Sweet Deepavali for diabetic and their family

- Nutrition Department


Deepavali is a major Indian festival celebrated by Hindus, Jains and Sikhs across the globe as the “Festival of Light,” where the lights or lamps signify victory of good over the evil within every human being. This festival is celebrated with joy and charm that is unmatched in celebration with any other festival.

Deepavali, as it is popularly called, is the festival of lights as “Deepam” mean lamp and Oli light. Both words when combined forms the word Deepavali. It symbolizes the victory of righteousness and the lifting of spiritual darkness. The word Deepavali literally means rows of clay lamps. It is celebrated on the New Moon day of the dark fortnight during October-November. It is also associated with the return to Ayodhya of Lord Rama, his wife Sita and His brother Lakshmana after their fourteen-year sojourn in the forests. The day also marks the coronation of Lord Rama.

Lord Krishna waged a fierce battle and killed the demon. When the evil Naraka was finally killed by Bhagwan Krishna and Satyabhaama, he begged pitifully for mercy; thus, upon his entreaties, Bhudevi declared that his death should not be a day of mourning but an occasion to celebrate and rejoice. Since then, Deepavali is celebrated every year with lots of fun and frolic and fireworks.

Deepavali is not just a festival for worshipping Goddess Lakshmi, eating sweets, wearing new clothes or lighting ghee lamps. There is a great secret significance of this festival and understanding it can enable one to celebrate the festival in the best possible manner. Diyas, candles and crackers add light to the festival, rangoli add colours and sweets and other delicious savouries add flavour to this festival.


You relish the delicacies but later on regret. Heart burns, gastric troubles, indigestion, high blood pressure, elevated blood glucose levels, weight gain…all are some of the after effects of Diwali celebrations. These problems may tarnish your festival spree especially those who are diabetic.

To keep blood glucose level normal, even after eating sweets, he/she as to substitute small portions of sweet for other carbohydrates containing foods in the meals and snacks. For example, if a person wants to have sweet in a meal, then he should replace any other carbohydrate content of his meal. The total amount of carbohydrate ingested during the meal will remain the same.

Though, the sweets does not provide any important vitamins and minerals, they may be high in fats and calories but while including them in the meal plan one must make sure that it provides necessary nutrients.

Person, who likes sweets & desserts, can try these tips
(a) Eat a small serving of the favorite dessert, instead of something common.
(b) Satisfy your sweet tooth with fresh or dry fruits.
(c) Share desserts with your friend or family member.
(d) Reduce the amount of sugar or fat in your favorite recipes.
(e) Choose low calorie and low fat desserts.


So, enjoy this Diwali with the scrumptious delicacies without cutting out anything from your menu. Just a little change in the preparation method and you get the same but much healthier recipe to relish on. Here are some low-calorie yummy but healthy recipes...

FRUIT PUDDING
INGREDIENTS:
(Note: You can Serve this for 4)

1. ¼ cup water.
2. 1 heaped teaspoon gelatin
3. ½ cup pineapple tidbits
4. 1 apple, chopped
5. 4 dried apricots, chopped
6. 2 cups curd made from fat-free milk, whisked.
7. A few drops vanilla essence.

METHOD:

1. Heat water in a small pan over low heat. Sprinkle in gelatin and remove from heat. Set aside for about 10 minutes, stirring occasionally till gelatin is dissolved.
2. Place dissolved gelatin, pineapple, apple, apricots, curd and vanilla in a bowl and stir till well mixed. Pour into a wet mould.
3. Refrigerate till set and chilled.
4. Unmould onto a glass dish and decorate with a few fruit pieces.

NUTRITIVE VALUE PER SERVING:
Calories-122
Protein- 5gms
Fat- 2 Gms.
CHO- 21gms

FRUIT&VEG PEEL HALWA



Serving size: 4 cups

Ingredients

* Apple peel, ½ cup
* Mango peel, ½ cup
* Carrot peel, ½ cup
* Beetroot peel, ½ cup
* Tomato peel, ½ cup
* Milk, 200 ml
* Wheat flour, 2 tbsp
* Ghee, 2 tsp
* Almonds, 25gm
* Sugar free, as required

Directions

1. Grind all the peel together in the mixer with 2 spoons of milk.
2. Heat kadai and add remaining milk and bring into boil.
3. Add ground peel mixture into boiling milk and mix well.
4. Add wheat flour and ghee little by little and cook until the mixture leaves side of the kadai.
5. Turn off the flame and mix the sweetener as required.
6. Garnish with chopped almonds and serve cold.

Nutritive values per serving:



1 cup= 150ml

Note:

1cup of dessert can be substituted for 1 cup of rice or 1 chapatti or 50-100g of fruit. But not in regular basis has too much of sweetener is not recommended.

Apart from this, stick to your meal timings and food quantities. Don’t increase your medication without your doctor’s consent. Continue your exercise routine as usual. Finally don’t forget to check your blood sugars and keep them within limits at all times.

Remember, you can have a sweet life without sweets!!!

Heel Pain (Plantar Fasciitis) in People with Diabetes

BAMILA.S, MPT.MIAP(NEUROLOGY)

What is Plantar Fasciitis?

The plantar fascia ligament runs between the heel bone and the toes and stretches with every step. It acts like a bowstring to maintain the arch of the foot .Inflammation develops when tears occur in the tissue.


Causes
1.Those who have very flat feet or very high-arched feet are at greater risk .
2.Abnormal stretching of the plantar fascia ligament.
3.Abnormal strain on the plantar fascia by wearing non-supportive footwear on hard, flat surfaces especially for jobs that require long hours on the feet or when a person is obese.
4.Inflammation of tendons due to certain types of arthritis, especially among the elderly.
5.Diabetes is also a factor that can contribute to heel pain and damage, especially among the aged. Prolonged high levels of blood glucose may result in the stiffening of soft tissues. Small tears can occur in the foot due to stress (load bearing) .Peripheral neuropathy makes the person unable to feel any injury and it could become ulcerated and get infected.
6.Athletes who do extreme exercises are also at risk for this damage.
7.Abnormal ways of walking can adversely affect the way weight is distributed on the feet. This can put added stress on the plantar fascia.
8.Wearing shoes that are thin-soled or loose, or those that do not have good arch support or the ability to absorb shock, don't protect the feet. Regular use of high-heeled shoes can contract and shorten the Achilles tendon which is attached to the heel, causing strain on the tissue around it.

Symptoms

The symptom of plantar fasciitis is PAIN …
•- that is on the bottom of the heel
•- that is usually worse upon getting up
•- that increases over a period of months

Treating Plantar Fasciitis
Plantar Fasciitis should be treated immediately. Treatment involves correcting the underlying problems. Some of the most common treatments are:
1)Stretching the calf muscles several times a day, especially in the morning and after prolonged sitting.
2)Putting an ice pack on the heel for 20 minutes several times a day to reduce inflammation.
3)Stretching the plantar fascia in the morning.
4)Rest .
5)Losing weight.
6)Not walking barefoot. Walking without shoes causes undue strain and stress on the plantar fascia.
7)Slowing down extended physical activities to give the heel a rest.
8)Temporarily changing to moderate activities such as swimming and/or bicycling instead of sports that involve running and jumping.
9)Modifying or wearing supportive shoes that have good arch support and a slightly raised heel to reduce stress on the plantar fascia and wearing shoes with soft heels and insoles.











10)Using medication.
Despite treatment, the underlying causes that brought on this condition may remain. Therefore, you will need to continue with preventive measures. Your podiatrist may suggest treatment such as…using orthotic devices that fit into the shoe to correct the fault; using padding, strapping or night splints; or physical exercises for relief. Stretching the plantar fascia can help decrease the symptoms of plantar fasciitis.

11)Plantar Fasciitis Taping
Plantar fasciitis taping is often used to alleviate stress on the plantar fascia ligament since it limits the movement of the fascia.

Athletic tape can be applied in the morning do reduce strain throughout the day, or just before exercise to keep the fascia from moving too much during physical activity. It is recommended that the tape not be left on the foot all day as well as all night because this prevents the skin from being able to breathe.



12)NIGHT SPLINTS
Night splints are usually designed to keep a person's ankle in a neutral position overnight. Most individuals sleep with the feet plantar-flexed, a position that causes the plantar fascia to tighten. A night dorsiflexion splint allows passive stretching of the calf and the plantar fascia during sleep. Theoretically, it also allows any healing to take place while the plantar fascia is in an elongated position, thus creating less tension with the first step in the morning.






Heel pain exercises: before getting out of bed
1)Before sitting up, stretch your foot by flexing it up and down 10 times.
2)While seated, roll a rolling pin or tennis ball with the arch of your foot. If you are able to, progress to doing this exercise while you are standing up.


After these exercises, put on your shoes (with orthotics inside them) or wear supportive sandals. Do not start the day walking barefoot on hard floors or tiles, or your heel pain will return.




Heel pain relief exercises: during the day
Calf Stretch


Stand facing a wall with your hands on the wall at about eye level. Put the leg you want to stretch about a step behind your other leg. Keeping your back heel on the floor, bend your front knee until you feel a stretch in the back leg.

Hold the stretch for 15 to 20 seconds. Repeat 4 times.


Achilles Tendon Stretch

Stand on a step as shown. Slowly let your heels down over the edge of the step as you relax your calf muscles.
Hold the stretch for about 15 to 20 seconds, then tighten your calf muscle a little to bring your heel back up to the level of the step. Repeat 4 times.

Hamstring Stretch


Extend one leg in front of you with the foot flexed. Bend your other knee and lean back slightly. Your pelvis should be tilted forward. Keep your upper body upright as you hold the stretch for 10-20 seconds, then switch sides.
You should feel the stretch all the way up the calf and thigh of your extended leg.

Marble Lifts



Place marbles on the floor next to a cup, as shown. Using your toes, try to lift the marbles up from the floor and deposit them in the cup. Repeat exercise 15 times.




Towel Stretch

Grab a rolled towel at both ends, holding it under the ball of your foot. Gently pull the towel toward you while keeping your knee straight. Hold this position for 15 to 20 seconds. Repeat 4 times.


Prevention
You can take some simple steps now to prevent painful steps later.
Maintain a healthy weight. This minimizes the stress on your plantar fascia.
Choose supportive shoes. Don’t use high- heeled shoes or shoes with very low heels. Buy shoes with a low to moderate heel, good arch support and anthe ability to absorb shocks. Don't walk barefoot, especially on hard surfaces.
Don't wear worn-out sports shoes. Replace your old ones before they stop supporting and cushioning your feet. If you're a runner, buy new shoes after about 400 miles.
Warm up before starting any athletic activity or sport, and start a new exercise program slowly.
Wake up with a stretch. Before you get out of bed in the morning, stretch your calf muscles, arch and Achilles tendon by reaching for your toes and gently flexing your foot. This helps reverse the tightening of the plantar fascia that occurs overnight.

References

1. Plantar fasciitis and bone spurs. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00149. Accessed Feb. 2, 2011.
2. Sheon RP, et al. Plantar fasciitis and other causes of heel and sole pain. http://www.uptodate.com/home/index.html. Accessed Jan. 27, 2011.
3. Pasquina PF, et al. Plantar fasciitis. In: Frontera WR, et al. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-6/0/1678/0.html. Accessed Feb. 2, 2011.
4. Thomas JL, et al. The diagnosis and treatment of heel pain: A clinical practice guideline — Revision 2010. The Journal of Foot & Ankle Surgery. 2010;49(suppl):S1.
5. http://www.yogaawayoflife.net/plantar_fasciitis.htm
6. http://www.footminders.com/plantar-fasciitis-exercises.html
7. http://www.sportsinjuryclinic.net/cybertherapist/front/foot/plantarfasciitis/plantartaping.php

NUTRITION WEEK 2011

DEPARTMENT OF NUTRITION,
M.V.HOSPITAL FOR DIABETES, ROYAPURAM


Nutrition is the focal point of health and well- being and is directly related to human resource development, productivity, and ultimately, to national growth. In order to provide education and to create an awareness of the importance of nutritional food habits among individuals, September 1st – 7th is observed as National Nutritional Week in our country.

It was celebrated for the first time in 1981 to highlight the problem of malnutrition which continues unabated despite significant achievements made in agricultural production, food sufficiency and industrial growth.

Malnutrition is a complex phenomenon. It is the cause and the effect of poverty and ill - health, and follows a cyclical, inter- generational pattern. It is linked with illiteracy, (especially female illiteracy), gender discrimination against the girl child, and the lack of safe drinking water and proper sanitation. It is directly linked with poverty, lack of purchasing power, food and nutrition insecurity, ignorance, and ill- health. It creates its own cycle within the larger cycle of poverty.


High levels of malnutrition, particularly among women and children, have directly and indirectly influenced mortality rates in infants, children and women. Although the country has been able to tackle nutritional deficiency syndromes such as pellagra, beriberi, scurvy and so on, chronic energy deficiency among adults, under- nutrition among children and micro-nutrient deficiencies across all sections of the population continue to be a cause of concern.

‘On the steps of nutrition lies the emancipation of the next generation - This is our vision and conviction’...

This was the theme for 2011. It was intended to address malnutrition and to generate awareness to tackle the problem through the existing health care delivery system by formulating strategies, policies and plans of action, thereby improving the nutritional status of the community.

On 2nd Sept, 2011, Nutrition Week was inaugurated at M.V.H Royapuram by the Managing Director, Dr. Vijay Viswanathan. The message of healthy eating habits was conveyed through a variety of programmes such as cooking demonstrations, puppet shows, exhibitions and film/ slide shows.


A COOKERY COMPETITION on “HEALTHY SNACKS’’ was held on the same day for the staff at M.V.H.




Winners of the cookery competition

LET’S ADD COLOUR TO OUR LIFE BY ADDING COLOURS IN OUR DIET...
Samples of VEGETABLE CARVING by members of the Department of Nutrition.


A QUIZ COMPETITION was organized for patients on 3rd September. The theme was “A HEALTHY DIET FOR DIABETES’’


The participants of the Quiz competition



Winners of the quiz competition

A PUPPET SHOW was held exclusively for patients on 5th September. The theme was “SWEET LIFE FOR DIABETIC PATIENTS ’’.



A quiz competition was also conducted for staff members. The theme of the quiz competition was “DIET AND DIABETES”



On 6th September a food court was set up where healthy snacks were sold to patients and members of the staff.
The same evening, Dr Sheba Sangeetha Jeyaraj (M.Sc., M.Phil.,NET,Ph.D), Assistant Professor, Womens’ Christian College was invited to speak on “Nutrigenomics”.





Dr. Vijay Viswanathan, Managing Director addressed the audience. This was followed by the prize distribution.

Our special thanks to the dedicated team of dietitians who organized the Nutrition Week.