Analysis Paralysis in the Name of Health

By Rajiv Ambat (CEO & Chief Health Officer @ NuvoVivo)
NuvoVivo Center for Obesity, Lifestyle Disorders & Research

All good things in life are simple and need a bit of patience, and consistency. This seems to be a universally true statement; more so when it comes to health & wellness. What is healthy and what is good for the body is the most confusing thing in the whole internet. Information overload has done nothing, but confuse the poor consumers! This along with half baked information and Instagram driven influencer marketing has put the poor common man at a super confused state of mind about making healthier food choices.

Nov 14th is the world diabetes day and this day is particularly relevant for a country like India which has one of the highest diabetic population, according to the WHO!
In this article, I am going to address some of the common questions our clients ask us at NuvoVivo, when they sign up for our online diabetes management programs, from across the world. I am sure you would relate to most of these questions

White Rice Vs Brown Rice Debate
The brown rice is traditionally known to be a healthier alternative than its white counterpart. Well, this is not wrong; brown rice has a slightly higher amount of fibre and protein, as compared to white rice. However, most of us miss the larger picture.

For example, if a person eats (option 1) brown rice with some curd or sambar, as against, (option 2) white rice with some green leafy vegetables and some protein (such as pulses, lentil, egg, fish, meat etc). In both cases, our body understands food as a whole; it does not act on white rice separately, or pulses separately and hence the second option is better than first with regards to a diabetic person.

It is the combined Glycemic Index of food and the total fibre + protein content that decides how soon the blood glucose levels will increase.

Healthy Eating is almost always a misnomer
Any supposedly “healthy food” if eaten more than required is unhealthy for the body. Our ancestors used to say – “Even Elixir if over-eaten is going to be poison”.

While one can consciously choose healthier food, it is equally important that he or she does not overeat! For example – a multigrain bread might be a better choice than white bread; but then, how many such breads are you eating?

Or in other words, are you eating more than what you spend in a day? If the calories consumed is more than calories expended, a person will gain weight in spite of healthier food choices. This eventually leads to high triglyceride levels, visceral fat and other issues!

Substituting Sugar with Honey or Jaggery
Table sugar is generally known to be unhealthy as it gets released as glucose into the blood almost immediately, owing to its high glycemic index. Besides, they are highly processed and often bleached with chemicals and thus lose most of its nutrients. In short, table sugar is just simple carbohydrates with no other nutrient value and hence it is also known as empty calories. For this reason, jaggery and honey are considered to be healthier counterparts.

There is no denying that, as compared to table sugar, jaggery and honey has a better nutrient profile as it contains many minerals, antioxidants etc. However, all the three have a reasonably high glycemic index and spike blood glucose levels immediately and are best avoided for a diabetic person.

Besides, honey has much more calories than table sugar; 1 teaspoon of sugar is only 16 calorie, while 1 teaspoon of honey is ~ 26 calories! At NuvoVivo, we prefer our clients to reduce, if not avoid sugar, honey and jaggery and instead resort to zero calorie sugar substitutes like stevia, there are organic and derived from leave of plant (Stevia rebaudiana)

Eating on time is NOT the definition of becoming healthy
When we ask our clients what they intend to do to become healthy or lose some weight, almost everyone tells us – “I’m going to eat on time!”.

Eating on time is definitely good as it reduces the chance of acidity and gastric diseases such as GERD (acid reflux), stomach ulcers, IBS (Irritable bowel syndrome) etc. However, becoming healthy does not stop at just eating on time!

Our next question to them – Are you eating healthy and nutritious food? And then – even if you are eating on time and eating nutritious food, are you eating within your calorie spend? Or are you eating more than what your body needs? This definitely puts some perspective in their thinking

Avoiding carbs is a bad idea
Carbohydrates are the villain as far as a diabetic person is concerned. But avoiding carbohydrates completely is not the right solution towards managing diabetes. Carbohydrates are important and are the most sought after source of fuel for the body – especially the brain.

Reducing or avoiding carbohydrates may create issues such as hypoglycaemia (i.e blood sugar levels fall below 70 mg/Dl), lack of concentration, weakness, headache etc.

As far as a diabetic person is concerned, it is best to keep carbs intake at around 200 – 250 grams in a day and reasonably spread out throughout the day. This range, of course, may vary depending on the age, physical activity levels and insulin sensitivity of the person. This carbohydrate has to be had along with a good amount of fibre (non-starchy vegetables) and also some protein (pulses, meat etc) for better control of blood glucose levels.

We also see some of our clients going hypoglycemic as they improve their body composition with proper exercise regimen, which inturn improves the insulin sensitivity of their body. This means, carbs can be slowly introduced.

Reducing Carbs & Increasing Protein is not the solution either
Reducing carbohydrates and increasing the protein intake along with a lot of exercises is a very simpleton approach towards managing diabetes and may not be the right thing to do always. This is especially true if the person has been having uncontrolled blood sugar levels for a long time.

It is always recommended to get a doctor’s advice, especially about kidney function, uric acid etc, before increasing the protein intake.

A protein intake of 0.8 gm per kilogram of body weight is normally suggested for an individual. This may however be even lower incase of medical conditions like Diabetic Nephropathy (kidney disease)

BMI is not the indicator of your health
Haven’t you seen people who are slim and within the BMI range (Body Mass Index), but still diabetic!? Such people will mostly be having very low muscle mass, compensated with higher fat mass, and thus total body weight within the range itself. This condition, also known as skinny-fat is classified under MONW (Metabolically Obese but Normal Weight) and such people are highly prone to lifestyle diseases like diabetes.

This means, while there is a high chance of diabetes along with obesity, a more reasonable predictor of such lifestyle diseases is the percentage body fat. A healthy fat percentage range is 12 – 20% for men and 15 – 22% for women.

Walking is NOT an Exercise
I hate to break this bubble for you. Please do not get me wrong! Walking is a good cardiovascular activity and is preferred, especially for the elderly. However, as far as younger people are concerned, walking is just a light cardio vascular activity.

Brisk walking for around 40 mins will burn nearly 150 calories and, to put that number in perspective, one homemade dosa is nearly 120 calories.

A more practical approach is to include a combination of resistance training and cardiovascular activity, so as to improve the metabolic parameters. However, just be cautious about the physical conditions of the body before doing exercises. For example – we tell our clients to avoid or reduce resistance training if they had episodes of piles in the past. Similarly, if a person has an arthritic knee or ivdp (disc prolapse) and obese, we strictly warn them against cardio exercises like running as it can futher exacerbate the injury.

In short, managing diabetes and becoming healthy requires some sensible approach and can be achieved without beating yourself up. It is possible to enjoy the journey and achieve the desired results. It only requires a flexible, yet scientific approach towards planning nutrition and exercises

And after all, a bit of patience and a lot of consistency always helps. Remember – Rome was not built in a day!


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