Abstract
Nutrition is crucial for maintaining normal growth, development, and glycemic control in young people with diabetes (PwD). Undue restrictions cause nutrient deficiencies as well as poor adherence to meal plans. Widespread availability of low-cost, ultra-processed, and hyperpalatable food is further damaging. Most families struggle to find ways to provide nutritious, yet attractive, food with a low glycemic index (GI). India is one of the oldest continuous civilizations with a rich and diverse cultural and culinary heritage. Traditional dietary practices, including the centuries-old ‘Thali’ (meaning plate) concept, emphasize combinations (grains, lentils, vegetables, dairy, spices, prebiotics and probiotics, and fats) of local, seasonal, and predominantly plant-based ingredients. These practices ensure that all of the necessary food groups are provided and fit well with current evidence-based recommendations, including the International Society for Pediatric and Adolescent Diabetes (ISPAD) 2018 Guidelines. Techniques for the preparation, cooking, and preservation of food further impact the GI and nutrient availability. These practices benefit nutrient density, diet diversity, and palatability and thus improve adherence to meal plans and glycemic control. This narrative review describes the ancient wisdom, food composition, and culinary practices from across India which are still valuable today. These may be of benefit worldwide to improve glycemic control as well as quality of life, especially in PwD.
Highlights
Working on the premise that people with diabetes (PwD) should have a healthy, balanced meal plan and that there is no special “diabetic diet” [7], this narrative review explores the benefits of traditional food practices from across different parts of India, with a special emphasis on low glycemic index (GI) foods which will be useful in type 1 as well as type 2 diabetes
The paper draws upon experience of traditional common usage, supported by available literature retrieved from various databases (PubMed, Google Scholar, and relevant Internet official websites) as cited, using relevant keywords related to the topics discussed
It is possible for PwD to get 45–50% of their energy from carbohydrates and achieve good glycemic control by switching to whole grains, especially unpolished millets, that provide low to moderate GI complex carbohydrates with resistant starch, high fiber, and micronutrients
Summary
Diabetes (ISPAD) Clinical Practice Consensus Guidelines recommend a diet “based on healthy eating principles suitable for all children and families, with the aim of improving diabetes outcomes and reducing cardiovascular risk” [5]. With increasing commercialization and availability of hyperpalatable foods with high glycemic index (GI), families struggle to ensure nutritious, yet attractive meals [6]. Working on the premise that people with diabetes (PwD) should have a healthy, balanced meal plan and that there is no special “diabetic diet” [7], this narrative review explores the benefits of traditional food practices from across different parts of India, with a special emphasis on low GI foods which will be useful in type 1 as well as type 2 diabetes. The paper draws upon experience of traditional common usage, supported by available literature retrieved from various databases (PubMed, Google Scholar, and relevant Internet official websites) as cited, using relevant keywords related to the topics discussed
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