By Mustaffa Embong
HEALTHY eating habit can help prevent pre-diabetes, which is caused by, among others, damage to pancreas, writes MUSTAFFA EMBONG
People with pre-diabetes have higher-than-normal blood glucose levels (although not quite as high as in those with diabetes).
These individuals are very likely to also have high blood pressure, high blood lipids (fats in the blood) and are usually overweight or obese.
The combination of these undesirable conditions not only significantly increases the risk of developing full-blown diabetes but also of having heart attack or stroke.
Fortunately, according to studies in China, US and Finland, pre- diabetes (and its associated problems) can be managed, if not reversed, through healthy eating, regular exercise and healthy weight management.
We looked at how a healthy lifestyle can beat pre-diabetes by overcoming an associated condition called Insulin Resistance (IR).
Let’s explore how healthy eating can help in managing another related condition called hyper-insulinaemia, or excessive insulin in the blood (resulting from excessive production by the pancreas).
Is your pancreas overworked?
When food is converted into glucose and the level of the glucose rises in the blood, the pancreas (an organ situated behind the stomach) starts to release more insulin into the blood stream.
This means there is enough to effectively help transport the glucose into your body cells, especially that of muscles and liver.
The amount of insulin that’s produced starts coming down as more and more glucose leaves the bloodstream and enters the body cells.
If you have pre-diabetes, however, things don’t quite go this way.
Due to IR (Insulin Resistance), glucose is not able to readily enter the body cells and tends to stay and accumulate in your blood.
As a natural response, your pancreas keeps producing even more insulin, in the hope that it can encourage more glucose to enter your body cells.
Just how effective this is depends on the degree of your IR. But the fact remains that insulin is being over-produced. The result is hyper-insulinaemia or excessive insulin in the blood.
Quite like high blood glucose levels, some researchers believe that high insulin concentrations by itself could actually damage the blood vessels.
But more evidently, hyper-insulinaemia is a warning sign that your pancreas is becoming seriously overworked.
If you do nothing to manage your pre-diabetes, your IR may get worse, your blood glucose levels may keep rising and, all the while, your pancreas will suffer tremendous stress.
By the time you develop full-blown diabetes, your pancreas would already be all tired out.
In fact, studies have suggested that by the time you develop Type 2 diabetes, your pancreas would have lost up to 50 per cent of its capacity to produce insulin.
And give yourself a few more years of neglect after that, your pancreas might just give up on you altogether.
When this happens, you’ll soon find yourself needing to take insulin injections to keep your blood glucose levels under control.
Pancreas-friendly eating tips
Since your blood glucose levels are greatly influenced by your diet, here are a few eating tips to avoid overloading your pancreas.
* Know your carbohydrates.
Carbohydrates come in two major groups: complex and simple. Complex carbohydrates are found in grains, cereals and tubers.
Simple carbohydrates come in the form of sucrose (white, brown or red cane sugar), fructose (fruit sugar) and lactose (milk sugar). Your body converts such foods into glucose to supply you with energy.
* Choose healthy carbohydrates.
Complex carbohydrate foods (eg rice, noodles, bread, other cereal products and tubers) are recommended sources of energy.
Even though complex carbohydrates are broken down into simple sugars, this is done more slowly resulting in slower absorption from your digestive system.
This in turn leads to a slower rise of glucose levels in your blood, thus giving time for your pancreas to adequately response to the glucose rise.
Fruits and milk, although containing simple carbohydrates, are also encouraged because they are rich in vitamins and minerals.
Sweetened food and drinks, however, should be minimised or avoided as these cause your blood glucose levels to rise quickly and they usually do no confer much nutritional benefit.
* Go high with fibre.
A type of complex carbohydrate, fibre is the undigestible portion of plant foods.
Natural sources of fibre include unrefined complex carbohydrate foods, legumes (eg peas and lentils), fruits and vegetables.
It’s important to note, however, that not all processed carbohydrate foods are high in fibre. Most polished rice varieties and ordinary white sandwich bread, for example, contain almost no insoluble fibre.
This has prompted certain health-conscious manufacturers to develop innovative methods to retain, restore or even increase the amount of fibre in their products.
* Consume low-GI carbohydrate foods.
GI or ‘Glycaemic Index’ is a measure of how quickly or slowly your body converts the carbohydrates in a particular food into glucose and releases it into your bloodstream.
While this is not the only consideration when choosing your carbohydrate foods, low GI varieties are obviously the better choice when you have pre-diabetes.
You must of course, pay particular attention on the amount you take as even low GI foods, if taken in excess will also increase in blood glucose levels.
* Eat sensibly and space out your carbohydrates.
Having pre-diabetes does not mean that you should go on a low carbohydrate diet.
You merely have to eat your carbohydrate foods in sensible and consistent daily amounts, spread over the day.
Some experts may recommend taking frequent but small meals throughout the day so that there is no sudden, sharp rise in your blood glucose levels that your pancreas is not able to cope.
* Cultivate good taste for health.
Besides controlling your carbohydrate intake (and total calorie too, if you are overweight or obese), you need to also keep your intake of high-fat and salty foods to a minimum.
This is to help reduce your high cholesterol and high blood pressure levels, if you have been diagnosed with these.
It might be hard at first on your taste buds but you can be sure that your heart loves the taste of healthy eating.
Overcome IR with a healthy lifestyle
Healthy eating and regular exercise help you manage your body weight - a very important factor when it comes to overcoming Insulin Resistance.
IR is a condition where body cells become less sensitive to the action of the hormone, insulin.
This makes it difficult for glucose to enter the body cells, whereupon it stays in the blood where it rises to harmful levels.
Excessive fat, especially in the belly area, contributes to IR. This may explain why many overweight or obese people (or normal weight people with big belly) develop pre-diabetes.
The good news is that, research has shown that losing just 5-10 per cent of excess body weight markedly improves the body cells’ ability to take up glucose from the blood.
So, if you are overweight or obese and have pre-diabetes, start eating healthily, be physically active or exercising regularly to trim down.
The healthier your body weight, the more likely that your blood glucose levels would have returned to the normal range, reducing your risk of developing Type 2 diabetes or of having a heart attack or stroke.
* Datuk Professor Mustaffa Embong is the Consultant Endocrinologist with the National Diabetes Institute.
Article courtesy of the Fight Against Diabetes programme organised by the National Diabetes Institute in collaboration with the Ministry of Health Malaysia, Nutrition Society of Malaysia, Malaysian Dietitians’ Association and the Malaysian Association for the Study of Obesity. For enquiries, call (03) 5632 3301/5637 3526.
(c) 2006 New Straits Times. Provided by ProQuest Information and Learning. All rights Reserved.