Hydrate and get that H2Glo

Dietitian, Estée van Lingen, expands on the importance of hydration, especially in summer. Plus, she shares the benefits of H2Glo for people living with diabetes


Summer is here and being well-hydrated is important for everyone, and who doesn’t want that H2Glo?

Benefits of hydration

Water is essential for life as the body consists of about 50 – 60% fluid (about 75% when born, gradually decreasing as you age). It’s a major part of the body and has many functions including transporting nutrients and compounds in blood as well as removing waste products through urine. Water also helps to regulate body temperature through sweating and acts as a lubricant and shock absorber in joints.

Drinking enough water is vital to maintain good health in the short as well as the long-term. In order for your brain (which also mainly consists of water) to function properly, you need to be well-hydrated to be alert and be able to concentrate properly.

Water also prevents constipation as it needs to bind with fibre to make the stools soft. Since the kidneys assist in filtering out waste through water, drinking enough can also reduce the risk of developing urinary tract infections, kidney stones and damage to kidneys which could lead to chronic kidney disease. Frequent dehydration, even if its mild, can lead to damage to the kidneys.

How much do you need to drink?

Drinks provide around 70 – 80% of your water needs. The remaining 20 – 30% comes from foods, such as soup, stews, fruit and vegetables.

Infants need to consume between 640 – 800ml water from fluids per day. Smaller children need to drink between 800 – 1600ml per day depending on their age, gender and activity levels. Adults need to consume between 1500 – 2000ml per day and pregnant and lactating women need to drink even more than that of an adult.

These are average amounts and your individual need will depend on factors like: temperature and humidity, medication consumed and exercise.

Warm and dry environments, such as hot sunny days and air-conditioned offices or strenuous physical exercise, can increase the need for water as they speed up the evaporation of sweat on the skin.

How much water is enough?

Thirst is one way you regulate hydration in the body. But when you drink, you stop feeling thirsty before your body is completely rehydrated. Some people also never feel thirsty as they haven’t been drinking enough water throughout their life.

So, observing the colour of your urine and the smell is a useful way to determine hydration status. Your urine should be a pale straw colour which shows you are well-hydrated. Dark yellow urine as well as strong odour urine means that your urine is very concentrated, and this is often a sign of dehydration, but in a few cases may have other causes. If you are concerned, contact your GP.

Signs of dehydration

  • Headaches
  • Tiredness
  • Confusion
  • Lack of concentration
  • Constipation
  • Urinary tract infection (UTI)

It can be hard to spot dehydration. The first thing you’ll notice is increased thirst and a dry sticky mouth. Darker coloured urine is also a good indicator.

Dehydration is a common problem in older people. It can be particularly difficult to detect as signs such as urine colour, thirst and a dry mouth aren’t reliable indicators in older adults.

What types of drinks will help with hydration?

Drinking water is one of the best ways to hydrate as its energy and sugar-free. Other choices, such as unsweetened caffeine-free tea and milk (as well as milk alternatives) also provide fluid to maintain hydration. Any drinks that contain caffeine (coffee and normal tea) as well as alcohol, can’t be counted towards fluid intake as these drinks also have a dehydrating effect on the body.

Some drinks contain added sugar, such as regular, fizzy and still drinks. These should especially be avoided in people living with diabetes as it can cause a rise in blood glucose levels.

Pure vegetable or fruit juices and smoothies also provide fluid and other nutrients but should again be limited in people with diabetes and also assessed before drinking.

H2Glo

H2Glo is a great alternative sparkling water drink to rehydrate with for people living with diabetes as it doesn’t contain any sugar and is also aspartame-free. It’s a nice refreshing drink in these hot South African summers. With a burst of flavour from the edible jelly balls inside, you can have a great-tasting drink without the guilt.

H2Glo comes in seven flavours (Blueberry, Strawberry, Pineapple, Passion fruit, Lemon, Naartjie and Energy) and is also gluten-free and enriched with ozone that can also provide the body with extra oxygen molecules.

Fluid intake in active people

Active people need to drink more water as they lose more in the form of sweat. It’s important that this is replaced to maintain performance and health. Water is the best choice during and after most activities, but those who participate in regular strenuous physical activity may need to consume sports drinks or drinks containing electrolytes.


Top tips for staying hydrated this summer

  • Keep hydrated by drinking small amounts frequently.
  • Find the best way to motivate you to consume more water. For example, keep a bottle or jug of water on your desk as a reminder, or drink a glass of water at specific times: when you wake up, with each meal and before every cup of coffee.
  • Remind children and older adults to drink regularly and also keep a bottle of water close by for them.
  • Increase water intake during hot weather or when you are exercising.
  • Fluid is particularly important if you’re unwell (especially with vomiting, diarrhoea or fever) as all of these conditions can also lead to dehydration especially in children.
  • Foods high in water, such as fruit and vegetables, can also contribute to hydration but fruit and starchy vegetables, should be taken with caution in people with diabetes.
Estée van Lingen is a registered dietitian practicing in Randburg and Fourways, Gauteng. She has been in private practice since 2014 and is registered with the HPCSA as well as ADSA and served on the ADSA Gauteng South Committee for 2020 – 2022.

MEET THE EXPERT


Estée van Lingen is a registered dietitian practicing in Randburg and Fourways, Gauteng. She has been in private practice since 2014 and is registered with the HPCSA as well as ADSA and served on the ADSA Gauteng South Committee for 2020 – 2022.


Header image by FreePik

Exploring the delicious world of Fabulite

Dietitian, Esteé van Lingen, explores the added benefits of including the tasty Fabulite range of yoghurts into your eating plan.


In the realm of dairy products, the Fabulite range stands out as a brand that truly understands the art of combining health and indulgence. Fabulite is a range of yoghurts, which is South Africa’s number one fat-free yoghurt.

With a wide range of products that cater for the diverse taste and dietary preferences of people living with diabetes, Fabulite has established itself as a beloved choice for those seeking both flavour and nutrition.

Nutritional information

Benefits

  • Rich in calcium: Fabulite yoghurts are good sources of calcium, a vital mineral that supports healthy bones and teeth. Since a lot of people have started reducing milk intake for various reasons, consuming these products can contribute to your daily calcium intake, promoting strong and sturdy bone health.
  • High-quality protein: Protein is an essential component of a balanced diet, and Fabulite yoghurt contains between 3,2 – 3,8g per 100g. These dairy delights offer a convenient and delicious way to incorporate protein into your diet, which is essential for muscle development and overall health.
  • Fat-free and no sugar added: Making it the ideal snack or addition to a diabetic meal. The sugar that is in the product is the lactose (milk sugar) that is found naturally in milk.
  • Halaal approved

Fabulite yoghurts are versatile and can be consumed with any meal or snack. It can even be used as a dessert alternative or added to dressings or sauces, without compromising on the taste.

Nutritional value

Nutritional info (per 100g)

Yoghurt Plain fat free Fat free fruited Fat free vanilla
Energy (kJ) 200 210 210
Protein (g) 3,8 3,2 3,4
Glycaemic carbohydrates (g) 6 8 6
Of which total sugar (g) 3,1 3,1 3,1
Total fat (g) 0,2 0,1 0,2
Calcium (mg) 110,9 102,9 100,2

What does the range consist of?

Whether you prefer the classic taste of plain yoghurt or the sweetness of fruit-infused yoghurts, you’re sure to find a Fabulite yoghurt that tantalises your taste buds. With its creamy texture, sweet taste and added benefits, this yoghurt makes for a perfect snack, breakfast option or even an addition to main meals or sauces.

You can choose from:

  • Fat free plain
  • Fat free strawberry
  • Fat free blueberry and pomegranate
  • Fat free black cherry
  • Fat free vanilla flavour

Each flavour is available in 1kg, also a select flavour range in 175g for single portion convenience, as well as a 6 x 100g multi-pack if you’re looking to indulge in more than one flavour.

Fabulite has won the hearts of consumers by offering a wide range of yummy yoghurts that also provides numerous health benefits. From plain to various flavours of yoghurts, Fabulite has something for everyone. So, next time you’re in the yoghurt aisle, consider Fabulite for a delightful and nutritious addition to your daily diet. Enjoy the best of both worlds with the exceptional yoghurts from Fabulite.

Estée van Lingen is a registered dietitian practicing in Randburg and Fourways, Gauteng. She has been in private practice since 2014 and is registered with the HPCSA as well as ADSA and served on the ADSA Gauteng South Committee for 2020 – 2022.

MEET THE EXPERT


Estée van Lingen is a registered dietitian practicing in Randburg and Fourways, Gauteng. She has been in private practice since 2014 and is registered with the HPCSA as well as ADSA and served on the ADSA Gauteng South Committee for 2020 – 2022.


This article is sponsored by Parmalat in the interest of education, awareness and support. The content and opinions expressed are entirely the health professional’s own work and not influenced by Parmalat in any way.


Header image by FreePik

Reducing postprandial blood glucose levels

Here are simple ways to lower postprandial blood glucose levels as well as the benefits that comes along with it.

What are postprandial blood glucose levels?

Postprandial means after a meal so postprandial blood glucose levels is your glucose level after eating a meal.

Glucose is the primary source of energy for your body and the cells in your body rely on this energy to function. Balancing your blood glucose levels can contribute to manage cravings, fatigue, hormonal and fertility issues, skin conditions, ageing/wrinkles, poor sleep, menopause and mental health symptoms.

Glucose control isn’t only necessary for people living with diabetes. Everyone needs to improve their knowledge and implement skills to ensure optimal blood glucose control and prevent spiking glucose levels that contribute to oxidative stress and inflammation, which have a magnitude of negative implications on human health. 

How is glucose metabolised?

When you eat a meal, the carbohydrate gets broken down into simple sugars (glucose). The glucose is absorbed into the bloodstream which can either result in a stable release or a spike (often referred to as hyperglycaemia or high blood glucose) of glucose, depending on the type and quantity of carbohydrate you consumed.

As the blood glucose level rises, so does the level of insulin. Insulin is a hormone that carries glucose from the blood into the cells so that it can be used where it’s needed for energy.

Why should blood glucose spikes be avoided?

Hyperglycaemic spikes can impact inflammation by contributing to an increase in inflammatory cytokine concentrations more significantly than continuous high blood glucose levels. These up and down, roller-coaster blood glucose levels may lead to cravings, fatigue, poor sleep and low mood which can affect you on a daily basis.

The consequences of increase in inflammation are being highlighted as a key concern when assessing overall health because the associated inflammatory response and oxidative stress are root causes of lifestyle diseases that develop when there is a constant state of chronic inflammation.

Moreover, prolonged high blood glucose levels after meals is usually the first indicator of a defect in glucose tolerance which may pose as a contributing risk factor in the development and progression of non-alcoholic fatty liver disease, Type 2 diabetes and cardiometabolic diseases.

With persistently high blood glucose levels, protein glycation occurs which further contributes to complications, such as vascular dysfunction (damage to retina, kidneys, nerves) and the generation of free radicals which cause further harm to the cells, fibrosis and skin aging.

The effect of carbohydrates on blood glucose levels

Carbohydrate-rich meals are the main drivers of glycaemic spikes throughout the day. The quality and quantity of carbohydrates can be categorised according to their effect on blood glucose. This measurement of how a certain carbohydrate will impact blood glucose levels is known as the glycaemic index (GI).

Carbohydrate food items are compared to glucose and can be categorised into the following groups: high-, medium- and low-GI; with high-GI foods (white bread roll) exerting a higher effect or spike on the blood glucose level when compared to eating a low-GI food (rolled oats).

The portion of carbohydrate consumed is just as important as the quality of the carbohydrate, as the quantity ingested will contribute to the amount of glucose available for absorption.

Tips to reduce postprandial blood glucose levels

  1. Carbohydrates: quantity and quality

Be mindful of the type of carbohydrate and portion eaten at a sitting. A portion of starch is normally about ½ cup of cooked starch. Give preference to low-GI foods over high-GI foods. For example, unprocessed high fibre carbohydrates (more than 6g of fibre per 100g) will generally have a lower effect on blood glucose levels.

Aim to eat foods in their natural, unprocessed form. Give preference to eating fresh fruit as opposed to having fruit juice or uncontrolled portions of dried fruit. Be cautious with dried fruit; all the fluid has been removed, and the portion size equivalent to 1 fresh fruit is a whole lot smaller.

  1. Adding natural food adjuvants

Mulberry leaf (ML) and mulberry leaf extract (MLE) have numerous biological properties, such as regulating glucose and lipid metabolism, reducing blood glucose, and increasing insulin secretion. These benefits may be attributed to the phytochemicals they contain. Mulberry leaf extract is best taken with a meal as you want the MLE to reach your small intestine at the same time as the carbohydrate so that it can compete for glucose absorption. MLE has been shown to reduce fasting blood glucose and HbA1c in a recent systemic review. Taking mulberry leaf extract preparations pre-meal appear to be safe and tolerable solutions in preliminary studies, longer term research is required.

  1. Apple cider vinegar

Add to your meals or salads as a dressing, or consume apple cider vinegar (diluted with water) prior to meals. This may aid in stabilising the glucose and insulin response. However, evidence supporting the long-term use is lacking; one of the concerns is the demineralisation of teeth and therefore it’s recommended to avoid taking in large amounts.

  1. Whey protein

Eating this 30 minutes before a meal lowers the glucose peak by delaying gastric emptying without stimulating insulin secretion whereas eating whey protein with a meal leads to a lower postprandial glucose level by increasing the insulin secretion. Therefore, more insulin is available to carry glucose from the bloodstream into the cells.

  1. Cinnamon

Adding to your meals may lower the postprandial blood glucose response by increasing the insulin sensitivity.

Leveraging food combinations

Adding slow-release carbohydrates, more fibre, protein or fat to a higher GI carbohydrate slows the absorption of the glucose from the carbohydrate and leads to a lower postprandial blood glucose level.

  • If you do eat a high-GI carbohydrate, combine it with a low-GI carbohydrate to slow the glycaemic response of the meal. For example: add milk and berries to instant oats porridge and other high-GI cereals.
  • Pair carbohydrates with proteins or fats. For example: serve an egg or avocado with a slice of wholemeal toast instead of with butter and jam or serve meat/chicken/fish/eggs/plant protein with grains/pastas/potato mash and prepare the meal with olive oil.
  • Add more fibre to your meal by adding a salad or vegetables (colour) to the plate; topping breakfast cereals with oat bran, nuts or seeds; or adding lentils, beans or pulses to soups and stews, or all in one dish.

Food order

Eating foods in a particular order, for example, eating the vegetable/salad/protein/fat portion before the carbohydrate portion on the plate appears to reduce the postprandial glucose release when compared with other meal patterns by stimulating a lower insulin and higher glucagon-like peptide 1 (GLP-1) response which plays an important role in maintaining glucose homeostasis.

Physical activity

A non-dietary way that is known to help reduce the postprandial blood glucose rise includes exercising after eating. Only 10 minutes of activity: walking; bench stepping; taking the stairs or clearing the table and cleaning the dirty plates instead of being sedentary is an effective way to burn the glucose that has been absorbed into the bloodstream. The exercise duration and intensity will no doubt impact the glucose response, however, it’s evident from research that moderate exercise is sufficient to improve the glucose response to a meal.

The benefits

The overall benefits of keeping blood glucose levels more stable include less cravings, improved energy and sleep, slower ageing due to reduction in inflammation, improved gut and mental health, improved glucose tolerance, reduced risk for disease and promoting remission from Type 2 diabetes.

In summary

Eat for more fibre, protein and fats with all meals. Give preference to unprocessed carbohydrates in sensible quantities. Pre-load with add-ons (apple cider vinegar, cinnamon, whey or mulberry leaf extract). Eat the carbohydrates last, start with vegetables and protein and opt for a walk after your meal.


References

  1. Alpana P Shukla et al., “Effect of food order on ghrelin suppression,” Diabetes Care 41, no. 5 (2018): e76-e77,https://care.diabetesjournals.org/content/41/5/e76.
  2. “Impact of nutrient type and sequence on glucose tolerance: Physiological insights and therapeutic implications,” Frontiers in endocrinology 10 (2019): 144,https://www.frontiersin.org/articles/10.3389/fendo.2019.00144/full#B58.
  3. Bellini, Alessio, et al. “Walking attenuates postprandial glycemic response: What else can we do without leaving home or the office?” International journal of environmental research and public health, vol. 20, no. 1, (2022): 253, https://pubmed.ncbi.nlm.nih.gov/36612575/.
  4. Patrick Wyatt et al., “Postprandial glycaemic dips predict appetite and energy intake in healthy individuals,” Nature metabolism 3, no. 4 (2021): 523-529,https://www.nature.com/articles/s42255-021-00383-x.
  5. Biplab Giri et al., “Chronic hyperglycemia mediated physiological alteration and metabolic distortion leads to organ dysfunction, infection, cancer progression and other pathophysiological consequences: an update on glucose toxicity,” Biomedicine & pharmacotherapy, no. 107 (2018): 306-328,https://www.sciencedirect.com/science/article/pii/S0753332218322406#fig0005.
  6. Zheng Zhou et al., “Glycemic variability: adverse clinical outcomes and how to improve it?,” Cardiovascular diabetology 19, no.1 (2020): 1-14,https://link.springer.com/article/10.1186/s12933-020-01085-6
  7. Chezem, J., Fernandes N., et al “Effects of Ground Cinnamon and Apple Cider Vinegar on Post prandial Blood glucose levels in healthy adults.Journal of the Academy of Nutrition and Dietetics, vol 112, issue 9, suppl: A43, https://doi.org/10.1016/j.jand.2012.06.148
  8. Singh VP, Bali A, Singh N, Jaggi AS. Advanced glycation end products and diabetic complications. Korean J Physiol Pharmacol. 2014 Feb;18(1):1-14. doi: 10.4196/kjpp.2014.18.1.1. Epub 2014 Feb 13. PMID: 24634591; PMCID: PMC3951818.
  9. Gheldof, N.; Francey, C.; Rytz, A.; Egli, L.; Delodder, F.; Bovetto, L.; Piccardi, N.; Darimont, C. Effect of Different Nutritional Supplements on Glucose Response of Complete Meals in Two Crossover Studies. Nutrients 2022, 14, 2674. https://doi.org/10.3390/nu14132674
  10. Mohamed M, Zagury RL, Bhaskaran K, Neutel J, Mohd Yusof BN, Mooney L, Yeo L, Kirwan BA, Aprikian O, von Eynatten M, Johansen OE. A Randomized, Placebo-Controlled Crossover Study to Evaluate Postprandial Glucometabolic Effects of Mulberry Leaf Extract, Vitamin D, Chromium, and Fiber in People with Type 2 Diabetes. Diabetes Ther. 2023 Apr;14(4):749-766. doi: 10.1007/s13300-023-01379-4. Epub 2023 Mar 1. PMID: 36855010; PMCID: PMC10064401.
  11. Lown M, Fuller R, Lightowler H, Fraser A, Gallagher A, Stuart B, et al. (2017) Mulberry-extract improves glucose tolerance and decreases insulin concentrations in normoglycaemic adults: Results of a randomised double-blind placebo-controlled study. PLoS ONE 12(2): e0172239. doi:10.1371/ journal.pone.0172239
  12. Takahashi M, Mineshita Y, Yamagami J, Wang C, Fujihira K, Tahara Y, Kim HK, Nakaoka T, Shibata S. Effects of the timing of acute mulberry leaf extract intake on postprandial glucose metabolism in healthy adults: a randomised, placebo-controlled, double-blind study. Eur J Clin Nutr. 2023 Apr;77(4):468-473. doi: 10.1038/s41430-023-01259-x. Epub 2023 Jan 17. PMID: 36650279; PMCID: PMC10115625.
  13. Phimarn, W., Wichaiyo, K., Silpsavikul, K. et al. A meta-analysis of efficacy of Morus alba Linn. to improve blood glucose and lipid profile. Eur J Nutr 56, 1509–1521 (2017). https://doi.org/10.1007/s00394-016-1197-x
  14. Kamruzzaman M, Horowitz M, Jones KL and Marathe CS (2021). Gut based Strategies to Reduce Postprandial Glycemia in Type 2 Diabetes. Front. Endocrinol. 12:661877. Doi:10.3389/fendo. 2021.661877.

Diabetes data tips

We learn tips for recording diabetes data and how digital support, such as smartphone apps, make managing it so much easier.


Listen to this article below or wherever you get your podcasts.
Visit our channel mypod.zone/diabetessa

You know how important it is to document diabetes data. You also know that keeping a diabetes diary requires patience, discipline, and neat handwriting because your diabetes healthcare team should ultimately be able to make sense of it. What you may not know is how much easier it can be with digital support, such as smartphone apps.

Diabetes diary or app: means to an end

In theory, it doesn’t matter whether you electronically extract your diabetes data from the blood glucose meter, manually write it in a diabetes diary, or initially stick colourful Post-it notes with values on the refrigerator.

However, healthcare professionals often report that handwritten diabetes diaries are incomplete or that errors creep in. This can affect the quality of the recorded data, ultimately harming the quality of diabetes therapy.

Therefore, especially if you prefer to keep your diabetes data in a classic diary, it’s essential to proceed systematically and with discipline. This way, the data can support you in organising your life with diabetes to improve your quality of life. For example, take notes for individual measurements; this will help you better understand how specific events, such as a birthday party or a hiking trip, influence your blood glucose levels. This allows you to become more familiar with your body’s reactions, regardless of the choice of tool.

If you want to keep up with the times, you can also take advantage of the numerous benefits of digital solutions for your therapy. With some technical assistance, you can:

  • Quickly and easily review data.
  • Better recognise the connections between insulin, blood glucose and meals.
  • Increase your awareness of blood glucose values and how they are influenced.
  • Share your data with your healthcare team.

Diabetes apps: more than just a diabetes diary

One of the simplest ways to keep track of your diabetes documentation is by using a tool that you probably already have with you all the time: your smartphone.

By using a diabetes app, you can easily ensure that you document all measured values. If you opt for a solution where the measured blood glucose values are automatically transferred to the app, the process becomes even easier.

The pros of mySugr app

If you use a blood glucose meter like the Accu-Chek Instant, the mySugr app automatically stores every measured value on your smartphone via Bluetooth. This combination offers additional features such as meal photos and a bolus calculator.

Do you want to customise how you view your health data? With mySugr, you can choose from charts, tables, or statistics that work best for you. It’s easy to use; just swipe through your phone to see more.

Have you been experiencing slightly elevated values lately? Quickly check your average values for the past seven days to see if you’re on track or if there’s a pattern to recognise. Also, try to identify when your blood glucose trend changes. This can often help you understand which life circumstances contributed to these values.

Please note that some features mentioned here are only available with mySugr Pro. However, if you pair your Accu-Chek Instant meter with the mySugr app and synchronise your readings, you’ll automatically upgrade to mySugr Pro for free.

Remember, you don’t have to manage diabetes on your own. There are plenty of resources available to help you stay on track.

Download the mySugr app now!

You can download the mySugr app in the Google Play store or the App Store.

 

 

 

Please contact our customer support team to check if your mobile device is compatible with the mySugr app.

For more information, contact your healthcare professional.

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