DR. JOY CALLENDAR, nutritionist, reports on some of the more common chronic diseases and the impact of nutrition on their development and control.
Diabetes - In the case of type 1 diabetes it is important for patients to time meals around insulin injections to regulate glycaemic response.
In the case of type 2 diabetes, nutrition plays a greater role in its management. It plays a role in the normalisation of blood sugar levels, blood lipids (cholesterol and triglycerides) levels.
The old way of managing diabetes was simply to tell patients, "eat no sugar at all", the newer thinking is that it is more important to keep total carbohydrate intake constant.
"It is no point taking away the condense milk out of the tea if breakfast is going to be three slices of yam, four green bananas and two dumpling, plus fruit juice, because what is going to happen is that your intake of carbohydrate is going to be still too high and you will continue to run high blood sugar," she advised.
Weight management is also important. Ideal weight is the goal but even those who achieve moderate weightloss can move toward normal blood sugar
values.
Hypertension Some people are described as salt sensitive. The general guidelines which hypertensive patients should
follow are:
- Eating fresh foods rather than canned
- Choose unsalted snacks;
- Use fresh herbs, seasoning, condiments as these are low in sodium.
Soy sauce should be avoided, but there are low-sodium versions of soy sauce
- Cooked cereals have less salt than the package ones
- For good measure everyone should keep sodium intake below one teaspoon per day
Heart disease triglycerides have impact on heart disease; they are fats and certainly contribute to coronary heart disease especially atherosclerosis plaques and arteriosclerosis.
Fibre is important. Insoluble fibre, the sort that encourages regularity, is more familiar but for CNRDs soluble fibre plays a very important role of lowering cholesterol
"Talking about cholesterol and heart disease, a more practical perspective in my experience, is that we need to pay far more attention to saturated fats in our diet and to trans fatty acids because this is the substrate (the raw material) that the human body actually uses to make that cholesterol," Dr. Callendar
advises.
Cholesterol is not found in plant product, including ackee, avocado and nuts. These foods are however, high in fats.
People with coronary heart disease have high homocystein levels and the nutritionist indicates that taking vitamin Bs actually lowers the homocystein levels.
Cancer The amount of body fat, the nutritionist said, is certainly associated with some cancers such as breast and prostate cancers. "We know that the body fat plays a larger role in these cancers perhaps because fatty tissues store carcinogens more readily than other tissues and also because we think that fatty tissues are important in the generation of the hormones...for example oestrogen, again central fat, is implicated in some of the cancers, and again we encourage people to achieve and maintain their ideal weight," she said.
