Vitamin D and Diabetes

Current scenario of Vitamin D and Diabetes

Mrs.Sheela Paul
Ms.Vimala - Dietitian


Vitamin D is quickly becoming the "it" nutrient with health benefits for diseases, including cancer, osteoporosis, heart disease and now diabetes.

Vitamin D foods are essential to life. Besides being needed for general health and well-being, foods high in vitamin D can have a positive effect on diabetes by reducing the risk of hypertension and atherosclerosis, minimizing the side effects of diabetes medication, reducing the oxidative process caused by diabetes, and enhancing the body’s ability to handle carbohydrates.

Vitamin D is very powerful . The body usually produces its own, with the help of by sunlight. A century ago, people who couldn’t get enough vitamin D risked developing rickets. Many foods are now fortified with vitamin D.

Many symptoms of diabetes such as high blood sugar level, increased urination, nerve damage, high blood pressure, high cholesterol, and the side effects of drugs used to treat these conditions, create a risk of developing nutrient deficiencies for patients with diabetes. One of these nutrients is Vitamin D.

ROLE OF VITAMIN D


Vitamin-D promotes calcium absorption in the gut and maintains adequate serum calcium and phosphate concentrations to enable mineralization of bone and to prevent hypocalcemic tetany.





It is also needed for bone growth and bone remodeling.







Prevents rickets in children and osteomalacia in adults.





Plays a role in modulation of cell growth, neuromuscular and immune function, and reduction of inflammation.


Vitamin D appears to make cancer cells less abnormal, less likely to multiply, and more likely to die. It also tunes up the immune system.

The major function of vitamin D is to maintain normal levels of calcium and phosphorus in the blood. Vitamin D aids in the absorption of calcium, helping to form and maintain strong bones.

Low levels of calcium can reduce the efficiency of the sodium-potassium working machinery in the cells and lead to high blood pressure.

Two reasons for making sure you have sufficient levels of vitamin D in your body

1.Vitamin D deficiency impairs the manufacture of insulin and its secretion in humans, suggesting a role in the development of Type 2 diabetes.

2.Researchers in Bulgaria showed that giving vitamin D supplements to diabetics during the winter improved control of their blood sugar levels.

Where do you find vitamin D?



Vitamin D is naturally present in very few foods. Dietary sources are:





Sometimes Vitamin D is added to milk, yogurt, bread, margarine, and breakfast cereals. Including an adequate amount of fish in your diet, 3 or 4 times a week, can be a good source of vitamin D.

Vitamin D is known as the sunshine vitamin because it can be obtained from the sun. In fact, as little as 10 minutes of exposure is thought to be enough to prevent deficiencies. Populations who may be at a high risk for vitamin D deficiencies include the elderly, obese individuals and dark-skinned people. Sunscreen “protects” against vitamin D formation, so if you wear it all the time, you are not making vitamin D.



Testing for Vitamin D deficiency
If you suspect you are low in vitamin D, ask your doctor to order a test. It is called 25-hydroxyvitamin D test, also known as 25(OH)D. Levels should be above 50 ng/ml (125 nmol/L).

Adequate intake of vitamin D may prevent or delay the onset of diabetes and reduce complications for those who have already been diagnosed. These findings appeared in the latest issue of Diabetes Educator.

"Management of vitamin D deficiency may be a simple and cost-effective method to improve blood sugar control and prevent the serious complications associated with diabetes.

Diet alone may not be sufficient to manage vitamin D levels. A combination of adequate dietary intake of vitamin D, exposure to sunlight, and treatment with vitamin D2 or D3 supplements can decrease the risk of diabetes and related health concerns. The preferred range in the body is 30 - 60 ng/mL of 25(OH) vitamin D.

And finally...

If your diet is not the healthiest one, you may not be getting the necessary amount of vitamin D or any others for that matter. However, do not rush to the nearest pharmacy and buy vitamin D. A multi-vitamin is usually okay but do not take a single vitamin by itself unless you are told to do so by your physician. Vitamins depend on each other to be effective, and large doses of one vitamin can upset the balance of nutrients.

Glycemic Index

Part 2

Shruti Kumari –Research Dietitian
Diabetes Research Centre,
M.V Hospital for Diabetes, Royapuram

Health benefits of low GI eating



Healthy low GI diets...

* Help to fill you up and keep you feeling satisfied for longer—thereby avoiding over- eating or too much snacking.
* Lower your insulin levels —which makes fat easier to burn and less likely to be stored.
* Help you lose body fat and maintain lean muscle tissue.
* Reduce your triglycerides, total and 'bad' (LDL) cholesterol.
* Increase your levels of 'good' (HDL) cholesterol.
* Reduce your risk of developing Type 2 diabetes.
* Help to manage your blood glucose levels and reduce your risk of developing diabetes complications.
* Reduce your risk of developing cardiovascular disease.
* Reduce your risk of developing certain eye diseases.
* Improve your skin
* Sustain your energy levels longer, — which improves both mental and physical performance.

Using the GI is easy.

It's all about balance. To achieve any of the health benefits of low GI eating, you need to make sure that you include plenty of low GI 'smart' carbohydrates as part of a healthy balanced diet.

How does one do that?

Step 1. Replace high GI foods with low GI ones from the same food group. The foods you choose should also be low in saturated fat, moderate in sodium (salt) and high in fibre. Foods that meet all of these requirements carry the GI symbol.




Step 2. Consume at least one serving of a low GI carbohydrate food at each meal and choose low GI carbohydrate foods for your snacks.

Step 3. Regulate the serving size. Be conscious of the quantity of carbohydrates you eat.

ALSO... Make sure you include at least 30 minutes of planned exercise like walking, swimming or riding a bike in your daily routine, plus 30 minutes of incidental exercise like using the stairs instead of the lift or going over to talk to a colleague instead of sending an email.

Some things to keep in mind about the GI

The GI only applies to carbohydrate-rich foods

It is not possible to obtain a GI value for foods which contain almost no carbohydrate. These foods include meats, fish, chicken, eggs, cheese, most nuts, oils, cream, butter and most vegetables.

The GI of a food does not make it good or bad for you.

High GI foods such as most potatoes and wholemeal breads still make valuable nutritional contributions to the diet. Low GI foods such as pastry that is high in saturated fat are no better for you because of their low GI. Different foods have a variety of nutrients. Choose a wide variety of foods that are low in salt and saturated fat, high in fibre and have a low GI.

Don’t avoid all high GI foods

There is no need to eat only low GI foods. While you will benefit from eating low GI carbs at each meal, this doesn't have to mean excluding all others. A meal that includes a high GI food such as a typical potato and a low GI food such as sweet corn will result in a lower GI overall.

It’s not necessary to add up the GI each day

The GI value of a food can be changed by the way it is processed or cooked, so it is not possible to calculate a precise GI value for recipes or to predict the GI of a menu for the whole day. That is why foods are categorised as low, medium or high GI. Just substitute low GI foods for high GI foods in everyday meals and snacks. This will make it easier for you to plan your diet.

Are foods containing sugar excluded?

Not all sugars are the same. Many foods naturally high in sugars like fruit, milk and yoghurt are very nutritious. It's more useful to focus on a food’s overall GI and total carbohydrate content rather than on the sugars .

Tips for reducing the GI of your diet...

1. Fill half your dinner plate with vegetables or salad

Try to eat at least five servings of vegetables every day. T his doesn’t include the starchy ones like potatoes, sweet potatoes or sweet corn. Choose from three or more different colours of vegetables.

2. Be wise with your potatoes

If you are a big potato eater and can't bear the thought of giving them up, you don't have to. Just choose wisely, and be careful with the quantity. Choose one or two medium-sized boiled.

3. Change to more nourishing bread

Instead of high GI white and wholemeal breads, choose a grainy bread where you can actually see the grains, or multi grain bread.

4. Make your starchy staples the low GI ones

Use more of whole grains, such as oats for porridge or muesli and broken wheat and opt for lower GI starchy vegetables.

5. Eat more legumes (pulses)

Include beans, lentils and chickpeas in your meals two or three times a week, more often if you are vegetarian. Use chickpeas, red kidney beans or any other variety of beans or lentils in the form of salad, soup or accompaniments.

6. Develop the art of combining

Combining high GI with low GI foods, results in a moderate overall GI. For example, lentils with rice , rice with beans , tabbouli in pita bread with falafel and a dash of hummous; baked beans on toast or with jacket-baked potato This makes meals more interesting too.

7. Have a lean protein source with every meal

Eat lean meat, skinless chicken, fish and seafood, eggs, milk, yoghurt or cheese;or legumes and tofu if you are vegetarian.

8. Tickle your taste buds

Try using vinegar or lemon juice with a dash of extra virgin olive oil with salads; yoghurt with cereal; lemon juice on vegetables or dhals. These foods contain acids, which slow stomach emptying and lower the blood glucose response to carbohydrates in the meal.

9. Use low GI when snacking

Keep foods that are healthy and have low GI in the house. Have fresh fruit, dried fruit, or fruit and nut mix, low fat milk and yoghurt (or soya alternatives), for snacks. Limit the use of high GI refined flour products such as cookies, cakes, pastries, crumpets, crackers, biscuits —whether home baked or bought— regardless of their fat and sugar content.


Don’t starve to be slim

You can lose weight by starving — BUT that is not a good step. On the other hand, it is very harmful. You will fall sick and you will soon gain the weight you lost.

‘Smart eating’ and ‘physical exercise’ are the key words if you are trying to shed kilos.

Can one lose weight through exercise alone? Yes, but it will take a long time. The best way is to integrate both smart eating and physical exercise.

Set goals for weight loss and eat healthy. Work out 5 days a week. Eat in small quantities at shorter intervals. You will not feel hungry between meals. Avoid snacking outside or eating in front of the computer or TV. Drink a lot of water. Keep some vegetarian snacks or seeds, nuts and fruit around.