Health: Start the day with whole grains

The recommendation for consumption of whole grains varies between countries. In the US, it’s three servings of 60g of whole grains a day.

Cereals are great for breakfast, especially for children, as they contain essential nutrients, discovers KASMIAH MUSTAPHA.

IT has been said often enough — breakfast is the most important meal of the day. It is even better if breakfast consists food that provides vitamins and minerals to boost energy. The right food can even help curb obesity.

For children, the best breakfast is cereals. It is easy to prepare, healthier than nasi lemak or roti canai, and can be just as tasty.

Cereal Partners Worldwide (CPW) director of nutrition John Athanatos says children need food that gives them vitamins and minerals to boost energy and provide health benefits.

Breakfast cereals can be a part of the strategy to reduce obesity. Studies have found that children who eat cereals daily have better nutrient intake than those who do not and are more likely to have healthier body weight.

“This is why it is important for parents to make sure their children eat a healthy breakfast. Since children are fussy about eating, parents can make cereals more interesting and fun to eat. Add fruit such as strawberry, mango or banana,” suggests Athanatos.

While a healthy breakfast is important to help reduce obesity among children, parents also need to ensure kids exercise.“Doing only one thing will not help them manage their health. Children need variety in their diet and more physical activities,” says Athanatos.Since 2008, CPW has changed its products to whole grains for added nutritional values.

“Studies have shown that people who eat more whole grain products are at lower risks of heart disease, diabetes and obesity. This has motivated us to use whole grains instead of refined grains. That also sets our products apart from the rest.

“All our breakfast cereal boxes are printed with the whole grain tick, highlighting that if you eat a serving of the cereals, you will get 8g of whole grains,” says Athanatos.

CPW, formed in 1990, is a joint venture between Switzerland-based Nestle S.A. and American food company General Mills.

In Malaysia, Nestle breakfast cereals for children are Koko Krunch, Koko Krunch Duo, Honey Stars, Cookie Crisp, Milo Cereal and Snow Flakes. Except for Snow Flakes, the other products are made from whole grains.“There are no specific regulatory requirements of the content of whole grains in the products but we decided to make it 100 per cent whole grains.

“We preserve the nutritional value of the grains through the milling process. Previously, milling removes the bran and germ which contain fibre, vitamins, minerals and nutrients. In the end, only the endosperm remains.

“But now we mill the grains and reconstitute and preserve the content, bake them and add flavour to the cereals. So consumers are getting whole grains in our products,” says Athanatos.

Grain comprises bran, germ and endosperm. The endosperm in refined products such as white bread and rice, contain carbohydrates, which if eaten in huge portions, leads to obesity and diabetes. Bran contains vitamins B and C, minerals, zinc and fibre while the germ has minerals, vitamins B and E and antioxidants.

“In most countries, the whole grain intake is lower than the recommendation level. Even in countries such as Germany, where breakfast cereals are a staple, studies show that the consumption of whole grains is still below the recommended level,” says Athanatos.

“It is not easy for people to eat whole grains regularly because sometimes the products are tasteless, difficult to cook and textures may be tough. So there is a role for industry to use technology to make the products more palatable.”

The recommendation for consumption of whole grains varies between countries. In the United States, it’s three servings of 60g of whole grains a day while in Denmark, it’s at least 75g.

CPW has also reduced the sugar and salt content in its cereals. Since 2001, 5,000 tonnes of sugar and 850 tonnes of salt have been removed from its products.

“In most European countries, which have higher consumption of breakfast cereals, the meal only contributes about five per cent of total sugar intake for the day.

“At the end of the day, breakfast cereals with milk contain 180 calories, so they are not a significant contributor to calorie intake.” Athanatos says he has been eating cereals from young and now if he does not eat it in the morning, he tends to snack on something unhealthy and then overeat at lunch. So he never skips breakfast.“

It helps me get through at least the first part of the day without feeling hungry. Studies have found that people who skip breakfast record lower physical and cognitive performance compared to those who eat. My sons, aged 2½ and 6 months, eat cereals.”

Article extract from: http://www.nst.com.my/nst/articles/Health_Startthedaywithwholegrains/Article/

Cool it!: Keep cool while exercising

Cool it!: Keep cool while exercising

Food: Eat right to sleep well

Food: Eat right to sleep well

Milk Matters cont.2

Are there any special recommendations for populations with high rates of lactose intolerance?

The American Academy of Pediatrics (AAP) recommends that population groups with high rates of lactose intolerance should not be encouraged to avoid milk and milk products.9 They should try the calcium consumption strategies to get dietary calcium.

Should children take calcium supplements?

Experts suggest that the preferred source of calcium is through calcium-rich foods.10 However, if calcium cannot be obtained dietarily, calcium supplements can be given to children.

What can I do to help my patients?

There are many things you can do as a health care provider to help your patients get enough calcium, including:

*If you have patients who are lactose intolerant, share the "calcium consumption strategies" with them so they know how they can still get calcium without discomfort.

*Provide parents with copies of the Milk Matters booklet, For strong bones…For lifelong health…Milk Matters.
To order free copies of the booklet, call 1 800 370 2943 or visit http://www.nichd.nih.gov/milk.

*Encourage patients ages 9 to 18 to consume 1,300 mg of calcium a day. If a patient does not want to add milk or milk products to his or her diet, suggest non-dairy sources of calcium and calcium-fortified foods.

*Learn more about discussing calcium consumption with patients and their parents in the fact sheet Building Strong Bones: Calcium Information for Health Care Providers.

*For more information, visit the Milk Matters Web site at http://www.nichd.nih.gov/milk.

Milk Matters cont.1

Most people with lactose intolerance do not require a completely lactose-free diet.

Is self-diagnosis of lactose intolerance accurate?

In some cases, self-diagnosis of lactose intolerance may be the result of culturally based attitudes toward or misinformation about milk and its effects on health. Consequently, many people may be unnecessarily limiting or depriving themselves of the best source of calcium and other nutrients, to the detriment of their overall health.

For instance:
• Ethnic minorities may consume less calcium in their diets because they believe that their ethnic group as a whole is lactose intolerant.
• Many people believe, incorrectly, that all milk and milk products are fattening.6 Among adolescents, particularly females, claims of lactose intolerance may be attempts to avoid the calories in milk.
• Children and teenagers may also maintain that they have lactose intolerance because advertising suggests that milk isn’t "cool."7

What are calcium consumption strategies for patients with lactose intolerance?
Although the degree of lactose intolerance varies, most people with lactose intolerance do not require a completely lactose-free diet. Milk and milk products should not be completely eliminated because they provide key nutrients such as calcium, vitamins A and D, riboflavin, and phosphorus. Studies indicate the following strategies can diminish symptoms in people who have lactose intolerance:

• Drink low-fat or fat-free milk in servings of 1 cup or less.
• Consume low-fat or fat-free milk with other food, such as breakfast cereal.
• Consume other dairy products, such as low-fat or fat-free hard cheeses or cottage cheese, or low-fat or fat-free ice cream or yogurt. These foods contain a lower amount of lactose per serving compared with milk and may cause fewer symptoms.8
• Choose lactose-free milk and milk products, which have an equivalent amount of calcium as regular milk.
• Use over-the-counter pills or drops that contain lactase, which can eliminate symptoms altogether.
• Consume calcium-fortified foods such as orange juice with added calcium, soy beverages with added calcium, and some fortified breads and breakfast cereals.

Some non-dairy foods, such as spinach and broccoli, are also healthy sources of calcium. However, the body absorbs much less calcium from these foods compared to milk or milk products.

Milk Matter

Lactose Intolerance:
Information for Health Care Providers

Most tweens* and teens are not getting the recommended 1,300 mg of calcium a day they need to build strong bones—in fact, fewer than one in 10 girls and just more than one in four boys ages 9 to 13 are at or above their adequate intake of calcium.1 And adolescents who may be lactose intolerant are even less likely to get enough calcium.

As you know, pediatric bone development plays a considerable role in osteoporosis prevention. The tween and teen years are critical for bone development because most bone mass accumulates during this time. In fact, by the time teens finish their growth spurts around age 17, 90 percent of their adult bone mass is established.

As a health care provider, you can help your patients get the calcium they need by talking with them and their parents to determine if they have trouble digesting lactose and by providing guidance about how they can get enough calcium each day in spite of this condition.

Note: Tweens are kids ages 9 to 12.

Are there different types of lactose intolerance?

Individuals with lactose intolerance are unable to digest significant amounts of lactose due to an inadequate amount of the enzyme lactase.2

Research shows that lactase is high at birth in all infants regardless of race or ethnicity, but wanes by age 5 to 7 in non-Caucasians and other populations that don't traditionally include dairy products in their diets.3

There are three main types of lactose intolerance:
• Primarily lactose intolerance, in which individuals who were able to digest lactose previously begin experiencing symptoms of digestive discomfort with no history or signs of underlying intestinal disease, is the most common form of lactase deficiency.
• Secondary lactose intolerance is the result of a gastrointestinal disease, such as severe gastroenteritis.
• Congenital lactose intolerance, such as galactosemia, is a lifelong complete absence of lactase, and it is relatively rare. However, it is not uncommon for secondary lactose intolerance to be misdiagnosed during the newborn period as congenital lactose intolerance.

Clinical symptoms of lactose intolerance can include abdominal pain, diarrhea, flatulence, and bloating. The severity of symptoms differs, often depending on the amount of lactase remaining in the body and how much lactose has been consumed.

Individuals vary in their degree of lactose intolerance, but even children and teenagers with primary lactose intolerance can usually consume 8 to 12 ounces (1 to 1 1/2 cups) of milk without experiencing symptoms. Some patients with lactose intolerance may believe they are allergic to milk or milk products. A milk allergy, however, is related to the proteins in milk rather than the lactose.

How common is lactose intolerance?

An estimated 30 million to 50 million American adults are lactose intolerant.4 The pattern of primary lactose intolerance appears to have a genetic component, and specific populations show high levels of intolerance, including approximately: 95 percent of Asians, 60 percent to 80 percent of African Americans and Ashkenazi Jews, 80 percent to 100 percent of American Indians, and 50 percent to 80 percent of Hispanics. Lactose intolerance is least common among people of northern European origin, who have a lactose intolerance prevalence of only about 2 percent.5

Most people with lactose intolerance do not require a completely lactose-free diet.

Milk and Bone Health

Why are milk and other dairy products important for bone health?

Our bones need calcium to grow and stay strong. They especially need calcium during the teen and tween years when bones are growing the fastest and gaining strength for later in life.

Although calcium is found in a variety of foods, low-fat and fat-free milk and other dairy products are great sources of calcium because they have so much of it.

Tweens and teens can get most of their daily calcium from 3 cups of low-fat or fat-free milk, but they also need additional servings of calcium to get the 1,300 mg necessary for strong bones.

Other reasons low-fat and fat-free milk and dairy products are great sources of calcium include:
Low-fat and fat-free milk has lots of calcium with little or no fat.

The calcium in low-fat and fat-free milk and dairy products is easy for the body to absorb and in a form that gives the body easy access to the calcium.

Low-fat and fat-free milk has added vitamin D, which is important for helping your body better absorb calcium.

In addition to calcium, milk and dairy products provide other essential nutrients that are important for optimal bone health and development.

Can everyone drink milk?

Some people get an upset stomach if they drink milk or eat dairy products. This may be (but is not always) a sign of lactose intolerance.

Lactose is the sugar found in milk and dairy foods. When lactose is not digested it may cause an upset stomach, bloating, diarrhea, and gas.

Lactose intolerance is not common in young children. It is much less of a problem if milk or dairy foods are taken with meals. Talk to your pediatrician if you think your child might have trouble digesting milk and dairy foods.

Check out the health information topic Lactose Intolerance or visit the What if milk is a problem for my kids? section of the Milk Matters Web site for more information.

Calcium is critical to building bone mass to support physical activity throughout life and to reduce the risk of bone fractures, especially those due to osteoporosis.

Articles extracted from: http://www.nichd.nih.gov/health/topics/milk_bone_health.cfm

Why do I need a low-GI diet?

Do you suffer from any of the following:
excess weight
general tiredness, particularly mid-afternoon
flagging energy levels that can be boosted by eating something
lack of concentration
tiredness or grogginess even after a good night’s sleep
mood swingsfood cravings, especiallyfor sweet, fatty foods
mid-afternoon or aftereating a meal
high blood pressurehigh cholesterol
craving for alcohol earlyin the evening
diabetesheart disease

The chances are that you do suffer from one or more of these symptoms. In fact, tiredness is the most common complaint cited in doctors’ surgeries today. A shocking 50 per cent of all UK adults are overweight and the number of seriously obese adults has trebled in the last 20 years. The amount of adults diagnosed with diabetes has doubled in the past 20 years and those developing heart disease has increased by 25 per cent since the late 1980s, resulting in 2.65 million people now living with this crippling condition. These are frightening statistics but perhaps even more frightening is the fact that we are not alone. Take a close look at almost any Western country and you will find a similar picture emerging.

WHERE ARE WE GOING WRONG?
The real key to understanding why so many of us are experiencing such health problems lies in our past. The diet and lifestyle of Westerners have changed almost beyond recognition over the past century. This in itself wouldn’t be a problem if it wasn’t for the fact that our basic physiology and biochemistry remain almost exactly the same as those of our ancestors 1,000 years ago. Consequently, there is a mismatch between the foods that we eat and the foods that our bodies really need.
Although our ancestors ate the same amount of calories as we do today, if not more, they were much more active than we are and obtained considerably fewer of their calories from carbohydrates. The carbohydrates they did eat came in the form of beans, vegetables, wholegrain cereals, fibrous fruits and berries. Lack of refrigeration and little knowledge of food processing meant that much of this food remained relatively unchanged from the field to the plate. Consequently, most of the processing of their food was done by the body after they had eaten it. This took the body a long time, resulting in a gradual, sustained release of sugars into the bloodstream, leaving them feeling full and satisfied for longer.

By contrast, today flour is ground as thin as talcum powder to enable us to bake the lightest, fluffiest cakes and breads. Preferred fruit varieties are those that are high in sugar and low in fibre because they taste better. Cereals are so highly processed that they become unrecognizable, then refined sugars are added to them to make many of the foods we see on our supermarket shelves. Fibre-filled pulses are often absent from our food cupboards. Instead they have been replaced by highly refined, fatty, fast foods that take little time to prepare and even less time to digest.

As a result, almost every meal we eat contains the sorts of carbohydrates that break down quickly and release their sugars rapidly into the bloodstream, such as baked potatoes, chips, easy-cook rice, biscuits, cereals, cakes, breads and fast foods. And it is these foods that are contributing to many of our health problems. While it may not be possible or even desirable to return to eating habits of old, thanks to extensive testing of carbohydrate foods by leading researchers, we can now monitor the sorts of carbs we eat by referring to something called the ‘glycaemic index’.

WHAT'S THE PROBLEM WITH EATING HIGH-GI FOODS?
The sugars in high-GI foods are broken down quickly so they do not supply a sustained source of energy. Instead, they cause our blood sugar levels to rise rapidly. The body has to respond to this by making large quantities of the blood sugar-lowering hormone, insulin, and releasing it into the blood. Unfortunately, insulin is often too good at its job and instead of just reducing blood sugar levels to a desirable level, it sends them plummeting to levels lower than they were originally. This sets up a yo-yo effect as the body then responds by making us crave fatty, sugary foods in an attempt to make our blood sugar levels rise once more. Many of the symptoms listed on page 8 can be linked to fluctuating blood sugar levels caused by eating too many carbohydrate foods that score high on the glycaemic index.

Food cravings and lethargy
Many of us experience this yo-yo effect as the ‘mid-afternoon lull’. We eat a high-GI lunch – sandwiches or a baked potato, for example – and by 3.30pm we are not only feeling tired, lethargic and lacking in concentration, but we are positively craving something sweet to give us that much needed energy boost. This often happens again after the evening meal when we find ourselves heading back to the kitchen for a dessert, some chocolate biscuits or a glass of wine just a short while after having eaten.

Weight gain
A diet rich in high-GI foods can cause you to eat more calories (and therefore gain weight) for two reasons. The first is that high-GI foods are quick to break down. The quicker a food breaks down, the sooner you will become hungry and the more likely you will be to want to eat again. Secondly, high-GI foods will cause your blood sugar levels to rapidly rise and then fall, which in turn will result in strong urges to eat fatty, sugary foods shortly after a meal. Both points are compounded by the fact that another of insulin’s main roles is to promote fat storage, so the more insulin you have in your blood the more likely you are to store any excess calories you eat as fat.

Lack of concentration and mood swings
The brain is entirely fuelled by blood sugar. Therefore when levels drop as a result of the excessive production of insulin, it becomes more difficult to concentrate. Research has also found that low blood sugar levels are often linked to mood swings, reduced reaction times and even depression.

Diabetes
Diabetes is one of the most common health problems in the world, but it is most prevalent in Western cultures where we tend to eat a diet rich in highly processed, refined foods. It is thought that the stress that high-GI foods place on the body to keep blood sugar levels constant can result in either the insulin not working properly or the pancreas, the manufacturing site of insulin, becoming less efficient at producing it, sometimes giving up altogether.

Heart disease
As we have already seen, a diet rich in high-GI foods can result in people becoming overweight or developing diabetes. Obesity and diabetes are two of the principal risk factors that can lead to heart disease. In addition, high levels of insulin, which are brought about as a result of eating high-GI foods, are strongly linked to increased blood pressure and cholesterol (along with other blood fats), both of which are also major contributing factors to heart disease.

Articles extracted from: http://www.lowgidiet.net/pages/lowgiwhy.shtml

Count Your Carbs (cont2）

Using Carb Choice to Meal Plan - How This Works

Sample Meal Plan: 1,800 calories 206 gram Carb, 60 grams Fat, 112 gm Protein (45%-30%-25%)

3 meals= 60 grams carbs; one snack 15 grams carbs

1,800 calorie food Exchange Plan

3 Milk, 4 Veg, 2 Fruit, 8 Starches, 8 Meat, 4 Fat - 13 carb choices

Distribute the 13 carb choices evenly throughout the day. A choice can be a milk, a starch or a fruit. So, if you happen to not have enough fruit (15 grams) in a day, you can switch a fruit choice for a starch (15 grams) choice (hopefully it has fiber!).

Using the Food Label to Carb Count

Suppose you are eating a frozen dinner meal, or a combination meal of fish, pasta and vegetables. You can use the food label to find the carbohydrate content. Find the total carbohydrates (in one serving or the entire meal - see sample nutrition label below). Fiber and sugars and sugar alcohols are sub-listed there also. If there is more than 5 grams of fiber, subtract half the fiber from the total carbohydrates. This is your amount of carb grams. Divide this number by 15 grams to find the number of carb choices you are using for this food item.

Articles extract from: http://www.diabetescare.net/management_detail.asp?id=1239

Count Your Carbs (cont1）

What is Glycemic Load?

Glycemic Index (GI) and Glycemic Load (GL) are terms you might here about carbohydrate foods. “Glycemic” means “sugar in the blood.” The GI and GL rank carbohydrates on a scale based on their immediate effect on the blood sugar after eating. This is called the glycemic response. Foods with a high GI/GL are rapidly digested and absorbed, raising the blood sugar quickly and high. A slower more gradual rise is preferred.

Sugar, sweets and most refined foods have high glycemic loads. Some surprises, such as cereals and potatoes, also have relatively higher GI-GL. However, when you eat these foods with milk containing protein or a potato with butter and steak and broccoli, the GI-GL changes. Also, the cooking method and food particle size can alter the values. So, GI-GL is a source of controversy because this method is not predictably consistent. It can shed light on why your blood glucose goes so high at times.

Understanding the Food Groups, or Exchange Lists

The American Dietetic Association, in collaboration with other health associations, created The Exchange System. This system was designed to make meal planning easier for people with diabetes and offer health educators a common and consistent way to instruct them. Foods are categorized together into six groups that are commonly alike - like all fruits - and portions into amounts that are the same composition. For example, all the servings of fruit are 60 calories and 15 grams of carbohydrate. So, each fruit can be “exchanged” for another and the amount of calories and carbohydrate consumed remains the same.

One serving in any group is an exchange. So, your meal plan will designate how many exchanges from each group you should eat. Here are some examples of common meals plans:

(Disclaimer: This chart provides possible meals plans based on about 20-25% Protein, 45% Carbohydrate and 30% Fat. Your dietitian may calculate your meal plan differently based on your food preferences, weight goals and diabetes management. )

Using Carbohydrate “Choices” to Carb Count

Carbohydrate counting is a useful tool to plan your meals, especially to balance with your diabetes medication and insulin. A carbohydrate “choice” is a portion of food that has 15 grams of carbohydrate.

The fruit group, the starch group, and the milk group all have 15 grams of carbohydrate per portion as described. So, if you are planning on having 45 grams of carbs at lunch, you could have one serving of milk, one serving of fruit and one serving of starch. Another 45 gram example for lunch - two starches (30 grams) and one fruit (15 grams).

1 carbohydrate choice=15 grams of carbohydrate

Samples of one carb choice or 15 grams of carbohydrates:
½ cup oatmeal
1 slice of bread
½ English muffin
1 6-inch tortilla
4-6 crackers
½ cup peas
½ cup potatoes
1/3 cup rice or pasta
1 8oz. glass skim milk
2 small cookies
1 medium apple
¾ cup blueberries
1/2 grapefruit

Count Your Carbs (cont)

Traditionally, diabetic diets are designed to start with this calorie distribution:

Protein: 15-25%
Carbohydrate: 40-55%
Fat: 25-35%

Based on your personal health, lifestyle and diet goals, you dietitian can calculate and educate you on the best diet design for you. Your dietitian will take into account your cholesterol levels, A1C, blood glucose patterns, kidney function, blood pressure, work and sleep habits, meal and snack patterns, and food likes and dislikes to create your unique meal plan.

Sample Calorie Distributions

Based on different calorie levels, you may be allowed from 120 gms to 330 grams of carbohydrate.

The amount of carbohydrate for each person varies with their calorie goals, exercise levels, blood glucose levels and male/female. A healthy diabetic meal plan includes:

Women : 45-60 grams of carbohydrate per meal (3-4 carb choices/meal)
Men: 60-75 grams per meal (4 to 5 carb choices/meal)
For snacks: 15-30 grams of carbohydrate per snack (1-2 carb choices/snack)

Here is a typical example:

1,500 calories - daily total carbohydrates 170 gm (45%). 40 grams (3 meals), 15 gram (3 snacks)

Count Your Carbs

By now you know that carbohydrates affect your blood glucose levels. No, you do not have to avoid all sweets and starches, and yes, you can have fruit, carrots, and even sugar (in limited amounts)! You need to have a good understanding of what foods have carbohydrates, pay attention to the amount or portion size, select the healthiest carbohydrate foods that offer some fiber, and distribute your “carbs” evenly throughout the day.

What foods have carbohydrates?
- Grains : bread, crackers, rice, cereals, pretzels, pasta
- Starchy Vegetables : potatoes, peas, corn, legumes
- Fruit and fruit juices
- Milk and yogurt
- Sweets and desserts
- Non-starchy vegetables: broccoli, tomatoes, spinach, carrots etc., contain small amount s of carbohydrates and tend to not affect blood glucose unless large quantities are consumed.

The fiber and water content render the small amount of carbohydrate in these foods less available to impact blood glucose.

What are the best carbohydrate choices?

Various forms of carbohydrate affect your blood sugar differently. The same amount of carbohydrate from different foods will have a different effect on your blood sugar. A slice of white bread will raise blood sugar faster than one slice of whole grain bread. In this case, the difference is the fiber content. Foods that digest slowly will relase carbohydrate in the form of glucose into the blood stream more slowly.

Your goal is to eat carbohydrates in such a way that the foods cause a slow, steady release of glucose into your blood stream, so your body can effectively process it. Listed are some factors to keep in mind:
- Carbohydrate foods with fiber will slow digestion and release of glucose; Soluble fiber is particularly favored, such as oat bran, dried beans and peas, fruits, vegetables.
- The more refined the food, the faster the blood sugar rises. Even though fruit juice is healthy, because it is liquid and not solid like the fruit, the quicker the blood sugar will rise. Raw foods tend to be more slowly digested.
- Concentrated sweets such as simple sugar, will quickly raise blood sugar.
- Eating a carbohydrate food with fat, such as butter on the potato, will slow blood sugar rise.
- Adding protein will also slow the digestion - Have peanut butter with some crackers. This is called a combination snack (combines protein, fat and carb)

How much carbohydrate should I have?

There is no official perfect diet for diabetes. The best diabetic diet for you is one that keeps your blood glucose levels as close to target as possible, with the healthiest food choices. There are recommendations from low carbohydrate diets to the Mediterranean diet to vegetarian diets - you can create a personalized diet plan with your dietitian or certified diabetes educator.

Diabetes Management: Diet & Nutrition

Food and Blood Glucose

Eating causes glucose in your blood to go up. How much it increases depends on what you eat (such as how many carbohydrates your food contains) and how much you consume.

Depending on the type of carbohydrate you eat, it can take shorter or longer to digest. The time it takes for food to pass through your stomach - "gastric emptying" in medical terms - affects the amount of glucose in your blood at any one time.

The amount of food you eat also plays a large part in your blood glucose levels. Too much food, or too many carbohydrates, can cause high blood glucose. Too little food or carbohydrates can cause low blood sugar.

Also, how much and what you eat affects the need for insulin in your body. The ability for insulin to lower blood sugar plays such a key role that the Food and Drug Administration (FDA) says eating marks the cornerstone of diabetes treatment.

How Much and What Foods are Right?
Many people with diabetes follow an eating plan, but no single plan is right for everyone. Your personal plan will depend on your lifestyle and individual preferences.

The American Diabetes Association recommends that people with diabetes follow these general guidelines:

* Eat carbohydrates from fruits, vegetables, whole grains, legumes and low- fat milk.
* Eat fiber-rich foods.
* Keep saturated fats to less than 7% of total caloric intake.
* Eat at least two servings of non-fried fish per week.
* Limit trans fats.
* Restrict cholesterol intake to less than 200 mg/day.

You’re in Charge
Do not get discouraged just because you need to think carefully about your food choices. For example, living with diabetes does not mean you can never eat foods with sugar however, you do need to make some changes to live as healthy as possible.

Articles extract from: http://www.diabetescare.net/management.asp?category=Diet

Health: Attack on nervous system

It is possible for multiple sclerosis patients to lead normal lives, discovers SUSHMA VEERA.

ALTHOUGH she had heard of the idiom, don’t judge a book by its cover, Nazatul Aqmar Nazri never gave it much thought until two years ago.

Nazatul, who worked as a chef in Bahrain at the time, felt a numbness on her left side while waiting in a queue to order her food.

She felt dizzy. Her gait was unsteady and her vision was blurring. The police, who did not know that she was suffering from multiple sclerosis, almost arrested the 25-year-old for drunk and disorderly behaviour. “Although I wasn’t locked up, I was traumatised by having to wait six hours before a policewoman attended to me,” says Nazatul.

She was allowed to go home only after a breathalyzer test showed negative for alcohol.

“Each time I recall the incident, I remember the phrase that I learnt in school. If you see someone acting in a strange way, do not judge that person immediately. They could be ill.” Nazatul first suffered from symptoms of multiple sclerosis when she was 14. However, she only underwent tests when she was in Bahrain. “I was admitted and diagnosed with the disease,” she says.

Farah Diana Mohd Amin has also been suffering from multiple sclerosis since her teenage years. “I feel weak and I tire easily. If I walk too much, my legs become swollen,” says Farah, who runs an online boutique.

The attacks became more frequent after her first child was born. She used to get one attack a year but it escalated to four.

“At first I was upset over my condition but I have now accepted it. But my heart breaks each time my 19-month-old son cries. I can only sit and watch. I am afraid to carry him for fear that my hands will become numb and I will drop him,” says Farah, 25. “I will only pick him up if my husband is beside me.” According to consultant neurologist Dr Joyce Pauline Joseph, multiple sclerosis affects the central nervous system, causing the body’s immune system to destroy a substance called myelin.

“Myelin serves as a nerve insulator and helps the transmission of nerve signals. When myelin is damaged, communication between the brain and other parts of the body is interrupted.” Dr Joyce says early symptoms of myelin breakdown include fatigue, dimness of vision, forgetfulness or difficulty concentrating, weakness in the legs, numbness or tingling in the face, arms and legs as well as numbness in the chest and abdomen.

“The symptoms vary widely, depending on the location of affected nerve fibres,” she says, adding that the cause of the disease is unknown.

Dr Joyce was speaking at the recent launch of the A Wake Of Hope campaign organised by the Multiple Sclerosis Society Malaysia. The five-week campaign is aimed at creating awareness of the disease. Also present at the launch was consultant neurologist Dr Shanti Viswanathan who advised patients to consult their doctors regularly and to update themselves on the disease.

“It usually affects those aged 20-40. Women are twice as likely to develop it as men,” she says.

According to Dr Joyce, the disease is common among Caucasians and those living in the Northern or Southern latitudes.

“These people are less exposed to sunlight, which increases the probability of having the disease. There seems to be a link between multiple sclerosis and Vitamin D metabolism.” Both doctors say there is a need to dispel the misconception that multiple sclerosis only happens in Western countries.

“Many think we are not susceptible to the disease, not realising that there are 500-600 multiple sclerosis patients here.

“Diagnosis is often done through blood tests, spinal tap (lumbar puncture), visual tests or Magnetic Resonance Imaging which will show white spots on a patient’s brain and spine,” says Dr Joyce.

There is no cure for multiple sclerosis. Besides oral drugs and steroids, treatment typically focuses on strategies to treat symptoms, which can slow the progression of the disease. “Although it is a life changing disease, with proper treatment and support, patients can lead a normal life,” adds Dr Joyce.

Main symptoms

* Numbness or weakness in one or more limbs, which typically occurs on one side of the body or the bottom half of the body

* Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement (optic neuritis)

* Double vision or blurring of vision

* Tingling or pain in parts of your body

* Electric-shock sensations that occur with certain head movements

* Tremor, lack of coordination or unsteady gait

* Fatigue l Dizziness

Read more: Health: Attack on nervous system http://www.nst.com.my/nst/articles/Health_Attackonnervoussystem/Article#ixzz1MrP8BTSs

The Nutrition Source

http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/calcium-full-story/index.html#intro