Indonesian food is in a league of its own. Imagine tucking into a meal of nasi goreng ayam with a side of martabak manis, and washing it all down with an ice-cold swig of Teh Botol. It’s a mouth-watering thought, at least until you register the damage done. After all, excessive rice, bread, and sugar never bode well for diabetes prevention.
As of 2019, 6.2% of Indonesia’s population, or 10.7 million people, were diabetic. Given that their population is among the world’s largest, the country also has one of the highest numbers of diabetic patients. With diabetes ranking as the third most deadly disease in Indonesia, after stroke and heart disease, its severity is plain as day.
Since diet is one of two main ways to prevent Type 2 diabetes (T2DM), how can we be more intentional about it? Sun Life's medical director Dr Raymond Tso weighs in on your FAQs.
Q1. Is there a diet to prevent diabetes?
According to Dr Tso, “There is no one optimal diet. The optimal diet is whatever you can follow and sustain to achieve optimal body fat percentage and avoid obesity.” Clearly, the short answer is no.
However, steering clear of added sugars and meats while doubling down on fresh vegetables and fruits, can reduce our risk of developing type 2 diabetes. The Mediterranean diet fits this brief exactly by prioritising fruits, vegetables, whole grains, and healthy fats while including dairy and red meat in moderation.
Alternatively, Dr Tso shares his own eating pattern: “Avoid refined carbohydrates and sugars. Eat lots of fibre (from whole grains, fresh vegetables and fruits), balanced with lean meat or a good quality plant-based protein. And practice portion control.”
Simply refer to the Piring Makanku plate guide, a dietary guideline by Indonesia’s Ministry of Health, for the recommended portions of food groups in each meal.
Fill My Plate One Meal (Example: lunch ±700 calories)
- Staple Food - Rice and its exchange 150 gr Rice = 3 scoops of rice = 3 medium potatoes (300 gr) = 1 1/2 cups of dry noodles (75gr)
- Pauka side dish. Animal side dish, 75 gr puffed fish = 2 medium pieces of skinless chicken (80gr) = 1 large chicken egg (55 gr) = 2 medium pieces of beef (70 gr) b. Vegetable side dish, 100 gr Tofu = 2 pieces of medium tempeh (50 gr)
- Vegetables = 150 gr = 1 medium bowl
- Fruit 150 gr papaya = 2 medium pieces = 2 medium oranges (110gr) = 1 small Ambon banana (50 gr)
(source: Isi Piringku Sekali Makan)
Q2. What about rice? Should we stop eating rice?
As white rice makes up a large proportion of daily energy intake in Asia, this question weighs heavily on our minds. While a study revealed that eating more than 3 cups of white rice a day increases the risk of diabetes substantially, things aren’t so black and white.
According to Dr Tso, it depends on calorie intake and optimal glycemic control, which relates to the regulation of blood sugar levels among people with diabetes. Green vegetables, most fruits, kidney beans, lentils, and bran breakfast cereals have a low glycemic index (GI), but white bread and white rice lie on the other extreme. Brown rice, which has a medium GI may well be the sweet spot in the middle. We will expound on GI further in Q4.
Q3. Can popular fad diets help prevent or manage diabetes?
Myriad diets have been placed in the spotlight lately, but don’t jump on the bandwagon just yet. Each one has its own “fine print”, and results may differ across individuals.
Let’s take ketogenic or low-carb diets for example. Because they eliminate foods that contain carbohydrates, even fruits, starchy vegetables, dairy products, and sugar, they may help achieve short-term weight loss or lower blood sugar levels. But precisely because they’re as strict as they sound, long-term maintenance is a challenge. Even if you followed through, these diets could have negative side effects such as fatigue, nutrient deficiencies, and flu-like symptoms. Overly selective diets could also deprive you of healthy dietary fibre which, ironically, reduces the risk of diabetes, heart disease, and some cancers.
What about intermittent fasting, then? Followers of the diet plan conventionally abstain from food for up to 16 hours at a time, but others have taken things up a notch by fasting for 24 hours once or twice weekly. While this can reduce blood sugar and promote weight loss, there is little evidence that it’s an effective alternative to healthy eating patterns for diabetic patients. Besides, intermittent fasting is arguably more difficult to keep up, and off the table entirely for people who’re on medication that can’t be taken on an empty stomach.
Q4. What's the best diet for those already living with diabetes?
While preventive diet plans tend to be generic, dietary management for diabetes is a whole other ball game. For people with diabetes, following their doctor’s or dietitian’s prescription and monitoring their blood sugar levels at home is key.
Foods with a low GI, a measure of how quickly carbohydrates get digested and blood sugar levels increase over a 2-hour period, can help. Avoid high GI carbohydrates like white rice, sushi rice, short-grain brown rice, and even medium GI carbohydrates like basmati rice, wholemeal bread, honey, and orange juice. Instead, opt for low-GI carbohydrates such as nuts, porridge, sweet potatoes, and soy products.
Still, it’s important not to get carried away by the GI of foods, which could lead to an unbalanced or high-fat and high-calorie diet. Also, you could lose sight of the end goal: Controlling the total amount of carbohydrates consumed.
“While lifestyle modifications like eating habits are the key to reducing the risk of Type 2 diabetes, diabetics should not over-rely on them and hope their disease can be controlled without appropriate medications, added Dr Tso.
Prevent and manage diabetes with the right diet
There’s no hard and fast way to prevent or manage diabetes through our diets, but the age-old rules of healthy eating apply. If you find the world of fad diets and food labels confusing to navigate, collaborate with your doctor or dietitian on a plan that fits you best.