disease Control, USA mentioned losing just 5% to 7% of your current body weight can significantly help in reversing prediabetes and reduce the risk of developing type 2 diabetes.
However, maintaining a healthy body weight should be a holistic long-term lifestyle modality that doesn’t end with losing a few extra kilos. Losing weight should also be accompanied by quitting smoking, less alcohol consumption and avoiding outside food.
Chose low-GI carbohydrates
Creating a healthy meal plan for prediabetes management begins with understanding the glycemic index (GI) of foods. To calculate the score, glucose is taken as the base with a GI value of 100. Foods are labeled as high GI, moderate GI and low GI based on their GI score ranging between zero to 100. Foods with lower GI slowly raise the blood glucose level and are preferred choices for people with prediabetes and diabetes type 2. Many people perceive carbohydrates, commonly known as carbs, as the culprit behind prediabetes and diabetes.
However, not all carbs are created the same. The amount and types of carbs you are eating in each meal influences blood glucose level. For example, a diet loaded with white refined sugar shoots up the blood sugar level quickly but complex carbs such as dietary fiber don’t have a similar effect on the blood glucose levels. So, eliminating carbs isn’t necessary. Include steel-cut oats, beans, non-starchy vegetables, leafy greens and low sugary fruits in your daily diet. These foods are low in GI, high in dietary fiber and prevent blood glucose spikes.
An average Indian consumes significantly less protein than recommended. Protein is an essential macronutrient crucial for optimum physiological functions. Protein foods such as lean chicken, grass-fed lean meat cut, eggs and fish don’t contain carbohydrates thus are the preferred choices of protein in the daily diet of people living with prediabetes or diabetes.
Vegetarian sources of protein include beans (kidney, lima, navy), legumes (lentil, moong, chickpea), soy products (tofu, soy chunk, soybeans), milk, paneer, cheese and yogurt. Ensure you include protein in each meal to fulfill the requirement.
Eat more healthy fats
Don’t fear healthy fats. Although carbs get all the attention in managing prediabetes or diabetes, fat is an important nutrient in blood glucose management. As part of your low-carb eating plan include healthy fat sources such as almonds, walnuts, chia seeds, flax seeds, sunflower seeds, eggs and oily fish. To cook your food, choose ghee, coconut oil or groundnut oil. Seek expert opinion from a qualified nutritionist to choose what’s best for you.
Drink plenty of fluid
Drink enough water to prevent dehydration. The amount of water you need every day depends on the climate around you, your physical activity level and body size. To avoid monotony, drink a variety of fluids such as green tea, coconut water, thin buttermilk, herb-infused water, cucumber-infused water and fruit-infused water. To know if you are drinking enough fluid, check the volume and colour of your urine, it should be pale yellow.
That said, managing prediabetes requires good knowledge of nutrients and how they impact blood glucose levels. The main goal of managing prediabetes and diabetes is avoiding foods that increase blood glucose levels and cause insulin resistance.
It is better to stay away from refined carbs, processed grains, breakfast cereals, sugary drinks and foods that contain refined carbs as a part of a prediabetes diet and focus on eating more complex carbs, lean protein and healthy fats. Along with healthy eating, include regular physical activity in your daily routine, get quality sleep at night and manage stress.
(Subhasree Ray is a Doctoral Scholar, Clinical and Public Health Nutritionist, Certified Diabetes Educator. She can be followed on her Twitter @DrSubhasree)
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