Q. How can one know whether he or she is suffering from diabetes?

A. The classic symptoms of diabetes—increased thirst and increased frequency of urination—are not always present and many patients are unaware that they may have diabetes. Hence, doing periodic blood tests to check blood sugar levels is recommended. HbA1c [Glycosylated haemoglobin] is the blood test, that indicates your glycaemic status accurately. This test does not require fasting but should be carried out in an accredited laboratory. A level of less than 5.7 is normal and 5.7 to 6.5 is considered pre-diabetes or “diabetes at risk” category. A level of 6.5 and above is definitely indicative of diabetes. Other tests like fasting blood sugar and post-meal blood sugar can also be done, but theses parameters can show variable results on different occasions.

Q. What lifestyle modifications can help us to prevent/treat diabetes?

A. Obesity is a social problem and the solution to it begins in the home. The family should adopt a healthier lifestyle and switch to eating a healthier diet. It’s understandable that high calorie foods are difficult to resist, but we should avoid foods that are rich in simple sugars, oil/ghee and processed refined flours. It is also difficult to find the time to exercise in today’s busy life schedule, but it should be made a habit. Sedentary lifestyles contribute to a lot of diseases including diabetes. Lifestyle modification should not be looked at as a punishment because you have diabetes or you are putting on weight—it should become a commitment to living a fuller life.

Q. How should one keep diabetes under check?

A. Follow the ABC approach—

• Quarterly monitoring with HbA1c [Blood test] helps to gauge the blood sugar control. The target level should be <6.5 – 7.
• Blood pressure should also be <140/90 mmHg. If persistently high, medications may be required to bring it under control.
• Cholesterol should be under control. LDL should be <70 – 100 mg/dl and HDL levels should be <40 – 50mg/dl. Triglycerides should be <150mg/dl.

Controlling blood sugar, blood pressure and cholesterol is critical to prevent complications like heart disease and kidney failure.

Q. Why is the number of diabetics increasing these days?

A. Obesity is the mother of diabetes. With the recent transition in our economy, and changing lifestyle, obesity has become rampant. Excess fat in the body leads to insulin resistance and high blood sugars. Heredity also plays an important role. Research has shown that recognising and tackling obesity with lifestyle changes can prevent diabetes.

Q. What medicines are available for diabetes control?

A. There are different classes of medicine available [oral/injectables]. Metformin is the basic and first line drug. It not only decreases blood sugar but also causes some weight loss and does not produce hypoglycemia [excessively low sugar level]. Other drugs like DPP4 inhibitors, sulphonylureas, glitazones, and insulins are to be used judiciously as add on drugs if metformin alone fails. Patients need to understand the dosing, frequency and other specifications attached with different medications prescribed.

This was first published in the November 2015 issue of Complete Wellbeing.

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Food was my friend, my saviour, my confidante. I ate when I was happy, sad, lonely, angry or bored. My eating had no connection whatsoever to being hungry or full. I don’t think that I have ever really experienced what being ‘full’ was. I was so disconnected from physical sensations that I no longer noticed them. My constant craving for food and overindulgence in it were also a way to ignore my emotions, ‘stuff the food, stuff the feelings’ was all too true in my case.

Did Genetics Cause My Addiction?

I was born at a time when parents wanted to prove that they could afford to feed their family, and feed them well—so I was a chubby baby. But as a child I was surprisingly skinny. I see photographs of myself back then and I’m shocked because I thought I have always been obese! My body dysmorphia [the belief that one’s body must be changed or hidden] began early and persists to this day. In a self-fulfilling prophecy the skinny child became the fat adult.

Was it because my mother’s mother lived through the Great Depression and World War II that food hoarding became routine? Was the desperation for food genetically passed from grandmother to mother to daughter? Or did I get it from my dad, because my father was raised in a residential boys’ home where meals were so meagre and brief that he learned to gulp food without pausing to chew?

Does it matter?

Past events might have formed me but as an adult, I realised that I am now responsible for whatever I put into my mouth.

My Life As An Addict

I treasure my intellect and usually approach life rationally. But no matter how many times I tried to deconstruct my food addiction and think my way out of it, I failed. I truly believe sugar and white flour are addicting, and when I ingest them I am in a crazed state of manic highs and crashing lows. In the midst of my addiction I am no longer a rational person, let alone a decent friend, a hard-working employee, a loving family member. I care more about my next mouthful than I ever cared about you.

Have you heard of someone break a tooth eating frozen food straight from the freezer, because you can’t wait to thaw it? Or do you know someone who has stolen a child’s holiday candy, then lied and told him he must have eaten it already? Is it rational to expect to find the answers to life problems in a refrigerator? No. It is not.

Changing My Relationship With Food

Therefore, to address my food addiction, I had to get clean first. Working with a therapist, or making list after list of food-related resolutions, proved worthless. Until I cut sugar and white flour from my life and flushed them from my system, I couldn’t begin to establish a new relationship with food.

I won’t lie—my first month was difficult. I ate so many vegetables that I thought I would turn green. I drank herbal tea non-stop and tripled the number of times I ran to the bathroom. I was sure I’d drop dead from malnutrition—but I didn’t.

I joined a support group of other like-minded food junkies. Doing this alone is a recipe for disaster. And, knowing that sugar is an additive in many pre-packaged foods, I started reading nutrition labels. Unless sugar [and her cousins sucrose, glucose, honey, etc.] were listed fifth or lower in the ingredients, I didn’t buy or eat it.

Feelings, which were previously stuffed down with the excess food, became overwhelming. I had to learn to feel my feelings, to truly experience sadness, loneliness, anger. Activities other than eating had to be mastered. Compulsive eating was no longer my go-to coping mechanism; so I had to find other coping skills.

The Big Changes Happen

Over time, amazing things have happened.  With sugar and white flour out of my system, the cravings have lessened. Like the volume of music on radio, I can dial down the cravings, so that food calls to me in a much quieter voice, making it far easier to resist. I no longer have afternoon energy crashes; because I eat complex carbohydrates instead of refined white flour, my blood sugar stays level without the spikes and slumps.

I am down 75 pounds and have remained that way for a dozen years. When winter comes, I am astonished that last year’s outfits still fit. Clothes wear out or become dated; I no longer own separate fat clothes and thin clothes.

My physician was stunned by the drop in my blood sugar and cholesterol levels. I was stunned at how much easier it became to exercise, take the stairs or even remain awake after a meal.

In Conclusion

I am a food addict, and I always will be. I can manage my addiction, but never cure it. The chubby baby still lives inside me, and always will. But I can learn to love her, rather than be embarrassed by her and to soothe her without using food. Though still glorious, food is now only food, and I can get out of the food and back into life.

This was first published in the March 2015 issue of Complete Wellbeing.

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Hence, detox diets—and even weight loss diets—require us to forgo some food groups. While some diets restrict carbohydrates, others say no to sugar or salt, still others forbid caffeine intake.

But evidence suggests that whenever our body observes the lack of supply of a particular ingredient, it reacts in a certain way, sometimes even violently. Let us have a look at the withdrawal symptoms of various food categories.

Withdrawal symptoms of a detox diet

Caffeine detox

Tea/coffee are the most targeted food group in a diet. A lot of people are addicted to tea and coffee and sometimes have several cups a day. On completely discontinuing tea or coffee, some changes take place in the nervous and vascular system, as the body tries to get rid of the poisons and realign its systems according to the new regime.

“Caffeine in coffee, tea, cola and energy drinks is habit-forming. It therefore creates dependability and withdrawal signs show up when it is stopped,” says Sheela Krishnaswamy, an independent diet, nutrition and wellness consultant.

Withdrawal symptoms of caffeine

The first symptom to manifest is a headache that stays for 2 – 3 days. You may also experience pain in the stomach and joints, which subsides after 3 – 4 days [the time taken by the receptors in the brain to be free of caffeine consumption]. Clogged sinuses and a running nose are other symptoms. For many people, tea and coffee work as a laxative, so constipation too is a common occurrence. Besides that, you may feel irritable and drowsy.

Cure: Take a couple of analgesics and ample rest. Having a very small amount of tea or coffee may also alleviate the symptoms. Switch to herbal teas or decaffeinated brews.

Cola detox

Soft drinks can be the primary source of calories and sugar for you. According to dietician Joanne Larsen of dietitian.com, there are nine teaspoons of sugar in each 12 ounce [355 ml] can of soda.

Caffeinated soda and energy drinks may contain other stimulants too, which may make you feel nervous. Reducing or eliminating caffeinated soda and energy drinks with stimulants should reduce feelings of nervousness.

Withdrawal symptoms of cola

Strong cravings and headaches are common symptoms. Dehydration may occur if soda is your main source of water for the body.

Cure: Switch to natural juices and decaffeinated drinks. Drink a lot of water to avoid dehydration.

Simple Carbs detox

Food items made of refined flour such as bread, cake, candy, pasta, noodles, and white rice are associated with a higher incidence of diabetes, cardiovascular disease, and even breast cancer. And eating refined carbs, over time, results in almost certain weight gain.

Withdrawal symptoms of refined carbs

The first week is miserable, with a feeling of fatigue and acute craving for carbohydrate-rich food. You may feel constantly hungry and irritable or even experience nausea.

S K Thakur, a senior gastroenterologist, explains, “When your source of income dries up, you utilise assets like gold and silver. Similarly, when the intake of carbohydrates gets restricted, the body starts using the stored fats.” This process is called ketosis. As a result, the insulin levels in the blood drops, stabilising the blood sugar and the body loses weight. After the first week, the person starts to feel better and the craving pangs reduce.

Cure: Drink plenty of water to enable fat metabolism. Eat protein-rich foods like eggs and dal. You can take a teaspoon of good quality MCT oil or even pure coconut oil — it helps ease your cravings for carbs. If you feel nauseous, take adequate rest. “Substitute refined flour with complex carbs such as jowar, bajra or nachni to help you feel fuller without the negative effects,” suggests Mukerjee.

Salt detox

Salt is a chemical compound consisting of sodium, which is detrimental to health. While reducing salt intake is good, when a person drastically restricts his intake of salt for an extended period of time, the old accumulations in the body are excreted through the skin and kidneys.

Withdrawal symptoms of salt

In the initial days, there may be a salty taste in the mouth. “Cramps are initially experienced as salt is removed from the diet or rapidly excreted from the body,” adds nutritionist Honey Khanna. Other withdrawal symptoms include high blood pressure, lethargy and drowsiness, and excessive urination [as salt is water retentive]. In extreme cases, you may experience hypernatremia [electrolyte disturbance in the body] and fits.

Cure: Reduce salt intake slowly. Replace regular salt with rock salt or low-sodium salt.

Meat detox

Meat eaters have a high acid content in their body. When they stop eating meat, the body attempts to revert to the healthier, alkaline condition.

Withdrawal symptoms of meat

As the acids leave the body through the pores, they leave behind a disagreeable smell, foul breath and a bitter taste in the mouth. You may also experience some hair loss and muscular weakness. Once all the acid has been neutralised, these symptoms disappear.

Cure: Consume lots of fruits, vegetables and fluids.

Dairy detox

Milk is considered by many as a complete meal in itself. However, some people become lactose-intolerant and have to cut down on milk. Milk contains tryptophan [essential amino acid], which is sleep-inducing.

Withdrawal symptoms of dairy

Lack of sleep, lethargy, grogginess, mood swing, and headaches are common. You may also experience ailments like multiple bowel syndrome and chronic constipation.

Cure: Replace regular milk [cow or buffalo milk] by soy milk. “By completely eliminating dairy products from our diet, we deprive ourselves of calcium, a mineral that’s imperative for strong bones and teeth. This is an open invitation for diseases like osteoporosis at a later stage in life,” explains Deepika Malik, executive director, LifeCentury, and a qualified Ayurveda practitioner. You can also meet your calcium requirements with the help of supplements.

Sugar detox

Many dieticians treat sugar as slow poison. Not only does it promote weight gain, but it is also deadly for a person with diabetic tendencies. In many ways, what seems harmless is actually a cause of diabetes, obesity, and a variety of other problems.

“We take sugar withdrawal as seriously as addictions to substances like alcohol or drugs,” says Malik.

Withdrawal symptoms of sugar

Due to low blood sugar levels, the first symptom is acute craving for sugar and sugar products. Next is fatigue, in the absence of the energy boost sugar gives.

Depression, anxiety and mood swings may be experienced as sugar enhances these emotions too. It is also common to experience headaches, similar to the ones experienced in caffeine withdrawal. Other withdrawal symptoms include drowsiness, skin rashes and throat discomfort. In extreme cases, fever with tremors, unconsciousness and seizures are observed.

Cure: Cut off sugar slowly instead on stopping all at once. Switch to fresh fruits, salads and nuts.

Fat detox

A major chunk of our population suffers from obesity. The prime suspects are our fat-intensive diet and sedentary lifestyle. However, fats also provide many of the necessary vitamins. Embarking on a fat less or low-fat diet, reduces the level of vitamins like A, D, E and K in the body.

Withdrawal symptoms of fat

All problems related to the deficiencies of vitamins A, D, E and K manifest. You may also suffer from dryness of skin and hair, itching, weakness of bones, and night blindness.

Cure: Eat good fats like almonds and walnuts and fresh fruits.

A word of caution about detox diets

While going on any type of diet, reduce in stages instead of imposing a total stop on the consumption of any food item. “If you are cutting down on the consumption of above foods, you can avoid some of the symptoms by doing it slowly. If the craving persists, substitutes can be used,” suggests Khanna. Some withdrawal symptoms like that associated with wheat/caffeine withdrawal might require medical management.

■ This article was last updated on 18^th February 2021

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