A dramatic increase in the prevalence of diabetes has been observed in the South Asian community in many parts of the world. South Asians are three to five times more likely to develop type 2 diabetes than the caucasian population. In fact, diabetes develops about 10 years earlier in South Asians than in Europeans. South asian children and adolescents are also at increased risk of developing diabetes.
Common myths that surround diabetes can cause confusion or stress in regard to behaviours around food, and can hinder the proper management of diabetes. Myths can be based on cultural or family traditions, and often spread through emails, chat rooms and other media. They can have a strong influence on what a person chooses to eat — when it is eaten and even how much to eat. It is important to understand these misconceptions and use credible and reliable information to reduce confusion.
Myth: Eating too much sugar causes diabetes
It is popularly believed that eating too much sugar causes diabetes. Studies have suggested that several factors increase a person’s risk of developing diabetes, some of which include genetics, increased body weight (especially in the belly region), and resistance to the hormone insulin (which regulates sugar levels in the blood).
Although an unhealthy diet can promote excessive weight gain and may increase the chances that someone will develop diabetes, high intake of sugar will not cause diabetes. It is therefore recommended to avoid high calorie diets that contain excess fat and sugar so as to achieve a healthy weight, and instead opt for diets high in vegetables and fruits, whole grains, low fat dairy and legumes.
Myth: If I have diabetes, I should avoid eating fruit
It is a myth that those with diabetes should avoid eating fruit, especially mangos and bananas. Although fruits have a high sugar content, they also offer an important source of vitamins, minerals, water and fibre that are needed by the body. The fibre in the whole fruit helps to prevent a spike in blood sugar levels.
Having a small piece of whole fruit (½ medium mango, 10 lychees, 1/3 cup chikoo, 2 small guavas, or ½ large banana) or a ½ cup of fruit salad for dessert is a fantastic complement to a healthy lunch or dinner. It is very important to watch the amount of fruit eaten because too much at any one time can cause increased blood sugars. This is why portion control is recommended rather than eliminating any specific fruit, especially for individuals with diabetes.
It is advisable to include whole fruits rather than fruit juices or sugary drinks in your diet, as juice often lacks fibre or other nutrients, and it is a concentrated source of sugar. This recommendation not only holds true for those with diabetes but also for those without diabetes.
Intake of fruit juices should be limited to an occasional treat, with a meal, once a day only. Excessive consumption of fruit juices may cause weight gain, and thus increase the risk of developing type 2 diabetes or hinder the management of those with diabetes.
With dried fruits, be cautious with the portion size since 2 tablespoons of dried fruits such as raisins or two dates contain 15 grams of carbohydrate, which is the same amount of sugar in a full cup of cubed papaya. Some excellent options of fruits to consider are temperate fruits such as apples, pears, oranges, peaches, plums, apricots, cherries, and berries. These are higher in fibre and water and lower in sugars.
Myth: If I have diabetes, I should avoid eating carbohydrates altogether
Another common misconception is that all carbohydrates (sugars and starches) must be avoided. This myth stems from the oversimplification of the term “carbohydrates”.
There are different types of carbohydrates. Simple carbohydrates are those that can enter the bloodstream quickly and cause blood sugar levels to rise quickly. Table sugar, brown sugar, candies, saker, gur, high fructose corn syrup, honey and sugar-sweetened beverages like sodas all fall into this category. It is recommended that these simple carbohydrates that offer no nutritional value be limited.
You can train your taste buds to enjoy foods with less sweetness by reducing the amounts used by half a teaspoon at a time. Soon, you might be able to enjoy your chai with no sugar at all.
Complex carbohydrates such as whole grains contain fibre, and thus take longer to digest, so they do not cause a drastic spike in blood sugar levels. Complex carbohydrates that have a low glycaemic index (GI) can help to stabilise blood sugars and also offer a host of other health benefits. Whole wheat roti/chapatti, brown rice, dahlia (cream of wheat), vegetables (ghia, kadhu, kerala, saag, tindora, etc.) and legumes such as lentils (dahl), chickpeas (channa) and beans are high in fibre, and most have a low GI – they are recommended as part of a healthy meal plan.
Foods such as pastries, white breads like naan or paratha, cakes and even plain white rice should only be eaten as a treat (once in a while) and be limited to small portions, so as to prevent a spike in your blood sugar levels and prevent weight gain.
There are some great ways to increase the fibre content of your diet. Why not consider using besan, ragi, samai, or anf juwar when making roti or naan? You can be even more creative and throw in some flax seeds to your dough to increase the fibre content and nutritional value.
Striving to manage your sugar levels does not mean having to give up eating sugars in the form of whole fruits and wholegrain complex carbohydrates. The best way to manage blood sugars is to follow a healthy meal plan that offers a variety of foods high in fibre (vegetables, fruits, pulses, etc), eat at regular time intervals (i.e. every 4 – 6 hours), achieve a healthy weight, and participate in regular physical activity. Following some of the tips above, you can work towards achieving target blood sugar levels and reduce the risk of diabetes-related complications.
- Canadian Diabetes Association Clinical Practice Guidelines
- Dietary acid load and risk of type 2 diabetes: the E3N-EPIC cohort study
- Dietary misconceptions in Pakistani Diabetic Patients
- Discard myths to successfully manage diabetes
- Exercise counteracts the effects of short-term overfeeding and reduced physical activity independent of energy imbalance in healthy young men
- Myths about diabetes and its treatment in North Indian population
- Nutrition Therapy Recommendations for the Management of Adults with Diabetes
- Prevention and Management of Diabetes in South Asians
- Top diabetes myths busted (World Diabetes Day 2013)