Friday, 18 February 2011

Are you getting your five a day?

Every day ‘we’ as a society are bombarded with images of what healthy should look like. It is a rarity these days to turn on the television and see a programme schedule that doesn’t include titles such as ‘Fat Families’, ‘Supersize versus Superskinny’, ‘Too fat for 15’ or ‘Biggest Loser’. It seems that over the years since the invasion of the junk food revolution, we have developed a kind of morbid fascination with the perils of being obese and now take pleasure in watching people as they journey through the trials and tribulations of re-educating themselves about what healthy is.

So, what is it? What do you think healthy is? Well, having been hooked on many of these programmes myself, the message I have taken is that ‘healthy’ would be a person who sits comfortably within a predetermined weight limit, eats around 5 portions of fruits and/or vegetables a day, consumes a balanced amount of carbohydrate, protein and dairy, exercises at least 4 - 5 times a week, doesn’t smoke, drinks a reasonably small amount and let’s not forget – avoids ‘processed’ foods as much as possible. I would also assume that I am probably not alone in thinking this seeing as most doctors, TVs shows and so-called 'experts' will highlight most of these points with some gusto.

The problem is - in my experience - ‘healthy’ for the average Joe and healthy for someone in Club-D are entirely different things. Yes, a person with diabetes should be exercising regularly. Yes, they should be avoiding processed foods. And yes, they should fall into what is considered a ‘normal’ weight (for no other reason that being hugely overweight or underweight would suggest either a surplus or deficit of something in your diet), but a pound here or there makes no difference.

But for me, the grey area starts when you begin to look at the whole fruit, carbs and protein equation. We all know that sugar raises your blood glucose. Common sense would say this is obvious really – consuming more sugar equals higher levels of sugar in the blood. Not really rocket science, is it? And it is for this reason that so many people (understandably) have a misconception that diabetics should simply avoid sugary food in order to keep levels of sugar in their blood on the lower side. But what is often forgotten - or on occasion not known to begin with – is that sugar is nothing more than carbohydrate in a simple form and in fact it is ANY carbohydrate that will increase blood glucose levels. This is where it gets confusing. Fruit for example, by any standards anywhere in the world is considered a healthy and natural food choice. But for a diabetic, fruit can be a complete nightmare, because it is absolutely packed with fructose (fruit sugar). The kind of blood sugar spikes that I have had after eating fruit has been astounding- not to mention extremely annoying – even after having weighed, calculated and injected for that one little piece of fruit. This is because fruit constains very 'fast acting' sugar, which is processed by the body very quickly. This means that no matter how well you calculate it, the insulin you are injecting to 'cover' that fruit, is unlikely to work at the same speed as the sugar, meaning a spike is almost certainly a guarantee.
Likewise potatoes, pasta and rice have an enormous effect on my blood sugar levels, despite being something often advocated as a ‘good source of energy’, and the only way I have found to successfully negotiate a meal with these kinds of food in, is to omit them from my diet all together. I have even discovered recently thanks to a lot of research and inter-surfing, that there are even large amounts of carbohydrates in vegetables! Onions for example - probably also a staple of your diet and the basis for many meals - have around 10g of carbs per average medium-sized onion. Granted you would be unlikely to eat a whole onion to yourself, but in our house we often have half each, which is around 5g per person. Seeing as I inject 1 unit per 10g of carbs, this is already half a unit of insulin I should be taking and potentially a blood sugar spike of 1 or 2 mmols. If you consider that in any one meal you would have at least 5 or 6 foods which make up the meal, many of which are vegetables which have lots of carbs, but are still in fact at the 'lower end' of powerful carbs, you are looking at some potentially big and problematic blood sugar spikes.

See for a diabetic, ‘healthy’ isn’t just about eating all the foods that doctors, dieticians and television shows so readily advocate. For those in Club-D, we also have the added issue of blood sugar levels. We have it constantly drilled into us that the primary measure of ‘healthy’ for us, is blood sugar control and that we should be aiming for blood glucose levels of 4-7mmol. Well that is all well and good, but when you are talking about a low fat-high carb diet, which is the way MOST newly diagnosed diabetics are guided, we are talking lots of food stuffs that will cause a big spike in sugars. Even in a non-diabetic, these types of food would cause the body to release large amounts of insulin in order to regulate their own blood sugar levels. The difference is, ‘we’ have to do this ourselves.

So what is the answer for PWDs (People with Diabetes)? Do we ignore popular medical opinion and eat low fact-high carb foods, which are notoriously difficult to estimate insulin requirement for (even when weighing our foods to the point of becoming mad!)? Or do we find another option?

Well, I have been on a bit of a journey of discovery lately. I will post about the different ‘diets’ I have tried lately as a way to ticking the final box when it comes to my diabetes management, but the last six months have shown me that it is not until you think ‘outside the box’ and start to embrace your own way of doing things that you really find the answer.

My conclusion from my experiments over the last few months is that the doctors don’t always know best and that you need to experiment with your own treatment rather than readily accept what you are told to do, just as I did for far, far too many years.

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