How much sugar is in 3 in 1 coffee in Myanmar?
Jamie
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Sugar rush
Dr Sarah Lawrence
Myanmar Times
15 February 2019
One in ten adults, a total of 5 million people, in Myanmar has diabetes. This is 10 times more than the number of people with active tuberculosis (TB) or HIV combined. Long thought of as a disease of wealthy Western countries, 20 percent of people with diabetes globally now live in South East Asia and almost half of these are undiagnosed. But what is diabetes? And why does it represent one of the biggest emerging health threats facing Myanmar?
Diabetes occurs due to a problem with insulin, a hormone involved in the uptake of sugar from the blood for use by the rest of the body. The vast majority of cases are type 2 diabetes, where an unhealthy diet, increasing age, lack of exercise and obesity interact with genetic factors to generate insulin resistance and high blood sugar levels. Crucially, 80 pc of cases of type 2 diabetes are preventable or even reversible with lifestyle modifications.
Spotting the warning signs
Many people with diabetes do not have symptoms until they develop complications, hence regular screening for those over the age of 40 is important. When they occur, symptoms include: blurred vision, fatigue, extreme thirst, frequent urination, poor wound healing, frequent infections and tingling or numbness in hands or feet.
Random blood sugar tests are the most common method of diagnosis in Myanmar but may miss more than 30 pc of cases. A fasting blood sugar is more accurate. Other blood tests include an oral glucose tolerance test, where the response to a sugary drink is measured.
One disease, many complications
When occurring in combination with other risk factors such as high blood pressure, high cholesterol or smoking, the risk of these complications can increase drastically. Hence, the true human cost of diabetes in Myanmar will only increase as the population ages, becomes more urbanised and more affluent. High sugar levels cause damage to blood vessels resulting in strokes, heart disease, blindness and kidney failure. Poor circulation, nerve damage and chronic ulcers may sometimes necessitate amputations of the toes or feet.
In the early stages, or when tests are borderline (‘pre-diabetes’), the disease can be managed with a strict low-carbohydrate low-fat diet but many people go on to require medication and even injected insulin in order to control their blood sugars.
Lack of awareness and primary health infrastructures in Myanmar mean that many opportunities for prevention and early diagnosis for diabetes are currently being missed. In line with the UN’s 2015 Sustainable Development Goals, a concerted national and global effort is needed to reduce premature death from non-communicable diseases such as diabetes. But at an individual level, there are a few simple ways to reduce your own risk.
Dr Sarah Lawrence, Physician and Greenshoots volunteer, Medical Action Myanmar, Yangon
7 ways to reduce your risk of diabetes
1. Know your risk
Even within a healthy Body Mass Index (BMI) range, South East Asians have a higher risk of diabetes due to differences in distribution of body fat. If your waist measures more than 31.5 inches (80cm) for women or more than 35.5 inches (90cm) for men, then your risk is increased. Having a close relative with type 2 diabetes also increases your risk.
2. Swap out rice
You can halve your risk by swapping refined simple carbohydrates such as white rice that lead to a large sugar spike for starchy slow-release alternatives such as brown rice, barley or lentils. You can also substitute rice noodles for mung bean (glass) noodles.
3. Reduce your meat intake
Highly processed or red meat has been linked to an increased risk of diabetes and conditions such as bowel cancer. Tofu, eggs, beans and nuts are excellent alternative sources of protein. A ‘Meat Free Monday’ is a good way to start cutting down.
4. Get up and get moving
The World Health Organization recommends at least 150 minutes of moderate-intensity exercise per week. Incorporate this into a busy day by getting off the bus a few stops early and walking briskly the rest of the way or waking up a little earlier for a 20-minute exercise video. Search for ‘beginner’s body weight exercises’ on YouTube for routines that don’t require any extra equipment.
5. Say no to sugar
Avoid sugary snacks and ask servers for no added sugar in drinks bought in cafes and restaurants. Ready-made coffee sachets have lots of added sugar so use a spoonful of instant coffee with your own sugar-free sweetener instead.
6. Watch out for hidden salt
On average, Asian diets include more than 10 times the recommended daily salt intake! This is associated with many diseases linked to diabetes including high blood pressure and heart disease. Soy and other sauces are extremely high in salt so go for low-sodium brands or use herbs and spices to flavour food instead.
7. Explore a variety of veggies
Myanmar’s natural resources and melting pot of people and ethnicities make for a national cuisine rich in a huge number of different vegetables. At least half your plate should be made up of green or brightly-coloured veggies such as tomatoes, beans, cauliflower, broccoli and gourds.
https://www.mmtimes.com/news/sugar-rush.html
