DIET SHEET IN ENGLISH FOR DIABETIC PATIENTS . FAQ

 

DIABETIC DIET CHART 

Early Morning (6:00 – 6:30 a.m.)

          Skimmed Undiluted Milk (Coffee / Tea without sugar) – 100ml (1/2 cup)

Breakfast (8:00 - 8:30 a.m.)

          Idly / Idiappam / Wheat Bread (Slices) – 3-4nos.

(OR)

          Dosa / Ragi Adai / Chapathi – 2-3nos.

(OR)

                Upma (Semolina / Oats / Sago) / Pongal / Kichdi – 1 cup

                Thick Sambar / Dal – 1/2 cup

                Chutney (Avoid Coconut) – 2-3tbsp 

Mid Morning (10:30 - 11:00 a.m.)

              Buttermilk / Veg. Soup – 1 cup

                            Fruits – 50-100g / Salad – 1 cup

Lunch (1:00 - 1:30 p.m.)

Rice – 1 cup / Chapathi – 2 nos. / Rice -1/2 cup + Chapathi – 1 no

Thick Sambar / Dhal – 1/2 cup

Vegetables as: Poriyal / Greens / Sabji / Salad – 1 cup

Curd (Skimmed Milk only) – 1/4 cup

Tea Time (4:00 – 4:30 p.m.)

Skimmed Undiluted Milk (Coffee / Tea without sugar) – 100 ml (1/2 cup)

Sundal / Sprouts / Roasted Bengal Gram Dhal – 1/2 cup

Fruit – 50-100g

Dinner (7:30 – 8:00 p.m.)

Same as Breakfast / Lunch

Bedtime (9:00 – 9:30 p.m.)

Undiluted Skimmed Milk (Without sugar) – 50 ml (1/2 cup)

Measurements

1 cup = 1 coffee dabera = 200 g cooked weight

1 tbsp = 15 g

1 tsp = 5 g

Note:

Oil – 2–3 tsp / day (10-15ml)          

   

-----------------------

GENERAL INSTRUCTIONS

• Fruits that can be taken are as follows,
• Fruits such as: water melon, melon (musk), papaya, figs, guava & amla can be taken frequently.’
• Fruits to be taken occasionally are: apple, apricots, dates, grapefruit, jambu fruit, peach, pear, pineapple, plums, orange, strawberries & sweet lime.
• Fruits that need to be taken rarely are: banana, custard apple (seethaphal), grapes, jack fruit, mango & sapota in very less quantity only.
• Vegetables to be taken rarely (1-2 times / week) in less quantity (50g) are: beetroot, carrot, green plantain.
• Foods to be avoided: sugar, glucose, honey, jaggery, sweets, halwas, burfies, jams, jellies, preserved fruits, dried fruits, aerated drinks, cake, pastries, candy, fried foods, horlicks, bournvita, proprietary drinks, chocolate drinks, chocolates, ice cream, alcohol, karakuzhambu.
• Foods containing lower calories and can be included freely in diet are: clear soups, diluted skimmed buttermilk, unsweetened lime & tomato juice, rasam/pepper water, plain coffee/tea, raw vegetable salads. These foods can be taken in between meals and whenever there is feeling of hunger.
• Dietary regulation involves consumption of a balanced diet with small frequent meals / snacks. Do not starve, skip a meal or go on an empty stomach. Equal spacing of the 3 major meals and snacks each day is very important.
• Include all five food groups namely, cereals, pulses, vegetables & fruits, milk products, fats & oils in the daily diet in the right proportion.
• Any type of cooking oil can be used, but use in moderation only for seasoning. Seasoning & frying of all foods should be within the oil allowance. Baking, roasting, steaming or boiling can be used as a method of cooking instead of frying foods.
• Non-vegetarian foods (Chicken / Fish / Eggs) can be consumed in restricted quantity (3-4 pieces / day) boiled, steamed or baked form, and not in the fried form without substituting dhal & vegetables.
• For restricted salt, use salt only in one dish in one meal. (Ex. If idly is with salt, sambar should be without salt). Avoid papad, pickles, preserved foods, chips, sauce, ketchup, dry fish, baking powder, masala powders, salt biscuits & pastries.
• Fluid normally 2-2.5 lt/day. If there is fluid restriction, output + 500ml is the recommended fluid intake. All dishes should be of thick consistency.
• Brisk walking for 30-45 mins is recommended every day.

---------------------------

    FAQ - Frequently Asked Questions

• Should wheat be substituted for rice in a rice eating population?

The amount of calories in rice and wheat are the same, however the quality of protein is high in rice whereas the quantity of protein is high in wheat. Wheat has more fibre and tends to delay increase in blood sugar levels when compared to rice. A mixed diet containing both rice and wheat are suggested.

• Should fruits be avoided?

Fruits are good source of vitamins, minerals, fibre and antioxidants but must be taken only in recommended allowance & at a particular time. Fruits are recommended as a whole fruit with edible skin instead of fruit juices.

• Can a diabetic undertake fasts?

Fasting must be avoided as it alters the metabolism of the body and it can be dangerous when taking medications for diabetes.

• What to take on a sick day?

On sick days, when normal food is not tolerated, food should be modified to suit the condition. Liquid, semisolid, bland or steamed food is recommended. But once the patient recovers, it is best to revert back to regular modulated diet.

• What are the guidelines while travelling?

While travelling it is suggested that food is carried whenever possible. If not, one must learn to choose from what is available and not starve. Low fat preparation based on cereal, pulse and vegetable combination is best preferred to rich oily food items.

• Should non-vegetarian foods be completely avoided?

Non-vegetarian foods can be taken daily / weekly / occasionally. These food items require regulated consumption such that it does not contain more calories. They must be consumed along with vegetables, dhal and cereals and be taken only in quantity prescribed each day.

• How many meals are allowed per day?

Three meals a day consisting of breakfast, lunch and dinner with a nutritious tea time snack is best suited for Indians. However, an early morning & bed time milk beverage is also allowed. A mid morning low calorie drink is also provided. It is best to have a gap of 3 to 4 hours between each main meal, as the GI tract needs a physiological rest. More than 4 hours of gap is also not advisable for diabetics and it is important to see that the overnight period of starvation is not too long. 

• Is timing of the meals important?

It is important that the diabetic patient takes meals at the right time. When a doctor prescribes anti-diabetic medication, it is even more important that the patient takes the medication and the meal at the appropriate time as specified.

• Can diabetic take alcohol?

Alcohol provides empty calories (calories with no nutritive value) and should generally be avoided. If one cannot do without it, take a drink with low alcohol content, that is, light beer, light wine. Calorie content of the drink should be adjusted in the diet.

• Should salt be restricted in the diet?

Salt restriction is necessary when hypertension is also present. Highly salted foods like pickles, papads, salted chips, processed foods, tinned foods, sauces, processed meat, etc. should be avoided. Soda water, baking powder, baking soda, ajinomoto that contain sodium should also be avoided.

• Is it necessary to avoid foods rich in fats and cholesterol?

It is better to follow a low fat, low cholesterol diet. If Cholesterol and Triglyceride values are high, avoid the following foods – fried foods, fats like butter, cheese, dalda, ghee, khoa, cream, coconut oil, coconut preparations, organ meats, etc.

• Is exercise helpful?

Regular exercise helps to maintain desirable body weight, and controls blood sugar level by increased glucose utilization by the muscles. Exercise tones up the body and improves cardiovascular fitness.

-----------------------------------

DEPRESSION IN OUR DOG AFTER DEATH OF HER PARTNER

 DEPRESSION IN OUR DOG AFTER DEATH OF HER PARTNER

Our German shepherd dog past couple of days, vocalized throughout the nights in a mild mourning fashion - not howling like dogs generally do. Over the past week she had some loss of appetite and ate very little. Even during the day, over the past few weeks, she used to come and mourn a lot to all of us in the family. This was quite different from her normal reserved self.

USED TO BE A RESERVED GSD

She started  to dig out the garden a great deal and recently used to come closer and lie down. Before that, she was a typical German Shepherd Dog (GSD) who used to keep a distance between her and me even while walking. But now her behaviour is more clingy and more docile to me. To outsiders, her behaviour is still the same.

She had lost her partner, an affectionate GSD about 3 weeks ago. Both of them had been with our family as pups . They used to hang out together all the time, eat together and play together.

HER PARTNER WHO PASSED AWAY

I examined her - no lumps or tenderness. Her temperature was also normal. The veterinary surgeon who examined her thoroughly also did not find any physical abnormality.

Depression in dogs occur for various reasons - one of them being the death of another household dog / pet. 

The symptoms of depression are decreased activity, refusal to feed, changing the place of sleeping, vocalisation as seen in our dog who normally is very quiet. Some dogs become more quiet. Some lose interest in taking a walk outside. 

Treatment consists of  taking more time to spend with the pet, and speaking to her. Generally with a lot of TLC, the depression is taken care of after a period of time - duration varies on the particular dog - days, weeks. 

LOT OF TLC

If nothing of the above works, medication may help. As always, vet surgeon has to rule out physical disorders and prescribe the medication.

Depression in dogs may sometimes take as long as a year.

One (വൺ) - A MOVIE (2021) REVIEW

 One (വൺ)

Political ‘drama' released on 26 March 2021.

Mammootty is the hero. 

Movie is about an honest  chief minister, who opposes corruption at all levels - inside and outside his party. 

An incident of an unreasonable behaviour of a guy who orders home delivery of food , where the person has to climb 12 stairs and gets a heart attack!

An ordinary young daughter taking on the bully who caused the heart attack!

Women parking vehicles in malls ( Kerala is always ahead in culture)!

VVIP culture and second rate treatment melted out to ordinary citizens by democratically elected leaders is portrayed lucidly as only a Malayalam movie can! 

A kind chief minister with his own personal problems ( health and family) comes to the rescue of ordinary citizens!

An auto ride by the chief minister of the state during a traffic jam!

I am reminded of the quote from another movie ‘WONDER’ -  'Greatness is not about how strong you are ..... but about the use of strength to protect the weak, value of your principles and the valour to protect those close to your heart’!

On the night of announcement of election results in 5 Indian states, it was worth watching last night. 

Movie may be classified as a ‘fiction' till it comes true,  when it can be labeled a ‘drama'.

APPA'S EASY CHAIR

 Appa’s Easy Chair

"Let's sit quiet a bit, Toady!" said the Rat, throwing himself into an easy chair, while the Mole took another by the side of him and made some civil remark about Toad's delightful residence.

1908: Kenneth Grahame, The Wind in the Willows 

In the seventies, I remember my father lying in an easy chair in the nights, a bit tired. He used to tell me about some main events, trials in his life. I was a young medical student then, not always receptive however, like most adolescent sons!

Though mostly amusing, the discussions had been educative, instructive, advisory in nature. He was a traditional strict dad.

His main words were, “Always, put in the best effort.Be wise as a serpent, but harmless as a dove”

He himself was a self made man and had worked hard during life; he took on 4 jobs after his retirement, to put me through a medical college education and my sister through mathematical higher education.

More than 2 decades had passed since his demise. 

I was looking through the attic the other day. I found a carefully packed easy chair. It was my father’s. I had not seen an easy chair, leave alone his, for many years. 

Thanks to covid, one gets a new overview of life! 

I took it upon myself to look for a cloth for the easy chair. The cloth I found was too long.With considerable difficulty,I located a tailor to alter it to fit the chair. Sadly due to my own stupidity, I had z small part of the chair cracked up, while setting it up 😷.

The furniture shop opposite to my house, glued it and gave it back. With the remark, would I be interested in selling it to them, because it was made of wood that you hardly ever get nowadays. 

I had never paid any attention to the type of wood; then I remembered my father once saying that he had the easy chair done out of rose wood as it would last a long time!

Late last evening, I finally took the easy chair out into the garden for a trial and sat out for half hour. 

It was cool, after the rains during the day. The jasmine smell was strong in the air. My new vigour in gardening had helped to blossom all sorts of flowers. I sat in a partially lit area considering the recent rains and the puddles, along with two of my German Shepherd dogs. 

It was wonderful to sit in my father’s easy chair, 25 years after he had left. And I don’t know how long he had the chair. It was in the family as long as I could remember.

It was very relaxing 😍, well, at least till the mosquitoes arrived on the scene. I beat a hasty retreat into the house!

5 minutes later, there was a knock at the door. The watchman showed me what he found at the spot where I was sitting… a large scorpion! 😳

Apparently it was moving across the floor , when the GSDs partially bit it with violent tossing of their heads. He managed to pry the scorpion away from the dogs, but a bit too late!

My father’s words rang through my mind, “Be wise ( cautious)” . I am sure he meant it in a different context. But even in this situation, I had chosen the lit area for sitting out, as the sun had gone down. I was  acutely aware of the dogs, as they always pick out reptiles around earlier than humans, rain or no rain. 

Some might have attributed this to karma!

If I had been sitting out for a bit longer, I might have picked up the scorpion in ways more than one 😩. I could not  help but thank  the mosquitos silently, for persuading me to go indoors!

So it is good to be cautious even when totally relaxed in a traditional easy chair, covid or no covid!😊