Monday 6 June 2011

Healthy Eating and Diabetes

This is from the information currently provided by the NHS:

What is a healthy diet for diabetics?

Eat regularly - don't skip meals and try to eat small, regular meals at the same time each day, so that sugar levels are consistent. Try to eat kind of the same thing so there are no major dips in blood sugar.

Include starchy foods with each meal, as they help balance the insulin in your body to control glucose levels. These are things like bread, potatoes, cereals, rice, pasta, chapatti.

Choose high fibre or low GI foods, as fibre shows down digestion, resulting in a slower rise in blood sugar. These are things like granary/wholemeal breads, biscuits and cereals, potatoes (esp jacket or boiled in skins), basmati rice, durum wheat pasta.

Aim for your 5 fruit and veg a day. They can be tinned as long as they are in natural juice. You could stew fruit and add sweetener. Green and root vegetables are particularly good.


What is a "portion" of fruit/veg?

Some examples:

Very large fruit (eg melon, pineapple) = 1 slice
Large fruit (eg grapefruit, mango) = Half the fruit
Medium fruit (eg apple, banana) = whole fruit
Small fruit (eg satsuma, plums) = 2 fruits
Very small fruit (eg grapes, berries) = a handful
Dried fruit (eg raisins, prunes) = 1tbsp
Cooked/canned fruit in juice = 2tbsp
Fruit juice = 1 glass a day*
Cooked vegetables = 2tbsp
Mixed salad = 1 dessert bowl
Vegetable sticks/crudites = a handful
Beans (eg kidney beans) = 3tbsp a day

* unsweetened juice increases blood sugar glucose levels, so drink with a meal


Alternatives to Sugar

Obviously sugary foods need to be reduced as much as possible, but try to use an alternative where possible.


Fats

Saturated fats tend to be of animal origin (eg meat and dairy products). A high intake of these increases the risk of coronary heart disease.

Unsaturated fats are a more healthy alternative and may be either poly-unsaturated (eg oily fish and corn or sunflower oils) or mono-unsaturated (eg olive, rapeseed or peanut oils) - which are even better.

Remember that all oils are high in fat/calories, so:

Avoid frying - instead, grill, steam, bake, poach, bake or microwave
Use less
Opt for low-fat versions of dairy and meats - trim visible fats and remove skin
Limit products that have hidden fats - eg crisps, biscuits, pastry, nuts, salad dressings
Oily fish (eg herring, mackerel, sardines, pilchards, trout, salmon) should be eaten at least twice a week.


Alcohol

Drinking is fine, in moderation. Try to have only with a meal and avoid sweet sherry, sweet wine, liqueurs and low-sugar high-alcohol beers.


Salt

Try using herbs and spices in place of salt. Go for low-salt options and don't add to your food. Look out for hidden salts - especially in tinned or processed foods.


Diabetic Foods

These over-priced alternatives offer no special health benefits.


Labelling Guidance

Quantities of labelled nutritional advice should fall between the following guidelines (these range from 'a little' to 'a lot':

Sugar = 2g-10g
Fat = 3g-20g
Saturated Fat = 1g-5g
Salt = 0.3g-1.5g
Fibre = 0.5g-3g


Exercise and Weight

Remember that apart from the normal health and weight loss benefits, exercise can help reduce blood glucose levels. Try to increase your activity by:

Taking the stairs instead of the lift
Walking instead of using the bus/car for short journeys
The official recommendation is to aim for at least 30min, 5 days a week.
Losing weight will help:
Improve blood glucose levels
Lower high BP
Lower cholesterol
Reduce joint and lower back pain
Improve breathing and sleep patterns
Improve self-esteem


Suggested Meal Plan

Breakfast:
Cereal or porridge
Toast with low-fat spread
Fruit

Mid-Morning:
Sugar-free drink

Lunch:
Lean meat/fish/beans/cheese/egg
Bread/toast/chapatti/crispbreads/crackers/potatoes/rice/pasta
Fresh fruit or diet yoghurt

Mid-Afternoon:
Sugar-free drink

Dinner:
Lean meat/fish/chicken/beans/lentils
Bread/chapatti/potatoes/rice/pasta
Vegetables or salad (large servings)
Sugar-free milk pudding/tinned fruit in juice/fresh or sugar-free stewed fruit/diet dessert

Late:
Sugar-free drink

Tuesday 31 May 2011

Hypertension (High Blood Pressure)

This is when the pressure of the blood in your arteries is greater than 140mmHg systolic (top number) or more than 90mmHg diastolic (bottom number) over a period of time. It usually shows no symptoms, but if left untreated, can leat to stroke, heart attack, heart failure or kidney disease.

Reducing Blood Pressure
It's our friends diet and exercise again, but here's some more help:

cut down on salt and fat (especially saturated fats)
eat lots of fruit and vegetables
keep alcohol limits to no more than 4 units a day (for men) or 3 units (for women)
make sure you are within your BMI
be active

Smoking
Smoking alone doesn't cause hypertension, but it does damage your arteries and therefore increases your risk of a heart attack or stroke (as well as other problems, such as lung cancer - which is terminal in 90% of patients).

Medication
Tablets can help to lower blood pressure and thus help reduce the risks for heart attacks and strokes. You are aiming to lower your BP to less than 140/85. If you are diabetic, this is set even lower, at 130/80. Try to take the medication at the same time each day, so that they become part of your routine. It is a long-term treatment, so do not stop taking them unless your GP advises you to do so, and ensure that your BP is checked regularly (ideally, monthly). If you believe you are suffering from side effects, let your GP know, as there are different types of BP tablet and they can therefore be changed.

This information was taken from the Blood Pressure Association in London, published 2005.

About Cholesterol

Cholesterol is a waxy fat that gets into the blood, and is known as a lipid. Your liver produces most of the cholesterol your body needs, but it also comes from fatty foods like butter, cheese and animal fats.

The body needs cholesterol for a multiple of functions, including making hormones. Your body produces two types of cholesterol:

"BAD"
The proper name for this is LDL (Low Density Lipoprotein) - if there is too much of this, it will stick to your arteries. When this happens, the blood cannot flow through properly and less will get through to your brain and other vital organs. This leads to heart attacks, strokes, hypertension and other signs of heart disease.

"GOOD"
The proper name for this is HDL (High Density Lipoprotein) - this flows through the blood and tries to mop up excess LDLs. What it doesn't mop up is what sticks to your arteries, so the object is to limit your LDLs and encourage more HDL.

Naturally a blood test can determine your levels (measure in millimoles per litre, or, mmol/l). You can get them done in some pharmacies, but one done through your GP will be more thorough.

The British Heart Foundation recommends a target of 5mmol/l or less, and keeping your LDL level under 3mmol/l. HDL should be more than 1mmol/l. So:

Below 5.0mmol/l = Target (for most people)
5.0 - 6.4mmol/l = Mildly high
6.5 - 7.8mmol/l = Moderately high
7.9mmol/l or more = Very high

Other negative factors to that may raise your risk level:

Weight
Smoking
Stress
Genetics
Exercise
Hypertension
Diabetes

What Can You Do?
Diet and exercise, obviously, as they can help to lower cholesterol. You already know the bad guys - butter, red meat, pastry, cakes, biscuits, sweets, crisps, cream, ghee, full-fat cheese, lard, suet, dripping, coconut cream, palm oil, chips, etc.

Some food manufacturers now make foods that help to lower your LDL. But you could also avoid fried foods, trim the skin and visible fat from meat, drink alternatives to full-fat milk, choose low-fat foods where possible (but check the ingredients), choose foods high in fibre (like oatmeal, wheatmeal and wholegrains) - when choosing cereals, pasta or bread, choose oily fish (like tuna, herring, kippers, mackerel, pilchards, salmon, sardines, trout) twice a week. Try to eat at least 2 servings or fruit and 3 of vegetables daily.

Think about cooking differently, and consider grilling, microwaving, steaming or boiling before frying. If you need to fry something, try using non-stick as much as possible. try not to use fry sprays on these as they burn at a lower heat - but you can buy a spray bottle and fill that with unsaturated oils (such as olive oil).

As far as exercise, try to increase what you are doing, and aim for at least 30 minutes a day. This can be broken up into manageable chunks. Maybe walk a bit more, cycle, walk for one bus stop, get off the lift one floor earlier, etc.

It is important to say that if you are unfit to start with, to gradually build the exercise up - anything is better than nothing. Too vigorously or too much can be dangerous. All responsible people will tell you to seek advice from your GP first, and I'm not going to say any different.

If your GP thinks you are at high risk of heart disease, they will put you on medication called statins (although you should still watch your diet).

Life Health Calendar


LIFE CALENDAR

TEST SCREENING FOR START AGE FREQUENCY
Dental Check-up Cavitites and Gum Inflamation 1 Each 6 months
Eye Exam Vision 5 Annually
Vitamin D Deficiency 18 Bi-Annual
Blood Pressure Hypertension 18 Annually
Clinical Skin Screening Skin Cancer 20 Annually
Blood Lipids Cholesterol and Triglycerides 20 Every 5 years
Fasting Glucose Diabetes 20 Every 3 years
Clinical Breast Exam Breast Cancer 20 Annually
PAP Smear Cervical Cancer 21 Annually
HPV Human Papillomavirus 30 Every 3 years
TSH (Blood Test) Thyroid Disease 35 Every 5 years
C-Reactive Protein Heart Disease 40 Every 5 years
Mammogram Breast Cancer 40 Annually
EKG Heart Disease 40 Annually
Colonoscopy Colo-Rectal Cancer 50 Every 5 years
PSA (Blood Test) Prostate Cancer 50 Annually
Digital Rectal Exam Prostate Cancer 50 Annually
Dexa Scan Bone Density 50 Bi-Annual
Vitamin B12 Deficiency 65 Every 3 years