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dedicated to education regarding nutrition

The myth of zero

6/21/2016

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When it comes to calories, we love to hear the number “Zero”.

Manufacturers love to position zero-calorie sweetened foods and drinks because they create a ‘guilt- free effect’ and therefore are more likely to fly off the shelf. The moment we read zero calorie or low calorie, it finds its way into shopping baskets, no questions asked. How correct is this?

There are two types of sweeteners: nutritive and non-nutritive
  • Nutritive or reduced calorie sweeteners approved by the FDA include sugar alcohols (polyols) such as erythritol, isomalt, lactitol, maltitol, mannitol, sorbitol, xylitol, tagatose, and hydrogenated starch hydrolysates. Sugar alcohols contain, on average, about 2 calories/g (one-half the calories of other sweeteners such as sucrose (table sugar). The use of sugar alcohols appears to be safe; however, they may have some side effects such as diarrhea in children.
  • FDA has approved five non-nutritive sweeteners for use:  acesulfame potassium, aspartame, neotame, saccharin and sucralose. FDA has also set an Acceptable Daily Intake (ADI) for these artificial sweeteners. Another sweetener inching toward the safe zone in this category is Stevia. It is a leaf, so would be best if one can get their hands on stevia leaves in its original form.

Have you ever wondered things like - how come the products with these artificial sweeteners taste so sweet? And these chemicals do not get digested in our body (hence no caloric load), then what happens to them once they’re past our tongues?
These sweeteners are mostly manufactured (the word ‘artificial’ is a giveaway) chemicals that are 1000 times sweeter in taste than naturally occurring regular sugar (or sucrose) that our bodies cannot digest or absorb. This puts a load on our organs to push them out. For years scientists are puzzled that non-caloric artificial sweeteners do not seem to aid weight loss, and some studies have suggested they may even have an opposite effect. Wondering how? Read on.

It’s that guilt free effect again – since the sweetener is supposed to be sugar-free, most of us tend to get a little trigger happy with the portions of sweetened food. What we need to understand is that a calorie from any source still counts and higher quantities of food will up the intake.
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Artificial sweeteners rewire your brain chemistry and metabolism confusing the body into thinking it is consuming real sugar. Your body reacts and gets ready to receive the sugar by revving up production of the fat-storage hormones. Your metabolism slows down, you become hungry more quickly, you’re prone to eat way more food (especially carbs), and increased belly fat is the inevitable result.
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I regularly see people who complain about not being able to kick their diet-soda habit. It isn’t just their imagination: Artificial sweeteners can quickly become addictive just like smoking. Research shows that non nutritive sweeteners and nicotine produce similar effects in the brain i.e. craving

It is imperative for people with diabetes to reduce stress on their organs by controlling blood sugar levels. And here we are, doing just the opposite by consuming highly processed food products laden with artificial sweeteners.

Don’t get carried away with what companies want us to believe in their glitzy ad campaigns highlighting their efforts to fight diabetes and obesity. Soda companies proudly promote the fact that their diet drinks have low or no calories and that they have cut sales of sugary drinks in schools by 90 percent. Is that a good thing? I don’t think so.

 Just cut these sodas out of your lives altogether and you’ll be healthier and happier for it. And if you have a desire for something sweet just have a little sugar and make sure you walk or jog it off.

For more information on eating Guilt Free!  

So my health Mantra still remains the same, eat natural, stay super!
 
 
 
 
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Elderly and diabetes

6/7/2016

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About 50% of people with diabetes are aged 65 years and above.

Living with diabetes maybe tough as every day brings new challenges. As one gets older this becomes tougher and specific age related complications require diligence and care to deal with. This is tough, but not impossible.

“My mother has Type 2 diabetes, but she won’t eat. My father gets up and snacks in the middle of the night. My mom complains of going in a hypo (low blood sugar phase) just to eat sweets that she craves”.   I often hear these and other gripes from my patients’ carers (mostly their children) all the time.

Elderly people with diabetes have higher risks of complications like heart attacks, kidney disease and blindness; they’re more likely than other seniors to end up in nursing homes.

But we need to hold back a little and tell ourselves that when it comes to the elderly, quality of life is much more important than (almost sacred) numbers on the glucometer and other laboratory reports.

Most medical guidelines state that as a person ages, we need to be a bit lenient with target blood sugar values. Treating diabetes too aggressively can make elderly more prone to hypoglycaemia, or low blood sugar. For frail older people with multiple conditions, this can be more dangerous than high blood glucose readings.

There are a number of psychosocial issues that need attending to in the elderly. Poor vision, diminishing hearing, loss of balance etc makes them less confident in managing their own health.

Poor oral health, effects of some drugs on the digestive system, limited mobility, dexterity or vision can all make eating difficult. Older people tend to drink less fluids , which can cause dehydration, particularly during bouts of illness. People at risk should have a nutritional assessment and individual advice from a diabetes educator or nutritionist to address areas of concern such as needing extra calories, meal supplements and replacements, weight reduction, low salt diet or manageable foods.
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It may not always be appropriate to reduce the fat, salt and sugar for every older person with diabetes. Poor or irregular eating can often be a cause of hypos.
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Few health tips:
  • Drink at least 8-10 glasses of water.
  • Be physically active. Does not mean you need to hit the gym or aerobics, just be active throughout the day. Water the plants, walk the dog, make your snack etc. Physical activity helps you maintain healthy weight, prevent or control illness, sleep better, reduce stress, avoid falls and generally look and feel better, too.
  • Quit smoking. 
  • Eat well. Combined with physical activity, eating nutritious food in the right amount can help keep you healthy. Many illnesses, such as heart disease, obesity, high blood pressure, type 2 diabetes, and osteoporosis, can be prevented or controlled with dietary changes and exercise. Calcium and vitamin D supplements can help women prevent osteoporosis. If your blood sugar is under control a little cheating is also allowed.
  • If chewing gets difficult, try and get nutrition from liquid and semi solid diets like, porridge with milk, yoghurt, smoothies, soups, poached eggs etc.
  • Maintain a healthy weight.
  • Prevent falls. We become vulnerable to falls as we age. Prevent falls and injury by removing loose carpets or throw rugs. Keep paths clear of electrical cords and clutter, and use night-lights in hallways and bathrooms. Did you know that people who walk barefoot fall more frequently? Wear shoes with good support to reduce the risk of falling.
  • Get regular dental, vision and hearing checkups. 
  • Manage stress. Try exercise or relaxation techniques—perhaps meditation or yoga—as a means of coping. Make time for friends, socializing and fun activities. Successful coping can positively affect our health and how we feel.
For older people with diabetes and their caregivers, the implications are clear.

Be on the lookout for symptoms of hypoglycemia, make sure you report these to your physician and be actively engaged in making treatment decisions.

Treat hypoglycaemia as an emergency. Immediately give 3 hard sugar candies/ 3 tsp sugar or honey or jam/ 3 glucose biscuits/ 150 ml juice or non-diet soda.

​ Avoid treating hypos with chocolates and other sweets like pastries as they contain high amount of fat, and takes more than 30 minutes before they start releasing sugar in the bloodstream.
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And remember, staying positive goes a long way.
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    Author 
    ​Pariksha Rao

    Pariksha is an IDF Diabetes Educator and Senior Nutritionist and based in Bengaluru, India

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