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Obesity is a common but often underestimated condition of clinical and public health importance in many countries around the world. Its general acceptance by many societies as a sign of well-being or a symbol of high social status, and the denial by healthcare professionals and the public alike that it is a disease in its own right, have contributed to its improper identification and management and the lack of effective public health strategies to combat its rise to epidemic proportions. In general, obesity is associated with a greater risk of disability or premature death due to type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD) such as hypertension, stroke and coronary heart disease as well as gall bladder disease, certain cancers (endometrial, breast, prostate, colon) and non-fatal conditions including gout, respiratory conditions, gastro-esophageal reflux disease, osteoarthritis and infertility. Obesity also carries serious implications for psychosocial health, mainly due to societal prejudice against fatness. The body mass index (BMI) is a simple and commonly used parameter for classifying various degrees of adiposity. It is derived from the weight of the individual in kilograms divided by the square of the height in metres (kg/m2). By the current World Health Organisation (WHO) criteria, a BMI <18.5kg/m2 is considered underweight, 18.5–24.9 kg/m2 ideal weight and 25–29.9kg/m2 overweight or pre-obese. The obese category is sub-divided into obese class I (30–34.9kg/m2), obese class II (35–39.9kg/m2) and obese class III (≥40kg/m2). A BMI greater than 28kg/m2 in adults is associated with a three to four-fold greater risk of morbidity due to T2DM and CVDs than in the general population
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Smart eating: Carbohydrate Counting for Indian Foods When a person uses carbohydrate counting, the focus is on the carbohydrate in the food. This is due to the fact that carbohydrate raises your blood glucose much more rapidly than the other two macronutrients that provide calories; protein and fat (excluding alcohol, which is not a macronutrient). Following is a more complete list of the food groups whose calories are mainly from carbohydrate: • Starches: rice, pasta, bread, cereal, crackers • Starchy vegetables: potatoes, corn, green peas, beans and lentils • Fruit and fruit juices • Non Starchy vegetables: spinach, tomatoes, cauliflower • Dairy Foods: yogurt, milk, and other dairy foods • Sweets / Desserts: cakes, cookies, candy • Beverages high in sugar Carbohydrate Counting and Blood Glucose Control? Blood glucose levels are directly related to the amount of carbohydrate one eats. If the amount of carbohydrate is tracked at meals and snacks, and the blood glucose levels are taken before and two hours after the meal; a trend or pattern will emerge. Keeping an eye on the carbohydrate intake daily and eating the same amount each day, will assist in maintaining the blood glucose levels within the target range. How much Carbohydrate should a person eat? For a female, a basic rule of thumb for estimating the carbohydrate servings is approximately 45-60 grams of carbohydrate, or three to four carbohydrate servings per meal. For males, it is four to five carbohydrate servings per meal or 60-75 grams of carbohydrate per meal. Tips for Successful Carbohydrate Counting • Educate Yourself: Attend support group meetings on diabetes and obesity offered at “Obesity and diabetes clinic” of Asian institute of gastroenterology, Hyderabad (Enquire at +91-9866646942 or mail to us aig.bariatric@gmail.com). • Start small: Pay attention to portion size, Learn what average portion sizes look like and avoid large meals when eating out. Share your meal when eating out. • Learn to read the nutrition facts label • Be consistent • Find Technology that works for you and use it: You may use the Lose it i-phone app to look up food’s carbohydrate counts. • Figure out what you can’t eat: Most people with diabetes can eat anything in moderation, but carbohydrate counters sometimes find foods that just aren’t worth the glucose spikes. • Study your body • Plan it out • When you are at a restaurant. Learn how to improvise • Be smart about mindless munching
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