Many Nigerians believe that when we fall ill or do not feel good, taking medicine is the best and most logical recourse. Depending on where we are, how ill we are, the resources available, and who is making the decisions, treatment could be traditional, herbal, orthodox, or a spiritual ministration. We also believe once we’ve taken medicine for an ailment, we should get better or, at least, start seeing some appreciable improvement.
For diseases like type 2 diabetes, it’s a bit more complicated, because in this instance ‘food literally becomes life’. The medications available, unfortunately, are not the magic bullet that we expect. Simply wishing the disease away also doesn’t work, neither does wonder drugs nor unhealthy food and lifestyle choices. There is a better way, but it’s so simple that it seems untrue. This tried, tested but often overlooked way is simply ‘eating right’.
When I say ‘eating right’, most people’s minds would go straight to dieting. Dieting is especially hard when you have to let go of so many of your favorite foods or treats, as most popular diets would have you do. However, dieting is not just about eating the barest minimum to reduce weight, even though this is typically the more popular version. It is the practice of consuming food in a regulated and supervised fashion to decrease, maintain, or increase body weight, or to prevent and treat diseases, such as diabetes and obesity. What should be important to you here is eating to prevent and treat diseases. As long as you eat right, you are unlikely to have weight problems.
Eating right is hard because it requires knowledge and discipline. This is where most people get it wrong; they jump into dieting without understanding what (and why) they are doing (it). Once you have the relevant knowledge, you will not have to cut out all or most of the meals you love because you would know how and when to eat them. As a diabetes and endocrinology specialist, I’ll be focusing on eating to prevent and manage Type 2 Diabetes (T2D).
T2D is a chronic condition that affects the way the body processes blood sugar (glucose). According to the International Diabetes Federation (IDF), an estimated 19.4 million adults aged 20-79 years were living with diabetes in the IDF Africa region in 2019, representing a regional prevalence of 3.9% (this means for every 100 people, 3.9 or 4 people have diabetes). This number is expected to be on a steady rise in the coming years, so it’s advisable to do whatever is necessary to live and thrive regardless of the statistics. All the carbohydrate we eat is converted to glucose. Sometimes, our bodies also convert fat, as well as protein, to glucose. So ultimately, the food we eat is what determines our blood glucose or blood sugar levels. As a result, dietary management forms the bedrock of diabetes management. Dietary management of T2D is targeted at improving overall health by achieving and maintaining optimal nutritional status, attaining good glycemic control, and preventing acute and long term complications of T2D. A combination of medical management with dietary management creates the best possible way to deal with T2D. It is important to note that before the 21st century, diabetes was rare in Africa. The main reason it has spread to its current level is that our bodies have been programmed to ‘fill up and use up’ and not to ‘fill up and keep’.
Think of a car. You fill the tank with fuel and drive the car to get you around. The fuel in the tank is used as you drive around and once the tank empties, you top it up again. Nowadays, we eat all sorts of processed and natural foods but we do not use up the energy derived from these foods because we’ve become a lot more sedentary. Diabetes is the body’s way of saying there’s an imbalance. Processed foods are particularly culpable because they have high-calorie counts from unhealthy fats and added sugar. Therefore, the first step on your path to eating right is to cut down on sugar and processed foods. I mean canned foods, fast food, noodles, biscuits, cakes, ice cream carbonated drinks, and so on.
Now, eating right, for anyone living with diabetes, doesn’t mean cutting out carbohydrates completely. Human beings need all the classes of food: carbohydrates, protein, fat, minerals, and vitamins. Eating right means decreasing the number of carbohydrates or calories you eat so you can reduce the imbalance. Secondly, it doesn’t mean you have to stop eating the foods you are used to. Rather, it requires learning how they affect your blood sugar so that you know how often you can eat them and what quantity you should eat. Take fried plantain, for instance. It contains a lot of calories and increases blood sugar quite well. If it’s a meal you love, you can eat it with something that doesn’t affect blood sugar like vegetable sauce. Or, if you’re like me and you like rice and plantain, reduce the quantity of rice you would normally eat.
The quality of the food you eat is also important. Quality has nothing to do with price because most times we associate expensive items with good quality. The quality of food is determined by the amount of nutrition you get from the food. When you think about nutrition, think of all the food groups – how much carbohydrate, how much protein, how much fat, and how many minerals and vitamins are in this food or meal? Most sugary drinks contain only water, sugar, flavour and colouring. The only nutrient in there is sugar (carbohydrate)! Did thoughts of how many bottles of soft drink you had last week just flash past in your mind? For diabetics, high-quality carbs are carbohydrates that do not increase their blood sugar levels too high, too fast, or for prolonged periods and which provide other additional nutrients.
Another thing to pay attention to, especially as a diabetic, is the glycemic index (GI). Simply put, the GI is how fast the carbohydrates in your food make your blood sugar rise. Meals or drinks which contain high amounts of sugar tend to have high glycaemic index values. Sugar is broken into glucose once it mixes with saliva. Once you swallow that sugary drink or pastry and it gets to your stomach, your body begins to absorb glucose, and your blood sugar levels shoot up. Complex carbohydrates like starch (found in yam, cassava, etc) take longer to break down into glucose. Your blood sugar levels rise gradually and do not tend to hit a high. If you have T2D, it would be advisable to consume more food with a low or intermediate GI rating. Below is a table of popular Nigerian foods and their rating on the glycemic index (courtesy Prof Egwim Evans, Federal University Of Technology, Minna and International Tables of Glycaemic Index and Load)
|Food||Glycemic Index Rating|
|Boiled White Rice||Low|
|Millet swallow (Tuwo)||Low|
|Maize swallow (Tuwo)||Low|
As you can see from the table above, most of our staple foods have a high glycaemic index. Sigh.
I really hope that this has, to a large extent, encouraged you to eat, live, and thrive. It is however paramount that as you go forward, you consult a nutritionist to create a proper meal plan specifically made for you. Everybody is made different and therefore can’t use the same approach. I also hope that I’ve been able to show you that it’s not too hard to eat right. It just takes a little more effort like every other good thing in life. I believe you’ll make the effort and I can’t wait to see you thrive.
This writeup is to help anyone who has ever struggled with diabetes as the whole world celebrates world diabetes day on November 14th.
Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition.