Twenty-six-year-old Reshma (name changed) panicked when she consulted a nutritionist as her HbA1c levels (average blood sugar count over three months) of over six indicated Type 2 diabetes. An IT professional in Pune, she was confused as she had normal body weight and wasn’t into overeating. “She weighed around 65 kg but was not careful about what she ate. She would order her meals from outside, sleep late and begin her day with a sugary cold coffee. With a job that entailed sitting at her desk for hours on end, she would hardly take a break on the hour or step out for a walk,” says Maitreyi Bokil, nutritionist and exercise physiologist. At her clinic, she is finding an increasing number of young people being diagnosed with prediabetes and diabetes. Some of them report extremely high cholesterol levels as well.
What are the fundamental mistakes in your diet?
Most youngsters have a low-fibre, low-protein and a highly refined carbohydrate diet. That’s because they rely less on home-cooked food and more on snacks and dial-a-meals. A high-fibre diet, which means including a good amount of fruits, vegetables and roughage, prevents sudden blood sugar spikes after a meal and adds bulk to your diet. They take time to be digested and, therefore, slow down the release of sugar in the bloodstream. Proteins, being heavy, also increase satiety, keep you full longer and reduce hunger pangs. “This controls your urge to snack in between. Refined carbs are broken down easily and make you hungrier,” says Bokil. Drinking fluids on the hour is also a good way to keep the snacking urge away.
Low fibre foods that young people may be consuming unknowingly are white breads, white pasta, white rice, pancakes, bagels, cereals and burgers. And while most may have eggs or chickpea chilla for breakfast, they may not be meeting the 0.8 gram/kg of body weight because they are not balancing out proteins the rest of the day. There are enough plant and animal proteins to build variety in the diet like lentils, pulses, Greek yogurt, almonds, cottage cheese, quinoa, lean meats, fish and chicken breasts.
Why is a sedentary lifestyle the culprit?
“Sitting for too long while eating high-sugar foods reduces the sensitivity of glucose receptors on the muscle surface as well as insulin sensitivity. This can elevate free sugar in the blood and, unnoticed, results in full-blown diabetes mellitus,” explains Bokil. Then there are erratic meal timings, little to no physical exercise, sleeping late, all of which hurt the body, causing inflammation, a precursor to diabetes. Most guidelines prescribe a moderate physical activity of 150 minutes a week, which basically means taking out 30 minutes every day. Sleeping late means your body is unable to process the sugar, repair cells or flush out waste, causing disease.
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“Inflammation manifests as increased fat around the midriff and upper back, darkening skin around the neck, irregular or painful periods in women, severe energy slump, poor sleep and frequent urination,” she adds.
Stress, the biggest trigger
Almost all young people are dealing with performance pressure and anxieties that add to their stress levels. “Psychological stress triggers an increase in cortisol – the stress hormone – which prevents the insulin from working efficiently. Hence blood sugar levels rise,” says Dr Vaishali Deshmukh, Department of Endocrinology, Deenanath Mangeshkar Hospital Clinic and Research Centre. Cortisol raises blood sugar by releasing stored glucose, so excess levels of it impairs the functioning of insulin. However, cortisol can be checked easily by sleeping at the right time, reducing caffeine intake at least three hours before bedtime and exercising regularly.
Then one needs to address immunological stress. “It could be the stress of a chronic illness or viral infection which can impact one’s immunity. Again the system responds by increasing cortisol levels and can go into a negative balance,” says Dr Deshmukh.
