According to Mrs M, I am part of a great conspiracy. Like many of my Muslim patients she thinks that I have some wonder cure for her diabetes that I treasure only to be given to worthy members of my family. What she and others fail to understand is that the key to successful diabetes treatment is a fundamental change in lifestyle. In fact, I would go as far as saying that this is the only `miracle' cure for diabetes.
|'If we started to do all this healthy eating stuff, you talk about then we would not get any visitors. This healthy eating is incompatible with our food
live in the real world!'
So, what exactly is lifestyle adjustment? Well, actually it is rather simple and the amazing thing is that everyone whether diabetic or not, should be doing it.
The most important lifestyle adjustment is diet. It is so important that I will concentrate solely on this issue, this month. As mentioned in previous articles, some Type 2 Diabetics can actually control their condition with dietary adjustments alone. Here is some ground breaking news for you
.there is no such thing as a diabetic diet
.there is just healthy eating and this is something all adults can and should be doing anyway.
Here is my seven point guide to a healthy diet:
1. Avoid snacking on high fat foods such as biscuits, crisps, fizzy drinks, chocolates, sweets, pies, cakes, Asian sweets and fried foods such as Samosas. It is okay to have one small portion rarely (say once every two months or so) at a wedding or on special occasions, but they should never be part of your regular diet. This adjustment will help you to stabilise or reduce your weight. Being overweight or gaining weight can make diabetes difficult to control and/or to get worse. This category of foods increases the risk of damage both to the arteries and the heart, which, is a key problem diabetics suffer with.
2. Cut down on the consumption of eggs and dairy products such as, butter, cheese, paneer, ghee or full fat milk and cream. Switch to semi-skimmed or skimmed milk and low fat spread This applies to cooking fats also
3. Eat five portions of fruit and vegetables a day. This bulks out your food, gives your gut a workout, helps prevent cancers and generally makes your body work harder for your food.
4. Reduce the amount of red meat that you eat and make sure that you have either lean cuts of meat or skinless poultry. Fish is good for you so try to eat 2 portions of fish each week with one portion as oily fish e.g. mackerel or salmon. However, make sure that the method of preparation does not involve frying, oil, butter and preferably not too much masala.
5. Many of my Muslim patients tell me that they <'don't take sugar'>. However adding sugar to our cornflakes or to tea and coffee only constitutes a small proportion of our daily sugar intake. Many foods contain huge amounts of hidden sugar. Sauces, baked beans and so-called 'fat free' products are a few. Next time you go shopping check a few labels for sugar content, aim to omit those with the highest sugar content.
6. It is important to include some starchy food at each meal e.g. rice or a chapatti but try not to add fat/oil and not to have too large a portion.
7. Finally, reduce the amount of salt in your diet. It promotes high blood pressure, which, as you may recall from last month is a complication diabetics need to avoid. Salt should be banned from the dinner table, but can be used sparingly in cooking.
The beauty of these dietary changes is that the entire family will benefit from them. By promoting healthy eating for the whole family, hopefully, our youth will grow up with far better eating habits than the present generation. I get very frustrated when I find that the diabetic in any household is catered for separately. Everyone should be eating the same healthy food at family meals. I am equally frustrated to find that many British Muslims are regularly indulging in foods that, in their culture or country of origin, used to be eaten only on very special occasions.
I always find it amusing when I attend family weddings, and find myself seated with a table full of diabetics, all whom feel coy about tucking into biryanis (rice cooked with meat curry) and curries in my presence. It's reasonable to eat the odd portion-wise indulgence at a wedding- however problems arise when the biryanis etc are eaten daily.
Family members, usually the women, often remark:
'If we started to do all this healthy eating stuff, you talk about then we would not get any visitors. This healthy eating is incompatible with our food
live in the real world!'
Well, actually I do live in the 'real world.' In this real world there are premature deaths from diabetes related complications in the British Muslim community. In the real world, if British Muslim diabetics avoid early death, they are often crippled, suffer daily pain and their families, usually the primary carers, are placed under great difficulties.
The real challenge to British Muslims is to start the process of seriously reappraising the way we eat. This will require active engagement and participation from us in organisations such as Diabetes UK (www.diabetes.org.uk), local health projects and organisations such as the Primary Care Trusts. You will be surprised, at how receptive they are and how willing to listen.
In the next article, I will look at lifestyle again, specifically focussing on smoking, obesity and exercise.