Manage your stress for a sweeter life

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So, here are the answers to yesterday’s quiz:

1. False. Those with Type 1 diabetes have a pancreas that doesn’t produce insulin. In contrast, the pancreas of those with Type 2 diabetes does produce insulin, but their body is unable to respond to the insulin. Here are the facts.

2. False. Most people have Type 2 diabetes. Those who have Type 1 diabetes usually have the condition before the age of 35 years. And in fact, experts project as many as 1 in 2 locals having diabetes by 2050.

3. True. Regular exercise and an appropriate diet both work to improve insulin sensitivity of people with Type 2 diabetes. Find out more about how exercise helps here. According to research, the total amount of carbohydrates that we consume is important for managing blood sugar levels. Read more to understand why here. You can also find out what it means to “eat right” here.

4. False. The risk of developing heart disease for those with diabetes is 2 to 4 times higher than people who don’t have this condition, and smoking doubles this risk if you have diabetes. Read more here. A 2015 study also found that those with mild cognitive impairment were more likely to progress to dementia (which is linked to heart disease) if they also had diabetes.

5. False. People with diabetes are at a higher risk of developing kidney disease because excessive blood sugar damages the kidneys over time. In fact, studies report that about 10 to 40% of people with Type 2 diabetes will need dialysis due to kidney failure. But research also shows early screening and early treatment to be highly effective for maintaining kidney function.

6. True. In addition to excessive sweating, weight loss, and other symptoms, people with undiagnosed diabetes may notice changes and problems with their vision. Read more about these eye problems here.

7. Experts recommend a balanced diet, regular exercise, and blood sugar monitoring for keeping blood sugar levels stable, not just oral medications and/or insulin injections.

And it’s not just common sense. Research shows that exercise does reduce the risk of diabetes. A 2014 study found that people who lived “walkable neighbourhoods” — neighbourhoods where the shops and amenities were within walking distance — were less likely to develop diabetes.

Here are some practical tips for monitoring blood sugar levels.

As this ADA help sheet suggests, it’s also important to tell yourself that tracking blood sugar levels helps you evaluate how well you’re looking after yourself. Instead of berating yourself for not doing better, try these techniques for managing your emotions.

8. True. Nerve damage and/or poor circulation from excessive blood sugar are the reasons why people with diabetes may experience slower healing from cuts and sores. So it’s particularly important to take care of our feet. Read more about that here.

Did you get all 8 questions correct? Good job!

But recent research shows that a balanced diet and regular exercise aren’t the only lifestyle changes to make in order to get a better handle on one’s diabetes.  In fact, a 2015 study found that chronic stress to be a factor for developing diabetes, while another 2015 study found that people who stay awake later at night have a higher chance of developing diabetes than people who sleep earlier, even when both groups have the same amount of sleep.

So there you have it. The key to having a sweeter life (and lower levels of un-metabolised sugar in your bloodstream): Get to bed earlier and manage your stress!

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Did you know?

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A recent study found that there are more younger people with Type 2 diabetes mellitus in Singapore than other countries in Asia. According to the same study, as many as 3 in 10 people have diabetes before the age of 40 years.

Even though diabetes is a condition that’s been known to us since the days when the Egyptians wrote about a “thirsty disease” on papyrus, it’s not always a well-understood condition. What do you know about diabetes? Try this quiz!

True or False?

1. If you have Type 2 diabetes, your body is unable to produce insulin.

2. Type 2 diabetes is more common than Type 1 diabetes.

3. Exercise helps insulin work better for those who have Type 2 diabetes.

4. The risk of developing heart disease for people with diabetes is the same as for those who don’t have diabetes.

5. About 1 in 10 people with diabetes will eventually develop kidney disease.

6. Blurred vision can be a sign of diabetes.

7. The only way for people with diabetes to control blood sugar levels is to take oral medications and/or have insulin injections.

8. Healing from cuts and sores can take longer for those with diabetes.

Find out the answers tomorrow for a healthy World Diabetes Day!

Source: https://www.singhealth.com.sg/…/…/Diabetes-Mellitus.aspx

Drink up! It’s good for you!

Champagne

We usually think only of food. Should we reduce our intake of saturated fat? Are whole grain carbs better for us? Is too much sugar a bad thing? Will eating half a plate of vegetables at each meal reduce our risk of heart attacks and cancer? (The answer is yes, yes, yes, and yes).

We’re usually stressed about what we eat. And what we eat often adds to our stress. But our drinking habits may not be helping us. Here’s a closer look at the health benefits (or lack of benefits) of what we drink:

Alcohol
Previous studies found that moderate drinking reduced the risk of heart attacks and strokes. This has lead us to think that having a drink a day helps. A 2015 prospective study which followed 15,000 middle-aged adults for 24 to 25 years found that heart failure rate was lower among moderate drinkers, those who drank up to 7 drinks a week, than heavier drinkers. But the same study also found that heart failure rate was highest for former drinkers.

There’s a reason why they stopped drinking. Not everyone can have just that one drink. Which is why mental health professionals argue that “there is no such thing as a safe level of alcohol consumption” (Guardian, March 2011). Drinking impacts our sleep, immune system, our ability to think, remember, and make decisions, and most importantly, our mental health.

Moreover, research indicates that it’s exercise not wine consumption which improves cardiovascular health. Both red and white wine lower undesirable cholesterol levels (LDL), but only exercise increases desirable cholesterol (HDL).

In fact, health experts advocate cutting down on alcohol. Why? Because it doesn’t actually protect against heart attacks or stroke. A 2015 prospective study of 53,000 people found little or no health benefit to drinking alcohol. And two other recent studies confirm the benefits of drinking less: Researchers who studied those who get easily flushed from drinking and who therefore drink less over time, have better cardiovascular health.

Need help? Read this.

Soft drinks
It’s getting more and more difficult to recommend diet soft drinks. A 2012 prospective study which followed over 2,000 adults over a decade found that drinking diet soft drinks every day increased the risk of stroke and heart attacks.

recent study found that those who drank diet soft drinks ate more than those who drank the regular version if they were overweight or obese. Another recent study showed that diet soft drinks increased the risk for diabetes.

Diet drinks don’t help us save on calories. Sugar substitutes tell your body to expect energy-rich food but when none comes, your body goes into energy preservation mode: It stores fat.

What about having the real thing, but in smaller amounts? Some nutrition experts suggest a mini can of Coca-cola to be a good snack (more about that here). But beware the 90 calories in that teeny weeny can of sugar.

Here are the figures (http://cspinet.org). Know the facts (http://hsph.harvard.edu) and make up your own mind.

Coffee
Coffee drinking has a number of known health benefits, but can we have too much of a good thing?

2014 prospective study which followed health professionals found that increasing coffee intake by 1 cup a day over a period of 4 years reduced the risk of diabetes, while other studies show that coffee consumption helps our cardiovascular health. Moderate coffee intake — 2 to 4 cups a day — reduced the risk of heart disease by 20%, while drinking at least 1 cup of coffee (or 3 cups of green tea) a day reduced the risk of stroke by 20%.

Coffee increases our stress hormones and raises our blood pressure, but the current consensus is that drinking up to 6 cups of coffee a day doesn’t spell bad news for our heart (read this article). Research finds that coffee increases the risk of fatal heart attacks, but this is because more smokers drink a lot of coffee. A 2014 prospective study which followed 131,401 Paris residents for 3.5 years found more smokers among heavy coffee drinkers (e.g., 4 cups a day) than moderate and non-drinkers. When the researchers took into account the effect of smoking, they found that coffee was not a risk for heart attacks.

So, have your cup of java. But don’t be fooled into thinking that it’ll give you immunity.

Black tea
Surprisingly, black tea may be better than green tea for slowing the glucose absorption, thereby being of benefit to people with diabetes.

But the cool thing is that our stress response recovery improves with black tea consumption. In a 2006 study where the smell and taste of tea were masked, elevated stress hormones induced by a stressful event returned to baseline levels more quickly in those who drank tea four times a day for 6 weeks than those given a placebo. That sounds like a lot of tea, but it’s not an unusual amount for those who live in the land of scones and clotted cream, fish and chips, and overcast skies.

Cuppa for me, please.

Green tea
A 2014 study found that green tea improved cognitive functioning through improved neural connectivity, while a 2013 study found that green tea enhanced frontal brain activity.

A recent study indicates that an active ingredient in green tea may be responsible for suppressing the growth of pancreatic cancer cells. In addition to the potential use of green tea for lowering the risk of pancreatic cancer, flavanols known as catechins consumed from a daily dose of green (or black) tea have been shown to reliably lower cholesterol levels and blood pressure.

Unlike black tea which is usually brewed at temperatures near boiling point, green tea is best brewed at about 80° Celcius. And it’s not just about taste. A 2011 study that finds the best way to extract catechins is to brew green tea at 80° Celcius for half an hour. So it pays to wait for your water to cool (or you can pour it into cups and back again, especially if you’re the kind that stands around and impatiently paces or taps the kitchen floor).

So now you can’t say that you don’t know how to get a nice cup of longjing (龙井).

Herbal tea
You might already know about the sleep inducing benefits of drinking chamomile tea. But you might not realise that the same properties which induce sleep also relieve muscle spasms, suggesting that chamomile tea can be helpful for getting us to relax.

Two other teas also have calming properties. Peppermint tea and ginger tea are known to help with digestion. Peppermint tea soothes inflammatory pain in the gut, providing relief from irritable bowel syndrome which can be related to stress, while daily intake of ginger reduces muscle pain.

Fresh juices
Along with red wine and tea, citrus juices which are high in flavanones have been found to reduce the risk of ovarian cancer. But watch out for that delicious thing known as fructose – it’s easy to consume more than the recommended serving size when you’re drinking juice out of a bottle.

So, the moral of the story is you can have more coffee and tea. But beware of the sugar-laden condensed milk that you’re adding to your kopi-kosong or teh-siu-dai!

There’s no sugar-coating it

Food is a national pastime.

We all scream for ice cream!

CNN Travel names chicken rice, char kway teow, wantan mee, chai tow kuay, and chill crab as the top 5 foods locals can’t live without (surprisingly, katong laksa didn’t make it to the top 5; it’s listed at #14). According to a 2012 Mastercard survey, locals spend as much as $262 in US dollars dining out each month. There are more local food blogs than supermarkets and more than just a few food apps (e.g., Hungrygowhere, BurpplePicky). With almost every other person a foodie, that’s quite a lot for a place less than half the size of Greater London and nearly double in its population density.

It’s not the problem of junk food here. Rather, if the National Nutrition Survey in 2010 is anything to go by, nearly half the nation dines out at their local friendly hawker centre more than four times a week (up from 40% in 2004: National Nutrition Survey by HPB). In addition to the problem of too much salt from eating out, which increases the risk of high blood pressure and vascular illness, the most recent data reveal a disturbing trend of overeating. As many as 6 in 10 locals consume too many calories, leaving them vulnerable to the risk of obesity and diabetes, and heart disease.

But there’s a bit more to the story than that. In reality, stress has a bit of a starring role, while sugar plays a vital supporting role.

We typically respond to a stressful situation at work with cortisol (since we can neither fight our co-workers nor flee from our emails, much as we try to sometimes), which encourages our appetite and desire for high energy foods — simple carbohydrates (find the science explained herehere and here). We often think of these as just sugar and honey. But in reality, they often wear clever disguises from white rice, breads, cake, muffins, cupcakes, doughnuts, and biscuits, to hot and cold desserts. And an overconsumption of these lovely, fragrant, heart-warming energy-dense foods increases the risk of impaired insulin function (read this to understand the link between overeating and diabetes).

And while prolonged exposure to stress leads to chronic inflammation, it should be recognized that sugar also contributes to inflammation. In fact, it is sugar in all its various nefarious disguises which is responsible for populating the blood stream with small, dense LDL cholesterol particles. And it’s these small, dense LDL particles which raise our risk of coronary heart disease (read this for a full review of the factors for cardiovascular disease).

So yes, stress and sugar are the bad guys (here’s an earlier blog entry on thwarting the ill intentions of sugar). But there is a simple solution. It’s called exercise.

Take control of your eating

Omega 3 and 6

We just had The Festive Weekend of the year. And it was not a fun time for people who need to watch what they eat.

A practical tip for those with diabetes has been to eat on smaller plates (Mind Your Body, 30 Jan 2014), while a useful guide for those with high cholesterol has been that they should choose foods which are low in saturated fat.

But here are some facts that you may not be aware of.

1. Not all carbohydrates are equal.

It’s always a good idea to fill up on vegetables that are coloured (e.g., broccoli, kai lan, peppers, brinjal, carrots, spinach), and to keep in mind that root vegetables are essentially sources of carbohydrates rather than fibre. But not all carbs are equal. White unpolished rice isn’t particularly diabetes-friendly. But sweet potato and yam have a lower glycaemic index (here’s a chart). And so do soba (buckwheat noodles), beehoon (freshly made rice noodles), steel-cut (Irish) oats, rolled oats, tortillas, lentils, and barley, while russet potatoes have moderate glycaemic index when eaten cold (here’s why).

2. Eat food rich in Omega 3.

Foods with omega 3 are the in thing these days (here’s the science behind it). So it makes sense that you’d want to fill up on oily fish (here’s a list), walnuts, cauliflower, and flax seeds. In fact, there’s evidence that a handful of almonds or walnuts a day decreased the bad cholesterol (low density lipoprotein or LDL) for participants in two separate studies (here’s that data). In comparison, walnuts and brazil nuts have to be eaten in moderation. For a comparison of oils and omega-3 among nuts, check out this table.

3. Don’t blame that bad egg.

The recent advice about eggs has been that what we really need to watch out for is the amount of fat in our food intake, not so much the foods with cholesterol that we eat (here’s why), particularly if our cholesterol levels and triglycerides are in the healthy range. Nevertheless, those of us with elevated cholesterol might want to be careful about eating foods which have relatively higher levels of cholesterol (read this piece of advice and this piece about quail eggs).