Saturday, December 5, 2015

A diabetic dilemma!-Heavy break fast vs heavy dinner

Diabetes is a dreaded disease and there is unanimity in calling it "the silent killer". A complex metabolic disorder, diabetes is still not understood well though there are well accepted treatment regime to control it. As it is related to the inability of the body to fully metabolize the glucose generated in the GI tract and absorbed by the blood stream, those affected by this disorder has to control their diet to prevent surges in blood glucose after consuming foods. The big dilemma facing diabetes affected people is how to balance the need for energy for sustenance and the ability of their metabolic system to handle the glucose derived from the foods they have consumed. Why is it called a silent killer? Most probably because the symptoms of the disease, especially during early stages, are not manifested and those affected have practically no knowledge about its onslaught. Untreated diabetes can lead to many other problems like heart disease, kidney ailments, declining eye sight, loss of pain sensation etc. How do we monitor our "sugar health"? As of now most physicians subject their patients to the "fasting sugar and postprandial sugar" testing and optimum sugar levels for normal health have been set. However these days many medical experts prefer to depend on the HbA1C or glycated haemoglobin test which is a cumulative record of unmetabolized glucose build up over a period of 3 months. Still daily monitoring is advisable to have a control of the glucose levels in the blood due to irregular consumption of food by some people. A new study coming from Israel has propounded a new diet regime that has the potential to have a control over blood glucose. Here is a take on this new development.

"A high-energy breakfast and modest dinner can control dangerous blood sugar spikes all day, says a new Tel Aviv University study published in Diabetologia. More than 382 million people in the world suffer from diabetes, predominantly type-2 diabetes. For these people, blood sugar surges - glucose spikes after meals - can be life threatening, leading to cardiovascular complications. The study proposes a new way to suppress deadly glucose surges throughout the day - eating a high-caloric breakfast and a more modest dinner. The combined consumption of a high-energy breakfast and a low-energy dinner decreases overall daily hyperglycaemia in type-2 diabetics, said the study. "We found that by eating more calories at breakfast, when the glucose response to food is lowest, and consuming fewer calories at dinner, glucose peaks and glucose levels throughout the day were significantly reduced," said professor Daniela Jakubowicz of Tel Aviv University. The new study was conducted on eight men and 10 women aged 30-70 with type-2 diabetes. Patients were randomized and assigned either a "B diet" or "D diet" for one week. The B diet featured a 2,946 kilojoule (kj) breakfast, 2,523 kj lunch, and 858 kj dinner, and the D diet featured a 858 kj breakfast, 2,523 kj lunch, and 2,946 kj dinner. The results of the study showed that post-meal glucose elevations were 20 percent lower, levels of insulin, C-peptide, and GLP-1 were 20 percent higher in participants on the B diet compared with those on the D diet. Despite the fact that both diets contained the same calories, blood glucose levels rose 23 percent less after the lunch was preceded by a large breakfast."  Read further

The concept of Glycemic Index (GI) was developed by a group of scientists in University of Toronto in 1980-81 and to day it is the golden standard to assess different foods regarding their potential to increase blood glucose levels. Once GI of any food is known, consequent glucose load (GL) can be estimated in order to exercise self discipline while eating. Unfortunately for an average consumer it is rather difficult to think or worry about these highly scientific way of planning his daily food with the result that wide fluctuations in glucose "reading" is unavoidable and can lead to a slow process of debilitation of the body. What the Israeli scientists are proposing is some what revolutionary and if true may offer some practical guidelines in controlling the intake of glucose rich foods. It is a remarkable finding which can easily be practiced by those affected by Type 2 diabetes. Distributing the calories needed every day with 45% being consumed during breakfast, 40% during lunch and 15% during dinner, it has shown that glucose spike in the blood can be reduced as much as 23% compared to a diet with low calories consumed during breakfast. With more than 85% of calories intake coming from breakfast and lunch, glucose management is much easier and such a change in the meal pattern can be easily achieved for the sake of a better health. One criticism of above study is that the size of the experiments is rather small with hardly about one and a half dozen subjects and further studies on a much bigger scale only can help to come to a firm conclusion.


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