Welcome to PANCHSHIL HOSPITAL

■ A balanced diet
A well-balanced, healthy eating plan is the cornerstone of good blood sugar control for all people with diabetes. Whether you are being treated with insulin or tablets, you still need to follow a sensible eating plan.

The so-called “diabetic diet” is nit in fact a diet, but rather a healthy eating plan ideal for all the family. Eating healthy not only helps to control blood sugar levels (thus also delaying the onset of diabetes-related complications), but also helps to maintain body weight and prevent heart disease. The old saying ‘you are what you eat’ is exactly right. Your blood sugar levels are affected by everything you eat. Wise food choices are the key to a healthy life and prevention of illness.

■ Physical exercise
The majority of adults and an increasingly high number of children are leading an overly inactive lifestyle. Although fitness is fashionable in developed countries, we are still becoming less and less active. Physical activity is vital for everyone. Exercise helps improve fitness, burn calories and thus reduce body fat, and increase muscle tone. Physical activity is key to good health.

For people with diabetes, exercise lowers blood sugar and, like insulin, also helps your body use its blood sugar efficiently. Exercise may also help insulin to work better. A person with diabetes will experience the same benefits and enjoyment from exercise as everyone else. Such benefits include weight control and psychological wellbeing.

■ Medical advice
Insulin lowers blood sugar levels and is essential for the treatment of type 1 diabetes, when the body cannot make its own insulin. People with type 1 diabetes require multiple daily insulin injections for survival. Their daily life includes regular blood monitoring to check the level of sugar in the blood. People with type 1 diabetes need to make provisions for this when planning and taking control of their lives. This may mean setting time aside during an activity to stop and take an accurate blood sugar reading and if necessary administer the correct dose of insulin.

In type 2 diabetes some insulin is made by the body, but not enough to satisfy it’s needs. People with type 2 diabetes may require oral hypoglycaemic drugs to lower blood sugar and some may need insulin injections (up to 30% of people with type 2 diabetes may use insulin injections some or all of the time to control their condition).

The important thing here is to make sure you receive the proper advice that is appropriate to your condition and incorporate the necessary adjustments into our life. That way you are the one in control.

■ Social life
Having a social life is a necessary part to any healthy lifestyle, yet it is hardly ever mentioned in any guidelines for the control of diabetes. A healthy social life, taking time out to relax with your friends and family is both vital in reducing our stress levels, thus reducing a factor in the development of diabetes, and helps people with diabetes to take control of their condition. Having to take extra care or yourself and administer medication does not mean that you cannot have healthy social life.

It is still possible to enjoy a party or celebration while maintaining a balanced diet. The guidelines to healthy food are advisable for anyone and eating this way does not have to be boring. Exercise can also be a part of your social life. Going for a walk with friends or family, or registering with a friend to join a local sports club can make exercise a lot of fun and a great opportunity to feel better in both body and mind.

Being Healthy

The prevention of lifestyle diseases and in particular Heart Disease has become a subject of prime concern the world over. Increasingly hectic lifestyles and spiralling stress levels have made lifestyle diseases a life-size threat. It is critical today to learn basic guidelines on how to steer clear of lifestyle diseases.

This brochure has been designed to provide you with a ready checklist to see if you are at risk of any of lifestyle diseases and what you can do to minimize such risk.

What is a Lifestyle Diseases?

The term ‘Lifestyle Diseases’ is a general term denoting all kinds of health problems, arising out of the way you live. It indicates that body systems are under excessive stress. The most common being diseases like Heart Disease, Blood pressure, Diabetes, etc.

Am I Likely to Develop a Lifestyle Disease?

The risk if developing a lifestyle disease depends on various factors. Some people are at higher risk than others. To find out your risk level, you can answer a simple questionnaire.

Has anyone in your family had a heart disease?	□ Yes	□ No

Do you have diabetes?	□ Yes	□ No

Do you smoke?	□ Yes	□ No

Do you have more than one alcoholic drink everyday?	□ Yes	□ No

Are you overweight?	□ Yes	□ No

Do you eat a diet that is high in fat?	□ Yes	□ No

Do you lead a sedentary lifestyle?	□ Yes	□ No

Do you have high blood pressure?	□ Yes	□ No

Do you live and work under a lot of stress?	□ Yes	□ No

Do you have high blood cholesterol level?	□ Yes	□ No

Have you reached menopause? (For women)	□ Yes	□ No

Do you take birth-control pills? (For women)	□ Yes	□ No

If your answer to any two of these questions is ‘Yes’, consult a Physician at Panchshil Hospital about what you should do.

If you are a man younger than 50 years of age and your answer to all the above questions is ‘No’, you should still seek advice at Panchshil Hospital on how to prevent heart disease. Men are known to develop heart disease more often than women do, particularly before the age of 50 years.

What can I do to Ensure a healthy Life?

There are many lifestyle changes that can help prevent lifestyle heart disease. To begin with, choose any two of the following suggestions and add them to your daily routine. Add more as you go along and watch the improvement in your health.

Exercise at least Every Alternate Day

Exercise lowers blood pressure and cholesterol. Walking, biking, and swimming are good exercises for you.

Eat Less Fat

Fat clogs arteries, which can cause a heart attack. Increase your intake of fresh fruits and vegetables, as these usually do not contain fat. Use milk and dairy products that are low in fat. Substitute red meat like mutton with lean meats like chicken and fish.

Control Your Blood Pressure

High blood pressure makes the heart work harder. If you have high blood pressure, lower the salt intake in your diet and learn relaxation techniques. You may need medication to help reduce your blood pressure if it is too high. If you are on medication for blood pressure, do not stop it on your own. For more information on how to control blood pressure consult a Physician at Panchshil Hospital.

Quit Smoking

Smoking makes you more prone to heart disease. If you are a woman smoker and take birth - control pills, your risk of developing heart disease in even higher.

Drink Less Alcohol

More than two alcoholic drinks a day on a regular basis can raise your blood pressure levels and increase the risk of heart ailments.

Get a Health Check-up done

It is always recommended to have a health check-up done after 35 years of age for every individual.

How do I get it done?

Register yourself for any of the health check-up packages. The team of medical professionals at Panchshil Hospital will make a professional evaluation following an examination of relevant pointers like blood pressure, cholesterol level and medical history. They will chart out a comprehensive health plan for your individual needs and counsel you on medication and a suitable exercise schedule.

Patient Information About Diet

Healthy diet decisions: Do you know what to eat?

If you're healthy and want to stay that way, do you know what to eat? Suggestions on what and how much to eat can be confusing, especially when faced with varied and conflicting nutritional advice. We at Panchshil hospital can help. Here we outline nutritional recommendations designed to promote health, and help prevent disease. Use these guidelines to plan your healthy diet.

Carbohydrates

Carbohydrates are your body's main energy source. Complex carbohydrates include legumes, grains, and starchy vegetables such as potatoes, peas, and corn. Simple carbohydrates, also called sugars, are found mainly in fruits, and milk, as well as in foods made with sugar, such as candy, and other sweets.

Recommendation

Get 45% to 65% of your daily calories — at least 130 grams a day — from carbohydrates. Emphasize complex carbohydrates, especially from whole grains and beans, and nutrient-rich fruits, and milk. Limit sugars from candy, and other sweets.

Cholesterol

Cholesterol is vital to the structure, and function of all your cells, but it's also the main substance in fatty deposits (plaques) that can develop in your arteries. Your body makes all of the cholesterol it needs for cell function. You get additional cholesterol by eating animal foods, such as meat, egg yolk, dairy products, and butter.

Recommendation

Limit your intake of cholesterol to no more than 300 milligrams a day.

Fats

Fats help your body absorb many essential vitamins, maintain the structure, and function of cell membranes, and preserve the integrity of your immune system. But fats are a very concentrated energy source, providing twice as many calories per gram as carbohydrates, and proteins. And too much of certain types of fats such as saturated fats, and trans-fats can increase your blood cholesterol levels, and your risk of coronary artery disease.

Recommendation

Limit fats to 20% to 35% of your daily calories. Emphasize fats from healthier sources, such as nuts and olive, canola and peanut oils.

Saturated Fats

Saturated fats are most often found in animal products, such as red meat, butter, and whole milk. Other foods high in saturated fats include coconut, palm, and other tropical oils. Saturated fats are the main dietary culprit in raising your blood cholesterol, and increasing your risk of coronary artery disease.

Recommendation

Limit your daily intake of saturated fats to no more than 10% of your total calories. For most women, this means no more than 20 grams a day, and for most men this means no more than 24 grams a day.

Fibres

Fibres are part of plant foods that your body doesn't digest, and absorb. There are two basic types: soluble, and insoluble. Insoluble fibres add bulk to stool, and can help prevent constipation. Vegetables, wheat bran, and other whole grains are good sources of insoluble fibres. Soluble fibres may help improve cholesterol, and blood sugar levels. Oats, dried beans, and some fruits, such as apples and oranges, are good sources of soluble fibres.

Recommendation

Women need 21 to 25 grams of fibres a day, and men need 30 to 38 grams of fibres a day.

Proteins

Proteins are essential to human life. Your skin, bones, muscles, and organ tissues, all contain proteins. It's found in your blood, hormones, and enzymes too. Proteins are found in many plant foods, and come from animal sources as well. Legumes, poultry, seafood, meat, dairy products, nuts, and seeds are richest sources of protein

Recommendation

Between 10% and 35% of your total daily calories — at least 46 grams a day for women and 56 grams a day for men — must come from proteins.

Vitamins and Minerals
You need vitamins and minerals for normal growth, function, and health. Not getting enough vitamins or minerals can lead to illness, but getting too much can cause toxic reactions. The best way to get the vitamins and minerals is through a healthy diet based on a variety of foods. But if you have a vitamin or mineral deficiency, a vitamin or mineral supplement may be appropriate.

Preventing Obesity and Diabetes

“ A small problem may grow into a big one.”
- Anonymous

The prevalence of obesity is rising to epidemic proportions at an alarming rate in both developed and developing countries worldwide. More than 1 billion adults worldwide are overweight and at least 300 million of these are clinically obese ( a body mass index, BMI, of 30 or over).Obesity is a primary risk factor for the development of diabetes and one way of preventing diabetes is to prevent becoming overweight or obese. Eighty percent of people are overweight when they are diagnosed with type 2 diabetes. Each kilogram increase in weight of the population increases the risk of diabetes by almost 5%.Obesity also worsens +he future outlook for persons with diabetes. Obesity can reduce the life expectancy of people with type 2 diabetes by up to eight years.

Being overweight is also now a common medical condition of childhood among urban residents. Overweight adolescents have a 70% chance of becoming overweight or obese adults, and this increases to 80% if one or both parents are overweight or obese. Weight gain is in most cases caused by overeating (especially the wrong types of food which cause excess weight gain) and physical inactivity (lack of exercise). The obesity risk of children increases for each additional glass of sugar-sweetened drink consumed each day. Eating while doing something else can often lead to overeating and thus increase chances of becoming obese. In certain industrialized countries, children today get 70% less physical activity than they did 30 years ago. Each two-hour daily increase of television viewing increases the risk of obesity and diabetes. Reducing malnutrition in pregnant women can prevent their children from becoming overweight later in life and ease the burden of obesity. Rare cases such as obesity that runs in families and caused by gene mutations should be ruled out confirmed by a specialist consultation.

Urbanization is a strong influence in the genesis of overweight and obesity because of several reasons, Around the world, more people are living in large towns and cities, more people are being born and more people are living longer lives. At the same time, people are taking less exercise and eating less healthy types of food in larger quantities than they ever did before. The result is that the total number of people in the world who are overweight, obese (grossly overweight), and with diabetes is spiraling out of control.
The main factors involved are:

1. Availability of more food, especially harmful calorie dense food
2. Advertisements and peer pressure that stimulate consumption of this food
3. Lack of availability of space and time for physical activity necessary to maintain optimum
health
4. Use of mechanized transport, avoidance of walking

Obesity is also the main modifiable risk factor for type 2 diabetes. It is estimated that at least half of all cases of type 2 diabetes would be eliminated if weight gain in adults could be prevented. Diet alone is not considered sufficient for sustained weight loss and needs to be coupled with exercise and a structured eating plan. Lifestyle interventions, including diet and moderate physical activity can reduce the risk of developing type 2 diabetes by as much as 60%. Physical inactivity was estimated to cause 1.9 million deaths worldwide in 2002. Currently 60% of the world’s population is estimated to not get enough physical activity, with adults in developed countries most likely to be inactive. About 10% of adults do no physical activity in their leisure time. More than 60% of adults do not achieve the recommended level of 30 minutes of moderate physical activity a day. Physical inactivity is estimated to cause about 10 - 16% of cases of diabetes. People aged 18 to 30 with low or moderate fitness levels are six times more likely to develop diabetes than those who are very fit. People with diabetes who walk 2 hours a day can lower their mortality risk by 39%, and their risk of dying from cardiovascular disease (CVD) by 34%. Moderate activity of just 30 minutes per day improves insulin sensitivity.

So the outlook is good, for the informed. Obesity and diabetes can be prevented. For an individual (or family, or society) it’s the attitude which matters most. We must learn to eat the right foods, in the right quantity, in the correct combination, at the right time; and perform regular physical activity in order to avoid becoming overweight or obese or getting diabetes. If we already have diabetes we can control it better with the proper food and exercise pattern, whether we are young or old.