Eating right for those with medical problems

Overeating is not a luxury that anyone with diabetes, high blood pressure and high cholesterol can afford.

We ask dietitians and doctors how to make the annual feasting healthier for those afflicted with the following conditions.

Diabetes Mellitus

It is a condition in which the body fails to use blood glucose or blood sugar properly. Try not to deviate too much from the carbohydrate intake patterns advised by your doctor or dietitian.

Dr Eric Khoo, a consultant at National University Hospital's Division of Endocrinology; NUH's senior dietitian Ong Fangyi; Singapore Heart Foundation's dietitian/nutritionist Lauren Ho; and National Healthcare Group Polyclinics' senior dietitian Janie Chua share their top tips.

Practise portion control: Choose nuts, such as unsalted almonds and cashews, to snack on. Stick to portions of 10 nuts or one cup of melon seeds a day.

Portion out dipping sauces and try not to ask for a refill.

Eat small and regular meals.

Limit cookies and tarts. Three pineapple tarts have the same amount of carbohydrates as half a bowl of rice. The same goes for five peanut cookies or kueh bolu or seven kueh bangkit.

Do not add too many root vegetables to your steamboat: Yam, potatoes and sweet potatoes are high in carbohydrates. Use non-starchy vegetables such as bamboo shoots, lettuce, fungus, wintermelon, long cabbage, mushrooms and seaweed.

Use fluids to your advantage: Choose drinks that are low in sugar. Unsweetened green or oolong tea has zero calories and polyphenols which have health benefits.

Sip slowly so you do not reach for another snack. Drink before a meal to prevent overeating.

Limit your alcohol intake: Keep to one standard drink (10g of alcohol) a day. Avoid sweet wines such as sherry and port.

Drinking a lot can mask symptoms of low blood glucose (such as dizziness, double vision, confusion, tremors in hands and passing out), which can therefore be neglected.

Limit your indulgence: Limit the number of days that you allow yourself to indulge in food and stick to it.

High Blood Pressure or Hypertension

This raises your risk of heart disease and stroke. Here is what to take note of, said cardiologist Lim Toon Wei from the National University Heart Centre Singapore.

Avoid high-salt foods: Or at least have them in moderation. Keep taking your medication as prescribed.

Have enough sleep: Too little sleep due to the festivities can also make your blood pressure go up. The same goes for tiring yourself out with too many activities you are unused to.

Enjoy alcohol in moderation: Alcohol is probably not as big an issue for hypertensive patients as it is for patients with atrial fibrillation or heart failure, but as with everything, it is best to enjoy it in moderation.

Do not ignore any symptoms: These include chest pain, shortness of breath, palpitations, leg swelling or even fainting spells, all of which could mean your heart condition is worsening.

"There is a temptation for patients to hide their suffering to avoid spoiling the celebrations for everyone else," said Dr Lim.

"This can be dangerous and we sometimes see patients come in after the Chinese New Year celebrations in very bad shape, which then really spoils it for their families."

Dr Lim acknowledged it is hard to avoid overeating during the festive period. But, "if you do not overdo it, a slightly indulgent meal once a year is not going to matter much," he said. "As with most things related to lifestyle changes, it is what you do day-to-day that counts."

High Cholesterol

Fatty deposits gradually build up in blood vessels to create blocks to blood flow, increasing your risk of heart disease, heart attack or stroke. Many festive goodies are sources of saturated fat and trans fat. Saturated fat and especially trans fat can increase low density lipoprotein, or "bad" cholesterol in our bodies.

National University Hospital's dietitian Cassandra Lim and National Healthcare Group Polyclinics' senior dietitian Janie Chua dish out some advice.

Practise portion control: Choose two or three types of goodies to sample and limit yourself to one or two pieces of each.

Look for healthier alternatives: Unflavoured roasted nuts, such as almonds or sunflower seeds, are rich in polyunsaturated fat which can help to lower your blood cholesterol levels and reduce your risk of heart disease. A serving of nuts is about 10 almonds or cashews.

Mandarin oranges or dried fruit such as raisins are good sources of fibre that help to prevent overeating by keeping you full. They also contain antioxidants that can reduce the risk of heart disease by preventing oxidative damage. Make your steamboat healthier: Choose white meat such as fish, skinless chicken or vegetarian sources of protein, like beancurd, over red meat.

It is okay to add prawns to sweeten the stock but do not eat the head of the prawn as it is high in cholesterol. Avoid quail eggs if possible.

Other cholesterol-rich food include chicken egg yolks, pig's brain and organ meats such as liver.

A diet high in cholesterol does increase blood cholesterol levels, though saturated and trans fats have a more significant effect on this problem.

The Health Promotion Board's recommended daily limit for cholesterol is less than 300mg, the equivalent of seven quail eggs. Add plenty of vegetables as they are rich in dietary fibre.

Make your own goodies: If you enjoy baking, you may reduce the amount of butter added or replace it with, say, unsaturated oils such as grapeseed or walnut oil, or unsaturated margarine. Butter is high in saturated fat and cholesterol.

You can also add oats or substitute plain flour with some wholemeal flour to increase the amount of fibre in the cookies.


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