Diabetics, think fast

Diabetics are being urged to take extra care while fasting this Ramadan, keeping their healthy diet firmly in check despite the urge to overindulge.

Health professionals are adamant that nutritional intake should be tailored to meet any special needs and address any medical problems prior to deciding to fast.

Dr Wafaa Helmi Ayesh, director of the clinical nutrition department at Dubai Health Authority, said: “The decision of fasting or not is dependent on the case of each diabetic patient and the advice of the physician.

“Some diabetic patients can fast in Ramadan if they follow a diet recommend by their physician to ensure that they are safe and healthy even while fasting. The diet must focus on a healthy food programme and modify the medicine timings to control the blood glucose level.”

When it comes to diabetic patients, no ‘one diet’ can be used by all. Each case of diabetes is different from the other, and the way the body responds differs too. However, it is important to ensure that people with diabetes eat enough to keep nourished, but avoid unhealthy options.

Dr Ayesh said: “Carbohydrates provide a lot of energy, but they affect the sugar level, particularly for people with Type 2 diabetes. Carbohydrates with a low glycaemic index such as brown rice, full grain bread and vegetables are better options than white rice, non-full grain bread or potatoes.

Healthy Iftar options in Ramadan should include: 
* Whole grain cereal, low-fat milk, cottage cheese with sliced peaches topped with toasted almonds
* Plain Greek Yogurt flavoured with blueberries and cinnamon, whole wheat toast with peanut butter
* Foul (a hearty Middle Eastern breakfast dish made of lentils or fava beans), small serving of sliced fruit
* Whole wheat roti (unleavened bread) and egg khagina (a Southeast Asian dish).

Studies have shown that 50-60 per cent of individuals who fast maintain their body-weight during the holy month, while 20-25 per cent either gain or lose weight.

Dr Ayesh stressed that the common practice of ingesting large amounts of foods rich in carbohydrates and fats, especially at the sunset meal, should be avoided, even in those without diabetes.

She said: “Because of the delay in digestion and absorption, ingestion of foods containing ‘complex’ carbohydrates (slow digesting foods) may be advisable at the pre-dawn meal, which should be eaten as late as possible before the start of the daily fast. It is also recommended that fluid intake be increased during non-fasting hours.”

Traditionally the fast is broken (Iftar) after sunset and begins with the eating of dates and drinking water. Nutritionists advise limiting the number of dates eaten to two each evening and drinking plenty of water and sugar-free beverages, but avoiding caffeinated beverages as they can be dehydrating.
 
Diabetics  must depend on fruits, fresh vegetable salads without oily dressings, lentils, yoghurt, whole serial, steam-cooked or boiled vegetables with no or less of oils/fats, non-vegetarian items grilled or steamed.

Diabetic patients are advised to delay their Suhoor meal to the maximum time limit permitted and break their fast promptly at the beginning of the stipulated time.

With the wide selection available during Iftar, it is easy to be tempted by unhealthy options, however, this is ill advised.

Dr Ayesh said: “Sweets may be popular dishes in Ramadan, but they aren’t advised as they can cause an increase in blood sugar levels. If you wish to consume sweets or ‘white carbohydrates’, it may be best to stick to much smaller portions of these. If your blood sugar levels become considerably raised as a result of these meals, it may be best not to continue with the fasting.”

Most health problems are likely to arise from inappropriate diet or because of over-eating and insufficient sleep. Thus, moderation in eating is the key to good health.

Discuss a plan with your dietician. Keep sensible portions in mind and follow the same guidelines for healthy eating that you do the rest of the year with an emphasis on whole grains, lean sources of meat, fish and poultry, small amounts of heart healthy fats and limit added sugars.