Eating with diabetes

ACCORDING to the US Centers for Disease Control and Prevention, almost 25% of adults older than 60 years suffered from diabetes in the US in 2007 and about 68% of older adults who suffered from cardiovascular disease and diabetes died from heart disease and stroke.

Factors that affect the eating patterns of older adults with diabetes include swallowing difficulties, poor dentition, limited mobility leading to difficulty in shopping and preparing food, economic limitations, social isolation, depression, and too many medications (polypharmacy.) Poor appetite, altered taste sensation, and impaired thirst mechanism lead to increased risk of dehydration, reduced activity level, and reduced absorption of some essential nutrients (DiMaria et al, 2005.)

Nutrition plays an important role in the management of diabetes. The challenge for older diabetic adults is making appropriate food choices. Many will gain confidence and control of diabetes when they know how food affects their blood glucose levels. The following are important considerations for them.

1. Regular meal times

To ensure that you have regular meals, keep a food diary in which you record all the foods, drinks, and snacks you take in a day. It should contain dates, times, blood glucose readings, medications, everything you ate, and your level of physical activity. Use a small note book, daily planner, or personal digital assistant (PDA) to record this information. Bring this record when you see your doctor and dietitian at the hospital.

The food diary will help you design a food plan that includes foods you like; know how your body responds to certain quantities of food; and review your blood glucose records and guide decisions about changes you need to make for better blood glucose control.

2. Practical cooking or eating out

Many older adults may not want to cook due to physical limitations. One good idea is to have catered food delivered to your home. The meals should consist of rice/noodles/breads with chicken/fish/lean meat, two types of vegetables and a soup. Fruits can be bought from local vendors and eaten at home. Discuss your requirements with the caterer.

If you enjoy cooking, buy small amounts of groceries, store them in the freezer or fridge. Utilise on-the-wheels vendors who sell groceries at your doorstep. Fine-tune traditional recipes by to reduce fat and/or calories. E.g. replace coconut milk with low-fat milk, bake meats instead of deep-frying them, and use fresh tomatoes instead of tomato sauce to reduce salt.

When eating out, use the Rate-Your-Plate concept. Divide your plate into two parts. One half should contain a variety of vegetables and fruits, the other half should be further divided into quarters. One should contain carbohydrates, preferably wholegrain, and the other should contain lean protein. Keep food within the borders of the plate. Finish off your meal with water or plain tea.

3. Meals and snacks

Space meals between four and five hours apart. This helps your pancreas produce adequate amounts of insulin after each meal without over-burdening. It also gives your diabetes medications time to work. The goal here is to have your blood glucose within your target range by your next meal.

Snacks are often unnecessary unless you:

·Are preparing for physical activity

·Eat the fruit that you didn’t want to eat during a main meal

·Need a snack for specific time, for example during 4 pm teatime. Remember, the snack is part of your daily calorie intake.

Meal replacement products (MRPs) provide a meal or snack alternative for people with diabetes. They may help to stabilise blood glucose levels and assist with weight loss. MRPs may replace a main meal or a snack in your daily eating pattern. Meal replacements include ready-to-drink powdered shakes, soups, bars, and puddings. Listed below are guidelines when choosing meal replacements

·Should provide 190-250 calories per serving.

·Should contain 10-15g of adequate protein per serving to promote health and mealtime fullness.

·Carbohydrates can vary between 14-34g per serving. It is advisable to have carbohydrates such as maltodextrin or tapioca dextrin rather than refined sugars such as sucrose, corn syrup, or high fructose corn syrup.

·Should contain 3-6g of dietary fibre and 5-8g unsaturated fats from trans-fat free vegetables oils.

·Should contain less than 20mg cholesterol and 100-300mg sodium per serving.

4. Dealing with hypoglycemia

Blood glucose tests are a convenient way to check blood glucose levels at a particular time, helping you avoid hypoglycaemia. Hypoglycaemia occurs if you take a wrong dose of diabetes medications, delay or skip of meals, consume insufficient carbohydrate portion at a meal, exercise more than usual, or drink alcohol without food.

Setting goals for blood glucose checks will help you improve your diabetes care. Before meals, your goal should be 3.8-7.7mmol/L. Two hours after a meal, it should be less than 8.8 mmol/L. At bedtime, it should be 5.5-7.7mmol/L.

To treat hypoglycaemia, follow the Rule Of 15.

Step 1: Check your blood glucose. If the reading is below 3.8 mmol/L, eat or drink 15g of carbohydrate e,g, half a cup of fruit juice or any sweetened drink or three medium-sized sweet biscuits.

Step 2: Wait for 15 minutes (the time it will take to feel better.)

Step 3: Check your blood glucose again. If your blood sugar is still low repeat steps one through three. If you still have low blood glucose after three checks, call for immediate help.

Step 4: Check you blood glucose an hour after the treatment and top up with a snack if you had missed your meal or snack.

Finally, it is prudent to see your doctor regularly and insist that he refer you to a qualified dietitian, physiotherapist, pharmacist, and diabetes educator for other areas of care. Diabetes care is managed by a team of professionals in different areas of expertise, not just one individual!

More conducive learning environment needed for Orang Asli

2009/10/27

BANGI: A more conducive and inclusive learning environment is needed to enable students with special needs including the Orang Asli community to receive proper education.

The Tengku Mahkota of Pahang, Tengku Abdullah Sultan Ahmad Shah, said an environment that was unfamiliar to the community was among the main factors that led to the poor achievement of the Orang Asli students in school.

He said the socio-culture and lifestyle of the community that preferred their natural environment and original lifestyle had played a big influence on their interest in going to school.

"The reason that the Orang Asli community is generally not that successful in school is because they are not on the same level as the local community and this seminar is hoped to come up with resolutions or new ideas for the Education Ministry to address the problem," he said after opening the Regional Conference on Inclusion and Special Educational Needs (RCISEN) 2009, here today.

He said this to reporters when asked to comment further on the educational hindrances faced by the Orang Asli community in the country.

Meanwhile, RCISEN 2009 Chairman, Professor Datuk Dr Zalizan Mohd Jelas said a paradigm shift in the system of learning was needed so that it would be more inclusive.

"They (Orang Asli) don't want to go to school because the existing environment is not inclusive for them. They feel as though they are being sidelined. Thus, there is no need for them to study because they will eventually return to their original lifestyle.

"So, such a change is necessary to give them the confidence that the system of education in the country is also relevant to them, and not meant specifically for certain groups," he said.

"This change is not only for the Orang Asli community, but also for all groups who are sidelined in the educational field such as the handicapped and special children. We need to analyse why they are not keen to go to school, and the schools must be made closer to them," he said.

The two-day seminar, which ends tomorrow, was organised by the Faculty of Education, Universiti Kebangsaan Malaysia (UKM) in collaboration with the Malaysian National Commission for Unesco and the Tengku Ampuan Afzan Endowment Fund.
-- BERNAM

Sugar Consumption

For the past few decades, sugar has been said to be the cause of a number of health problems. It is also said to be the culprit of tooth decay and the main cause of children being hyperactive. Studies carried out by the USA Food and Drug Administration in 1986 concluded that moderate consumption of sugar does not cause heart disease, diabetes, cancer or obesity. The scientific data also revealed that sugar does not cause hyperactivity and sugar alone does not promote tooth decay. Scientist today recognise that all fermentable carbohydrates whether from starch or sugar also play a part in dental caries. Hence, we should dismiss our 'sugar-phobias' as sugar at the end of the day is not that 'sinful' after all.

Education Minister confirms no return to PPSMI policy

2009/10/20

KUALA LUMPUR: The government will not return to the policy of teaching and learning Science and Mathematics in English (PPSMI) as the new policy of dignifying Bahasa Malaysia usage and raising English proficiency (MBMMBI) is in line with the country's need to dignify Bahasa Melayu as the national language.

Education Minister Tan Sri Muhyiddin Yassin said that towards this objective, the government would thus not turn back despite appeals and pressure for PPSMI to continue, as the government could not please every group.

"However, their views have been considered in planning and implementing the MBMMBI policy," he said in his reply to Mohd Nor Othman (BN-Hulu Terengganu) who wanted to know whether the government could ensure that it would not return to the old policy.

Muhyiddin, who is also deputy prime minister, said to avoid problems when implementing MBMMBI as what happened with PPSMI, the government had set 2012 for its implementation so as to give enough time for preparations, unlike the six months taken to prepare for PPSMI's implementation.

For instance, he said, the ministry would need 13,000 additional teachers while to improve students' English proficiency, it would need many teachers who had mastered the language, including the 1,000 to be recruited from next year.

To a question from Mohamed Azmin Ali (PKR-Gombak) whether former prime minister Tun Dr Mahathir Mohamad's strong statement against the PPSMI being discontinued would have an impact on the current administration, Muhyiddin said he believed that Dr Mahathir did not mean asking the government to reverse its new policy.

"He (Dr Mahathir) understands... that it was the decision of the Barisan Nasional (BN) government and he's an Umno and BN supporter. And I had already stated that was not all about the national language but also the English language. So, English usage would also be strengthened."

Later speaking to reporters at the parliament lobby, Muhyiddin said the people should not be unduly worried about the reversal of policy as the government was already taking preliminary measures to implement the new policy (MBMMBI) in 2012.

"We may even have to recruit English teachers from abroad," he said, adding that the implementation of the new policy also meant the urgent need to produce Science and Mathematics textbooks in Bahasa Malaysia as well as a new curriculum for teaching English.

He said the ministry was also looking at the possibility of implementing MBMMBI in 2011 for Year One pupils only as they would not be involved in PPSMI.

"However, this will depend on several factors like whether there will be enough teachers, and whether the new curriculum and Science and Mathematics textbooks will be ready by the end of 2010."

Muhyiddin said for Year Four, Form One and Form Four students, the implementation of MBMMBI would commence in 2012, to enable the ministry to make proper preparations. - BERNAMA

(source:http://www.nst.com.my/Current_News/NST/articles/20091020190131/Article)

A Generation Set Aside

A Generation Set Aside

Often we hear of the generation gap -- that huge expanse between parent and child. Perhaps it is an acquaintance gap. Young people and adults do not know each other. The inability to communicate often enters the picture. Sometimes it is because neither knows what the other is interested in. They live under the same roof, but they rarely see one another, especially after the teenage years come along. The father goes off to work before the children are awake. Mother may go back to bed after seeing the husband off to work; or off to her own job. Teenagers get themselves up and off to school without seeing either parent. Then after school there is ball practice, band practice, or something else that consumes their time; maybe a job that lasts until bedtime. Parents have things that tie them up in the evenings; so the days come and go, and there is precious little time spent together. A meal together is even a rare occasion. All of these activities may be wholesome and proper, but still the family suffers because there is so little time spent together. This causes many children to make too many decisions on their own, and so often they will leave important and crucial matters out of their thoughts and plans. This generation often gets labelled by the media and the older people in society as the "youngsters who are tearing this country apart." The fact of the matter is that we are a product of our parent's mistakes and remain to be misunderstood.

In the past several years we have seen much media attention focused on the generation that followed the boomers, popularly known as Generation X. Born between the mid-1960s and early 1980s , this is the most complex of the generation, and by far the least understood in spite of its current celebrity. This generation can best be described as the "Misunderstood Generation." They are the generation that dealt with and are still dealing with broken homes, drug addiction, AIDS, and bleak futures. A great deal of the young people in this "Misunderstood Generation" think very little about the future or present issues. This generation has lost sight of long terms goals and the idea that hard work pays off in the end. Instead, the people in this generation concern themselves only with what will bring immediate satisfaction and gratification. This part of society cares only about money and themselves, never thinking about the consequences of their actions. The "Misunderstood Generation" feels overwhelmed with the idea of a country with a multi- trillion dollar deficit, a high rate of poverty, and relatively no jobs. The "Misunderstood Generation" wants less out of life. This generation has evolved from the children that came home from school to an empty house because mom had to go back to work after the divorce. This is the generation that got its morals from watching T.V. after school and was parented by an older brother or sister. This is the generation that has unconventional ways and does not always reason for them. They are uncertain and need answers. They poke and prod to find what is lying ahead. They have loud voices but are seldom heard. This is the generation which has high expectations and are often disappointed.

I, as well as all of the others born in my generation, were unleashed into an ever changing world. The advances of today can easily be old news tomorrow. Along with this they, the people who have lived and controlled up until this day, have allowed the respect of the living to dwindle with the consistently increasing ease of everyday life. Transportation from one point to another can be the simplest of tasks. Communication with someone in any far off land can be reached with just the touch of a button. And access to almost all the information the world has to offer is free for all with the use of the Internet. No other group of people have grown up with these things as being such the standards and necessities of life and living that they are today. We have never had a war in our country. All of the wars that might have occurred while we've lived our young lives could only be seen through the glare of the t.v. The same thing that has totally been a part of our life feeding us knowingly false images of what it means to "be", but which seems to relate to us all. The same thing, however, does indeed show us the horrors of ever increasing crime and the vitality of these acts. Living has become an easier accomplishment with every new device, but with each new mark we leave on this world a new problem arises for us and all that follow. Today the marks are abundant and the affects are already in motion. This is what has made us a generation set aside and why it appears that we are some wonder to the rest of society. Tomorrow, however, we will wonder the same.、

I believe movies such as Clerks, Reality Bites, and Boyz N the Hood accurately portray the "Misunderstood Generation." All of these movies deal with real life problems of this generation and have characters that seem extremely life like. For example, in the movie Reality Bites, the main female character gets out of college to discover that she can't find a job making much more than minimum wage. Another character in the movie gets fired regularly from different minimum wage jobs, lives with different friends from week to week, and only worries about what will make him happy. These movies reflect the "Misunderstood Generation" in a way that all people can try to understand what it is like to grow up this day in age. This is a generation that has never known a world without televistion.

In my own research I have found that all this and much more to be true. A male 18, says "In ten years I see myself employed in my field of study and with my first girlfriend." When I asked him when the turning point of his live was he said; "It sounds really funny but it was when I read Catcher In the Rye. I went through a psychotic and depressing state of mind, after which I made a pact not to waste time and make the best out of every second of my existence." His was just an example that justifies the fact that there are many things that could influence the awaking of an individual. A male 17, wrote "I don't think that we aren't so complex, just that the real complexities of young people are finally being treated seriously and studied for the first time" when he was asked what his feelings were towards the statement; "Generation X is considered to be the most complex but least understood generation"

Role models and heroes paly a crucial part in the decision-making of today's youth. Many of us look to somebody who's popular, good-looking and successful to imitate, look up to and take advice from. Xers will sacrifice their lives for a worthy cause. Many are ready to do so now. But we need evangelists who will take the time to befriend us and listen to us and be genuine the whole time. I am not too aggravated with the statement "Generation X is considered to be the most complex but least understood generation" anymore. After all, everybody is different, society is different, and lets face it, I am only one of the thousands maybe even millions of gen exers out there.

Suicide

Suicides can be said to be the ultimate condemnation of our society’s care for the depressed and mentally disturbed. It is believed that every two hours one person tells society that life isn’t worth living. And every three minutes one person attempts to take his or her own life. In today’s society, suicides are as common as deaths on the road. Depression, anxiety, personal tragedy and drug abuse are among some of the common reasons why people opt to take their lives. More often than not it is cry that goes unheeded by society. There are many health professionals that often pass unfair judgements without taking into consideration the distress that leads to such a decision. While suicide is no longer considered criminal, it is seen as an unforgivable sin in most religions.

Rick strengthens to Cat 5 storm off Mexico Pacific

MEXICO CITY (Reuters) - Hurricane Rick intensified to a top Category 5 storm off Mexico's Pacific coast on Saturday as it headed toward resorts on the Baja California peninsula next week, the U.S. National Hurricane Center said.

A Category 5 storm ranks at the top of the five-step Saffir-Simpson scale and can cause catastrophic damage.

Hurricane Rick is seen about 290 mi (467 km) south of Acapulco, Mexico in this National Oceanic and Atmospheric Administration (NOAA) satellite image taken at 1500 GMT on October 16. (REUTERS/NOAA)

Rick, the seventh hurricane of the eastern north Pacific season, was about 290 miles (467 km) south of Manzanillo, Mexico, with maximum sustained winds of 160 mph (258 kph).

The center projected the hurricane turning toward the Mexican coast on Tuesday and slamming into Baja California on Thursday, also dumping heavy rain on the mainland.

Pacific storms pose no threat to Mexico's large oil industry in the Gulf of Mexico, but the Baja California peninsula is popular with U.S. tourists for its resorts in the Los Cabos area.

(Reporting by Robin Emmott; Editing by Peter Cooney)

(source:http://in.reuters.com/article/worldNews/idINIndia-43235620091018)

Environment: Lessons on Mother Nature

2009/10/11

NURJEHAN MOHAMED

Parents can do a lot to make their children environmentally conscious, writes NURJEHAN MOHAMED

THE gloomy morning and light rain did nothing to deter environmentally conscious Klang Valley denizens from turning up at the recent second Organic Day organised by the Centre for Environment, Technology and Development, Malaysia (Cetdem).

For most, it gave them a chance to stock up on organically grown groceries and food and, for others, a chance to teach their children environmentally sound practices.

Cetdem executive director Anthony Tan Kee Huat says the event is held to raise awareness of what is organic and what is not.

“People use the term ‘organic’ indiscriminately,” he says, adding that the purpose of Organic Day is to educate the public, especially children.

Kids got the chance to participate in activities where they smelt, touched and tasted organic food in addition to visiting the Cetdem organic vegetable garden at its office — a corner terraced house in SS19, Petaling Jaya.

Visitors were also treated to a qigong demonstration, health talks and presentations on making compost and eco-enzymes.

The predominantly Chinese crowd was also treated to activities organised by Chinese language radio station AiFM, a strong supporter of Organic Day — a number of the first-time visitors say they found out about the event through the station (see story on H3).

Zuhairah Ali, executive director of Taman Pendidikan Raihan, a kindergarten in PJ, was at the event last Saturday to buy the week’s groceries and get tips for maintaining her own organic garden at home.

“I learnt about this event through a flyer I picked up at a health shop in Bandar Utama,” she says, adding the visit had been educational and an eye-opener.

Though familiar with organic food, having such a wide variety in one place made it much easier to survey the available products and learn about new ones.

“Cetdem’s organic garden is also a great place to bring children, and even adults, to learn how to grow vegetables in a healthier and safer way,” she says.

Inculcating the green habit in children is vital, she adds, as people’s everyday lives have become toxic through the food and water they consume and air they breathe.

“Teaching children to care for the environment also helps them to appreciate God’s gifts,” she adds.

For Zuhairah, it means doing the simple things — to use less plastic bags and save in terms of what you eat and use — and it has to start at home.

“My four children and I are members of several environmental non-governmental organisations; we have also helped raise funds for them,” she says, adding that one of her sons is also an active member of his school’s Eco-Club.

Zuhairah tries to raise her children’s awareness of environmental issues by taking them to events such as Organic Day — they missed out on the recent one because of extra-curricular activities but will be going for the next one in December — and forwarding them emails on the environment.

She also encourages them to eat as healthily as possible so she tries to get organic food as often as her wallet allows her.

“Organic food can be expensive but if you think of how much you would save in terms of medical bills and supplements, it may well be worth it,” she says.

The family has a small vegetable plot but it still needs work.

“Parents have to make their children aware of the choices they have and the consequences of making unhealthy and un-environmentally friendly ones,” she says.

“We have to be responsible for what we inherit and what we leave behind, and it has to start with you first.”

Homemaker Goh Lee Choo, who learnt about Organic Day from an organic vegetables vendor as well as AiFM, decided to make it a day trip for her children.

Goh says: “It’s an educational event as there are activities for children to learn about organic vegetables and eating well.”

She and her children were also interested in seeing how an organic vegetable garden can be maintained in the city.

Her family started eating organic food over a year ago because of its high nutrient content and natural methods of production. And her children say it is more delicious than “conventional” food.

Goh advocates healthy living by maintaining her own organic vegetable patch and informing friends and family of events such as Organic Day.

“I think it is imperative to teach children about the environment.

“When taught from young, children will practise green habits when they grow up.”

She adds that more people should use natural methods of growing their greens instead of using chemical pesticides and enhancers.

“If we don’t care about how we use the earth to grow our food, one day we won’t have any more land to do so,” she says.

Calin Tho, who was at the event with her two daughters, says it is a good way to learn about organic living.

“They talk about the processes that go into organic farming and we also got a chance to meet suppliers and farmers,” she says.

Tho used the opportunity to do her weekly grocery shopping — she normally buys organic vegetables if the price is not much higher than conventional ones.

She brought her children so that they could learn about organic food and the processes that go into making it.

At home, she teaches her children to recycle by providing bins for different recyclable items and showing them how to separate them.

(source:http://www.nst.com.my/Current_News/NST/articles/20091011084207/Article/index_html)