More about diabetes type II. STOP it!

hi everyone!

hope all is well. it’s quite a Monday here in Sydney. it has been all gloomy since morning- and now it’s pouring.

i have started running diabetes education group session at the clinic i work- Mt Druitt Medical Centre. If you have type 2 diabetes, and if you’re interested, do give us a call.  or you can drop a comment and i’ll follow up.

since i am the one who is running the group, i have been researching a lot about diabetes and it’s management. so i would like to share it with you.

i have talked about diabetes in the past. read here.

so, as we all know, diabetes has its complications. generally, if we have diabetes type II and we control our diabetes well, our risks of complications are minimal. however, most people i have met in my practice do not control their diabetes well. it can be damaging to our health.

we probably don’t feel it now, but having uncontrolled diabetes may cause many severe complications later on in life such as:

1. kidney damage (nephropathy), can lead to kidney failure

2. eye damage (retinopathy), can also lead to blindness

3. nerve damage to the feet and other parts of body (neuropathy), can also lead to amputation

4. sexual problems

we also cannot disregard that as we have diabetes, our risk of developing heart disease are much greater. this is because we often have abnormal lipid profile- meaning we have high blood cholesterol/LDL/triglycerides.

so what do we do?

healthy lifestyle is essential in diabetes management. proper diet and exercise has significant impact on our blood glucose control. our GP or endocrinologist will be able to tell us our blood glucose target. once we know our target, then we aim to achieve them through diet and exercise.

healthy eating has been shown to: improve blood glucose control and modify cardiovascular risk factors. modest weight loss (<10% body weight, for example if you weigh 90kg, a modest weight loss is 9kg) in overweight/obese person has been shown to: improve insulin sensitivity, improve blood glucose control, reduce body fat percentage, improve blood pressure and other cardiovascular factors, may reduce or even eliminate the need for medications and may reduce insulin dose. 

basic healthy eating:

1. eat regular meals: 3 main meals and 1-2 snacks

2. evenly spread your carbohydrate intake throughout the day. it is unnecessary to eliminate all carbohydrate from your diet. carbohydrate is main source of energy for us. be consistent and eat mostly from complex carbohydrate such as whole grains, legumes and vegetables.

3. portion control. a healthy plate consists of 1/2 plate of vegetables, 1/4 plate of low GI complex carbohydrate and 1/4 plate of lean protein.

4. switch to healthy fats, from oily fish, nuts and seeds, olive oil, canola oil, avocado.

be sure that you go to your GP regularly- every 3 months to check your HbA1C which shows your glucose control in the past 3 months. and check your sugar level at home daily if you have the equipment.

so, to be a healthy diabetic:

1. achieve normal and stable blood glucose control (target should be discussed with your GP/endocrinologist)

2. achieve normal lipid profile (tot cholesterol <4.0mmol/L; LDL cholesterol <2.0mmol/L; HDL cholesterol >1.0mmol/L; triglycerides <2.0mmol/L)

3. achieve normal blood pressure (<130 systolic /90 diastolic)

4. eat healthy

5. be active (try to exercise every second day, as simple as walking- and work your way up gradually)

References:

Diabetes. 2011. Better Health Channel.
Diabetes facts. 2010. Australian Diabetes Council.
Mahan and Escott-Stump. 2008. Krause’s food and nutrition therapy, 12e. Canada: Elsevier.
Mann and Truswell. 2007. Essentials of human nutrition 3rd edition. US: Oxford University Press Inc

medical check-up in our lifetime. what to do and when!

dear readers

hope you’re doing well. it’s almost Summer in Sydney- and the temperature has started rising significantly.

we’ve been having days of 30 degrees and above. hot.

and unfortunately the bushfire happened too. my heart goes out to all who were affected.

today i just want to quickly share with you a very nice-looking info-graphic by Greatist. you can probably tell by now that i love Greatist! they’re really creative in summarizing information. and they put it nicely in graphics too. what’s not to love?!

this time is about medical check up. what to do and when. 20s, 30s, 40s up to 70s and beyond.

ignorance is bliss. but in term of our health- there is no such thing. the earlier we know the better it is. so we can act accordingly, treat appropriately.

Get health and fitness tips at Greatist.com, one of the best health blogs online.

Hope you find it useful! I really did and that’s why I’m sharing it with you all. and you should share it with your loved ones too.

health is something that we only feel ourselves and we’ve got to look after too!

ciao- have a nice day!

 

references:

The Greatest Team. 2011. A lifetime of medical check ups (infographic). http://greatist.com/health/lifetime-medical-checkups-infographic

the almond myth-busters!

Hi everyone!

Just following my previous post about almonds, I thought I share with you some myths around almonds.

Image from http://www.telegraph.co.uk/health/healthnews/9188524/Eating-almonds-could-aid-dieting.html

These might be true for other nuts too!

1. I’m trying to lose weight. Does it mean I can’t have nuts?

That is nonsense! Latest research shows that enjoying a handful of nuts regularly as part of a healthy diet can help with weight management. If you’re trying to lose a few cms doesn’t mean you can’t eat nuts. Enjoy a handful of nuts, along with 2 serves of fruits and 5 serves vegetables and you’re on your way!

2. My cholesterol is through the roof. I heard that nuts are very fatty hence I should avoid them.

The fats in nuts are healthy fats- predominantly unsaturated fats that help reduce your risk of heart disease. It does not increase your cholesterol level- in fact, almonds can lower total and ‘bad’ LDL cholesterol, as confirmed by one study which shows that a 73g serve of almonds each day reduced LDL cholesterol by almost 10% while 37g (a handful) reduced by around 5%.

References

Almond. Nuts For Life. http://www.nutsforlife.com.au/index.php?option=com_docman&task=cat_view&gid=157&Itemid=165

Strahan ™. Nuts for cardiovascular protection. Asia Pac J Clin Nutr. 2004;13(suppl):S33

have you had your handful today?

Hi everyone!

Today, I thought I would like to share bits and pieces about almonds- and hopefully you’ll learn something new about almonds 🙂

Almonds are very good for you- they are packed with vitamins, minerals, antioxidants and phytochemicals that are great for your health. A handful of almonds a day (20 almonds) may reduce your risk of heart disease and diabetes type II. Here are a few reasons why you should reach your share of almonds today:

 1. almonds contain healthy monounsaturated fat (66% of total fat) and they are low in saturated fat (7% of total fat)

 2. almonds are cholesterol-free. instead they contain natural plant sterols which can lower cholesterol levels by reducing cholesterol reabsorption in the intestine

 3. almonds are high in vitamin E- have your handful of almonds a day and you also get 70% of vitamin E you need in a day. vitamin E is important as it can help maintain a healthy heart- and watch out girls- they are good for your skin too!

 4. almonds are source of plant protein making them good meat alternative for vegetarians and vegans. a specific amino acid in almonds called arginine can help prevent blood clotting hence reducing your risk of heart disease

 So, a handful of almonds a day is certainly doing you good! Have you had yours today?

 

image from http://www.almondboard.com/CONSUMER/ALMONDLIFESTYLE/Pages/HandfulADay.aspx

References:

Almond. Nuts For Life. http://www.nutsforlife.com.au/index.php?option=com_docman&task=cat_view&gid=157&Itemid=165

Strahan ™. Nuts for cardiovascular protection. Asia Pac J Clin Nutr. 2004;13(suppl):S33

how toxic is Gillespie’s new book- Toxic Oil?

Hi everyone!

Hope you’re doing well.

Today, I want to share with you my take on David Gillespie’s new book: Toxic Oil, which was recently published in Australia.

Gillespie is a corporate lawyer turned into an author (http://sweetpoison.com.au/?page_id=2). His first book is Sweet Poison Why Sugar Makes Us Fat.

It has brought so much controversy as he is neither a dietitian/nutritionist nor a health professional nevertheless saying that sugar is poisonous. (and i’m thinking- where did all these come from!)

Today, we won’t be talking about his first book but his latest one- Toxic Oil: Why vegetable oil will kill you and how to save yourself.

Before we start, I just want to make myself clear that I am just lining out the position statement on this book by Heart Foundation, released in February 2013. I have no interest or association with anyone or any food industry. I am here, as a dietitian, to reach out and inform the evidence surrounding this book. Why did I do it? Just because it is my interest to get the right message out to consumers and public. Because it bothers me that someone can publish a book based on theory which is against the national guideline, against the scientific evidence.

This is what the description of the book- from Itunes Books:

Everything you believe about fat is wrong.

Polyunsaturated oil – everyone knows it’s good for you, right? Wrong! And we all know artery-clogging, cholesterol-forming saturated fat is bad for you, don’t we? Wrong again! In his previous book Big Fat Lies, David Gillespie showed that these ‘truths’ are in fact myths, based on poor research and bad evidence.

‘Vegetable oil’, which isn’t made from vegetables at all, but manufactured from seeds, has systematically replaced saturated fats in our diets over the past one hundred years, but our rates of obesity, heart disease, diabetes and cancer are higher than ever.

There have been many studies done in the past. All chronic diseases, including heart disease, are not caused by only one particular thing. There are always a few factors affecting heart disease in an individual. Take Mr.A- he is a successful businessman, a smoker, exercise everyday, eat quite healthily with occasional junk food. Can he have a heart disease? Maybe. And if he did have a heart disease, could we really pinpoint the cause? Is it the smoking? Is it the occasional junk food? or is it the stress? or perhaps the combination of everything? It’s really complex and it’s difficult to determine a single cause.

Literatures show that replacing saturated fat in your diet with unsaturated fat, in particular polyunsaturated fat, reduce your heart disease risk. This is in contrary to what Gillespie says in his book. The Heart Foundation believes that the claim in his book is dangerous, misleading and wrong (quoted from the position statement by Heart Foundation). If you follow such advice, it could lead to the rapid development of serious health conditions.

This position statement regarding unsaturated fats and heart disease risk is not only by Heart Foundation, but also by the worlds leading health organizations, such as World Health Organisation, British Heart Foundation and American Heart Association. On national level, this is supported by Dietitians Association of Australia and National Health and Medical Research Council (NHMRC- contributor of our Australian Guide to Healthy Eating).

So, now you see what I meant- how could a lawyer give such advice- not to mention advice against world leading health organization?

The Heart Foundation, like other health organizations, is committed to helping Australians lead a healthy lifestyle by recommending advice based on good quality, strong scientific evidence and is continually reviewing the evidence.

To cut the story short- everyone, don’t be afraid of healthy fats (monounsaturated and polyunsaturated fats). 

Image from http://www.livestrong.com/article/399182-safflower-vs-sunflower-oil/

Evidence shows that omega-6 polyunsaturated fats reduce your bad or LDL cholesterol and increase the good HDL cholesterol, which helps to lower the risk of heart disease.

and what about saturated fats? until this date, the literatures still strongly stand that saturated fats and trans fat are unhealthy fats. too much of it increases cholesterol and over the time causes the build up of fatty material on the inside of your blood vessels. These material blocks the blood flowing through the blood vessels and is a major cause of heart disease (stroke or heart attack). If you can imagine, you’re watering the garden with your water hose. If we are being slack and say- there is soil and dirt built up on the inside of the water hose, over the time the water flow is reduced and eventually blocked completely. no water coming out of the other side of the water hose=no blood flow which means no oxygen to the heart and brain thus stroke or heart attack occur.

Image from http://www.wisegeek.org/how-does-artery-plaque-build-up.htm

the last thing I want to talk about is margarine. there is a claim that margarine and some oils are unhealthy because they undergo industrial process and have trans fats.

this was true a gazillion years ago. margarine in history (this was years and years and years ago) did contain trans fat due to the hydrogenation process (converting oil to a solid spreadable margarine).

However, Australian margarine nowadays are made from locally grown polyunsaturated and monounsaturated plant seed oils, water, milk and salt to taste. The most important thing is hydrogenation is no longer used in margarines and polyunsaturated oils on the supermarket shelf contain negligible trans fats. 

Image from http://www.hospitalityinfocentre.co.uk/Fats%20&%20OIls/margarine.htm

If you see preservatives on the label- it is often citric acid or lemon juice and is put to keep the spread tasting fresh. And what about carotenoids? it is there for colour.

I hope I’m not confusing anybody here! What you have to remember from this rather-long-post are:

1. there is no reason to be scared of polyunsaturated oils. use them wisely, i’m not saying that you should drizzle generously, but there is absolutely no harm in using polyunsaturated oils.
2. saturated fats and trans fats are unhealthy fats. they can be found in butter, processed foods, junk foods, biscuits and cookies, etc. we should minimize them in our diet. 
3. Australian margarines contains almost no trans fat. if there is, it would be negligible and we shouldn’t need to worry!
4. I would never recommend anyone to buy this book. waste of money for incorrect information. head over to a trustworthy website such as Heart Foundation website, DAA website, etc. even better, find an Accredited Practising Dietitian near you, if you need help! we are here to help!
5. pass this message to your friends and family! we want everyone to get the right, evidence-based information. 

If you need more information on Heart Foundation’s statement on Gillespie’s book Toxic Oil, please click Heart Foundation statement – Toxic Oil – David Gillespie Feb 2013 (1) for the complete statement.

For more information about the Heart Foundation position on healthier fats, click here.

For more information about the Heart Foundation position on saturated fats, click here.

For more information about the Heart Foundation position on sugar, click here.

If you want to know what Paula Goodyer of Sydney Morning Herald has to say about Gillespie’s Toxic Oil, click here. I was really glad when she stated “I’m inclined to take dietary advice from respected nutritionists, rather than lawyers.”

References:

Heart Foundation. 2013. Heart foundation response to claims in David Gillespie’s Toxic Oil. 

Images of Gillespie’s Toxic Oil book and its description are from iTunes- Books website https://itunes.apple.com/au/book/toxic-oil/id602050247?mt=11.

Image of Gillespie’s Sweet Poison book is from iTunes- Books website https://itunes.apple.com/au/book/sweet-poison/id491198216?mt=11

Disclaimer: this post is intended only for education and is based on Heart Foundation’s statement which you can find on the references or Heart Foundation website. I am not associated with any industry or organization. and I did not receive any monetary reimbursement for this post. 

Want to know more: eggs!

Hi everyone!

You must have heard someone saying, “If you have high cholesterol, you can’t have eggs“. Well, I heard it many times! Eggs, particularly the yolks, contain cholesterol which turn people away from these little wonders.

Before turning your shopping basket away from eggs, please have a quick read of this brochure, Eggs. (clicking on the link will take you to the pdf file)

I made this brochure in order to clarify people’s misconception of eggs.

In summary, the old statement is incorrect. The latest research has shown that consuming eggs does not increase your cholesterol, particularly if it’s a part of healthy balanced diet. What does it mean? It means that you can eat an egg a day without any worries! Regardless your cholesterol level, or family history of cardiovascular disease 😉 People are encouraged to eat eggs together with fruits, vegetables, wholegrain cereal and low-fat dairy products.

So, now, you can eat eggs without having to worry about your cholesterol! Tell your parents that they can eat eggs, too 🙂 just in case if they had been told to not eat eggs previously.

How often do you eat eggs in a week?

this resource was developed to serve the best intention of education only