India’s first and only magazine about diabetes july-aug 2013
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food
for thought vegan
is the way Why adopt a vegetarIan dIet
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ways to lose calories
doctor speak
meet the real heroes
the great Indian meal decoded!
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contents cover story
18 Meet the real heroes Time to salute prominent diabetologists of India
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26 Vegan is the way Switch to vegetarianism for a healthy living 18
Photo by Girish Mason Food Courtesy: Shraman, Hotel Ashok, New Delhi
Volume-3 | Issue-4 | july-aug 2013
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in every issue 4 Welcome 5 Editorial Advisory Board 6 Editorial Advisory Board 7 Letters To The Editor 8 Ask Our Expert 12 Thrive
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contents
WorldMags.net Volume-3 | Issue-4 | july-aug 2013
medication
related ailments
34 Infertile? Get a diabetes check
56 Home remedies Ways to treat diabetes at home
Problems in conception could be due to existence of diabetes
weight loss
38 When eyes speak
59 Weight and watch
Kidney problems can be detected through the eye
78 Tarot forecast for July-August 2013 What the cards predict on health front special report
Make small changes for health
63 Exercise is the key wellbeing
tarot
80 Don’t sweat the small stuff
Have Type 2 diabetes. Switch to exercise
Travel with your care routine if you are a diabetic
42 Strengthen your inner self Combat stress, ailments and anxieties with tai chi
fitness
82 Anger-just a letter short of danger
66 Just right! 44 Being healthier Make gradual changes for a healthy life
Learn to control your anger
Exercise in the right way food nutrition
69 Grain of thought 48 Power up Power yoga-the new way to stay fit
72 The best combination
How Barley is a wonder grain
Choose the right food combination
88 The great Indian meal 52 The Midas Touch Find life’s true purpose with reiki
86 A fruit full life Make fruits a part of your life
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Enjoy a variety of tasty yet healthy Indian meal sans onion and garlic
INDIA
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time to get
wet ‘n’ wild Come July the rains come pouring down leaving us refreshed and rejuvenated. July 1 is the day when the world celebrates Doctors Day. We dedicate this issue to all those diabetologists who live day in and day out for the fulfillment of that one mission of their lives-giving a new lease of life to diabetics. In our Wellbeing section, we take you through the nuances of what makes for a healthy living. Make simple changes in your lifestyle for long-term benefits, practice taichi, or energise your life with power yoga and reiki. In the Medication section we suggest home remedies for diabetes. Weight loss is crucial for a healthy life. Shed those extra kilos and get in shape. Just pick those walking shoes and get going. Eating good food is something we all like. But not all of us know that there are certain food combinations that just don’t work. Who does not like the taste of a freshly picked berries, the juicy red watermelons, or even the refreshing daab (coconut water). Fruits are a panacea for a lot of ills apart from being highly nutritious. Some like Jamun prove to be good for diabetics. Let’s see what your cards have in store for you healthwise in the tarot section. Our special feature will give you tips on how not to worry if you are a diabetic and love to travel. I suggest carrying your care routine. The food section offers you a delectable Indian meal sans the onion and garlic. Whilst we are talking food let me tell you that if you don’t have Barley as part of your meals, you are missing out on something. I had dishes made out of this humble grain, loved every bit of it. I am sure you’ll love them too. Being vegetarian is the key to good health. Let’s give it a try. Maybe it works! Do write to me at pallavis@ maxposure.in. Stay healthy, stay happy. Cheers! Pallavi Singh
INDIA
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Distributed by: CNA Distributors 4-E/15, Jhandewalan ExtensionAshoka Centre-Second Floor, New Delhi-110055 Ph No-91.11.41541111.Fax No-91.11.23626036 Diabetic Living India magazine is printed and published by Vikas Johari on behalf of Maxposure Media Group (India) Pvt. Ltd. at Maxposure Media Group (India) Pvt. Ltd. Unit No F2b ( Second Floor), Mira Corporate Suites, Plot No . 1 & 2 Ishwar Nagar, Mathura Road, New Delhi -110065, India. Diabetic Living India is published bi-monthly. Diabetic Living India magazine is a trademark of Maxposure Media Group (India) Pvt. Ltd. and the entire contents of Diabetic Living India magazine are copyrighted to Maxposure Media Group (India) Pvt. Ltd. all rights reserved. The writing, artwork and/or photography contained herein may not be used or reproduced without the express written permission of Maxposure Media Group (India) Pvt. Ltd. Maxposure Media Group (India) Pvt. Ltd. does not assume responsibility for loss or damage of unsolicited products, manuscripts, photographs, artwork, transparencies or other materials. Maxposure Media Group (India) Pvt. Ltd. does not assume any liability for services or products advertised herein. For inquiries | Tel: 91.11.43011111, Fax : 91.11.43011199, diabeticlivingonline.in Disclaimer : Diabetic Living (India) is not responsible nor liable for any advice, course of treatment, diagnosis or any other information, services or products that you obtain through this magazine.
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It’s all good inside
Page 82 Learn to control your anger
Page 12 Avoid coffee if you can
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Page 26 A vegetarian diet is the key to good health
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Editorial advisory board The following health care professionals—all experts in diabetes management— review articles that appear in Diabetic Living ® magazine: Connie Crawley is a nutrition and health specialist for the University of Georgia Cooperative Extension Service in Athens, specialising in diabetes and weight loss. Connie is a member of the American Dietetic Association Diabetes Care and Education practice group.
Marion J. Franz has authored more than 200 publications on diabetes, nutrition, and exercise, including core-curriculum materials for diabetes educators. Marion is a member of the American Dietetic Association Diabetes Care and Education practice group.
Joanne Gallivan is executive director of the National Diabetes Education Program at the National Institutes of Health. Joanne is a member of the American Dietetic Association Diabetes Care and Education practice group.
Marty Irons practises at a community pharmacy and also served in industry and the military. Jeannette Jordan works for the Medical University of South Carolina in Charleston and consults with the Centers for Disease Control and Prevention.
Irene B. Lewis-McCormick is a fitness presenter and educator. Certified by the nation’s leading fitness organisations, she is a faculty member of the American Council on Exercise.
Chris Smith, The Diabetic Chef ® is the president of Health Range, Inc., and a professionally trained chef. He is a food consultant and cookbook author and conducts healthy-cooking classes.
Hope S. Warshaw is a writer specialising in diabetes care. She has authored several American Diabetes Association books. Hope is a member of the American Dietetic Association Diabetes Care and Education practice group.
Fred Williams practises endocrinology and specialises in diabetes. He is an active member of the American Association of Clinical Endocrinologists and serves on the board of directors.
John Zrebiec is director of Behavioural Health Services at the Joslin Diabetes Center in Boston and a lecturer in the department of psychiatry at Harvard Medical School.
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INDIA
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Editorial advisory board, India The following health care professionals—all experts in diabetes management—review articles that appear in Diabetic Living ® magazine’s India edition: Decorated with the Padma Shri and BC Roy award, Dr. Anoop Misra is Chairman, Fortis-CDOC Center of Excellence for Diabetes, Obesity, Metabolic Diseases, and Endocrinology, in New Delhi. He is also Chairman of the National Diabetes, Obesity and Cholesterol Foundation (N-DOC) and Director of the Diabetes and Metabolic Diseases, Diabetes Foundation of India. Dr. Misra has led several pioneering research studies on diabetes and published more than 300 research papers. Dr. Ambrish Mithal, Doctor of the year DMA 2005, cited in Limca book of records since 2005, is presently the Chairman and Head of Endocrinology and Diabetes division at Medanta, the Medicity, Gurgaon. Dr Mithal is immediate Past President, Endocrine Society of India and chairs the Nutrition Working Group of the Committee of Scientific Advisors of the IOF, Switzerland. Dr. V. Mohan is Chairman and Chief Diabetologist of Dr. Mohan’s Diabetes Specialities Centre and President & Director of Madras Diabetes Research Foundation, Chennai. He has published over 600 papers in prestigious peer reviewed journals and contributed over 100 chapters to text-books on diabetes. He has received the prestigious Dr. B.C. Roy National Award, and Fellowships from all the four Royal College of Physicians of London, Edinburgh, Glasgow and Ireland. Dr. Shashank R Joshi is a well-known endocrinologist in Mumbai. He is president of the All India Association of Advancement for Research in Obesity and vice president of the Association of Physicians of India. Padma Shri and BC Roy awardee Dr. KK Aggarwal is an eminent name in cardiology. President of the Heart Care Foundation of India and editor-in-chief of the Indian Journal of Clinical Practice, Dr. Aggarwal has a keen interest in mind-body healing. He is a regular columnist and expert for both print and television networks. Rekha Sharma is director of Clinical Nutrition and Dietetics at the Diabetes Foundation of India. This former chief dietician of the All India Institute of Medical Sciences in New Delhi has devoted several years of her life to the study of diabetes management. Madhuri Ruia is a nutritionist and fitness expert in Mumbai. A certified pilates expert from the Pilates Institute of UK, she runs Integym, a state-of-the-art centre that promises ‘intelligent fitness’ to its clients. Dr. DS Chadha is head of cardiology at the Command Hospital in Bengaluru. He has won dozens of awards, written several research papers in leading medical journals and chaired several national and international conferences on health issues. Working Committee Dr. Swati Bhardwaj is vice head at the Center for Nutrition and Metabolic Research and a nutritionist with the Diabetes Foundation (India) and National Diabetes Obesity and Cholesterol Foundation (N-DOC). Shubhda Bhanot is a certified diabetes educator and nutritionist with 10 years of experience in the field. She is presently working as senior diabetes educator at Medanta, The Medicity, Gurgaon.
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Readers Write
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Inspiring
I liked the story lifestyle-tips to control blood sugar. It proves as a handy advice kit for a person like me. It tells us how there is a scientific explanation to why one should eat smart, curb added sugars or sleep well. Kiran S. type1, Chennai
Tea magic Your story ‘Tea Time’ got me acquainted with the numerous variants of this humble beverage. Its good to know that teas such as black, green and oolong tea contain polyphenols that researchers believe increase insulin activity upto 15 times. Karan Batliwala, type2, Mumbai
Organic Delights It was interesting to read the interview of Seema Jindal Jagodia, owner of Nourish Organic Foods. It feels good to know that there are entrepreneurs like her who wish to make lives of diabetics like us enriching. Arpita Sarkar, type1, Kolkata
letters
to the editor
T h e b e s t l e tt e r w i n s a one year subscription of Diabetic Living India WorldMags.net
A sour k expert y o u r ask
e x e r t
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Dr Anoop Misra
Chairman, Fortis-C-DOC (Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology); Chairman, National Diabetes,Obesity and Cholesterol Foundation (N-DOC)
QA +
Q1
I am 40 plus. I want to know if I should undergo a Diabetes test as part of a daily check-up though I assume I do not have this problem. Prerna Chugh, Chandigarh
Ans: Yes, with increase in the prevalence of lifestyle-related disorders including diabetes, regular, periodic screening for diabetes and other lifestyle related disorders has become a necessity. Early diagnosis of diabetes helps in effective management as well as preventing/delaying the complications and improving the quality of life.These days all health care centres offer diabetes screening as part of their regular comprehensive health package. You should undergo the following tests; oral glucose tolerance test and glycosylated hemoglobin.
8 Diabetic Living july-aug 2013
regular,
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Q + A
Q2
I am over 50 years old. I have a sweet tooth. I love to have a sweet dish with all my meals. Is that something to be worried about? Geetanjali Chopra, Mumbai
Q3
What are the health benefits of muesli and how could one use it in the daily diet? Sameer Singh, New Delhi
Ans: Muesli is a popular breakfast meal based on uncooked rolled oats, fruit and nuts. When it was first developed, muesli was typically a dry cereal made from toasted whole oats, nuts, fruit and wheat flakes. At present they are available in several versions, including gluten-free/ fresh muesli (soaked overnight in water or fruit juice to soften), toasted/untoasted muesli etc. The health benefits or the nutritive value of muesli depends on how it
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muesli is a
potent source of antioxidants is made. Some of the health benefits of muesli include: • It is high in fibre and whole grains, which regulate the digestive system, are filling and can aid in weight control. • It is a potent source of antioxidants. • The addition of nuts provides a great source of protein and omega-3 fatty acids (especially walnuts). • Milk or dairy alternatives that usually accompany muesli are a source of dairy and protein. However, these days the commercially packaged muesli is actually laden with extra sugar, unnecessary calories, carbohydrates and fat, which make it a not so healthy option. Therefore, keep in mind the following points in mind before buying muesli: • It should be unroasted • Aim for varieties containing <20g of carbohydrates per serving • <3g of saturated fat per 100g • Low glycemic index (GI<55) • A mixture of healthy fats home cooked, whole grains-based meals (whole wheat porridge/oats/ stuffed chapati, etc.) are always better than the so called “healthy” commercial options. DiabeticLivingOnline.in
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Our experts will be happy to help you. Send us your queries at
[email protected]
Ans: Too much consumption of sugar/sugar containing products can lead to increase in total calories which might lead to weight gain (obesity) if the extra calories are not burnt out effectively (through adequate physical activity). Sometimes it directly affects insulin secreting cells of pancreas or even liver. It is a bigger problem for people with diabetes as it can increase the blood glucose levels making its management even more difficult. You can follow the following healthier ways to curb sweet cravings: • Keep fruit handy, even chilled fruit after main meal can not only provide sweetness but also fibre and vitamins. • Take a walk: Whenever you get a sugar craving, take a walk around to take your mind off the cravings. • Eat regularly: Waiting too long between meals may make you fall for sugary, fatty foods that cut your hunger, instead, eating every three to five hours can help keep blood sugar stable and help in avoiding irrational eating behavior. Having too much of craving for sugary foods could also mean that there is an underlying/ undiagnosed problem such as increased function of thyroid etc. You need to get a thorough medical checkup done.
j u v e n i l e
d i a b e t e s
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tender years our expert answers all queries regarding your little one’s wellbeing
Dr. Neeta Kejriwal,
Associate Consultant, Paediatrics, Fortis Memorial Research Institute, Gurgaon.
QA +
10 Diabetic Living july-aug 2013
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Q + A
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Q1
My six-month-old infant keeps a loose stomach. What can be the problem?
educate yourself and everyone around you about subjects related to baby care, feeding and kids with other complications
Kriti Kaushik, Nagpur
Ans: How frequent and of what consistency? Baby is on breast feeds, top feeds with bottle or without bottle and whether has been started on weaning food or not? What is the growth pattern and development of the baby? We need to look at all the details to find out the problem. If your baby is active, taking feeds, passing good amount of urine, growing well, few semisolid stools a day might be just normal.
Q2. My three-month-old infant cries a lot during nights. How can I control it? – Surbhi Arora, Bangalore
Ans: Some babies just become cranky at night without any obvious reasons or it could be abdominal colic which will settle spontaneously may be in a couple of weeks. You need to burp your baby properly after every feed and avoid bottle feeds. Does the baby cry for feeds or wants to play, is your milk supply enough? Try to breast feed for 20-30 minutes in one go so that the baby’s tummy is full and can have a sound sleep for few hours. If your baby is active and growing well, don’t worry, things will settle.
demand whichever is earlier. After few weeks of life, baby can be fed on demand. Sometimes baby might demand in half-an-hour and sometimes might not demand for 4-5 hours also. You should be looking at the activity and number of wet diapers (minimum 6-8 in a day). Let the baby feed for 20-30 minutes at a time. You don’t go by the clock, it’s a demand feed.
Q4. My breasts do not produce much milk. What should I do? – Sumita Mathew, Hyderabad
Ans: How old is your baby and whether on exclusive breast feeds or not? You need to have a good diet yourself and enough liquids. Even bottle feeding and less number of breast feeds decreases the production of breast milk. See your pediatrician and check the growth of baby and what exactly is the problem. Q5. While choosing a product for my infant, what should I keep in mind? – Sumita Mathew, Hyderabad
Ans: Food products should be age appropriate and what is recommended for the age group. Cosmetics should be mild and non-irritant. Clothes should be soft, preferably cotton.
Q3. What is the best time to feed a baby? – Vikram Nandwani, Delhi
Ans: A newborn baby should be fed every 2-3 hourly day and night and on
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thrive
WorldMags.net shed the kilos
Scientists believe that lifestyle changes can help prevent or delay the onset of type2 diabetes. A healthy meal plan, weight control and physical activity are important prevention steps. If you are at risk, type2 Diabetes can be prevented with moderate weight loss (10–15 pounds) and 30 minutes of moderate physical activity each day.
coffee linked to weight gain, cardiovascular,
diabetes risk
New research suggests too much coffee may be linked to weight gain and diabetes. As per earlier studies drinking coffee in moderation could help with weight loss and decrease the risk of type2 diabetes. The new dietary study suggesting otherwise, published in the Journal of Agricultural and Food Chemistry, was conducted over a period of 12 weeks in overweight male mice. The ingredient of concern is one of coffee’s major components: chlorogenic acid. Mice given the equivalent amount of CGA found in 5 or 6 cups of coffee per day showed greater fat retention. They also showed glucose intolerance and increased resistance to insulin regulation - risk factors for diabetes. Reduction in BMI cuts diabetes risk in obese teens Researchers found that obese teenagers who reduced their body mass index (BMI) by 8 percent or more had improvements in insulin sensitivity, an important metabolic factor related to the later development of type 2 diabetes. The teens followed a familybased, lifestyle-modification weight loss program that offers the potential to become a broader model. BMI is a measure of body weight adjusted for height.“This threshold effect that occurs at 8 percent suggests that obese adolescents don’t need to lose enormous amounts of weight to achieve improvements,” said pediatric endocrinologist Lorraine Levitt Katz, M.D., of the Diabetes Center for Children at The Children’s Hospital of Philadelphia. “The improvements in insulin sensitivity occurred after four months of participating in a lifestyle-modification program,” Katz stated. The study team analyzed results in 113 primarily urban adolescents, aged 13 to 17, of whom 81 percent were female, and 62 percent were African American. At the start of the study, their mean BMI was 37.1, placing them in the severely obese range. None had type 2 diabetes, but their obesity placed them at high risk to develop the disease in the future. An important goal of the study was to determine the threshold of weight loss that significantly impacted insulin sensitivity, glucose tolerance and the presence of metabolic syndrome (MS).
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The diabetes ‘breathalyzer’
Chemists at the University of Pittsburgh have demonstrated a sensor technology that could simplify the diagnosis and monitoring of diabetes through breath analysis alone. Their findings were published in the latest issue of the Journal of the American Chemical Society (JACS). Those with diabetes recognize the condition’s symptoms through their breath acetone - a “fruity” odour that increases with high glucose levels.
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time to control
fish oil supplements may help fight diabetes
Good control of Diabetes significantly reduces the risk of developing complications and prevents complications from getting worse
Fish oil supplements can modestly increase amounts of a hormone that is associated with lower risk of diabetes and heart disease, according to a new study. Fish oil supplements, also called omega 3 fatty acid capsules, raise levels of adiponectin in the bloodstream. Adiponectin is an important hormone that has beneficial effects on metabolic processes like glucose regulation and the modulation of inflammation. In long-term human studies, higher levels of adiponectin are associated with lower risks of type2 diabetes and coronary heart disease. The meta-analysis reviewed and analysed results from 14 randomised, placebo-controlled clinical trials. In total, 682 subjects were treated with fish oil, and 641 were given placebos-most commonly olive and sunflower oils. In those taking fish oil, adiponectin levels increased by 0.37 microgrammes per millilitre.
No tell-tale signs
It may sound strange but Type 2 diabetes often does not have any symptoms.
Type 2 Diabetes Progresses Faster in Kids Type 2 diabetes is more aggressive in children than adults, with signs of serious complications seen just a few years after diagnosis, new research finds. “Based on the latest results, it seems like type 2 is progressing more rapidly in children,” said Dr. Jane Chiang, senior vice president of medical affairs and community information for the American Diabetes Association. “Complications are appearing faster, and it appears to be at a more significant rate than we see in adults.” The results are alarming, Chiang and other experts said. “If these children continue to progress this rapidly, we could see many of the consequences of type 2 diabetes at a much younger age, like kidney disease and heart disease,” she said.
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unfolding woes
People with Diabetes are twice as likely to develop heart disease than someone without diabetes. Diabetes is the number one cause of kidney failure in the world. Besides this every year it is responsible for 5% or 5 million blindness in adults and one million limb amputations. Diabetes is also an important cause of heart disease, stroke and cataract.
with women diabetes in india rising
The disease itself may not discriminate on the basis of gender, but when it comes to healthcare for patients with diabetes, women in India find themselves at a disadvantage compared with men. This is the conclusion of a study, Impact of Gender on Care of type2 diabetes in Varkala, Kerala, which analysed gender roles, norms and values in a household and found women patients to be more vulnerable. This vulnerability influences all phases of diabetic care, according to the paper by Dr Mini P Mani at the Achutha Menon Centre for Health Science Studies (AMCHSS) in Thiruvananthapuram, the capital of the southern state of Kerala. Even when they suffer from diabetes, women cannot abandon the “caretaker role” in the family and have to continue to prioritise the health of other family members above their own, the study found.
Got diabetes? There’s an app for that For kids with diabetes, summertime isn’t always as care free. Dr. David Repaske with Ohio’s Nationwide Children’s Hospital says, “There’s no weekend off, there’s no summer vacation from diabetes. It’s something you’ve got to deal with every single day. And that makes it really tough, because you just get tired of it.” To make that process easier Dr. Repaske came up with the first online app to help kids and people who care for them chart their blood sugar levels in advance. Simply plug in a few numbers and you can print a graph that calculates how much insulin and carbs a child needs, which not only helps kids with diabetes, but everyone from teachers to relatives. A child uses a pump to automatically deliver the right amount of insulin into his system.
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Number game
Research shows that only about five percent of all people with diabetes have Type 1 Diabetes
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Diabetes - shiftwork a big challenge
While working shifts can play havoc with any person’s diet, this can be a particularly serious issue for people with diabetes, a dietician has warned. According to Rosemarie Kelly, a dietician at the South infirmary Victoria University Hospital in Cork, working shifts can be a big challenge for those with diabetes because ‘like it or not, a lot of time in your week is probably spent at work and what you eat and do there inevitably has an impact on blood glucose control’. While some people are able to cope with irregular hours, long shifts and even night shifts, for others, ‘it can take a bit more thought to eat in a healthy way’. She noted that shiftwork can make a person ‘work against the natural rhythms of their body clock’. This can lead to shift-related fatigue and when you are tired, foods high in fat and sugar can be more tempting. This can lead to a reliance on fast foods and takeaways. Ms Kelly also noted that it can be difficult to know when to take your diabetes medication or how to time insulin doses. She said each individual should work this out with the help of their diabetes team. Physical activity can also have an impact. If you mainly sit at a desk, your blood glucose levels may rise. If you have a very physical job, you may be more prone to hypoglycaemia, which is when the level of glucose in the blood drops below a certain point. This can cause symptoms such as dizziness, sweating and palpitations. These usually go away 10-15 minutes after eating sugar.
statin drugs may increase risk of diabetes
Did you know?
Did you know that about one third of all people with diabetes do not know they have the disease?
Certain statins - also known as cholesterollowering medications - could increase your risk of developing type 2 diabetes, a new study suggests. The risk was most significant in patients taking atorvastatin (Lipitor), rosuvastatin (Crestor) and simvastatin (Zocor), according to the study, published in BMJ. Statins are the most widely prescribed medications for the prevention of cardiovascular events. Generally, these medications are well received, however, a new link to diabetes has been suggested. Previous studies have indicated a 27% elevated risk of diabetes with rosuvastatin. WorldMags.net
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thrive
WorldMags.net weigtht loss is the key
Research shows that modest weight loss and regular physical activity can help prevent or delay type 2 diabetes by up to 58 percent in people with prediabetes. Bariatric surgery can reduce the symptoms of Diabetes in obese people.
mango
diabetes buster
Mangoes are a whole lot more than just a delicious, refreshing treat produced by nature. As evidenced by copious scientific research, mangoes are also a powerful medicinal food, as they contain nutrients that can help clear up skin, promote eye health, stave off diabetes, and even prevent the formation and spread of cancer. Research recently presented at a meeting of the Federation of American Societies for Experimental Biology (FASEB), for instance, revealed that eating mangoes every day can help moderate and even lower blood sugar levels, despite their natural sugar content. This is good news for people with type2 diabetes who may benefit from consuming mangoes regularly as part of a low-sugar diet. Managing diabetes through metabolic surgery
For obese people, especially the morbidly obese, metabolic or weight loss surgery is now a viable option to effectively manage or cure their type2 diabetes or adult onset diabetes, according to Edward Oliveros, MD of St. Luke’s Medical Center. Metabolic surgery is now considered the biggest development in the battle against diabetes in recent years as it offers the possibility of cure of or remission from diabetes. 16 Diabetic Living july-aug 2013
Wireless Technology could be the future for treating Diabetes and more
Scientists are developing a way to treat diseases like diabetes and heart failure in real time with wireless body sensors. The technology is based on ultrasound that the Navy has been using for years for underwater communication. University at Buffalo (UB) researchers are now developing a way to treat heart failure, diabetes and more with sensors implanted in the body that monitor medical conditions. The technology that started 10 years ago is called “body area network” that consists of a series of wireless sensors.
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‘nano’ medicine might someday free diabetics
Researchers have developed a network of so-called “nanoparticles” that theoretically could be injected into the body and release insulin to counteract rising blood sugar levels in people with diabetes. Tested so far in mice, the nano-network was able to maintain normal glucose levels for more than a week with a single injection. Currently, patients have to inject themselves with insulin several times a day to control their blood sugar levels. “The main aim was to mimic the activity of the pancreas. In our system, when glucose levels go up, the nanoparticles degrade to release insulin,” said study author Zhen Gu, from the joint department of biomedical engineering at the University of North Carolina at Chapel Hill and North Carolina State University. Gu, along with Robert Langer and Daniel Anderson, developed this technology when Gu was working at the Massachusetts Institute of Technology. Although exciting, the research is very preliminary, one expert said. “From a patient perspective, this could be incredible. It would reduce the burden of diabetes,” said Sanjoy Dutta, senior director of treatment therapies at JDRF (formerly known as the Juvenile Diabetes Research Foundation). “But there are still lots of questions to be answered. This was a first-pass study.” This treatment would likely be most useful for people with type1 diabetes, an autoimmune condition in which the pancreas no longer creates insulin.
Hearty issues
Diabetics are twice as likely to develop heart disease than someone without diabetes
meal plan
A meal plan for a person with diabetes isn’t very different than that which is recommended for people without diabetes
Re-Analysis of diabetes drug finds no increased risk in heart attacks A re-analysis of the data from a pivotal study of rosiglitazone found no increased risk of cardiovascular events associated with the controversial diabetes drug. The Duke Clinical Research Institute (DCRI) study of the drug, marketed in the US as Avandia, reassessed the original findings of a clinical trial called RECORD, which drew criticism during an advisory committee meeting of the US Food and Drug Administration in July 2010. Rosiglitazone has not been widely marketed in the United States since 2010, when the FDA restricted its use after studies showed it was associated with a higher risk of heart attacks; it is no longer marketed in Europe. The FDA required the new analysis, which was funded by the drug’s manufacturer, GlaxoSmithKline. The findings are published in American Heart Journal.
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Cover story
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heroes meet the real
On the occasion of Doctor’s Day on July 1, we at Diabetic Living India pay a humble tribute to diabetologists across India who have been the guardian angels to patients suffering from Diabetes. They talk about their beginnings, their success stories and their vision as a Diabetologist. What is it that makes them special, what would they have been if not for a doctor? -By Pallavi Singh
18 Diabetic Living july-aug 2013
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“at one point during my MBBS career, I strongly
Dr. Anoop Misra
Q A
thought about joining national school of drama. I still feel that I would make a creative and innovative movie director”
When did you know that you wanted to become a doctor and a diabetes expert?
There are several reasons. First, my father was a doctor, and I used to see him stich wounds and cuts. At age of 8, I had my own drug box and used to hand over aspirin and vitamins to maids, servants and the underprivileged. Further, I wanted to learn about diabetes since my father was a diabetic, and he suffered from disabling complications. I remember when I was young, we always had a car driver since my father was unable to drive because of hemorrhages in retina of both eyes caused partial blindness. In addition, when I was a student, we had extremely knowledgeable and charismatic teacher who was a renowned diabetologist. He taught the subject in such a manner that it became the most interesting subject in medicine for me. Since he was considered to be one of the top diabetes expert in the world at that time, many of us looked up to him as a role model. Finally, even in my student days, I thought that this specialty is most exciting for research and therapeutic advances. And, how this has come true; we do see a number of exciting new treatments and new concepts, with India as a hub of patients and new centre point in a world full of diabetes!
Q E
A success story. Any case you think was your most important achievement till date. ducating Asha. She was
admitted in deep coma. The chances of survival in coming out of diabetic ketoacidosis were minimal. I had a treatment plan for her, throwing all medical science had to offer; insulin, fluids, antibiotics and the works. I would have done the same for any other similar patient. But for her, my actions were more urgent, my usually commanding voice was a trifle wavering, and my heart had an extra prayer. I had taken to her 3-year old daughter. She was playing with her teddy, munching cookies and trying to wake up her mother. She was un-
Q
What if you were not a doctor? I used to act in plays and directed several of them when at AIIMS, Delhi. People told me that I was very good at it. At one point during my MBBS career, I strongly thought about joining National School of Drama. I still feel that I would make a creative and innovative movie director. At present, those creative surges of mine are often incorporated in my powerpoint presentations and lecture. The students have often remarked that I make telling academic points in a bit of ‘theatrical mode’ sometimes!
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aware that at that time her mother’s blood pressure was dropping to dangerously low levels, her kidney cells were and her brain was nearly dead. Her mother’s fault; she ignored her primary doctor’s warning that in the variety of diabetes that she had, she would be dead without insulin therapy. Or may be it was not her fault after all. Perhaps her doctor did not emphasize it enough. Instead of insulin she took untested alternative therapy till her blood sugar reached 500 mg% and her blood and brain were filled with acids (acetone). She came with her daughter and husband the other day, clearly enjoying active life. Her daughter is now a bright 13-year-old girl, performing very well in class under close watch of her mother. She has learned to take care of her mother’s disease; does blood sugar profiling, and gives insulin injection. What did we do for her mother’s continued good health?. Appears like we did nothing much, but give her education needed to prevent any further bad event from happening. After she recovered from her coma 10 years back, I spent just about 30 minutes educating her regarding diabetes and emphasized, in no uncertain terms, importance of not missing a single dose of insulin. She never did. Only 30 minutes of education and saving three lives! DiabeticLivingOnline.in
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Q A
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Your vision as a Diabetologist in the next 5 years.
Clearly, there is an evolution here, albeit in a slow mode. Knowledge treatment of these disorders is changing fast. I believe that in next five years a number of new drugs/techniques for diabetes will revolutionize the treatment (e.g. once a week injection to control diabetes etc.). The monitoring devices will become smaller and will transmit data of blood sugar in real time mode. Bloodless estimation of blood glucose will become a reality. Cell phones will have blood glucose, blood pressure and ECG monitors, which could be transmitted real time to physicians. The devices and testing strips will become cheaper. Specialized stand-alone diabetes centres and hospitals will increase in India (presently there just a few). Bariatric surgery will become a standard diabetes treatment. Finally, it would be possible to decrease capacity of stomach and intestine (as is done by bariatric
surgery) non-surgically. I also visualize that in the next five years general practitioners in India would be better trained with upto-date knowledge and skills about prevention and management of diabetes. I also think, to achieve this MBBS curriculum would be modified to teach diabetes and its complications effectively to students. Next five year should also bring forth, viable and effective National Diabetes Control Programme, covering most of the states of India. With these concerted efforts, the increasing prevalence of diabetes will plateau, and may decrease over the next ten years.
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Your advice to the budding doctors in the field.
There is no short cut to hard work in medicine. Once your grass root training is strong, you will score anywhere in the world. Be honest and ethical in dealing with patients. And finally, update yourself with knowledge even later in your career, because ‘knowledge is a weapon’.
Prof. Anoop Misra is the Chairman, Fortis-CDOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, and Chairman, Center for Internal Medicine, Fortis Hospitals, New Delhi and Director, National Diabetes, Obesity and Cholesterol Foundation, India. He is Advisory Board Member of British Medical Journal. Prof. Misra is a Technical Advisory Board member of National Programme for Diabetes, CVD, Stroke and Cancer, Prof. Misra has more than 25 years of experience in teaching, service, research and community health intervention programs directed towards Asian Indians and particularly for underprivileged people. He has been a member of WHO and ICMR Expert Groups for Childhood Obesity, Fatty Liver, Diabetes, and Gestational Diabetes and Member, Governing Committee, National Institute of Nutrition, National Nutrition Monitoring Bureau, and Expert Committee for Drugs Controller General of India, India. He has been awarded the highest award for medicine in India - Dr BC Roy award (2006) and prestigious National Honor, Padma Shree (2007). He has been conferred two National awards ‘Americare Award’ (Americare Foundation) and “Swastha Bharat Samman” (from Zee TV) for most outstanding contribution to Diabetes in India. He has received “Outstanding Investigator Award” for Diabetes from World India Diabetes Foundation in 2013.
“there is no short cut to
hard work in medicine. once your grassroot training is strong, you will score anywhere in the world” 20 Diabetic Living july-aug 2013
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WorldMags.net Dr. Ambrish Mithal
Q A
When did you know that you wanted to become a doctor and a diabetes expert?
My family had many engineers; I wanted to do something different. I had seen a fair amount of illness in my family and felt a strong urge to do something about it; moreover treating people always fascinated me. My Biology teacher helped me take the final call; in my 10th grade I had decided, I will be a doctor.
Q A date.
A success story. Any case you think was your most important achievement till
I have many interesting and successful cases to share but one case of diabetes that I clearly remember is of a gentleman who was nearly 130 kgs when he came to me. He was injecting 160 units of insulin with 4 different kinds of diabetes drugs and still his sugars were uncontrolled. He had asked me “Dr Mithal will diabetes always control my life?” He had lost hope and was demotivated. After intensive life style and motivational counselling we added GLP1 agonist, one of the new molecules, which not only helps control sugars but also helps in achieving weight loss. Gradually, his insulin doses were reduced; he lost 22kgs and sugar control improved markedly. The diet, the changes in treatment, the counselling, all made the difference. His outlook to life changed!
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Your vision as a Diabetologist in the next 5 years.
As an Endocrinologist I am very disheartened to see the numbers of type2 diabetics rising rapidly in India, especially the rise in the younger generation is particularly disturbing. Over the years the trend has changed, the disease of late 40’s is now a disease
“I’d like to see molecules that fight diabetes & obesity together, are cost effective with fewer side effects”
of early 30’s or even 20’s! In the coming years I would like to see a greater emphasis on prevention of diabetes, as India cannot deal with the burden of diabetes and its complications. Prevention has to be the main strategy for the future. School-based programmes on awareness and availability of healthy food, along with facilities for exercises have to be emphasized. Strategies for the prevention of type2 diabetes in children and adolescents need to involve government, parents, society, as well as individuals. Programmes should focus on the prevention of obesity through promoting physical activity, promoting healthy eating, achieving excellent pregnancy outcomes with regard to avoiding low birth weight and treating gestational diabetes. Healthy eating options should be easily available may be as easily as these days you get junk food! On the research front, I would like
to see more new molecules that fight diabetes and obesity together which are cost effective and have fewer side effects. I would also like to see drugs that can work for longer periods (weekly or monthly). A major hope is newer devices for insulin delivery (artificial pancreas), oral insulin, newer blood sugar monitoring devices and non invasive methods of measuring blood glucose. The dream is to see successful stem cell therapy curing type 1 diabetes. I also hope for better insurance coverage for diabetes and its complications in the future.
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What if you were not a doctor?
Had I not been a doctor I would have surely been a journalist as I love to write on many issues including health, lifestyle, music, art and history. Dr. Ambrish Mithal, Doctor of the year DMA 2005, cited in Limca Book of Records since 2005, is presently the chairman and Head of Endocrinology and Diabetes Division at Medanta, the Medicity, Gurgaon.
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Your advice to the budding doctors in the field. My advice to all budding doctors may sound very boring but it is very clear; I think the single goal is to work hard and excel in your field. There are no short cuts in medicine. Newer technology should not take away the compassion for our patients. Always remember, if we are performing our job with sincerity towards our patient, to the best of our ability, success will follow. May be, I am old fashioned but I do believe that doctors should not worry about “marketing themselves”.
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WorldMags.net Dr. S.D. Mehtalia
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When did you know that you wanted to become a doctor and a diabetes expert? I was a medical student and subsequently the resident in medicine from 1961 to 1964. During this period I saw quite a few patients with diabetes. I realised that a lot needed to be done for this patients, more about education and management. So I decided to pursue it further. I consulted several senior professors at our medical college. Some seniors like Dr V V Shah, Padmashree awardee and Dr Hansoti encouraged me for diabetes as a speciality. I decided to write to the American Diabetes Association as to where I can get training in Diabetes. I wrote to all the prominent hospitals. They were all willing to give me an appointment but I needed to be an American resident. Finally, I picked up a county hospital in New Jersey. From here, I would go to several hospitals in New York and attend their weekly Diabetes meetings, particularly of the New York Medical College, and Mount Sinai Hospital. The Prof. and head of Diabetes Department- Dr Camerini was impressed with my knowledge and desire to learn more. One day after attending several clinical meetings, he offered me the job. After joining the New York Medical College, there was nothing stopping me. I joined the research unit also and received two prizes from the New York Diabetes Association.
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Tell us about your journey so far?
The first research project was to establish the micromethod for simultaneous insulin and growth hormone assay from the blood of KK mouse. The mouse weighed only 15 grams and blood in the mouse was less then 5ml. We needed glucose tolerance test five times in 2 hrs and also estimate
22 Diabetic Living july-aug 2013
the growth hormone levels in each sample. If the test was done by conventional method, only one test would be possible with small amounts of blood in the mouse. So I worked for one year on this project and I was awarded a prize by the New York Diabetes Association. After successfully completing the task, my next assignment was the rat liver perfusion study. First time we showed that ketones can be utilised by the brain for energy purpose. I received another prize for this research paper by the New York Diabetes Association. After that I decided to go to Joslin Clinic in Boston, the best place for research and patient care in the United States at that time. My experience in patient care was great and satisfying. Subsquently, I joined the University of Southern California at Los Angeles. The L.A. County hospital was the biggest hospital in USA. I developed the Glucagon stimulation test for Insulinoma there which helped in diagnosis of Insulinoma. I came back to India and joined the T N Medical College as Hon. Prof of Medicine and Diabetes. I served there
until my retirement in 1996. During this time I also joined Sir H N Hospital in Mumbai where I carried on research on hormones secreted from fat tissue in the body. I was also appointed as Diabetologist to the Governor of Maharashtra in 1990. I am also a diabetologist at the Asian Heart Hospital.
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A success story. Any case you think was your most important achievement.
There are many difficult cases that I must have treated. There was patient with .2600 mgms blood glucose I had treated in Los Angeles. In Mumbai, I treated a patient with 1500 mgms%.
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Your vision as a Diabetologist in the next 5 years.
In the next five years it will be possible to have an artificial pancreas for the children with diabetes who will live a normal life without injections. The Stem Cell therapy may become a reality.
“In the next five years it may be possible to
have an artificial pancreas for children with diabetes. the stem cell therapy may become a reality” WorldMags.net
WorldMags.net Dr. Deep Goyal
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When did you know that you wanted to become a doctor and a diabetes expert?
I grew up in a family of doctors. Both my grandfather and father were general physicians in a small town. I had seen them treating hundreds of patients each day. I was fascinated since childhood by the respect a doctor gets. At the age of nine, I decided that I wanted to become a doctor.
Q A date.
A success story. Any case you think was your most important achievement till
There are various cases which came to mind. One young male came to our outpatient clinic, weighing 180 kg and severely diabetic on high doses of insulin. While counselling he collapsed due to severe weight-related breathlessness. He was managed by our critical care team and laparoscopic bariatric surgery was done. This young man had dramatic recovery from his obesity-related problems. He is off insulin now.
“a patient surrenders oneself to the doctor
based on complete faith and trust. dream big and chase those dreams. don’t forget to follow excellence, money will follow”
is just a click away. Doctors should remain updated in these subjects and treating their patients with dedication Your advice to the budding and humility. One must realize that a doctors in the field. patient is surrendering himself or herself to the doctor based on complete Younger generation is blessed to faith and trust. Dream big and chase be living in an era of technology & those dreams. Don’t forget to follow information. Any information today excellence, money will follow.
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Your vision as a Diabetologist in the next 5 years Diabetes & obesity are two major diseases which are crippling our country. It is the relatively younger population that is being affected by these problems leading to loss of productive years of this generation. If we don’t wake up now and take account of these problems, we would be facing the biggest epidemic of “Diabesity” Diabetes and obesity ever. Direct and indirect financial burden of this would be unimaginable. The World Health Organization has predicted that India would be the world’s capital of Diabetes & Obesity by 2020. WorldMags.net
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What if you were not a doctor?
A
I am equally fascinated by the idea of meeting new people and visiting different places. I would have been a traveller and a painter because I love nature and like to meet different people to know about different cultures. Dr. Deep Goel is an alumnus of KGMC, Mangalore. He secured a specialist surgery registrar-ship at the Department of Minimal Invasive Surgery and Vascular Surgery at the Royal London Hospital, UK. With an extensive experience of over 300 bariatric operations, he has the largest single surgeon experience of Bariatric operation in the sub-continent. He is currently the Director of Surgical Gastroenterology, Minimal Access and Bariatric Surgery at the BLK Super Speciality Hospital, New Delhi, India. DiabeticLivingOnline.in
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WorldMags.net Dr. S.K. Wangnoo
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When did you know that you wanted to become a doctor and a diabetes expert?
My dream to become a doctor dates back to 1996 when I was studying in the 10th standard and my mother was detected to be diabetic. In those times, the only treatment available was few oral antidiabetics and animal insulins. I took this as a challenge to become a specialist in the field and do something innovative to ease the life of millions of diabetics.
Q A date.
“there ought to be awareness regarding the disease even
A success story. Any case you think was your most important achievement till
In my career of 30 years as an endocrinologist, time and again there have been cases which have been challenging. But one case which I found really challenging was one which was referred to me by a leading GP about a decade ago. There was this middle aged lady who came to me with recurrent episodes of low blood sugars. On thorough evaluation we could find a small tumour like lesion in the pancreas on selective pancreatic angiography. The patient became alright after the successful removal of tumour from the pancreas and the histopathology report also confirmed insulinoma. The real challenge came when unfortunately the patient came back with creeping eczematous dermatitis in the body. It then struck me that may be we are dealing with another neuroendocrine tumour like glucagonoma which we might have missed on our previous selective angiography of pancreas. Finally, my suspicion was confirmed on radiological imaging of the pancreas including transesophageal ultrasound. The patient was operated again and tumour lesion was successfully resected. She responded well with all skin lesion disappearing dramatically within a week. 24 Diabetic Living july-aug 2013
in the remotest areas of the country and every patient should have access to affordable insulin and oral antidiabetic drugs”
Q A
Your vision as a Diabetologist in the next 5 years.
My vision for diabetes in India is that there be awareness regarding the disease even in the remotest areas of our country and that every patient has access to affordable insulin and oral antidiabetic drugs through government-run pharmacies. This will be possible only by mass education which in turn needs a strong health care policy tackling the burden of non- communicable diseases in India.
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Your advice to the budding doctors in the field.
The irony is that most of the doctors today after completing their post graduation want to have quick success by earning a handsome amount of money. My personal
experience is that unless and until you get a practical hand to hand experience in treating various kinds of diseases related to endocrinology /diabetes under the supervision of an experienced endocrinologist it becomes difficult to provide minimal standard of care to most of the patients.
Q A
What if you were not a doctor?
Had I not been a doctor, I would have been serving as a government servant in some public sector undertaking, the reason being that most of my family members including my uncles are pursuing a career with PSUs. Dr Wangnoo is a Senior Consultant Endocrinologist and Diabetologist, Apollo Centre for Obesity, Diabetes and Endocrinology
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Cover story
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vegan
is the way Nutrition plays an important role in the prevention of Type 2 diabetes, managing existing diabetes as well as preventing or reducing the progression of diabetes-related complications -By Dr. Swati Bhardwaj & Dr. Anoop Misra
26 Diabetic Living july-aug 2013
vegetarian diet in diabetes India is facing an “epidemic” of diet-related non-communicable diseases including obesity and related comorbidition.1 The prevalence of diabetes, specifically Type 2 Diabetes has also seen a magnificent rise in both rural as well as urban India.2 Type 2 diabetes mellitus accounts for approximately 95% of all diabetes and is associated with severe complications like nephropathy (damage to the kidneys), neuropathy (damage to the nerves), retinopathy (damage to the retina of the eyes), stroke (blockage in the blood vessel of the brain) and coronary heart diseases (CHD; blockage/ hardening of the arteries). These complications not only reduce quality of life for those affected but also lay an economic burden on the individual as well as the nation.
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WorldMags.net types of vegetarianism Type of Vegetarianism
Foods included/ excluded
Ovo vegetarianism
Includes eggs but not dairy products.
Lacto vegetarianism
Includes dairy products but not eggs.
Lacto-ovo vegetarianism
Includes animal/dairy products such as eggs, milk, and honey.
Veganism
Excludes all animal flesh and products, such as milk, honey, and eggs, as well as items refined or manufactured through any such product, such as bone-char refined white sugar or animal-tested baking soda.
Raw veganism
includes only fresh and uncooked fruit, nuts, seeds, and vegetables. Vegetables can only be cooked up to a certain temperature
Fruitarianism
Permits only fruit, nuts, seeds, and other plant matter that can be gathered without harming the plant.
Sattvic diet (also known as yogic diet)
Plant based diet which may also include dairy (not eggs) and honey, but excludes anything from the onion or leek family, red lentils, durian fruit, mushrooms, blue cheeses, fermented foods or sauces, alcoholic drinks and often also excludes coffee, black or green tea, chocolate, nutmeg or any other type of stimulant such as excess sharp spices.
Buddhist vegetarianism
Different Buddhist traditions have differing teachings on diet, which may also vary for ordained monks and nuns compared to others. Many interpret the precept ‘not to kill’ to require abstinence from meat, but not all. In Taiwan, su vegetarianism excludes not only all animal products but also vegetables in the allium family (which have the characteristic aroma of onion and garlic): onion, garlic, scallions, leeks, chives, or shallots.
Jain vegetarianism.
includes dairy but excludes eggs and honey, as well as root vegetables
Macrobiotic diets
Consist mostly of whole grains and beans.
a vegetarian diet with lots of
fruits & veggies and less of total, saturated and trans fats may help in preventing diabetes
Nutrition has known to play an important role in the prevention of Type 2 Diabetes, managing existing diabetes (type 1, type 2, and gestational diabetes) as well as in preventing or reducing the progression of diabetes-related complications. There have been several nutritional approaches suggested for prevention and management of diabetes.3 Since consumption of red-meats has been found to be strongly associated with higher risk of developing diabetes, a vegetarian diet with increased intake of fruits and vegetables, decreased levels of total, saturated and trans
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fats may help in preventing diabetes as well as achieving good glycemic control. Displacement of saturated fat and increased intake of fibre have been seen as general reasons for increasing fruit and vegetable consumption. Further, increased fibre intake may improve glycemic control in diabetes.4 Vegetarianism is the practice of abstaining from consumption of meat, red meat, poultry and seafood. It may also include abstention from by-products of animal slaughter, such as animal-derived rennet and gelatin. There are several types of vegetarianism, which exclude or DiabeticLivingOnline.in
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WorldMags.net include various foods. In India, vegetarianism is usually synonymous with lacto vegetarianism (i.e. inclusion of dairy products in the diet but not eggs). According to the 2006 Hindu-CNN-IBN State of the Nation Survey, 31% of Indians are vegetarians, while another 9% consumes eggs, while other surveys
vegetarian
cited by the Food and Agriculture Organization of the United Nations (FAO) estimate 20% - 42% of the Indian population as being vegetarian.5,6 A balanced vegetarian diet with emphasis on plant foods such as fruits, vegetables, whole grains, legumes and nuts, can easily meet the nutritional recommendations and
diet is linked to a greater improvement in quality of life & mood
scientific studies on effect of different types of vegetarian diets on metabolic parameters Author (Year)
Place
Number of Subjects
Methodology
Me Result/ Conclusion
Tonstad et al (2011) [Adventist Health Study-2]8
United States of America and Canada
15,200 men and 26,187 women
Participants across the U.S. and Canada who were free of diabetes were grouped as vegan, lacto ovo-vegetarian, pesco vegetarian, semi-vegetarian or non-vegetarian (reference group). A follow-up questionnaire after two years elicited information on the development of diabetes.
Vegetarian diets (vegan, lacto ovo, semi-) were associated with a substantial and independent reduction in diabetes incidence.
Kahleova et al (2011)9
Europe
74 subjects with Type 2 diabetes on oral hypoglycemic agents
24-week, randomized, open, parallel design was used. Seventy-four patients with Type 2 diabetes were randomly assigned to either the experimental group (n = 37), which received a vegetarian diet, or the control group (n = 37), which received a conventional diabetic diet.
A calorie-restricted vegetarian diet had greater capacity to improve insulin sensitivity compared with a conventional diabetic diet over 24 weeks.
Yang et al (2012)11
China
169 healthy Chinese lactovegetarians and 126 healthy omnivore men aged 21-76 years were enrolled.
Cardiovascular risk points and probability of developing CVD in 5-10 years in participants aged 24-55 years were calculated.
Lacto-vegetarians had remarkably lower body mass index, systolic and diastolic blood pressure, and serum levels of triglyceride, total cholesterol, low-density lipoprotein cholesterol, serum creatinine, uric acid, fasting blood glucose, as well as lower total cholesterol/high-density lipoprotein cholesterol ratio. Vegetarians also had higher homeostasis model assessment cell function and insulin secretion index
28 Diabetic Living july-aug 2013
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WorldMags.net may have a number of benefits over a meat-based diet for the prevention and management of diabetes and its related complications.7 Scientific studies indicate that individuals following vegetarian diets are about half as likely to develop diabetes, as compared to non-vegetarians. Studies in the past have reported a significantly lower risk of diabetes in vegetarians as compared to non-vegetarians, while on the other hand there have been strong relationship between self-reported diabetes and increasing frequency of meat consumption, even after adjusting body weight, other dietary factors, and physical activity. These findings were strengthened with new evidence in a recent study (Adventist Health Study 2), which demonstrated a significantly lower risk of diabetes in vegetarians and vegans compared with nonvegetarians.8 Studies have also shown that a calorie-restricted vegetarian diet had greater capacity to improve insulin sensitivity among diabetics as compared to a conventional diabetic diet over a period of 24 weeks.9 The addition of exercise training further augmented the improved outcomes with the vegetarian diet. Vegetarian diet has also been associated with a greater improvement in quality of life and mood.10 In clinical trials among individuals with type 2 diabetes, low-fat vegan/ vegetarian diets have shown to
Conclusion: Thus to conclude we can say, a diet that might serve the purpose of both preventing diabetes in healthy subjects and contribute to glycemic control in patients with diabetes should contain complex carbohydrates and low Glycemic Index foods (GI <55), abundant fibre (25–40 g/day) from wholegrain foods, fruits and vegetables, including pulses and nuts, lower intake of saturated fats (less than 10% of total energy/day), optimal ratio of essential fatty acids/ day [linoleic acid (LA; omega 6 fatty acids) 5–8% and alpha linolenic acid (ALA; omega 3 fatty acids) 1–2 % of total energy], optimal ratio of LA/ALA 5–10, cis monounsaturated fatty acids (MUFAs) 10–15%, slightly higher protein intake (10–15% of total energy/day), negligible amounts of trans fats (<1% of total energy; hydrogenated oils; vanaspati and margarines) lower intake of salt (< 5 g/day). It should include low-fat dairy products and avoid simple sugars, especially those found in sweets, sodas and fruit juices.14
low fat vegetarian diets have
shown to improve glycemic control to a larger extent than conventional diabetes diets WorldMags.net
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WorldMags.net improve glycemic control to a greater extent than conventional diabetes diets. Although, this effect is primarily attributable to greater weight loss, evidence also suggests that reduced intake of saturated fats and high-glycemic-index foods (GI ≥70), increased intake of dietary fibre and vegetable protein, reduced concentrations of intra myocellular lipid (fats stored in muscle cells) and decreased iron stores mediate the influence of plant-based diets on glycemic control.12 Most nutrients, foods and dietary patterns showing a benefit on diabetes are associated with reduced biomarkers of inflammation and endothelial dysfunction and, more importantly, with protection from cardiovascular diseases.13 The presently available literature indicates that vegetarian diet present potential advantages for the management of type2 diabetes. It is the position of the American Dietetic Association that appropriately planned vegetarian diets are healthful, nutritionally adequate and may provide health benefits in the prevention and treatment of certain diseases.7 However, a vegetarian diet high in total, saturated and trans fats, providing simple sugars with negligible amount of fibre can increase the risk of developing diabetes especially among people in the high risk group and can also complicate
vegetarian diet present potential
advantages for the management of type2 diabetes 30 Diabetic Living july-aug 2013
the glycemic control in patients suffering from diabetes.
references
1. Misra A, Singhal N, Sivakumar B, Bhagat N, Jaiswal A, Khurana L.Nutrition transition in India: secular trends in dietary intake and their relationship to diet-related noncommunicable diseases. J Diabetes. 2011 Dec; 3(4):278-92. 2. Misra P, Upadhyay RP, Misra A, Anand K. A review of the epidemiology of diabetes in rural India.Diabetes Res ClinPract. 2011 Jun; 92(3):303-11. 3. Ajala O, English P, Pinkney J. Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. Am J Clin Nutr. 2013 Mar;97(3):505-16. 4. Chandalia M, Garg A, Lutjohann D, von Bergmann K, Grundy SM, Brinkley LJ. Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. N Engl J Med. 2000 May 11;342(19):1392-8. 5. The food habits of a nation, The Hindu. URL: http://en.wikipedia.org/wiki/ Vegetarianism_by_country. (assessed Feb 16, 2013). 6. 2.3 Growth and Concentration in India FAO Document Repository. URL http://www. fao.org/WAIRDOCS/LEAD/X6170E/x6170e09. htm (assessed Geb 16, 2013) 7. Craig WJ, Mangels AR; American Dietetic Association. Position of the American Dietetic Association: vegetarian diets. J Am Diet Assoc. 2009 Jul;109(7):1266-82. 8. Tonstad S, Stewart K, Oda K, Batech M, Herring RP, Fraser GE. Vegetarian diets and incidence of diabetes in the Adventist Health Study-2. NutrMetabCardiovasc Dis. 2011 Oct 7. 9. Kahleova H, Matoulek M, Malinska H, Oliyarnik O, Kazdova L, Neskudla T, Skoch A, Hajek M, Hill M, Kahle M, Pelikanova T. Vegetarian diet improves insulin resistance and oxidative stress markers more than conventional diet in subjects with Type 2 diabetes. Diabet Med. 2011 May;28(5):54959. 10. Kahleova H, Hrachovinova T, Hill M, Pelikanova T. Vegetarian diet in type 2 diabetes--improvement in quality of life, mood and eating behaviour. Diabet Med. 2013 Jan;30(1):127-9. 11. Yang SY, Li XJ, Zhang W, Liu CQ, Zhang HJ, Lin JR, Yan B, Yu YX, Shi XL,
Li CD, Li WH. Chinese lacto-vegetarian diet exerts favorable effects on metabolic parameters, intima-media thickness, and cardiovascular risks in healthy men. Nutr Clin Pract. 2012 Jun;27(3):392-8. 12. Barnard ND, Katcher HI, Jenkins DJ, Cohen J, Turner-McGrievy G. Vegetarian and vegan diets in type 2 diabetes management. Nutr Rev. 2009 May;67(5):255-63. 13. Salas-Salvadó J, Martinez-González MÁ, Bulló M, Ros E.The role of diet in the prevention of type 2 diabetes. Nutr Metab Cardiovasc Dis. 2011 Sep; 21Suppl 2:B3248. http://predimed.onmedic.net/Portals/0/ the%20role.pdf 14. Misra A, Sharma R, Gulati S, Joshi SR, Sharma V, Ghafoorunissa, Ibrahim A, Joshi S, Laxmaiah A, Kurpad A, Raj RK, Mohan V, Chandalia H, Krishnaswamy K, Boindala S, Gopalan S, Bhattiprolu SK, Modi S, Vikram NK, Makkar BM, Mathur M, Dey S, Vasudevan S, Gupta SP, Puri S, Joshi P, Khanna K, Mathur P, Krishnaswamy S, Madan J, Karmarkar M, Seth V, Passi SJ, Chadha D, Bhardwaj S; National Dietary Guidelines Consensus Group. Consensus dietary guidelines for healthy living and prevention of obesity, the metabolic syndrome, diabetes, and related disorders in Asian Indians. Diabetes Technol Ther. 2011 Jun;13(6):683-94.
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Dr Anoop Misra Chairman, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology; Director, Centre of Internal Medicine (CIM), Fortis Hospital, Vasant Kunj, New Delhi; Chairman, National Diabetes, Obesity and Cholesterol Foundation (N-DOC); Director, Diabetes and Metabolic Diseases, Diabetes Foundation (India) (DFI)
Dr Swati Bhardwaj Vice Head, Center for Nutrition and Metabolic Research (C-NET); Head, Nutrition & Fatty Acid Research, National Diabetes, Obesity and Cholesterol Foundation (N-DOC); Senior Research Officer (Nutrition), Diabetes Foundation (India) (DFI)
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reader survey
?
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how can we help you
thrive with diabetes?
Please take a few minutes to tell us what you think about this magazine. Then fold the survey, place it in an envelope, and mail (address on opposite side). Your comments will help us meet your needs as you live with diabetes.
1
Where did you get this issue of Diabetic Living magazine? At home A store Friend or family member Doctor’s office or clinic Other _____________________
name address city
state
pin
e-mail
3
Where else do you find diabetes education/support? Please check all that apply.
Diabetes education class(es) Registered dietitian Family doctor Endocrinologist In-person support group Online support group/community Magazines/books Videos/DVDs Online Other ________________________
6
How often do you look for diabetes or other health information online? Daily Weekly Monthly Less than once a month I have never looked online for diabetes information (please go to question 9).
7
1.
4
Please list the top three diabetes or health websites you visit.
What information do you feel has been missing from your diabetes education?
2. 3.
2
Why are you interested in reading about diabetes? Please check all that apply. I have type 2 diabetes For how long?_________ I have type 1 diabetes For how long?_________ I have pre-diabetes (elevated blood glucose) My child has diabetes I am the caregiver for an adult with diabetes Diabetes runs in my family I am a medical professional
5
Where do you access the Internet? Please check all that apply. At home At work Through a mobile device At the public library I do not have Internet access (please go to question 9). continue to back
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Which of the following would you like to read most in Diabetic Living? high interest
low/no interest
moderate interest
Diabetes medical news and research Everyday recipes 30-minute (or less) recipes Low-carb recipes Low-sodium recipes Special-occasion recipes Holiday recipes Recipes for two Dessert recipes What/how much to eat Getting started (newly diagnosed) Medication and treatments Diabetes procedures and tests Weight loss Easy exercises Reducing blood glucose and/or A1C Pain management How to avoid complications Mentally coping with diabetes Reducing stress Diabetes products and services Inspiration from people with diabetes Other
Is there anything else you’d like to tell us?
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Please indicate your level of agreement with the following statements that describe your feelings about Diabetic Living. neither agree disagree agree disagree agree completely
somewhat
nor disagree
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completely
The magazine is well-organised Articles do not give me enough information Articles are colorful and attractive The text size is too small to read The text size is easy to see and to read Stories inform and educate me Stories inspire me to take self-care actions Stories encourage me to talk to my doctor or health care provider I can get the same information elsewhere The magazine keeps me up-to-date on the newest information about diabetes The articles are difficult to understand The stories are realistic for someone with diabetes The magazine shows/describes people I can relate to
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infertile? get a
check diabetes
If you are facing difficulty with respect to conception, its time to check for ‘diabetes’ -By Dr. Kaustubh D. Kulkarni
34 Diabetic Living july-aug 2013
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D
iabetes and its complications are well documented in numerous research studies, and the complications include problems relating to fertility. Termed as a global epidemic, Indian Council of Medical Research in its India Diabetes study (ICMR – INDIAB) pegs the number of diabetics at 62.4 million. With such a vast footprint, steps that could prevent its complication/impact on the fertility potential of the couple along with improvement in quality of life is one of the major goals of any delivery package. The outcome of the couple’s quest for parenting involves getting to have a baby when they want and having it without complication (ante natal complications) both these are affected directly by diabetes. Diabetes Mellitus is associated with very subtle disorders and it affects, either directly or indirectly, various functions of the reproductive system. Subfertility, among both males and females, is one of the problems encountered because of uncontrolled blood sugar. Logically therefore, one of the most important preliminary tests in the infertility work-up of a couple is to rule out diabetes (blood sugar testing). Infertility has been a steadily rising problem among young couples, with researcher’s noting a whopping 50% jump in infertility rates since past three decades. A woman aged between 25–35 years suffering from diabetes is highly prone to urinary tract infections along with tubal infections. Tubal infections fall under the ambit of Pelvic Inflammatory Disease (PID), one of the major causes of infertility in India. Natural conception involves fusion of sperm and egg in the fallopian tubes. Any tubal infection or blockage reduces the chance of natural conception drastically. The causative factors of female Infertility can be loosely classified into hormonal imbalance, structural defects (inborn and acquired). Hormonal imbalance is one of the most common reasons resulting in infertility. Diabetes, on the other hand, is also a
Diabetes & Infertility
Dr. Tommaso Falcone, professor and chairman of the department of obstetrics-gynecology at the cleveland clinic, says diabetes and insulin-related infertility are quite common. Think of it this way: Insulin is a hormone. So when you have diabetes, or any form of insulin resistance, you have a hormone imbalance. When one hormone is out of balance, it can trigger a domino-like effect with the rest of your hormones, including estrogen, progesterone and testosterone levels. These hormone imbalances can cause a wide variety of side effects, ranging from ovarian cysts to erectile dysfunction and infertility. Fortunately, Dr. Falcone says that most cases of infertility, whether they are related to diabetes complications or not, can be treated. In cases where infertility is related to insulin levels, correcting the imbalance is often enough to result in a successful pregnancy. WorldMags.net
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combination of a balanced and nutritious diet & regular exercise along with drug compliance can ensure success in procedures like IVF
hormonal condition with a genetic base characterized by insufficient secretion of insulin from the pancreas or lack of its action on the target organs. Change in the level of insulin results in a domino effect, disrupting sex hormone equilibrium in both women and men. Diabetes can be unmasked by decadent lifestyle and can be suppressed by a disciplined lifestyle, good food habits, exercise, and hygiene. Hormone imbalance in females causes a variety of side effects like delayed menarche, menstrual irregularities, subfertility, and early onset of menopause. For women, efficient blood sugar control is of equal importance in the treatment of infertility and it can impede the best efforts of assisted reproduction. Diabetes can affect the embryo implantation and success of pregnancy. Combination of a balanced and nutritious diet and regular exercise along with drug compliance can ensure success in procedures like in vitro fertilization (IVF) Diabetes can exist as spectrum being a minor irritant to being a major hurdle depending on the strict control of blood sugar. Diabetes can be aggravated by bad lifestyle which includes lack of exercise, consumption of junk and ready to eat foods can mask the subtle 36 Diabetic Living july-aug 2013
changes induced due to borderline diabetes. This can result in full-blown diabetes directly affecting fertility too. Therefore, as a preventive measure regular blood sugar checks of a person having familial history can prove very useful in identifying the disease early. It is a well-known fact that endocrinopathies like polycystic ovarian disorder (PCOD) is a major cause of infertility. Change in the level of insulin results in a domino effect, disrupting sex hormone equilibrium in both women and men. Latent diabetes is one of the most common disorders which go hand in hand among patients suffering from PCOD. Women with PCOD are four to six times more prone to type II diabetes mellitus. Diabetes can play havoc in a women’s ante natal career as well. Women with diabetes are three times more prone to early pregnancy losses or miscarriage than their non-diabetic counterparts. They are advised to undergo regular blood sugar checks to manage diabetes. In males, diabetes can seriously affect the ejaculatory function which is one of the hidden but treatable causes of infertility. Excess circulating levels of sugar in the blood damages nerves and because of this condition, penile capillaries shut down leading
to decreased libido and erectile dysfunction. Diabetic males are at a disadvantage in terms of sperm quality and count too, when compared to non-diabetic subjects. A study noted severely altered semen parameters and hormonal profiles among diabetic males. Experts blame excess of sugar in blood which depresses the production of sperms. The biggest problem is the stigma and shame attached to the condition. Diabetes causes premature aging of body cells. The only solution is adequate, regular and timely diabetes management to help prevent or delay the progression of this lifestyle disorder. With good compliance, issues of erectile dysfunction and abnormal sperm count in males can even reverse it. With the use of patient- friendly hormone application gels and self-administration pens, women can ensure they stay on the treatment regime even on the move. Blood sugar testing strips and glucometers have redefined blood sugar control. With such comforts around, diabetes induced changes in fertility can be easily tackled.
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The writer is Clinical Director and Co-founder of Siddhi Life Assisted Reproduction Centre.
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when eyes speak
Did you know that that it is possible to detect kidney diseases through the eye in patients with type 2 diabetes -By Dr. Lloyd Vincent
T
oday, diabetic nephropathy or diabetic involvement of the kidney presents a major and growing health problem. There is a worldwide increase in the incidence of Type 2 diabetes (T2DM), and nephropathy is found in 40% of diabetic patients with about 10% going on to need dialysis and kidney transplantation. Diabetic nephropathy is today the most prominent cause of end stage renal disease (ESRD) in India. ESRD is responsible for elevated medical costs, and high death rates in these patients due to numerous complications. Furthermore, less advanced stages of diabetic nephropathy are also associated with higher death rates due to heart attacks or arrhythmia. Primary and secondary prevention of diabetic nephropathy is thus pivotal in preventing the progression of early kidney disease to end stage renal disease, ESRD. A recent study evaluated the value of using eye changes of diabetic retinopathy in predicting the occurrence of diabetic nephropathy (T2DM) in patients with Type 2 Diabetes. Value of predicting diabetic nephropathy based upon diabetic retinopathy has been suggested
38 Diabetic Living july-aug 2013
by some studies in the past. These observations have been recently confirmed by performing a metaanalysis of available results. A high diagnostic value of diabetic retinopathy in diabetic nephropathy screening has been found. The 26 trials with 2012 patients were assessed; all patients with nephropathy were evaluated by renal biopsies in T2DM patients with renal disease, together with retinal examination. When results were pooled, sensitivity of diabetic retinopathy to predict diabetic nephropathy was 65%, and specificity was 75%. If a severe form of retinopathy called proliferative diabetic retinopathy is present, it seems to be a highly specific indicator for diabetic nephropathy with the specificity being 98%. The authors concluded that diabetic retinopathy is useful in diagnosing or screening for diabetic nephropathy in patients with T2DM and renal disease. Proliferative diabetic retinopathy may be a highly specific indicator of diabetic renal disease. These data are of importance, as it is possible to prevent or to reverse diabetic kidney disease, even in a highrisk T2DM patient with long standing diabetes with intensive glucose control.
Progression of albuminuria in diabetes is significantly reduced by 10%, and its regression significantly increased by 15%. These data emphasizes the importance of detection of diabetic nephropathy, and of its early and intensive prevention. However, a very important spin off is also the fact that a nephrologist can prevent blindness by encouraging eye screening in his patient and also an ophthalmologist could aid early detection and prevention of progression of kidney disease in their patients.
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prevention of diabetic nephropathy is pivotal in preventing the progression of early kidney disease to ESRD
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Diabetic nephropathy risk factors
The writer is the Head of Department, Nephrology, Narayana Hrudayalaya Hospital
There are several factors that can increase your risk of developing diabetic nephropathy. These include: 1.Having chronically elevated blood sugar levels. 2.Being overweight or obese. 3.Smoking. 4.Having a diabetes-related vision problem (diabetic retinopathy) or nerve damage (diabetic neuropathy). 5.Having a family history of kidney disease or belonging to certain ethnic groups (African American, Mexican, Pima Indian) can also increase your risk of diabetic nephropathy. However, the factors listed above are the ones you can do something about.
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nocturnal hypoglycemia Nocturnal Hypoglycemia or Night Time Hypo is defined as hypoglycemia whilst asleep
N
octurnal hypoglycemia is a drop in blood sugar levels while a patient is sleeping. It is most commonly seen in patients with diabetes, and can pose serious health risks if it is not managed appropriately. One problem with hypoglycemia in general is a phenomenon called hypoglycemia unawareness, where people may not realize they have dangerously low blood sugar because the symptoms are often subtle, and this can be an especially big problem with drops at night, when patients aren't awake to take note of even slight physical changes. It can also happen when people do not eat a snack before bed, don't monitor their glucose levels enough, or exercise heavily before bed and fail to make up for it with additional nutrition. Patients with nocturnal hypoglycemia will experience night sweats and can wake up with a headache and a feeling of being generally run down. Their blood sugar levels in the morning may also be very low. Symptoms of Nocturnal Hypoglycemia are usually only realised once waking up from a hypo. In patients who need insulin therapy, nocturnal hypoglycemia can be a reflection of the need to change the dosage or switch medications. Due to their nature, you will usually only
40 Diabetic Living july-aug 2013
Causes of nocturnal hypoglycemia For people with diabetes, nocturnal hypos are generally related to the level of medication taken and other activities earlier in the day. For people without diabetes, night time hypoglycemia may result from fasting or could be a reaction to food eaten close to going to bed in the case of reactive hypoglycemia Chances of having night time hypos may be increased by the following: • Physical activity during the day can increase insulin sensitivity which can lead to night time hypoglycemia, particularly for the first night after a sustained session of activity • Absence of a night time snack when one is usually taken • Alcohol consumption • Too high a level of basal (background) insulin • Following a period of illness
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find out about having a hypo during the night after waking up from a hypo. Therefore people may not even be aware that they are having night time hypos, so it’s useful to be able to spot the signs and symptoms of when nocturnal hypoglycemia may be taking place. Whilst nocturnal hypoglycemia is most common in insulin users, it can also occur for people who take oral anti-diabetic drugs.
Nocturnal hypoglycemia in children For parents on children with diabetes, nocturnal hypoglycemia can be particularly worrying. Parents of diabetic children may wish to check their child’s neck whilst they are sleeping if they are worried that night time hypoglycemia may be occurring.
Treating night time hypoglycemia Night time hypoglycemia can be treated by having 10 to 15 grams of quickly absorbed carbohydrate, which should raise blood sugar levels back to normal. This should be followed by some slower absorbed carbohydrate such as bread, fruit or milk to maintain blood sugar levels until breakfast.
Preventing nocturnal hypoglycemia It may be possible to prevent nocturnal hypoglycemia by having some slow acting carbohydrate or food containing a good source protein before bed. People with diabetes on insulin or other blood glucose lowering medication may need to decrease dosages if nocturnal hypoglycemia happens regularly. Speak to your doctor for advice on whether to change your dosage.
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Symptoms of night time hypoglycemia Some people may wake up mid way through a hypo and it is also possible to sleep through hypos. Signs of night time hypoglycemia can include: • Waking in the middle of night • Confusion upon waking • Difficulty waking • Waking with a headache • Waking with sweaty bed clothes • Feeling tired despite a full night’s sleep • Bad nightmares • Talking, shouting or screaming whilst asleep • Parents of children susceptible may wish to check their children at night for signs of hypoglycemia. A clammy neck can be an indication that a child has been hypo. DiabeticLivingOnline.in
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Wellbeing
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strengthen your inner self Use the power of mystical science of tai chi to combat stress, ailments and anxieties -By Khursheed Dinshaw
T
ai Chi Chuan or Tai Chi literally translates as supreme ultimate fist and is a Chinese martial art form. Unlike other martial arts, it has both hard and soft forms. The hard form is meant for self-defence and was originally used for combat and warfare. Most of the techniques are targetted at the joints, nerves, internal organs and energy points. The soft form is a camouflaged version of the hard form. It exercises the body and mind and in the process, raises ones spiritual level. Although it was originally a form of martial art, Tai Chi is widely practiced for good health and longevity. It was designed to work with your body’s energy systems, also known as meridians in Chinese medicine. It is popularly described as a moving meditation because the movements are slow, evenly paced and like a flowing river. Its continuous movements are based on the principle that running water never stagnates. Some call it Chinese Yoga because it is a combination of physical exercise, breathing techniques and meditation. It is a form of exercise characterised by slow moving forms varying in sequence and postures, performed in a relaxed and conscious manner, creating vitality with calmness, balanced strength with flexibility, and controlled energy with awareness. “While practicing the authentic Yang-style Tai Chi, the spine remains straight, the movements are rhythmic and gentle. The pulse rate does not go up, breathing remains the same but you sweat like in any other form of exercise. At the end of each practice session, one feels
42 Diabetic Living july-aug 2013
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WorldMags.net more energetic,” explains Sifu George Thomas, head of the authentic Yang family Tai Chi in India, who has been authorised by the Grand Master and the World Yong Nian Tai Chi Federation. Initially, one tends to focus only on the movement but then, the grace and joy of doing Tai Chi steps in. Learning new movements helps in brain synchronisation. It is gentle and safe for all trimesters of pregnancy because it is done slowly while standing up. “Physically, it will correct many side effects of pregnancy. It helps prevent back pain, swelling in the hands and feet and prevents excessive weight gain. Tai Chi helps strengthen the body and prepare it for labour and delivery,” explains Thomas, the Founder and President of Fu Sheng Yuan Tai Chi Academy-the India Chapter, which he established in Chennai in 1998 and later set up branches in major Indian cities. Emotionally, Tai Chi can help calm your mind and alleviate the feelings of stress and worry associated with the changes in life brought about by pregnancy. Because it teaches you deep breathing and meditation techniques, it
people who actively practice tai chi experience peace reigning inside their body, mind and soul too
tai chi teaches you deep breathing and meditation
techniques, it helps you relax and feel more balanced and centered helps you relax and feel more balanced and centered. People who practice the exercise experience peace inside them. Over the time, they respond to stressful situations differently and feel more in control of their thoughts and reactions. Research proves that Tai Chi lessens the incidence of falling, a common concern in pregnancy and improves muscle tone and flexibility, which supports the changes in your body due to pregnancy. It calms anxiety and feelings of stress, thus helping to create mental clarity and easing the emotional side effects of pregnancy. It lowers high blood pressure and assists in labour by strengthening the pelvic muscles. “Tai Chi increases your immune system, keeping you well during pregnancy. It improves your daily energy levels, fighting against fatigue which is a common complaint in pregnancy. It also helps by reducing pain levels in the body, which sometimes occur in the last trimesters,” adds Thomas. It is believed in Chinese medicine that practicing Tai Chi can improve the functioning of your brain and internal organs. Additionally, it is believed that the exercise will help regulate your body chemistry by normalising the function of your endocrine system which affects hormonal release. Very often, pregnancy problems can be related to hormonal imbalances which can be corrected with
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regular Tai Chi practice. Even though Tai Chi is often called Chinese Yoga, it is very different in actual practice. Although both are holistic practices— meaning they affect the body and mind—each is performed in varied ways. Yoga involves lying on the floor, bending over and holding postures for long periods of time, making it dangerous for inexperienced pregnant women. Additionally, because of the constant bending over and getting up and down off the floor, doctors do not recommended Yoga during second and third trimester unless you are already an experienced and very fit yoga practitioner. “In Tai Chi, you are always moving slowly and standing upright which greatly reduces any chance for injury. Unlike other exercise forms, no special facilities or equipment are required for it and it can be practiced at home, in a park or any other open space. It is not time-consuming either—one needs to set aside just 21 minutes a day for it,” explains Thomas. Tai Chi uses a range of movements which reflect the pregnant woman’s capacity. Since the exercises are taught and practiced at a slow pace, they are easily grasped. Any loose clothing and comfortable shoes are suitable for Tai Chi and like any other exercise, the best time to practice it is early morning or early evening (at sunrise or sunset time).
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being healthier Want to become a healthier person? It is all about making gradual changes -By Ashish Thomas
44 Diabetic Living july-aug 2013
A
healthy body and mind will make it easier to survive your teenage years. Looking after your body by exercising regularly, eating well, getting regular sleep and reducing stress can make you feel good. Feeling good about yourself can affect the way you think and feel. It can give you the confidence to help you achieve what you want in life. “I am running out gas”or “I feel
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total wellness goes beyond balanced diet and regular exercise
like I’ve got a flat tyre.” These days sometimes it is hard to tell whether a person is talking about their car or their health. Then again we need both our bodies and our cars running right if we want to get around. Here are some handy hints on how to live a healthy life and look after yourself.
what’s on your plate?
Most people are creatures of habit. We go to the grocery store and fill our carts with the same stuff. We are so used to eating a certain way that we rarely think about what we are actually putting into our bodies. So to eat a healthier diet means actually waking up and paying attention to what is there on your plate.
observe your current eating habits
Track everything that goes into your mouth, including drinks and treats, no matter how small. Keeping a food journal will surely open your eyes – realizing that you ate 10 cookies over the course of the week might make you think twice before reaching the cookie jar again tonight. You might not realize how bad your present eating habits are until you see an unhealthy pattern right there in black and white.
your body wants healthy food!
If you know you need to eat more fruits, start by adding some sliced bananas to your cereal in the morning or bake an apple with a bit of brown sugar for a yummy, low-cal dessert.
Fresh berries and yogurt make a nice, light breakfast or snack too. As you adopt this new style of eating, you will find that your food preferences will gradually change – when you cut out high sugar, high fat goodies, your cravings will actually go away in time. One of the biggest challenges to eating healthier is finding substitutions for existing foods in your diet. Here are some tips to make the transition easier: Select whole wheat bread over white bread - Be sure to
read the label to ensure getting whole grains, not just colorized white bread. Eat the white meat - Chicken, which is lower in fat than dark meat, red meat and pork. Animal fat is the number one dietary source of unhealthy saturated fat. Change your cooking methods
Bake, grill or broil your meals instead of frying. Use non stick sprays, non stick pans- instead of oil. Drink more water - Slowly reduce the amount of soda you drink and replace it with herbal tea or water. Aim for eight cups of water each day. Don’t drink your calories - Eat a whole orange instead of drinking
a glass of juice. For example real food is usually more filling and more nutritious than juices, fruit drinks, and other high calorie beverages. Serve sauces and dressings on the side - Dip your fork into the
sauce and then dip your fork in the food. You’ll still have the flavour but with fewer calories. Gradually switch to skimmed milk - Milk commonly comes in
four varieties: Whole (4% fat), 2%, 1% and skim (0% fat). Gradually wean yourself from the higher fat varieties to the lower fat milk every two weeks. For example: Continue drinking your normal 2% milk for two weeks, then move to 1% for 2 weeks, and then your palate will be ready for the consistency of skimmed milk. Switch from full-fat cheese to reduced-fat or fat-free cheeses - the same way you would
with milk. Order vegetables on the side instead of fries - Flavour them
with lemon juice or herbs instead of butter. Snack on fruit and nuts instead of sugary treats - The
fibre, protein and healthy fats in this
Cutting back on “sit” time
is just as important as increasing “fit” time More recently, studies have found that people who spend more time each day watching television, sitting, or riding in cars have a greater chance of dying early than people who spend less time on their duffs. Researchers speculate that sitting for hours on end may change peoples’ metabolism in ways that promote obesity, heart disease, diabetes, and other chronic conditions. It is also possible that sitting is a marker for a broader sedentary lifestyle. Some ways to get you off your seat: Turn off the television, and catch up on chores or play with the kids. Stroll down the hall to chat with a colleague, instead of sending an email or picking up the phone. Walk or bike for errands instead of driving. WorldMags.net
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WorldMags.net combo will sustain you to your next meal and you won’t have the energy slump that comes after eating candy. Reduce your portion size -
Start putting your meals on smaller plates. Eating a healthier diet does not have to mean deprivation. You don’t have to cut out your favourite foods completely - you just have to make few changes. Treat yourself to a mini chocolate bar instead of a full sized one. By trying to eat the most nutritious foods possible, you are creating a healthy lifestyle that will help you reach your best weight.
stay active
Workouts help you lose weight. Exercise helps flush toxins from your body and skin, giving you a healthy glow. It can also help you improve your posture and muscle tone, which can help you look and feel better. It does not take marathon training to see real health gains. A 30-minute brisk walk on five days of the week is all that most people need. Or you can do 25 minutes of vigorous activity- jogging, step aerobics, or single tennis on three days of the week. You can also do a combination of both. Getting any amount of exercise is better than none. A lot of activities count as exercise: dancing, skating, gardening, cycling, scrubbing floors, washing the car by hand, playing with kids, in short anything that gets you moving.
Sleep well
life is too short to be miserable,
so start turning your thinking around! Don’t have the free time to go to the gym? Weave activity into
your day by bicycling or brisk walking to commute to work, to go to the store, or to drop and bring your children back from the school.
The term “beauty sleep” exists for a reason. When you rest, your cells - including the ones in your skin -basically repair themselves. Getting a good night’s sleep is one of the most important things you can do for your overall health and well-being. Adequate sleep gives your body time and energy to recover from the day’s stresses, and helps you to stay sharp and focused throughout your day. Lack of sleep can not only give you puffy eyes with dark circles under them, it can make your skin look dull, dry, and lifeless. So definitely try not to skimp on sleep if you want to look your best. 46 Diabetic Living july-aug 2013
manage stress - optimism
How you feel on the inside can have a huge impact on how you look on the outside. Stress, anxiety, depression, and other things that affect your emotional health have been linked to negative physical changes. A positive outlook on life strengthens the immune system, cardiovascular system and the body’s ability to handle stress. Optimists believe that their own actions result in positive things happening, that they are responsible for their own happiness, and that they can expect better things to happen in the future. Optimists don’t blame themselves when bad things happen. Optimism is a skill of emotional intelligence, which translates to a better career and a greater success in life. Life is too short to be miserable, so start turning your thinking around! Positive thoughts, an optimistic outlook, and happiness can advance your prospects for work and a healthier living. Being healthy is not only being free of illness or disease, but a state of being and of mind. Total wellness goes beyond a balanced diet and regular exercise. To be truly well, we should also be emotionally happy, socially connected and able to contribute to the society around us.
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Wellbeing
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power up Power Yoga is the new way to stay fit, has the potential of emulating a rigorous full-body workout, promotes mental stability and concentration -By Ashish Thomas
P
ower Yoga is the Western version of the Indian Ashtanga Yoga which emphasizes developing one’s physical flexibility and nurtures the desire for self-discipline. The name Power Yoga says it all. It is one of the several types of Yoga that has the same potential of emulating a rigorous full-body workout and promotes mental stability and concentration. Be forewarned though that Power Yoga practice may hurt at first.
48 Diabetic Living july-aug 2013
The concept of Power Yoga was introduced to the West by devotees of Sri K. Pattabhi Jois, a renowned Sanskrit scholar who inspired Western Yogis with his Ashtanga Yoga style and philosophies. It’s a small wonder why Power Yoga is considered as the Western version of the Indian Ashtanga Yoga. The term “Power Yoga,” however, was coined by Ashtanga Yoga teacher Beryl Bendere Birch, author of the widely-read book Power Yoga: the Practice.
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power yoga is also done for warming up our body.
The benefits of Power yoga are immense. As you complete a series of postures of power yoga, you will be able to stretch and strengthen your body and have a relaxed and calm mind. The most prominent benefits offered by power yoga are: 1. Improvement in joint flexibility 2. Improved muscle strength and also tones them 3. Increased physical endurance and stamina 4. Corrects posture 5. Makes more mentally aware 6. Flushes out toxins and cleans up the system 7. Increases the ability of focusing and concentrating 8. Eases out tension and stress 9. Reduces aches triggered by stress 10. Offers overall relaxation of mind and body
it helps in achieving high levels of awareness, besides eliminating harmful bacteria from our body
It is basically a term used by the people belonging to the western part of the world for describing a fitness based, vigorous approach of performing yoga of vinasya style. Power yoga is described as one of the variants of Ashtanga yoga. This technique was modified to allow people in performing yoga in a more energetic, lively and appealing way. These features make it extremely popular among the people of the modern generation. The emphasis of this yoga variation is mainly on the fitness of the performer. You must have higher levels of flexibility and fitness for getting involved in this yoga form as majority of the power yoga poses are extremely difficult. The first step of power yoga training revolves around two significant approaches, synchronizing your mind and body and flushing out the toxins from your body. The next step of power yoga training will concentrate on increasing your muscle flexibility and stamina and will also work by cleansing your nervous channels. Other than the above mentioned benefits, power yoga is also done for warming up our body. This not only helps people in achieving high levels of awareness, but also eliminates the harmful bacteria from our body. Power Yoga is done by doing a series of Yoga Poses while synchronizing one’s breathing patterns to each movement, or Vinyasa, resulting in actions with perfect unity and grace. In the eyes of a person who does not practice Yoga, the movement may seem soft and free-flowing, comparable to a trancelike dance. But in the perspective of a Power Yogi, the process is like a vigorous exercise, pushing and contorting every limb to its limit while maintaining a strong sense of inner peace and concentration to pull off
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WorldMags.net each move flawlessly and gracefully. Keep in mind that the transitions of the Yoga Poses are done in a slow yet steady pace. Some poses are even held longer than the required five breaths. This is the aspect of Power Yoga that raises one’s physical endurance and the ability to focus on one task for a long period of time without breaking one’s concentration. Initially, the sole purpose of practicing yoga was to experience spiritual enlightenment. In Sanskrit (the ancient language of India), yoga translates as “yoke” or “union,” describing the integration of mind and body to create a greater connection with one’s own pure, essential nature. Power Yoga is usually done in a heated room for a Yogi to achieve optimum muscle flexibility. This is because the moves involved in it can be very painful to successfully pull off to those who are new to Power Yoga. Therefore, it is imperative to condition the body before going through this rough and rigorous type of Yoga. This feature of Power Yoga limits the Yogis to those who are physically fit and are not suffering from chronic ailments. To get the full benefits of a power yoga practice, make sure you tailor your practice to your goals and don’t sacrifice the importance of basic yoga principles in favour of a hard workout. The following steps are a great way to combine the mental, physical, and spiritual benefits of yoga: Choose the right time of the day You might want to do power yoga first thing in the morning, when an energetic routine is most likely to get you going for the rest of the day. Try pairing that practice with a very short, relaxing routine at night if you can. Even just a few poses may help you sleep and set the tone for the next morning. Learn to breathe Whatever your level, yoga always starts with breath. Breathing properly will help you keep your rhythm throughout the class, know your limits, and maintain good habits. When your breathing and your asanas (poses) are in perfect sync, you’ll really feel the flow of power yoga. 50 Diabetic Living july-aug 2013
Start easy, and then work your way up Many students who pick a power yoga class or home practice do so because they’re hoping to achieve health benefits or want an aerobic workout. Power yoga offers these things, but it’s important to remember that the benefits of yoga accrue slowly, over time. Don’t get frustrated if you need to pause in a class and rest in child’s pose, downward dog, or savasana. The only important thing is
to breathe. If you are breathing, you are practicing yoga. Always take take in Savasana Lie flat on your back, legs slightly apart, palms facing up at your sides. Let your feet fall open and your eyes close. Breathe deeply and concentrate on your breath. This asana is more beneficial than all the others combined, and is a great time to soak in the benefits of your challenging practice.
Power yoga still focuses on the general aim of classical yoga, which is to unite the body, mind, and spirit. It uses traditional yoga practices in order to tap in to the inner core of one’s power and to help this individual to recognize the different levels of power which are: 1.The physical power which is developed, poses in power yoga resulting in an improvement of the body’s natural strength and health. 2.The mental power or the willpower, which is disciplined during the course of the practice as it clears the mind of unorganized thoughts and helps the self to concentrate on a single task. 3.The spiritual power, the driving force behind one’s physical and mental power, is nurtured, allowing complete mastery of one’s thought and actions. It is through Power Yoga that a person can achieve total unity since it connects the body, mind, and spirit in the deepest level. WorldMags.net
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Volume VII Issue VII July 2013
www.spiceroutemag.com
The inflight magazine of SpiceJet
GROUP
REEL REALITY
ANIMALS TURN ACTORS
EDIBLE COCKTAILS HOW ABOUT EATING THEM RIGHT?
DHARAMSHALA 2
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SOMEWHERE EXTRAORDINARY
Wellbeing
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the midas touch
Reiki - the Japanese art of healing, not only helps to feel calmer, content and serene, feel more positive, better able to cope, and not get affected by stressful situations, it also helps to fill that spiritual void and find true life purpose -By Dr. N. K. Sharma
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eiki is a Japanese art of healing which has its origin in the ancient Indian knowledge. It has become popular in the West as well as in the East. After making an in-depth study of the subject, Dr. Mikao Usui of Japan invoked his own energy centres through strenuous meditation and fasting regimes thus developing it as an art. He has made an intensive research on the writings of the disciples of Gautam Buddha. It is based on the idea that an unseen “life force energy” flows through us and is what causes us to be alive. If one’s “life force energy” is low, then we are more likely to get sick or feel stress, and if it is high, we are more capable of being happy and healthy. It’s a very easy divine natural healing system without any side effects. It involves flow of powerful positive energies through touch of hands on the problem areas of the body. It has done wonders and has treated lay person as well as highly qualified doctors. It has become so popular that many people have opted to learn this simple technique of cure for their benefit. And the best part of Reiki is, any body can learn it in a very short period of time and heal his/her own self and others. In its original form Reiki was a path to enlightenment, and this spiritual aspect has never really left Reiki, though it is usually presented as a treatment technique. So for many people, Reiki helps to fill that ‘spiritual void’, and also helps to find the true life purpose. It makes oneself feel more connected spiritually no matter what the religious beliefs might be. And because Reiki is not attached to any religion, it is not attached to any belief system. Reiki helps to feel calmer, content, and serene, it helps to feel more positive, better able to cope, and not so affected by stressful people and stressful situations. So people might come for a treatment with everything from depression to a pain in their big toe. And they all go away feeling calmer and content.
Reiki from a practitioner’s view Generally reiki practitioners feel a tingling sensation in their fingers after the session. A kind of heat is augmented which raises the energy flow in the body. Some people experience only the tingling sensation, while some experience both. Tingling isn’t so much like pins and needles, but more of a fine ‘fizzing’ in the hands. There is a whole range of different feelings like throbbing, pulsing, heaviness, magnetic feelings, coolness, or even a breeze blowing under the hand. Giving a Reiki treatment is an exquisite experience. Particularly, if there’s a lot of energy coming through, one can really ‘merge’ with the energy. It gives a complete sense of meditation that can take anybody in a different world of purity. And because one’s energy does not get drained, the practitioner does not even feel exhausted after the session. Overall, it’s a lovely experience and should be tried by all! WorldMags.net
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WorldMags.net Reiki does not mean overnight transformation, but usually something is experienced which can make oneself feel lighter and peaceful. It gives a sense of clarity and detaches oneself from all the clutters that surround people’s lives nowadays. Concentration power increases bringing more focus on the things that are really important, the real priorities. In simpler language, it’s a “kick start” that gears the tyre of life and helps to make the necessary alterations required. Various hospitals in India like Apollo, use Reiki widely. Reiki Healing Foundation, the world’s largest nonprofitable institute of Holistic Sciences, Delhi, has created wonders. People have experienced a life transforming sessions which have revolutionized the inner self of many.
reiki and spa Although Reiki is a spiritual practice, it is also considered to be an alternative therapy. Reiki treatment in spa centres is gaining wide popularity. It is becoming a premier choice of the customers along with the massage in the parlours. Reiki treats the whole body, mind, spirit and emotions while invoking the feelings of wellbeing, peace and security on the flip side. Reiki sessions generally start with an individual lying down fully clothed, with relaxing music in the background. The Reiki practitioner gently rests their hands in a series of positions, from the crown of the head to the feet. He holds the position for several minutes, then moves to the next position. A good Reiki session is deeply relaxing, calmer and balanced.Also, the practitioner’s own energy blockages are also cleared during a session. Within a few minutes of the therapy people experiences immediate stress relief, pain relief, deep relaxation, balanced chakras, and enhancing ability of body to heal. After a Reiki session of 40- 60 minutes, one can easily let go of tensions, anxiety, fear or other negative feelings. Individuals at the end of the session have generally reported a feeling of freshness, positivity, and calmness. The ‘big three’ 54 Diabetic Living july-aug 2013
after a reiki session of 40-60 minutes
one can easily let go off tensions, anxiety, fear or other negative feelings
where people pay to de-stress their mind, body and soul. Such relaxing therapies have left people asleep completely. A lot of heat is experienced from the practitioner’s hands. Another common experience is visualization of colours in the air with the closed eyelids. It is quite common to see colours like blue, lilac, violet and purple. In addition to stress-reduction, many other profound effects may unfold over time if one continues with this practice. Reiki starts from a point in the body, where imbalance begins. All superficial symptoms disappear and the body’s healing capacity gets enhanced.
sensations that are generally felt after receiving Reiki are bottomless relaxation, heat from the practitioner’s hands, and colour in the air. Reiki is paired with the treatments like skin-calming facials
The author is a Spiritual Mentor and Founder of Reiki Healing Foundation (RHF), world’s largest organisation in the field of Reiki Healing & Mystic Sciences. He can be reached at
[email protected]
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Medication
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home
remedies Medication is not always the last resort to problems related to health. Let’s take a sneak peek into some of the ways to treat diabetes at home -By Dr. N.K. Sharma
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illions of people all over the world are slacking rope between too little sugar in the bloodstream or too much. People with diabetes, deal with health problems every single day. If diabetes is poorly controlled or left untreated, it may lead to blindness, kidney disease, blood vessel damage, infection, heart disease, nerve damage, high blood pressure, stroke, limb amputation, and coma. Here we have a physician who talks about all the home remedies for diabetes including food remedies for weight control and blood sugar levels.
natural uncooked food: Natural uncooked food is the best medicine for all types of diseases. They have got their own enzymes. They are not diluted with chemicals. Food such as sprouts, fruits, juices, nuts and so on can be taken raw. Eating a diet rich in fibre helps the body to absorb sugars slowly, which in turn keeps blood sugar levels balanced. Soluble type of fibre does the best job of stabilising blood sugar levels. Apples, apricots, beets, berries, carrots, citrus fruits, parsnips, and winter squash are some fruits and vegetables which are rich in soluble fibre. Soluble fibre is also helpful in lowering elevated LDL cholesterol levels, a serious problem in many people with diabetes.
wholesome diet: Diet which is a combination of vegetables and fruits get a rich array of antioxidants such as vitamin C. Antioxidants prevents the oxidation and damage of artery walls, which otherwise can lead to plaque build up and heart disease.
helps to tackle the root cause of Type 2 Diabetes. Also, regular exercise can also help to reduce cholesterol levels and help people to reduce high blood pressure. Even a little extra activity each day can be of help.
meditation: Meditation lowers the insulin resistance in our body. Stress hormones such as cortisol, adrenaline and noradrenalin intensify the production of insulin and glucose levels. Reducing these neurohormones through the Transcendental Meditation Technique helps to balance glucose and insulin in the blood. This helps to normalise metabolic syndrome and diabetes.
eating a diet rich in fibre helps body to absorb sugars slowly, which in turn keeps blood sugar levels balanced
exercise: Exercise has the potential to control the diabetes by non medical means. It reduces the severity of the disease and significantly reduces the risk of long-term complications. The energy needed for exercise can help people to lose weight which helps to take some of the risk related to central obesity. Exercise is known to increase insulin sensitivity which essentially WorldMags.net
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WorldMags.net basil leaves: Basil leaves have the power to lower blood sugar levels. They contain potent antioxidants that relieve oxidative stress; it is this stress that compounds problems in diabetics.
cactus juice and flax seeds: Cactus juice is also helpful. It can help decrease and stabilise blood glucose and insulin levels. Consuming flax seeds reduces postprandial sugar level by 28 per cent.
leaves of bilberry plant and cinnamon: The leaves of the bilberry plant are known to lower blood sugar levels. Also, 1 gram cinnamon in the diet for a month lowers the blood sugar levels
green tea: This tea is unfermented and hence has high polyphenol content, which has strong antioxidant and hypoglycaemic effects. The polyphenols help in a controlled release of blood sugars.
drumstick leaves: The fibre content in the leaves increases satiety and slows the breakdown of food.
Unani medicines for diabetes:
kernel of jamun seeds: Jamun seeds are very
helpful in controlling sugar and help to ease from diabetic symptoms. Chewing of Jamun leaves are also suggested to patients with diabetes. karela bark (bitter gourd): Bitter melon has plant insulinpolypeptide-P, a bio-chemical useful in reducing blood sugar. Bitter gourd can also be used as bitter gourd recipe, bitter gourd tea, for preparing dishes, curry, and soup. neem: For diabetic treatment, tender shoot of neem is used. The extract should be taken in the morning for a better solution to diabetes. binola seeds: Reduces blood sugar due to the presence of natural antioxidants Borage oil. Other herbs and unani seeds like Bel Leaves, Falsa Berry and Kalonji or Black cumin are also used for curing diabetes as they reduce the blood sugar level. jambul (Indian blackberry): A glycoside present in the seeds of Indian Blackberry prevents conversion of starch to sugar. It lowers blood sugar and keeps sharp insulin spikes in check. This fruit also has heart-protecting properties. isabgol: Also known as psyllium husk is often used as a laxative. When isabgol comes in contact with water, it swells to form a gel-like substance. This slows the breakdown and absorption of blood glucose. Metformin, a drug commonly used in diabetic treatment, can upset your stomach for which isabgol works as a safe guard.
reflexology can enhance the production
reiki: Reiki is more effective than any other dummy treatment at improving the health. It balances the sugar level and natural energy flow in the body.
reflexology: Reflexology can enhance the production of insulin by helping the cells that produce insulin in the body. It is done by working on the pancreas and generally the endocrine (hormonal) system. The liver would be another key area to work on through reflexology, due to its processing functions being affected by an increase in blood sugar levels.
of insulin by helping the cells that produce insulin in the body
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The author is a Spiritual Mentor and Founder of Reiki Healing Foundation (RHF), world’s largest organisation in the field of Reiki Healing & Mystic Sciences. He can be reached at
[email protected]
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weight and
watch T
rying to lose weight but can’t bear the thought of giving up your favourite dish? Calories can be cruel. Sweat through a 30-minute workout and you can torch 200. Take three big gulps of a frothy frappuccino and you’re back to where you started. Don’t worry. Trimming more than 500 calories each day can lead to a weight loss of one pound per week.
Weight Loss
Making small changes in the way you eat and what you eat will lead you to shed those extra pounds and help you to look your healthiest best -By Ridhima Ahluwalia
Small changes in the types of food you eat and in the portion sizes you choose will quickly add up. Eliminating high-calorie foods and substituting lower calorie, nutrient-dense foods can provide you with the nutrients you need and help you shed extra weight. Here are few ways to help you reduce your calorie intake throughout the day and help you stay at a healthy weight:
1
Reduce Calorie intake: A simple and effective way to lose weight is to slash calories. Decrease the consumption of sweetened beverages. Getting rid of 3 servings of orange juice or soda daily can save 510 calories. Drink more water, unsweetened tea & coffee. WorldMags.net
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Ditch the large bag of chips: When you have got a craving for potato chips or any other snack, don’t just eat from the bag or box. Instead, stick to one serving of about 15 chips. This way, you know exactly how much you’re eating and aren’t left mindlessly munching until the bag is empty.
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Have Mini-meals: It has been suggested that eating five to six mini meals a day reduces blood sugar swings and out-of-control hunger. Ditch the three-square meal and try this method to lose weight. DiabeticLivingOnline.in
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Cut the soda: High in calories, soda has no nutritional value whatsoever. They contribute to obesity as well as diabetes, tooth decay and weakened bones. If you want to lose weight, giving up your soda consumption is probably one of the best beginning moves.
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Avoid Alcohol: No doubt that alcohol causes weight gain, because the calorie intake associated with alcohol might not be that big, but they are empty calories which take more out of your body than they give back. What’s worse, on top of the empty calories, alcohol increases your appetite, which adds even more unwanted calories. Drink in moderation and alternate each drink with water or skip the alcohol altogether.
6
Stay away from nuts: Avoid nuts if they’re served in a big bowl. Nuts may help the heart by reducing cholesterol levels but they are high in calories. One handful of oil-roasted mixed nuts has about 175 calories and three handfuls have about 525. To save more than 500 calories avoid nuts altogether.
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Have more of fruits and vegetables: Fruits and vegetables provide essential vitamins and minerals, fibre, and water that helps you stay fuller longer. Instead of 1 ounce of cheese and 2 ounces of meat in your sandwich, have one-half cup of fruits or vegetables to save 225 calories. Or, decrease your meat portion at dinner by 2 ounces and add 1/2 cup vegetables to cut 125 calories.
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Leave Enough Leftovers: Sometimes the food is so delicious that it’s hard to quit eating. But if you leave 25% of your food on the plate at every meal, you’ll cut 500 calories. Save what you don’t eat as leftovers for a yummy lunch the next day
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Get enough sleep : Those who don’t get enough shuteye are more likely to overeat than others. Getting less sleep causes us to crave sugary and fatty foods. Getting at least 8 hours of sleep per night will help curb those cravings. If it’s not possible to log more shuteye then alter your diet.
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Eliminate white food: Eating white bread, white rice and white pasta can increase your weight. The way your body possesses these foods, it can lead to cravings for more carbohydrates and also sugar. But if you avoid them, you decrease your food craving and making it easy to cut more calories and lose weight.
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Out of Sight, Out of Mouth: If you keep tempting food in front of you, you’re more likely to eat it. Avoid sweet treats or trigger foods in sight. Place the treats or snack foods on the highest shelf or hide the candy jar. It’s easier to avoid temptation when it’s not staring back at you every time you open the cupboard. WorldMags.net
Make simple changes Today!: Implement simple changes in your lifestyle that you can stick with for long. Reduce stress in your life. Take out some ME time. With little patience and planning you can cut down your calorie intake to reach your weight-loss goal.
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Limit Fried food: Avoid fried foods if you want to lose weight. French fries, deepfried foods, potato chips, onion rings, tempura and donuts are just a few of the common high-calorie and high-fat fried foods to avoid. Instead of frying, choose different cooking methods like baking, steaming or microwaving and you can save hundreds of calories.
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Tap your foot: A day just by tapping your foot or being restless or dancing for just two hours a day can burn up to 500 calories. While you’re on the phone walk or tap out a tune with your hands or feet. Do an hour of circuit training and you’ll burn 544 calories.
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Listen to your stomach: You may find that you’re not even hungry and are just eating out of habit! This will only lead to those tummy twinges. Instead of denying certain foods or limiting the calories, just listen to your stomach. Eat when you are hungry and stop when you are full. 62 Diabetic Living july-aug 2013
Use less of Condiments: A condiment is an edible substance that is added to some foods to impart flavour. Condiments like mayonnaise, salad dressings, dips and butter are all source of calories. For example, one tablespoon of mayonnaise contains 100 calories. If you want to cut calories and lose weight substitute low-calorie condiments like hummus, mustard, salsa or chutney.
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Don’t eat in front of the TV: If you watch TV while eating, you’re likely to eat more as it increases your appetite. Distraction increases our food intake. People who watch TV while eating ate up to 288 calories more than those who ate without the television on. So do yourself a favour, turn off the tube and trade that time of TV for a casual walk.
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Fitness
exercise
is the key
Amongst the multifarious benefits of exercising, it is to be noted that the biggest advantage lies in the fact that it is extremely useful for patients with Type 2 Diabetes given that it makes it easier to control one’s blood sugar levels -By Ridhima Ahluwalia
exercise tips for people with type 2 diabetics Exercise has so many benefits, and the biggest one is that it makes it easier to control your blood sugar level. People with Type 2 Diabetes have too much glucose in their blood, either because their body doesn’t produce enough insulin to process it, or because their body doesn’t use insulin properly. Along with diet and medication, exercise will not only help you lower blood sugar and lose weight, but also avoid longterm complications, particularly heart problems. Exercising helps you keep your heart healthy and strong and also maintain good cholesterol. If you’re ready to fight to reverse your Type 2 Diabetes, a pair of sneakers can be one of your best investments. Go and pick one up today and get started with a healthy regime.
keep moving Any type of aerobic activity, such as cycling, or fast walking, helps cells sop up sugar. One should aim to get at least 30 minutes of aerobic exercise most days of the week. If you think that you can’t find 30 minutes, you can start with 10 minutes and gradually increase your workout duration as you become more fit. If you pick activities that you enjoy, you’ll be more likely to stick with your exercise plan.
count your steps A pedometer is a good motivational tool for physical activity. A common goal of 10,000 steps a day is important. Walk at a fairly brisk pace of 3 kmph to get the health benefits of walking. Using a pedometer increases the activity by 27% and people lost more
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weight, had a greater drop in blood pressure and walked about 2,500 steps a day than those who didn’t use a pedometer.
friends with benefits Working out alone can be pretty difficult, but working out with friends can be another important motivator, especially for people over 60. Having a friend next to you to talk with while you slave away can make the time fly by and help you reach your exercise goal.
track your progress Write down what exercise you’ve done each day. It can really help you see how far you’ve come. Record on your calendar every day whether you exercised for 10 or 15 minutes or more. This helps you to see your DiabeticLivingOnline.in 63
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set specific goals It’s better to have specific goal while exercising. For example, set a goal of walking ten minutes every alternate day. Don’t set goals too. You are much more likely to be successful if you start with small, easily attainable goals and gradually increase them. This helps in increasing your sense of confidence.
flexibility training Another kind of exercise to do is flexibility training. It will improve how well your muscles and joints work. Stretching before and after exercise (especially after exercise) reduces muscle soreness and actually relaxes your muscles.
Strength training: Include strength training along
with aerobic activities as it gives you lean, efficient muscles and also helps you maintain strong, healthy bones. Strength training is very useful for Type 2 Diabetes because muscles use the most glucose, so if you can use them more, then you’ll be better able to control your blood glucose level. One of the most used strength training techniques is weight training. Lifting weights for 20-30 minutes two to three times a week is enough to get the full benefits of strength training. Set reminders: Set a daily reminder on your phone, or put a note on the refrigerator or keep your walking shoes next to the entrance as a reminder to go for a walk and it’ll be more likely to happen.
the ultimate goal People with Type 2 Diabetes should have an ultimate goal to lose a minimum of 1,000 calories per week via physical activity for health benefits, or 2,000 calories per week for weight loss. Keep in mind that these are goals that will help you lead a healthy life.
test yourself regularly Get your haemoglobin A1C and blood glucose test done regularly. Good test result encourages you to keep with an exercise programme, even when you feel tedious.
people with type 2 diabetes should aim at losing at least 1000 calories per week via physical activity
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don’t just make a commitment to exercise, make it a priority. your long term health depends on it
alternate plan You don’t have to go to the gym or play a sport. If you don’t like to exercise there are a lot of things you can do to be more active. Take the stairs when you can, or walk fast around the mall a few times when you go shopping. Try doing jump rope while watching TV. Make a list of some things you like to do. Hang it in your room as a reminder.
stick to the plan Not just make a commitment to exercise, make it a priority. Your longterm health depends on it, find time to motivate yourself to exercise and keep at it. It will help you lose weight (if you need to do that), and it will make your body more efficient at using its insulin and glucose.
keep a check on your weight Manage your weight as excess body fat, particularly if stored around the abdomen, can increase the body’s resistance to the hormone insulin. This can lead to Type 2 Diabetes.
drink water and have snacks handy Have plenty of water before, during and after you exercise. Keep yourself hydrated. Have a healthy snack during exercise to keep you energised.
eat healthy Incorporate a balanced and healthy diet in your mean. Reduce the amount of fat in your diet especially saturated
and trans fats. Eat more fruits, vegetables and high-fibre foods. Cut back on salt.
see your doctor See your doctor for regular checkups. As you get older, it’s a good idea to regularly check your blood glucose, blood pressure and blood cholesterol levels.
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be in charge of your diabetes Remember if you are suffering from Type 2 Diabetes, you need to choose healthy food, be active every day, take your medicine without fail. Taking care of your diabetes will help you stay healthy, feel better and keep your blood glucose where you want it to be. DiabeticLivingOnline.in 65
Fitness
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just right! 66 Diabetic Living july-aug 2013
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Do the workout but remember to find the right way out -By Dr. Atul N.C. Peters
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don’t get fooled by the term ‘spot reduction’, there is no such thing expand your lungs Music and physical strength compliment each other. Playing a musical instrument like saxophone which requires immense endurance, uses lung power and needs physical strength. You can develop lung power in the gym by breathing in the right way. It will help you go longer during your workouts too. For example, when you’re performing chest flies, your lungs expand with your rib cage, allowing more air to come in. Over a period of time this will increase your lung capacity.
check your heart rate Cardio exercises increase the stroke volume, which will result in a lower resting heart rate eventually. The cardiac input also is known as stroke volume, which is basically the volume of blood pumped by a heart ventricle with each beat. The target you have to maintain to melt fat is calculated by subtracting your age from 220. Maintain that figure for at least 20 minutes while working out. It’s why many people don’t burn fat even though they sweat over the treadmill for a long time… they’re not exercising at the optimum heart rate.
kill the fat
W
e all dream of a perfect body and for that we work hard too. We put so much effort, put in hours of workout, take supplements but do we actually get what we desire for. Here Dr. Atul N.C. Peters, Bariatric Surgeon & Fitness Expert for weight training for the last 25 years, suggest you some easy tips to do the right work out.
mind over muscle Lift your weights with your brain, not your limbs. For example, while performing dumbell curls, don’t consider the amount of weight and the number of reps you are going to do. Your mind should think of the main movement, which is contracting the biceps.
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Most people start with cardio and then move on to weights. You’re actually using the glycogen content during your cardio that would have fed your muscles. So your fat, which is ideally burnt after your glycogen reserves are depleted, gets burned when you lift weights. This is not a lot. Instead, you can warm up for five to seven minutes, followed by weight lifting and finishing off with cardio to burn maximum fat. Also, don’t get fooled by the term ‘spot reduction’. There is no such thing; you cannot lose fat from your belly by doing crunches. DiabeticLivingOnline.in 67
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even 20 minutes of workout when you’re travelling
is enough to help you stay in shape
You don’t need supplements
there’s always time
When you provoke your muscles to lift more, they don’t add fibre on their own. They require more nutrition to grow. Vegetarians (who have a tougher time building muscle) should consume 400gm worth of milk products to equate the protein from 100gm of chicken. Another thing you don’t require is vitamin pills. Just consume adequate quantities of vegetables and fruits, especially the ones in vitamin C as it repairs the wear and tear your muscles face in the gym. 68 Diabetic Living july-aug 2013
Indian man is not focussed enough, hence he makes excuses. Even 20 minutes of a workout when you’re travelling is enough to help you stay in shape. Always carry a workout DVD and a resistance band with you while travelling. They can work almost every part of your body. Pushups and free squats can be performed almost everywhere, but only in the privacy of your hotel room, not during that business dinner.
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The writer is Director of Institute of Bariatric, Metabolic and Minimal Access Surgery, Fortis Hospital, Shalimar Bagh, New Delhi & Fitness Expert for weight training for the last 25 years and has been practicing an Israeli form of self defense called ‘Krav Maga’.
Food
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grain of
thought
An underdog when it comes to making ostentatious meals, Barley is one grain that not only is a low glycemic grain, it can also be used as a delicious breakfast cereal -By Pallavi Singh
B
arley, an ancient grain is sadly overlooked by today’s culinary trendsetters, yet it is one of the grains with the greatest health benefits, delightful flavour and versatility. Barley can be used as a delicious breakfast cereal, in soups and stews and as a rice substitute for dishes such as dosa. Not only is barley a low-glycemic grain, it is high in both soluble and insoluble fibre. Soluble fibre helps the body metabolize fats, cholesterol and carbohydrates, and lowers blood cholesterol levels. Insoluble fibre - commonly called “roughage”promotes a healthy digestive tract and reduces the risk of cancers affecting it (e.g., colon cancer). Dietary fibre is critical to health - yet few people in our modern society even come close to the recommended daily intake. Many experts believe that good health begins in the colon, and without sufficient dietary fibre in the diet, we run the risk of a host of diseases, ranging from hemorrhoids to colon cancer. The fibre found in barley provides food for the beneficial bacteria in the large intestine. This is important as the “good” bacteria can crowd out the disease-causing bacteria in the intestinal tract, resulting in greater health and disease resistance.
Health benefits of barley 1. Controls blood sugar better 2. Lowers glucose levels 3. Barley beta-glucan lowers glycemic Index 4. Insulin response better with barley beta-glucan 5. Beats oats in glucose response study 6. Reduces blood pressure 7. Lowers serum lipids 8. Cholesterol and visceral fat decrease with barley 9. Significantly improves lipids 10. Barley pasta lowers cholesterol 11. Barley’s slow digestion may help weight control 12. Greater satiety, fewer calories eaten with barley WorldMags.net
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WorldMags.net Barley is sold in many forms, all of which are nutritious. But hulled barley, in which the outer hull (the bran) is left intact, is richer in fibre and contains more fibre and nutrients than other forms, such as Pearl Barley or Scotch Barley.
health benefits of barley for breakfast The benefits of eating barley for breakfast are numerous and welldocumented. A cereal grain taken from the annual grass called Hordeum vulgare, barley is so versatile that it presently offers itself up for use in many aspects. It is utilized in both stews and soups, barley bread of different cultures, animal fodder, as a malt base for beer and other kinds of distilled drinks, and a part of various types of health foods. A recent survey of different forms of cereal crops found barley to be ranked number four in the context of both its area of cultivation as well as the amount produced. One of the top reasons that barley is produced in such a great magnitude is due to the health benefits it provides for people who pick it as a part of their breakfast meal.
benefits for blood sugar Eating barley for breakfast can provide benefits to your blood sugar levels. Partially because of the eight kinds of essential amino acids that barley has, studies have found that regularly ingesting barley (the whole-grain kind) can actually control your blood sugar levels. Regularly eating barley can lessen the usual blood glucose reaction that people typically get after eating a meal. These blood sugar-reduction benefits were observed for up to 10 hours after each meal in people who regularly ate barley, and these observations were based on comparisons to other things such as whole-grain wheat or plain old white wheat. Another reason for this effect was thought to have been the colonic fermentation of carbs that were indigestible. 70 Diabetic Living july-aug 2013
Eating hulled barley on a regular basis: 1.Lowers blood cholesterol levels 2.Protects against cancer because its high fibre content helps speed food through the digestive tract, and because its a good source of selenium, shown to significantly reduce the risk of colon cancer 3. Is a good source of niacin, the B vitamin that is cardio-protective 4. Slows starch digestion, which may help keep blood sugar levels stable 5. Provides high concentrations of tocotrienols, the ‘super’ form of vitamin E 6. Provides lignans, phytochemicals that function as antioxidants. Women who consume lignans (also present in high levels in flaxseed) are less likely to develop breast cancer. dietary fibre The content of dietary fibre in a moderate serving of barley, such as 100 grams, also constitutes another benefit of eating it for breakfast. The dietary fibre in barley packs quite a punch, as the above serving size would equal nearly 16 grams of fibre. Fibre is essential to basics that people take for granted, such as successful and effective bowel movements, and also helping you feel full longer, which goes a long way towards helping you manage your weight. Fibre absorbs water, but the insoluble kind of fibre is the one that really expands in your stomach, sticking around longer and contributing to feeling full for a longer period of time. When you feel full, you obviously don’t eat as frequently as when you don’t, so fibre also helps in weight control.
source of zinc The final benefit of eating barley for breakfast is the amount of zinc you get by eating it. Zinc is a vital element that has advantageous effects on the human body. It’s been proven as a healing element in that it contributes to speeding up healing after an injury. Additionally, it is seen as a source of antioxidant properties, which work to slow down the visible signs of aging on your skin as well as accelerated aging of your muscles.
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regularly eating barley can
lessen the usual blood glucose reaction that people get after eating a meal
WorldMags.net recipes barley dosa Ingredients
rice - 1 cup barley - 1 cup black gram (Uzhunnu/Urad dal) - 1 cup balt - As reqd. olive oil or sesame oil How to make
1. Soak the rice, barley and urad overnight or at least for 8 hrs. Remember barley takes a long time to soak. 2. Grind the urad dal separately first and then the rice and barley together with water only as much as needed so as to not make it too watery. 3. When the batter is smooth and done, mix the urad and the rice barley batter together. 4. Add the salt and let it undisturbed in a warm place for around 8 hrs. 5. When the batter rises, mix gently, adjust the water consistency and take a ladle and pour it on the tava. If you like it crispy pour it a little cold (from the fridge). 6. Pour olive or sesame oil around the sides and leave it on low-medium flame 7. Once brown and cooked, remove it without overturning it. Do not touch the dosa till its done or it tears on the sides. Serve hot with peanut chutney or any chutney.
1. Drain the soaked barley and keep aside. 2. Heat the oil in a pressure cooker, add the garlic and spring onion whites and sauté till the onion whites turn translucent. 3. Add the barley, masoor, carrots, salt and 4½ cups of water and pressure cook for 3 to 4 whistles. 4. Cool slightly. 5. Add the spring onion greens, tomato, coriander and pepper and bring to a boil. 5. Serve hot.
barley dosa
Note: Pearl barley is easily available at most grocery stores and also at chemist shops. Courtesy: Tarla dalal
Ba r l e y S o u p
Note: Healthy breakfast for kids and adults. You can substitute white rice with brown rice also.
Nourishing Barley Soup Ingredients
2 tbsp barley, soaked for 3 to 4 hours 2 tbsp masoor (whole red lentil) 1 large sized clove of ginger (adrak), chopped 3 spring onions with greens, finely chopped 1 /4 cup carrot cubes 1 /2 tomato, chopped 2 tbsp chopped coriander 1 tsp oil salt and freshly ground black pepper (kalimirch) powder to taste How to make
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Nutrition
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F
the best combination
It is important for us to know what is the best combination of food to be had for a meal in order that our body is able to streamline digestion. Time to look at the best combination of foods. -By Dr. N.K Sharma
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ood combination refers to the best combination of foods to eat together at the same meal or in the same recipe to ensure easy and perfect digestion to avoid fermentations and indigestions. The reason for food combination is very simple. Foods of different character require different body enzymes and stomach conditions for digestion. Body can handle, secrete and digest completely one food at a time smoothly. It has no provision to secrete and digest different foods at a time, hence delayed, imperfect digestion and fermentation. Consequently, the best food turns into poison without proper combination. For example, protein requires an absolute acid environment in the stomach for their digestion and starchy food requires alkaline environment for their digestion. The stomach of course cannot possibly be acidic and alkaline at the same time. As many students of chemistry will assure you that acid and base (alkaline), neutralize each other. If you eat starch with a protein, digestion is impaired or completely arrested. The intestinal channel remains deranged until it is passed out. Undigested food mass is the best soil for bacterial worms and parasitic developments. Fermentation, putrefaction and decomposition leads to poisoning and a variety of diseases.
fruits and sugars ferments with all foods.
The sugars and fruits need little digestion and pass quickly through the stomach to the intestine for absorption. However, if they are eaten with slower digesting foods such as proteins, starches or fats, they will be held up in the stomach and consequently ferments, interfering in digestion.
WorldMags.net why these foods to be consumed alone?
Why not protein-protein combination?
It is impossible to meet the requirements of two different proteins at the same meal. Two proteins of different characters and different compositions call for different modifications of the digestive secretions and different timings of secretions in order digest them efficiently. The strongest juice is poured upon flesh in the first hour of digestion and upon milk in the last hour, egg receives the strongest secretion at a different time than that received by either flesh or milk or nuts. However, nuts can be eaten with different nuts and flesh with different flesh.
Why not acid-fruits and starch combination?
Acid-fruit destroys ‘ptyalin’ a salivary alkaline enzyme and inhibits starch digestion. In the presence of acids, no alkaline juices are property secreted hence gas and fermentation. Lemon, Tomato, Tamarind, etc. are great hindrance to starch digestion.
Melons: Melons digest quickly than other foods and may ferment even with fruits sometimes and being a sweet fruit, it can go with sweet fruits but not with acid fruits. Milk: Milk is designed to be taken alone. It is a totally different protein than other concentrated proteins like meat, eggs, nuts, etc. Being a liquid food, it cannot go efficiently with any other food. Milk does not digest in stomach but in deuodenum, hence in the presence of milk the stomach does not respond with its secretion. This prevents the digestion of other foods introduced along with the milk. Due to its fat and protein contents, when it enters the stomach, milk coagulates the formation of curd. This curd tends together around the particles of other foods in the stomach insulating them against the gastric juices, preventing digestion of the other food. Milk prevents insalivations and acts as a gastric insulator. Nature herself directs milk to be consumed alone and solids separately. Milk creates gas with all foods except acid-fruits. Liquids: As a law, no liquid should be taken with solids. Liquid tends to pass away immediately into the intestine, taking away all the digestive enzymes thus inhibiting the digestion. Liquids must be taken prior to meal, not immediately after or along with meal but should be taken one hour after meal. All toxic beverages like tea, coffee, alcohol, soft drinks are great hindrance to normal digestion. Gastric secretions are severely restricted in their presence. Juices: All fruit juices are passed faster than fruits into the intestine. Its stagnation with solids definitely ferments and can play havoc. Citrus fruit juices and lemon water dumps down starch digestion creating severe gas and fermentation. Better to take it alone on an empty stomach.
liquids must be taken prior to meal, not
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WorldMags.net Make a rule - do not eat proteins and starches at same meal
If at all, circumstances force you to eat protein and starches together, never mix them together. Eat protein first and after 20-30 minutes follow the starch so that starch digestion will be taken care of. However, this is not an ideal combination and does not ensure perfect and complete digestion. Body must be given full rein and opportunity to digest and take care of a single concentrated food. Human digestive system can handle only green beans, peas and legumes in green state, therefore sprouts are the only better way to eat with starches, the proteins of legumes convert into digested form (digestible amino acids) after soaking and sprouting. Hence the digestion of starch is not much interfered. wrong combinations protein carbohydrate Never eat a concentrated protein and a concentrated carbohydrate at the same meal.
This means do not eat nuts, meat, eggs, cheese, or other protein foods at the same meal with bread, cereals, potatoes, sweet fruits, cakes, etc. The processes of digestion of these two types of foods are so different that they do not take place with any degree of efficiency in the same digestive cavity at the same time.
Proteins are also undigested: It is true that the eating of starches and proteins at the same meal will retard protein digestion considerably. It is not starch that remains undigested, but protein also remains completely undigested and this undigested protein bulk can be found in stools. The acid and alkaline both contrast and neutralize each other inhibiting the digestive process of starch and protein. Those who posses strong digestive systems make the stomach glands overwork and further try to produce enzymes so that the remaining protein can be digested to its full extent. People with weaker digestive systems suffer heavily.
acid-starch combinations Never eat carbohydrate foods and acid foods at the same meal. Do not eat bread,
potatoes, bananas, dates, or other carbohydrates with lemons, limes, oranges, grapefruits, pineapples, tomatoes or other sour fruits. The enzyme, ptyalin, acts only in an 74 Diabetic Living july-aug 2013
alkaline medium; it is destroyed by a mild acid. Fruit acids not only prevent carbohydrate digestion, but they also favour their fermentation. Oxalic acid diluted to one part in 10,000 completely arrests the action of ptyalin. There is enough acetic acid in one or two teaspoonfuls of vinegar to entirely suspend salivary digestion. Tomatoes should never be
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combined with any starch food. They may be eaten with leafy vegetables and fat foods. The combination of citric, malic and oxalic acids found in tomatoes (which are released and intensified by cooking), is very antagonistic to the alkaline digestion of starches in the mouth and stomach. They should not be used on salads at a starch meal.
tomatoes should not be
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all fats delay digestion
Fat depresses the action of the gastric glands and inhibits the pouting of proper gastric juices for any food eaten with it. It lowers entire digestive tone by more than 50%. Fat insulated foods may lead to a breakdown of digestive mechanism in the long run. Eat naturally fat combined proteins and foods. DiabeticLivingOnline.in
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avoid eating sweet fruits with acid fruits. do not
eat nuts, meat, egg, cheese, other protein foods at the same meal with bread, cereal, potatoes, sweet fruits, cakes, etc.
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WorldMags.net acid-protein combination Do not eat acid fruits with proteins
This is to say, oranges, tomatoes, lemons, pineapples, etc., should not be eaten with meat, eggs, cheese or nuts. The active work of splitting up (digesting) complex protein substances is accomplished by the pepsin enzyme. Pepsin acts only in an acid medium; its action is stopped by an alkali. When proteins are eaten, the gastric juice becomes acid, furnishing a favourable medium for the pepsin action. Because pepsin is active only in an acid medium, it has been assumed that taking acids with a meal will assist in the digestion of proteins. On the contrary, these acids demoralize gastric digestion either by destroying the pepsin or by inhibiting its secretion. Gastric juice is not poured out when acid is present in the mouth and stomach. The normal stomach secretes all the acid required by pepsinin digesting a reasonable quantity of proteins. An abnormal stomach may secrete too much acid (hyperacidity). In either case, taking acids with proteins does not aid digestion. Milk and orange juice, while by no means an indigestible combination, is far from a good combination. Orange juice and eggs form an even worse combination. Pineapple juice and flesh is equally as bad. Pineapple juice does not digest flesh. It is well to bear in mind that flesh is not digested by acid but by pepsin. The hydrochloric acid of the stomach supplies the proper environment for the action of pepsin.
sugar - the enemy of starch & protein digestion Starch - Sugar Combinations
Starch digestion normally begins in the mouth and continues for some time in the stomach. Sugars do not undergo any digestion in either the mouth or stomach, but in the small intestine only. Jams, jellies, fruits, butter, commercial sugar (white or brown, beet, cane or lactic), honey, molasses, syrups, etc., which are added to cakes, breads, pastries, cereals, potatoes, etc., produce fermentation. The regularity, with
Sugar & protein combination
All sugars - white sugar, syrup, jaggery, sweet fruit, honey, etc., taken with protein & milk hinder protein digestion. Sugars undergo no digestion in mouth and stomach. Still they are digested in the intestine. If taken alone, they are not held in the stomach for long but are quickly sent into the intestine. When eaten with other foods, either protein or starches, they are held up in the stomach for a prolonged period awaiting the digestion of other foods, they undergo fermentation. Fruits and sugar as a law ferment with all solid foods and milk. Sugar is an acidic food. The fermentation of sugar leads to further multiplication of the problems like acidity and indigestion. Based on these facts our suggestion is - Eat sugars & proteins at separate meals. which people eat cereals and sugar for breakfast and suffer with sour stomach, sour belching and other evidence of indigestion, consequently, would seem to verify the need for a better understanding of proper food combining. Sweet fruits combined with starch also result in fermentation. Breads containing dates, raisins, figs, etc., are improper combinations. Many believe if honey is used instead of sugar, problems may be avoided. Such is not the case. Honey with hot cakes, syrup with hot cakes, etc., are sure to ferment. There is every reason to believe the presence of the
milk and orange juice is far from a good combination. Orange juice and eggs are even worse
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sugar with starch definitely interferes with the digestion of starch. When sugar is taken into the mouth, there is a copious outpouring of saliva, but it contains no ptyalin for ptyalin does not act upon sugar. Ptyalin is essential to starch digestion. If the starch is disguised with sugar, jellies, jams, syrups, etc., the taste buds are deceived and carbohydrate digestion is impaired. Monosaccharids and disaccharies ferment quicker than polysaccharides and are prone to ferment in the stomach while awaiting the completion of starch digestion. To eat sugar, white or brown, jellies, jams, honey, syrups and molasses, sweet fruits, etc., with bread or other starch is to invite fermentation. Sweet fruits with starch result in as much fermentation and the same fermentation products, as does sugar, jellies or syrups. We do not feed these with starches. Wm. Henry Porter, M.D., in his book, Eating to Live Long, says that eating fruits is “one of the most pernicious and reprehensible of dietetic follies”. The writer of this article is a veteran naturopath and founder of Reiki Healing Foundation
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Prediction
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tarot forecast for july-aug 2013 Aries
Taurus
Gemini
Card of the Period: Temperance Health matters seem to be in your hands, with no immediate problems. But you might want to stay ahead of the game by researching health issues of importance. If certain problems run in the family, get as much information on how to improve your chances of remaining free of the disease. Get a health coach to give you advice or tips for you to implement healthier habits on a daily basis. Lucky No.: 2 Lucky Colour: Mustard
Card of the Period: Nine of Wands Balance all the areas of your life with the celestial atmosphere you are currently facing. Relax first, breathe in deeply and let yourself feel the healing energy. Then see what is threatening your overall sense of well-being. Just taking time to notice your feelings will often allow balance to settle in. If you follow healthy protocols and listen to your gut instincts, you will feel energized. Lucky No.: 5 Lucky Colour: Green
Card of the Period: The Empress There is beauty in the air, and it’s going to make you feel good to notice it. Take time to notice the little things that are truly beautiful in your life. If you are watching your diet and making sure to consume only locally grown organic produce you can see the beauty in the simple nutrition. If you are preparing the food you eat for yourself and others, there is beauty in this communion. Lucky No.: 7 Lucky Colour: White
Cancer
Leo
Virgo
Card of the Period: The Wheel of Fortune Compliments on your energy! Much is made of the explosiveness your sign is associated with but you are not often praised for the quality of initiation it brings, and which our planet could not survive without. You have the capacity to spark acts of initiation in others, and if approached with the right intention this can in effect change the world! The alignment at play gives you a context in which to act for the greater good. Lucky No.: 6 Lucky Colour: Magenta
Card of the Period: The World Your sign is going to be getting a lot of planetary attention throughout the next several months, so get used to hearing general statements. What is critical that you do however, is pay straightforward attention to your body and its health needs. You must drink plenty of water and get regular exercise. There is something going on, and you must be prepared to get the most out of the energy that you possibly can. Lucky No.: 1 Lucky Colour: Yellow
Card of the Period: Seven of Swords So many ideas, so little time! You will feel light-headed these days with the current influence from the planetary alignment. And off you go, on to other realms besides this earthly existence! There is exquisite energy to be gleaned from journeys of the spirit, but the effect is only as good as your physical condition. Ground yourself during this special time with a diet that includes fresh meals made with seasonal vegetables. Lucky No.: 9 Lucky Colour: Maroon
Libra
Scorpio
Sagittarius
Card of the Period: Three of Pentacles Your tendency to go along with what everyone else is doing can sometimes give you the impression that what’s good for the group is good for you - and this is just not true. We each have an individual recipe for health, and it’s up to each of us to discover it and follow it religiously. Plan a few meals to prepare at home this week. You may wish to invite others to join you, but know deep down inside that you’re doing it for you. Lucky No.: 3 Lucky Colour: Peach
Card of the Period: The Two of Wands Your diet will be important during this period. You could be down with illness or a lack of energy to consider other dietary options. You might want to explore the possibility of food intolerances or allergies. Your stomach may seem tender due to stress. Try make improvements in your lifestyle by resolving problems and taking more rest. Perhaps a spa day or some pampering is the answer. Avoid overindulging in comfort foods. Lucky No.: 8 Lucky Colour: Brown
Card of the Period: Eight of Cups Focus your intentions on something physical and real. Start take your health seriously. Are you finding excuses rather than getting the regular exercise your body requires? Are you drinking enough water? Are you looking for healthy food when you go grocery shopping? Healthy habits can be formed during this transit. Something or someone will act as a catalyst, paving the way for dynamic change in your health regimen. Lucky No.: 4 Lucky Colour: Mauve
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WorldMags.net Capricorn Card of the Period: The Star With the present astral configuration, you may sense that something is afoot! Focus on staying in optimal health. Try to eat at home instead of eating out. It’s a better way to stay healthy - at restaurants you are prone to eating things you wouldn’t eat at home. When you prepare your own food you are aware of how your digestive system reacts to a particular food. Make lifestyle changes to insure greater health. Lucky No.: 2 Lucky Colour: Cream
Aquarius Card of the Period: Ace of Cups There is often more than meets the eye, even for a sensitive soul like you! You could be seeing more than most but may not be focused on what’s right in front of you! The aspect of this period makes us all the more aware of what has real value for the heart. It’s important to centre yourself during this time of spiritual expansion. Your body, health, and relationships deserve focused attention. Lucky No.: 6 Lucky Colour: Golden
Pisces Card of the Period: Five of Pentacles There’s no doubt that our homes can have an effect on our health. You may get an offer to make changes that will not only make you far more comfortable but also contribute to overall wellness. If you have any plans to create a home gym or a sauna, you will have a great success in finding exactly what you need. Look at your habits, diet, and exercise routine and not take your health for granted. Lucky No.: 7 Lucky Colour: Pink
Manisha Koushik is an astrologer, tarot card reader, numerologist, vastu and Feng Shui consultant. Contact her at support@ askmanisha.com or +91-11-26449898, 26489899
for the book lovers Discover the first and only food in the world that can be considered a natural weight loss ingredient. The Oat Bran Miracle -By Dr Pierre Dukan
In this book, Dr Dukan reveals the secrets behind his magic ingredient: oat bran. Oat bran is a key component of The Dukan Diet, the unique 4-step programme which combines two steps to lose your unwanted weight and two steps to keep it off for good. Not only does it reduce hunger, it also helps to reduce cholesterol, prevent diabetes and cancer, as well as aiding digestion. By eating oat bran as part of The Dukan Diet weight-loss programme you can lose the weight you want like millions of others have around the world. Devised by Dr. Pierre Dukan, a French medical doctor who has spent his career helping people to lose weight permanently, The Dukan Diet is the culmination of 35 years of clinical experience. Beyond its immense success in France, The Dukan Diet has been adopted by more than 50 countries and translated into 25 languages. Many international observers agree that this is the method most likely to put a stop to the world’s weight problems. Publisher: Hachette India Page count:185 Price: `: 695
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Secrets from the Kitchen Fifty Years of Culinary Experience at the India International Centre -By B hicoo Ma n e k s haw a n d V i jay T h u k ra l
The book, with a list of 200 handpicked recipes, cooking tips and basic procedures from the India International Centre’s kitchen – has been compiled by Bhicoo Manekshaw, long time associate and catering consultant of IIC and Chef Vijay Thukral. The book traces the evolution and promotion of IIC’s cultural exchanges, eclectic views and exclusive dining experience representing all corners of India as well as the globe. The kitchen secrets are let out for the first time since 1962, when the first platter of mixed grills, pork chops and treacle tarts made its way to the dining hall. Bhicoo Manekshaw’s passion for good food and cooking began early in her grandmother’s kitchen. Trained at the Cordon Bleu School of Cookery, London, she was a Catering Consultant at IIC, Delhi and later, at the Basil & Thyme Restaurant, Delhi. She has also been a Catering Consultant to the West End Hotel and Raj Bhavan, Bengaluru and Chef Air, Air India. Bhicoo has several cook books to her credit. Vijay Kumar Thukral, Executive Chef, IIC, has been serving the global hospitality industry for more than 35 years and the IIC since 1988. Trained in Food Craft and Food Production (Cookery), he supervises the IIC F&B section, specially contributing to IIC special dinners and food festivals. Publisher: Niyogi Books No of pages: 264 Price: `: 995 DiabeticLivingOnline.in
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special report WorldMags.net
don’t sweat the small stuff
Have diabetes? Nothing to worry about anymore even if you are travelling to places far and wide. Just follow these simple tips -By Pallavi Singh
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P
eople with diabetes do not need to choose ‘special’ holidays just because they have diabetes. There is no reason at all why you should not enjoy your normal activities – holidaying with friends, eating meals in a relaxing atmosphere and generally joining in with whatever you feel like doing. The key is planning ahead. People with diabetes – both Type1 and Type 2 – travel all over the world and holiday in every known destination. Diabetes is certainly no barrier. If you make the right preparations you should be able to minimise any potential problems and have an enjoyable and safe trip. Getting out of the routine is part of the fun of vacation and traveling. But your care routine should travel with you, especially if you have diabetes. Meals away from home, changes in how much physical activity you get, and differences in time zones as you travel can affect how well you manage diabetes. Use this time to be refreshed, lose the stress, and be open to healthy habits. Before you hit the road, review these tips for taking care of yourself.
your care routine should
travel with you, especially if you have diabetes don’t forget your medication
1.Pack twice the amount of diabetes supplies you expect to need, in case of travel delays. 2.Keep snacks, glucose gel, or tablets with you in case your blood glucose drops. 3.Make sure you keep your health insurance card and emergency phone numbers handy, including your doctor’s name and phone number. 4.Carry medical identification that says you have diabetes. 5.Keep time zone changes in mind so you’ll know when to take medication. 6.If you use insulin, make sure you also pack a glucagon emergency kit. 7.Have all syringes and insulin delivery systems (including vials of insulin) clearly marked with the pharmaceutical preprinted label that identifies the medications. Keep it in the original pharmacy la-
Staying healthy 1.Changes in what you eat, activity levels and time zones can affect your blood glucose. 2.Check levels often. 3.Talk with your doctor before increasing physical activity, such as going on a trip that will involve more walking. 4.Stick with your exercise routine. Make sure to get at least 150 minutes of physical activity each week. 3.Wash hands often with soap and water. 6.Protect your feet. Be especially careful of hot pavement by pools and hot sand on beaches. Never go barefoot. 5.Make sure you are up-to-date with immunisations. WorldMags.net
beled packaging. 8.Find out where to get medical care if needed when away from home. 9.Take copies of prescriptions with you.
on the road
1. Reduce your risk for blood clots by moving around every hour or two. 2. Pack a small cooler of foods that may be difficult to find while travelling, such as fresh fruit, sliced raw vegetables, and fat-free or low-fat yogurt. 3. Bring a few bottles of water instead of sugar-sweetened soda or juice. 4. Pack dried fruit, nuts and seeds as snacks. Since these foods can be high in calories, measure out small portions (¼ cup) in advance.
in the air
1. If you’re flying and do not want to walk through the metal detector with your insulin pump, tell a security officer that you are wearing an insulin pump and ask them to visually inspect the pump and do a full-body patdown. 2. Place all diabetes supplies in carry-on luggage. Keep medications and snacks at your seat for easy access. Don’t store them in overhead bins or checked luggage. 3. If a meal will be served during your flight, call ahead for a diabetic, low fat, or low cholesterol meal. Wait until your food is about to be served before you take your insulin. 4. If the airline doesn’t offer a meal, bring a nutritious meal yourself. 5. Make sure to pack snacks in case of flight delays. 6. When drawing up your dose of insulin, don’t inject air into the bottle (the air on your plane will probably be pressurized). 7. Reduce your risk for blood clots by moving around every hour or two. DiabeticLivingOnline.in
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special report
anger - just a letter short of DANGER
Anger can be a dangerous emotion and despite one’s best attempts to curb the same, erupts occasionally to mar one’s health with far reaching consequences. Better control it! -By Ashish Thomas
E
motions and beliefs are very well related to each other and can largely control people. Certain emotional conditions may pilot to anxiety and self-defeating behaviours; and anger is the most self-destructive one among them. However, anger can be turned into a healthy and handy emotion if you exercise your controlling power over it! Do you have a short fuse or find yourself getting into frequent arguments and fights? Anger is a normal, healthy emotion, but when chronic, explosive anger spirals out of control, it can have serious consequences for your relationships,
82 Diabetic Living july-aug 2013
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WorldMags.net Reasons for being ANGRY?
The most common factors that make people angry are:
your health, and your state of mind. Anger is a completely normal, usually healthy, human emotion. But when it gets out of control and turns destructive, it can lead to problems—problems at work, in your personal relationships, and in the overall quality of your life. And it can make you feel as though you’re at the mercy of an unpredictable and powerful emotion. Many times, reacting in anger is how we express our dissatisfaction with life. It’s defined in the Greek language as the strongest of all passions. Anger begins with a feeling that’s often expressed in words or actions. We feel something and it causes a reaction. “I punched out my boss; now I don’t have a job!” “I broke my expensive television after watching my favourite team lose the championship!” or “She said, don’t call until I handle my anger issues!” Screamed at the boss? Snapped at a colleague? Threw your cell phone into your @#$%%&* computer monitor? Does this seem familiar, or at least come close to similar incidents? If so, read on!
dealing with anger
Everybody has to deal with anger from time to time. But what is the best way to handle it? If you have a hot temper, you may feel like it is out of your hands and there is little you can do to tame the beast. But you have more control over your anger than you think. You can learn to express your emotions without hurting others- and when you do that you will not only feel better, you will also be more likely to get your needs met. Mastering the art of anger management takes work, but the more you practice, the easier it will get.
• Grief - losing a loved one • Sexual frustration • Rudeness • Tiredness • Hunger • Pain • Withdrawal from drugs or some medications • Some physical conditions, such as premenstrual syndrome • Physical illness • Mental illness • Alcohol, certain drugs, alcohol & drug abuse
• Injustice • Being teased or bullied • Humiliation • Embarrassment • Deadlines • Traffic jams • Disappointment • Sloppy service • Failure • Infidelity • Burglary • Financial problems •B eing told you have a serious illness
When we are angry the body releases stress hormones, such as adrenaline, nor adrenaline, etc. The heart rate, blood pressure, body temperature and breathing rate increases. Regular episodes of anger can eventually make people ill.
Do I need Help? The following may indicate that you need anger management help: • You have trouble with the authorities (the law) • You frequently feel that you have to hold in your anger • You have numerous arguments with people around you, especially your partner, parents, children, or colleagues • You find yourself involved in fights
•Y ou hit your partner or children •Y ou threaten violence to people or property •Y ou have outbursts where you break things •Y ou lose your temper while driving and become reckless •Y ou think perhaps you do need help
you can learn to express your emotions without hurting others
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And the payoff can be huge. Learning to control your anger and express it appropriately can help you build better relationships, achieve your goals, and lead a healthier and more satisfying life. If you are struggling with out of control anger, you may be wondering why your fuse is so short. Anger problems stem from what you have learnt as a child. If you watched others in the family scream, hit each, or throw things, you might think this is how anger is supposed to be expressed. Traumatic events and high levels of stress can make you more susceptible to anger as well. With insight about the real reasons for your anger, you can learn to keep your temper from hijacking your life. 84 Diabetic Living july-aug 2013
explore what is really behind your anger
Anger is the fruit of rotten roots. One of the primary reasons stems from the family. Angry people come from angry families because they learn from their role models and carry on the same behaviour in their own lives, eventually passing it on to their children. Injustice - When people mistreat us but there is nothing we can do about it and we get angry because we feel it is not fair. We would like to change the situation or the person who is treating us badly, but the truth is we can’t. People cannot change people; only God can change people. So it is best to put our energy into praying for the offender. Strife - which is hidden, repressed
anger begins with judgment gossip, backbiting and thinking too highly of yourself. Strife is often exhibited in arguing, bickering, heated disagreements and angry undercurrents. Impatience - often produces anger when we cannot get what we want and when we want it. When our progress is hindered or slowed down because of others, it is easy to become impatient. Most of us struggle with impatience on a daily basis simply because of today’s fast paced world. Abuse of any kind - sexual, physical, verbal, emotional or mental abuse almost always leads to anger. They are all injustices, which eventually leave the abused feeling helpless and angry. Abuse of any kind cannot be ignored. We
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WorldMags.net must deal with it and process it before it starts affecting our lives. Unmet needs - can also produce anger. We all have needs that can and should be met by those closest to us; however, they don’t know and understand our needs unless we communicate with them. But even then they may sometimes fail to meet our needs. Therefore, the answer is to go to God with our needs and not to other people. Jealousy - In today’s society many people feel their status is dependent on their job or position in the society. Because of this mindset, they’re afraid someone else may get promoted ahead of them. Jealousy causes them to try to be important in the eyes of man.
face the truth...
Sometimes we use masks to cover up the things we don’t want anybody to see. If we’re harbouring anger, we think masking it keeps others from knowing the real us. So we hide behind masks in an attempt to trick people into thinking we’re something or someone we’re not. Get rid of the masks and face the things that happened in your life that made you the way you are. Admit that you can’t change by yourself. Until the root is removed, it’ll continue to produce one bad fruit after another. Too often we spend our lives dealing with the bad fruit of our behaviour, but we never dig deep enough to get to the root of the problem. When we’re faced with anger, we must choose our pain. Digging deep to sort the bad root is painful, but it’s the only lasting way to take care of the problem.
maintaining & strengthening relation ship rather than winning argument should be priority
Learn ways to cool down There are many techniques that can help you cool down and keep your anger in check. 1.Take some deep breaths- Deep, slow breathing helps counteract rising tension. The key is to breathe deeply from the abdomen, getting as much fresh air as possible into your lungs. 2.Exercise-A brisk walk around the block is a great idea. It releases pent-up energy so you can approach the situation with a cooler head. 3.Use your senses- Take advantage of the relaxing power of your sense of sight, smell, hearing, touch and taste. Try listening to music or getting clicked in a favourite place. 4.Stretch or massage areas of tension- Roll your shoulders if you are tensing them, for example, or gently massage your neck and scalp. 5.Slowly count to ten- Focus on the counting to let your rational mind catch up with your feelings. If you still feel out of control by the time you reach ten, start counting again.
find healthier ways to express your anger
Make the relationship your priorityMaintaining and strengthening the relationship, rather than “winning” the argument, should always be your first priority. Be respectful of the other person and his or her viewpoint.
focus on the present
Once you are in the heat of arguing, it’s easy to start throwing past grievances into the mix. Rather than looking to the past and assigning blame, focus on what you can do in the present to solve the problem.
be willing to forgive
Resolving conflict is impossible if you’re unwilling or unable to forgive. Resolution lies in releasing the urge to punish, which can never compensate for our losses and only adds to our injury by further depleting and draining our lives.
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know when to let something go
If you can’t come to an agreement, agree to disagree. It takes two people to keep an argument going. If a conflict is going nowhere, you can choose to disengage and move on. People are born to be free; it’s a gift from God. Any time our freedom is taken away or given away, we experience anger. Are you willing to go through whatever it takes to be free, or do you want to stay in the mess you’re in for the rest of your life?
you can be bitter or better-it’s up to you!
If you’re mad about something, instead of letting it ruin your life, turn it into something good. Overcome evil and anger by praying for those who hurt and abused you. Forgive them and be a blessing to them. It may not be easy at first, but after you make the decision and stick with it, God will take care of the rest. DiabeticLivingOnline.in
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Nutrition
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a fruit full life Few things compare to the sweetness of fresh-picked strawberries or the luscious first bite of watermelon that leaves juice dripping down your chin -By Ashish Thomas
F
ruits are not only delicious but healthy too. Rich in vitamins A and C, plus folate and other essential nutrients, they may help prevent heart disease and stroke, control blood pressure and cholesterol, prevent some types of cancer and guard against vision loss.
keep the doctor away Blueberries, oranges, bananas, apples, kiwis, grapes, strawberries, and papayas - take your pick and take a bite, because these fruits are super foods for your health. With five to six portions a day of fruit and vegetables being the recommended minimum, there is plenty of room to incorporate fruit into your diet, as a breakfast, snack, dessert, or made into a juice or smoothie to drink. Here we look at some surprising benefits of eating fresh fruits:
raw foods contain more nutrients Raw foods are better for you because the enzymes and nutrients in fresh produce are broken down by the cooking process. This means you get more essential vitamins and other nutritional benefits from snacking on a fruit in its natural state.
satisfies a sweet tooth without empty calories If you enjoy or even crave something sweet, fruits can give you that sugary taste sensation with none of the drawbacks of a candy, chocolate, cookies or cake. This can help you stay satisfied if you love to indulge in sweet foods and want to lose weight or switch to a healthier diet. All fruits offer health benefits, but the
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WorldMags.net following stand out as nutrient-dense powerhouses with the most diseasefighting potential.
apple One medium-sized apple is a filling, ready-to-eat snack that is packed with four grams of soluble fibre - 17% of the Daily Value (DV), or the amount you need each day. It is important for colon health and controlling blood sugar levels. It’s also a good source of immune-boosting vitamin C. An apple’s flavour and aroma comes from fragrance cells in apple skin, so for maximum flavour, don’t peel your apple. Plus, the vitamins lie just beneath the skin. Apples are also a natural mouth freshener and clean your teeth with each crunchy bite.
lemon The citric acid in lemons helps break down lipids and stimulates digestive juices. Adding the juice of half a lemon to a glass of water every morning supports liver and gall bladder function. The energizing scent has been shown to mitigate fatigue, anxiety, and nervousness, and can increase concentration and alertness.
papaya Papain, an enzyme in papaya, has been shown to relieve gas from indigestion. Another of its enzymes, chymopapain, has been used to relieve inflammation. One cup of fresh, ripe papaya has only 60 calories, yet packs a whopping 144% of the DV of vitamin C (88mg). The black seeds inside the papaya are edible and have a sharp, spicy flavour. Try blending them into salad dressing as a substitute for black pepper.
amla Also known as Indian gooseberry, has high vitamin C content (600mg/100g) and has been used in Ayurvedic medicine for 10,000 years to treat problems ranging from bed wetting to heart disease. It is a potent antiviral, antifungal, antimicrobial agent and also helps lower inflammation, bad cholesterol as well as triglyceride levels.
Great source of dietary fibre Fibre is very important for healthy and efficient digestion, and for your overall colon health. A lack of it can cause nasty side effects, ranging from constipation and haemorrhoids to cancer of the colon. Fruit is an excellent way to boost the amount of dietary fibre you are getting, helping to keep your digestive system in top working order. A high fibre diet has also been proven to help with slimming – another reason why dieters love fruit. mango Mangoes are high in the antioxidants lutein and zeaxanthin, which may help protect vision and reduce the risk of age-related macular degeneration (the leading cause of blindness in adults). Mangoes - a good source of vitamins A and E can be enjoyed ripe as a sweet, juicy dessert choice or unripe as a sour, crunchy addition to chutney and salads.
orange Oranges are a good source of folate, an important vitamin for pregnant women that can help prevent neural tube defects in their infants. They also contain a phytochemical called hesperidin, which may lower triglyceride and blood cholesterol levels. The edible white part of the orange rind has nearly the same amount of vitamin C as the flesh, so eat that part too!
pineapple Pineapple contains a natural enzyme called bromelain, which breaks down protein and helps aid digestion. Bromelain may also help prevent blood clots, inhibit growth of cancer cells and speed wound healing.
pomegranate Pomegranates contain antioxidant tannins, which may protect the heart. Daily consumption of pomegranate juice may promote normal blood pressure levels and reduce the risk
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of heart attacks. It also contains glistening, jewel-like seeds called arils that can be pressed into juice. One medium pomegranate yields about 1/2 cup (125 ml) of juice.
watermelon Source of Vitamin A, Watermelon is 92 per cent water. It’s a great addition to any weight-loss diet because it is low in calories and satisfies the sweet tooth. Watermelon rinds and seeds are both edible. Roasted, seasoned seeds make a great snack food, and the juicy rind can be stir-fried, stewed, or pickled. Different fruits contain different proportions of different vitamins, so by consuming a rich mixture of fruit you can be sure you are getting a nicely balanced vitamin supply. With a wide range of vitamins, minerals, antioxidants and other compounds, they help protect the body against everyday and chronic health conditions. However, there is a word of caution for those managing diabetes as excess consumption of fruits may create difficulty in the balancing act and may raise the blood glucose levels. Therefore, a well-balanced diet containing adequate amounts of fruits and vegetables (5-6 servings), whole grain cereals, pulses and legumes, low fat dairy products, healthy fats/oils including nuts, spread out throughout the day in the form of 6-7 meals is the best solution. Remember, moderation is the key! DiabeticLivingOnline.in
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Food
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88 Diabetic Living JULY-aUG 2013
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the great
indian meal
Put that chopping board back in the cabinet and enjoy the monsoon showers with some quick recipes by Chef Vinod Kumar, Restaurant Manager, from the newly opened fine dining space - The Shraman, Hotel Ashok. These vegetarian recipes minus the sweaty onion and garlic will keep you satiated through out the season.
Photos by: Girish Mason Prop Styling: Dolly Jain Food Styling: Pallavi Singh Nutritionist: Dr. Swati Bhardwaj Food Courtesy: Shraman, Hotel Ashok, New Delhi Recipes by: Chef Vinod Kumar
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WorldMags.net 30
minutes to prep
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B esan , ben g al g ram flo u r , W ith its lower g ly cemic inde x , hi g her p rotein content, bein g g l u ten free and hi g h n u tritive val u e has a lot of health benefits like wei g ht loss , controllin g diabetes , heart health & more
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WorldMags.net Dhokla aur khandvi ki chaat Dhokla Servings
2 portions
Ingredients
1 cup gram flour 1 cup sour curd 2 teaspoon Eno/fruit salt 1 /2 cup water for final preparation A pinch of turmeric powder 1 /2 teaspoon ginger paste 1 /2 teaspoon mustard seeds 2 teaspoon refined oil 1 /2 teaspoon extra oil for greasing the pan 4 green chillies, sliced 1 sprig curry leaves 2 teaspoon coriander leaves, chopped 1 tablespoon desiccated coconut 2-3 teaspoon lemon juice salt to taste, water for mixing 1. Mix gram flour, curd, eno fruit salt, salt, ginger paste and turmeric powder. 2. Add some water to make the batter thicker than that used for making pakodas. 3. Immediately pour the mixture in a greased pan. 4. Pour a glass of water in the pressure cooker. 5. Keep the pan in the pressure cooker over a stand. 6. Close the lid and do not put weight. 7. Steam for 10 minutes or till done. 8. Cool and cut into squares. For seasoning: 1. Heat oil in a pan. 2. Add mustard seeds. 3. When they start to sputter add curry leaves , green chillies, lemon juice and half a cup of water. 4. Boil, then add dhokla pieces. 5. Stir, keep on low heat till all the water is absorbed. 6. Remove from the heat. 7. Sprinkle with desiccated coconut & chopped coriander leaves. 8. Serve hot / cool. Per Serving :
S u r k h Pa n e e r
/2 2 4-5 1
teaspoon green chilli paste teaspoon oil teaspoon grated coconut tablespoon chopped coriander leaves 3 /4 teaspoon mustard seeds 1 sprig curry leaves a pinch asafoetida 1
1. Make curd and water together. 2. Add gram flour, salt, ginger paste, turmeric powder and green chilli paste. 3. Put the mixture in a heavy- bottomed pan and keep boiling on a very low heat till the mixture starts sticking. 4. Pour 2 ladle (or 1/4 cup ) of the mixture on a greased plate evenly (make very thin layer ) and s a n g r i k i s ha m i
269 kcal, 13g fat, 27g carb,
10g protein.
1. Heat oil in a frying pan. 2. Add mustard seeds. 3. When they start to splutter, add curry leaves and asafoetida. 4. Pour this seasoning over khandvi. 5. Serve cold. Per Serving:
253 kcal, 11g fat 26g carb,
10g protein.
SURKH PANEER Servings
3 portions
Ingredients
250 g ms paneer (cut in square pieces) green capsicum 1pcs (diced into squares) Tamato 2pcs (diced into squares) 1 spoon degi mirch powder 2-3 spoon mustard oil 1 spoon carom seeds salt to taste 150 gms curd 1 teaspoon jeera powder 1 tea spoon coriander powder red chilly paste to taste salt to taste
2 portions
Ingredients
1 11/2 1 1 /4 1 /2
For Seasoning
for the dip
Khandvi Servings
let it cool. 5. When cool, cut into either two or four pieces. 6. Now roll them carefully. 7. Sprinkle coriander leaves and coconut.
cup curd (dahi ) cups water cup gram flour ( besan ) teaspoon turmeric powder teaspoon ginger paste
1. Mix ingredients for marination & keep aside 2. Brush the marinate to the paneer and refrigerate for an hour 3. Put the
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WorldMags.net A ltho u g h the n u tritional val u e of ma j orit y of forest foods like B er , ker , san g ri , kachri is not p recisely known , b u t research shows them to be a storeho u se of no u rishment
m a n g o r i k e pa k o r e K i M o o n g Da l
30
minutes to prep
paneer pieces & vegetables in steel sticks and roast in the tandoor. Garnish & serving:- Fresh coriander and chaat masala Per Serving:
279 kcal, 22g fat 10g carb,
13g protein.
SANGRI KI SHAMI Servings
2 portions
Ingredients
100 100 1 /4 1 /4 1 /4 3-4 2
gms sangri gms zimikand spoon of mace spoon of small cardamom spoon of amchoor powder spoon of desi ghee pcs of green chillies salt to taste
1. Boil sangri and zimikand and mash it 2. Add the spices 3. Mix the mashed sangri & zimikand with spices 4. Make it into round small tikkis & shallow fry in desi ghee Garnish & serving:- Chaat masala & dahi ki chutney Per Serving:
173 kcal, 8g fat 25g carb,
1g protein.
Mangori ke pakore ki Moong dal Servings
3 portions
Ingredients
200 1 /2 1 /3 3
gms dal moong washed spoon chopped green chilly lemon juice pcs tomato fresh coriander salt to taste
1. Wash the moong dal & boil it 2. Make some pakodi of moong daal paste 3. Now cook with cumin seeds, chopped tomato in desi ghee 4. Add spices and pakodi in dal and cook well Garinsh:- fresh coriander Per Serving:
16g protein. 92 Diabetic Living JULY-aUG 2013
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284 kcal, 7g fat,40g carb,
WorldMags.net A balanced diet is im p ortant to maintain health and a sensible bod y wei g ht. N o sin g le food will p rovide all the essential n u trients that the bod y needs to be health y and f u nction efficiently
30
minutes to prep
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30
DAL SHRAMAN Servings
2 portions
Ingredients
100 1 /3 3 2 1 3 1 /2 3 2 1
minutes to prep
gms arhar dal turmeric powder pcs green chillies pcs red chilly whole tea spoon coriander powder tea spoon desi ghee tea spoon aniseeds teaspoon cream tomato ginger salt to taste
1. Wash and boil the arhar dal 2. Cook with aniseed, chopped tomato in desi ghee 3. Add the dal and cook it 4. Add some Indian spices 5. Add some curd and some cooking cream while cooking Garnish:-Fresh coriander & fried red chilly Per Serving:
253 kcal, 11g fat, 29g carb,
13g protein.
METHI CHAMAN Servings
2 portions
Ingredients
seekh e mehboob
30
minutes to prep
300 gms fresh methi (1bunch) 150 g ms paneer (cut in square pieces) 2 pcs tomato 1 spoon cashewnut paste 1 /2 spoon chopped ginger 1 /3 spoon chopped green chilly 1 pcs ginger Salt to taste 1 /2 spoon coriander powder 2 tea spoon cooking cream 3 spoon desi ghee 1. Wash a bunch of fresh methi , chop it and blanch. 2. Take a pan, fry the cumin seed and Indian spices in desi ghee. 3. Add some chopped tomato 4. Add the cubes of fresh paneer 5. Cook it well. 6. Garnish it with fresh cream. Garnish : Fresh cream and jullian cutting ginger. Per Serving:
395 kcal, 47g fat, 19g carb,
18g protein.
SEEKH E MEHBOOB Servings
2 portions
Ingredients 1 /4 cup boiled and mashed potatoes 200 gms grated cauliflower
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WorldMags.net 2 2 2 1 /4 1 /2 2 2
tbsp grated carrot tbsp boiled green peas tsp chilli powder tsp garam masala tsp turmeric powder (haldi) tsp chaat masala tbsp chopped coriander (dhania) salt to taste 1 tbsp oil for brushing green chutney for serving
v e g e ta b l e c r u d i t s a l a d
1. Combine the cooking with all the remaining ingredients, except the oil, and mix well. 2. Divide the mixture into 12 equal portions. 3. Using a thick seekh (metal skewer) press each portion of the dal mixture on it using your fingers to make a 100 mm. (4”) long kebab. 4. Brush each kebab very lightly with a little oil. 5. Cook the kebabs over a grill or over a charcoal barbeque till they are evenly browned (approx. 3 to 4 minutes). 6. Serve hot with green chutney Per Serving:
a s a l a d p l at t e r
154 kcal, 5g fat, 21g carb,
5g protein.
VEGETABLE CRUDIT SALAD 150 gms carrots (Julienne matchsticks) 200 gms bell peppers (Julienne matchsticks) 100 gms baby corn (Julienne match sticks) 100 gms radish (Julienne matchsticks) 1 pcs beetroot (Julienne matchsticks) 100 gms beans (Julienne matchsticks) 1 tea spoon olive oil 1 /2 tea spoon honey green lettuce; salt to taste 100 gms fresh curd For the DIP
100 1 /2 1 /2 1
gms curd teaspoon black pepper crush tea spoon honey tea spoon olive oil salt to taste
1. Take fresh vegetables- baby corn, french beans, carrot, cucumber and bell pepper. 2. Cut them in julienne cutting. 3. Blanch them. 4. Serve with curd dip. Per Serving:
206 kcal, 10g fat, 24g carb,
7g protein.
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R.N.I No. DELENG/2012/45214 DCP NO. DELENG18407
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