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| Wednesday, 19 September 2001 |
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This article has been sent to us by two Sri Lankan doctors working in Germany - Dr. Mrs. Pete Subasinghe and Dr. Chandima Subasinghe.Healthy nutrition is an important part of a long and healthy life. That is even more true for diabetic patients. In order to prevent short term complications like diabetic coma or long term complications like blindness, kidney failure or arteriosclerosis, the sugar level should be well balanced on every day. But that requires both a good knowledge of the patient about adequate nutrition and a high degree discipline. The 50-20-30-Rule Every person, no matter if diabetic or not, should split the required
calories as follows: Fibres Food containing a lot of fibres releases its energy slower into your body. As a consequence the blood sugar level rises more slowly and more constantly, which has a positive effect on the diabetic patient. So try to eat mainly bulky food wherever possible, like wholemeal bread (brown bread), cereals, porridge, fruit and vegetables, especially legume like soy, lentils and beans. Six meals per day Doctors advise diabetic patients to divide their daily food intake into six small meals in order to have a permanent but slow uptake of calories. That prevents the too high sugar level called hyperglycaemia, which is to be prevented. So make it minimum five meals a day, having a small portion between breakfast, lunch and dinner. If possible,add a late dinner as a 6th meal. Total calory uptake for the day You determine your amount of calories required every day by the formula:Body weight multiplied by 30 multiplied by a certain factor according to your age. It is given in the table below: Age factor 20-30 1 30-40 0,97 40-50 0,94 50-60 0,86 60-70 0.79 above 70 0,65 As an example we take a person with a weight of 70 kilograms at an age of 75. So at first you multiply he weight 70 times 30 equals 2100. This number you multiply by the age factor, which is 0,65 for anybody over 70 years, 2100 x 0,65 = 1365 cal.That is the amount of allowed calories per day with light physical work. Weight control If you increase your physical exercise, your body burns more calories than at rest .For instance 15 minutes of walking spends an additional 78 calories,running takes up 188 cal per 15 minutes and cycling 98. Gymnastics uses up 65, swimming 158. In case you are overweight, you should do a lot of exercise and do not substitute the spent calories. That way you can reduce your weight. Do it as slowly as possible. 1-2 kilograms per month are enough. That way it has a long lasting effect and you are more likely to maintain it. As you know, overweight aggravates diabetes and is a burden for your heart. In order to calculate your ideal weight, take your body height in centimetres and subtract 100. One inch equals about 2.5 centimetres. One foot equals 30 cm. As an example a person with height of 5 feet 8 inches measures 5 x 30 plus 8 x 2.5 cm. that makes 150 + 20=170 cm. According to above formula your body weight should so be 170-100=70 kilograms. Bread Exchange Diabetic patients have to calculate, what and how much they are allowed to eat for each meal. This is very important especially for the carbohydrates. To make counting easier, carbohydrates are counted in bread exchange instead of calories. One bread exchange (BE) is the amount of carbohydrates calories in one bun or one slice of white bread weighing 20 grams. One BE always has 50 calories How do I know, how much of any other food items I can eat in order to get one bread exchange?Below table shows you the amount of various foods, that contains one bread exchange. For example rice: the table says, that 15 grams of (uncooked) rice contains 1 BE: food Grams per 1 BE white bread 20 g brown bread 25 g cornflakees 15 g oats 15 g muesli 15 g potatoes 70 g mashed potatoes 75 g chips 30 g noodles 15 g rice 15 g flour 15 g popcorn 15 g beans 200 g peas 95 g pumpkin 200 g carrot 190 g beetroot 120 g sweetpotatoe 50 g sweet corn 60 g watermelon 120 g jackfruit 70 g mango 80 g mangosteen 60 g okra 460 g papaw 80 g passion fruit 110 g rambutan 70 g apple 100 g pineapple 80 g dried fruit 20 g banana 50 g milk 200 g curd 250 g cadella 25 g dhal 20 g mung 25 g soybean 160 g soymeat 75 g
extras Once in a while, for instance at some celebration or dinner party you might wish to “sin” and eat, what diabetics should not. Then it should be only a small quantity, and you to have take into consideration the total calory amount. Here is a list of “extras” and how much they contain: extras Once in a while, for instance at some celebration or dinner party you might wish to “sin” and eat, what diabetics should not. Then it should be only a small quantity, and you to have take into consideration the total calory amount. Here is a list of “extras” and how much they contain: Amount, that equals
Total calories in All other food, that contains a lot of fat or protein beside the carbohydrates, have to be listed separately, because for your daily required calories you have to take into consideration the fat and protein as well as the carbohydrates (as you already did with the “extras”). Below list gives a number of selected food, but it is not possible to list all of them. Many products are labelled on the package, giving you the total amount of calories. Amount, that Calories consist Calories consist Food contains 50 cal most of fat mostly of protein coconut oil 5 x vegetable oil 5 x butter 5 x cheese 20 equal curd 60 x tunafish 20 x meat 30 x sausage 15 x egg 80 cal/egg equal equal Calory chart To make the calculation of your bread exchange more easy, below table shows, how much of carbohydrate, fat and protein you can eat according to the amount of total calories allowed. Total BE Fat Protein calories/da (carb) (calories) (calories) 1200 15 200 250 1300 16 200 250 1400 18 200 300 1500 19 200 300 1600 20 250 350 1700 21 250 400 1800 23 250 400 1900 24 300 400 2000 25 300 450 2100 26 300 500 2200 28 300 500 2300 29 350 500 2400 30 350 550 2500 31 400 550 2600 33 400 550 2700 34 400 600 2800 35 400 650 2900 36 450 650 3000 38 450 650 For instance our 70-kg patient from our example above, who is allowed 1365 calories (rounded up to 1400) should take up 18 BE, 200 fat calories and 300 protein calories per day. Balanced nutrition for a diabetic in Sri Lanka - an exampleThe person from our example is allowed 1400 calories a day, as long as he has not much of physical work. He should divide these calories in 18 BE - 200 cal of fat - 300 cal of protein. Let’s see what the menu could be like: Breakfast: Lunch: Afternoon tea: Dinner: Late dinner:
Are you fit to drive? “Are you fit to drive? is a question best answered by yourself before you sit behind the wheel. The first question should be “do I see enough” (is my vision all right), said Mr. Rohan Rajapakse, Optometrist, F.S.L.O.A. You do not take vision into consideration when answering the question “are you fit to drive”. Police attitude In the event of a car accident, the driver is first suspected of being under the influence of alcohol or any other drug that could affect his relaxes and provide a reason for speeding and other reckless driving. They also inspect the condition of the car, for example, brakes and lights. But no consideration is given to the condition of the driver’s eye sight. They are not trained or equipped to conduct a basic evaluation of the vision of the driver.A pedestrian could easily be missed and not spotted, especially with an oncoming bright light, which leaves you temporarily dazzled, when your eyes cannot accommodate the contrast. Let’s avoid an accident Once you become a licensed driver, get your vision examined. You yourself may not detect any deficiency, but an optometrist whom you rely on for a diagnosis, might find that your eyes are not giving adequate vision. This is one of the findings that a basic eye examination can reveal and can help answer the question “are you fit to drive” Stress and driving This is an area that cannot be measured, but Mr. Rajapakse emphasized that if you think you are upset and could be under stress, you must spend a few minutes on something other than driving. It has been found that the eyes of a person under stress could be less reactive. Study Team meets
Diyawadana Nilame * Centenarian Orchid Plant to be offered to the Dalada Maligawa. The Health Watch SPC Centenarian Study Team on Sunday met Diyawadena Nilame Nirajan Wijeratne of the Dalada Maligawa, Kandy to discuss the possibility of the Vanda 100 centenarian plant which we have dedicated in honour of the living centenarians in Sri Lanka and the world over, and in recognition and respect for human life. Being blessed at the sacred tooth relic. The Diyawadena Nilame Mr. Wijeratne while commending the objectives of study and dedicating an orchid plant in honour of centenarians, and respect for human life for the first time in the history of the world as laudable, said that in keeping with the religious traditions only a Bo-sapling could be blessed at the Maligawa, because a plant is a living thing and the only plant connected with the Buddha is the Bo-plant. He suggested instead for us to make an offering of an orchid plant of the centenarian variety at the second Tooth relic and the Maligawa will look after it, and it will be on display and could be seen by the public who visit the Maligawa.He said the plant could carry the Vanda 100 centenarian tag. He said if the suggestion is agreeable to the study team, he could make arrangements for the team and the connected centenarians and their family members, to make the offering at a special ceremony at the Maligawa any day convenient for the team, after October 7th.Prof. Colvin Goonaratna, and the centenarian study team will meet this week to discuss this suggestion with the Peradeniya Botanical Garden Authorities and the Interim Committee of the Centenarian Family Association Sri Lanka, who are connected with the centenarian plant project. Health Watch and the SPC wish to thank Mr. Niranjan Wijeratne for finding time amidst his busy schedule of duties to meet the centenarian study team. HEALTH WATCH QUESTION BOX
We had another question from Mr. Shelton Perera of Godigama, Maharagama on
vision impairment. He says he is 72 years old. A radio technician by profession. Since of
late, he has been finding it difficult to read, as the vision gets blurred sometimes. What
could this be due to? he asks. Can Humans Be Cloned? In 1997 a sheep named Dolly made headlines around the world. What was special about Dolly? She was the first mammal successfully cloned from an adult cell, taken from a ewe’s mammary gland. Thus Dolly became a younger “twin” to the sheep from which the cell was taken. Before Dolly, cientists had for decades cloned animals from embryonic cells. Few thought that it was possible to reprogram a cell from an adult mammal to generate another animal in its exact genetic image. Cloning from an adult cell makes it possible to see in advance what the offspring will be like.The aim of the scientists who cloned Dolly was to improve farm animals as a valuable source for producing pharmaceutical secreted in their milk. The report of the scientists’ success first appeared in February 1997, in the scientific magazine Nature, under the title “Viable Offspring Derived from Fetal and Adult Mammalian Cells”. The media quickly seized on the report and its implications. Two weeks later the cover of Time magazine featured a photograph of Dolly along with the headline “Will There Ever Be Another You?” That same week, Newsweek magazine ran a cover series entitled “Can We Clone Humans?”Since Dolly, scientists have cloned dozens of individual animals-all from adult cells. Can the same technology be used to clone adult humans? Yes, say some biologists. Has it been done? Not yet. Ian Wilmut, the British scientist who led the team that cloned Dolly, points out that cloning is presently “a very inefficient procedure”, producing a death rate among features that is about ten times higher than in natural reproduction.Some wonder, ‘What if someone were to perfect the technique and cloned, say, multiple Hitlers? In an effort to allay such fears, Wilmut points out that while a cloned child would be a genetically identical twin of the person from whom it was cloned, a cloned human would be influenced by its environment and would develop a distinct personality as natural twins do. Courtesy Awake Sept. 2000 Health Watch - SPC centenarian study First Centenarian Buddhist monk in Kandy Health Watch SPC centenarian study team met the 104 year old Ven. Prof. Hapugoda Nandarama Nayake Thera, the first Buddhist monk in the centenarian study at the Nandarama Pirivena, at Pujapitiya Kandy on Sunday. The interview and medical examination of the thera took over two hours at the end of which the thera invoking blessings of the Holy Triple Gem on the study team said, meeting centenarians this way by the medical team was a great meritorious act. The social objective of the study of fostering respect and honour for human life through recognition of one living up to 100 years as an achievement in itself was praiseworthy.He asked, “Is there anything greater on this earth than human life? Most people have forgotten this vital point. Life and living is all connected to health. The full report of this study will be carried in this page next week.Information about this centenarian Thera was given to us by Major General W. K. Ranawaka (rtd) of Moragoda. A. C. G. Kariyawasam secretary Buddhist Publications Society Kandy accompanied the study team.
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