World HEALTH Day: BEAT Diabetes

Reference: http://www.who.int/campaigns/world-health-day/2016/poster-halt-the-rise.pdf?ua=1

April 7^th marks World Health Day, a day recognized by many health enthusiasts and given a theme annually by the World Health Organization.  This year’s theme, “Beat Diabetes”, is undeniably, a very important and timely one, as it aligns with achieving the global Sustainable Development Goal three target of reducing premature mortality from noncommunicable diseases by one-third by 2030.

Diabetes is a chronic disease and epidemic that is rapidly increasing in many countries, most dramatically in low- and middle-income countries. Just in 2012, the disease was the direct cause of 1.5 million deaths. In fact, the World Health Organization projects that diabetes will be the 7^th leading cause of death by 2030.

However, the facts of the increasing prevalence of both types of diabetes has a silver lining. Diabetes is both treatable and in many cases, preventable.

Diet and physical activity are key health behaviours that can be altered to reduce or increase your risk of developing diabetes.

Physical Activity

The World Health Organization has developed a set of guidelines for daily physical activity levels. For those aged 18–64 years old:

1.       Adults aged 18–64 years should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week, or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week, or an equivalent combination of moderate- and vigorous-intensity activity.

2.       Aerobic activity should be performed in bouts of at least 10 minutes duration.

3.       For additional health benefits, adults should increase their moderate-intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate- and vigorous-intensity activity.

·         Muscle-strengthening activities should be done involving major muscle groups on 2 or more days a week.

Diet

Last month we featured an interview with Dietitian Kiran Bains who provides some great nutrition tips and advice!

The World Health Organization also produces a list of recommended nutrient requirements: protein, energy, vitamin A and carotene, vitamin D, vitamin E, vitamin K, thiamine, riboflavin, niacin, vitamin B6, pantothenic acid, biotin, vitamin B12, folate, vitamin C, antioxidants, calcium, iron, zinc, selenium, magnesium and iodine.

The case of OJ vs. the Orange; The jury trial

Your honor... Today this glass of orange juice or OJ you see before you is on trial for causing several humans to become overweight. Take this boy, Tommy for example. He’s 12 years old and doctors have prescribed more physical exertion to bring his body weight to a healthier level. Tommy would consume about 2 glasses of orange juice every morning. Generally, juices are full of free sugar (glucose, fructose, sucrose etc.) which are often added by the manufacturer to enhance flavor. According to a Press Release dated 4^th March 2015, the World Health Organization outlined a guideline recommending adults and children to reduce their daily intake of free sugar to less than 10% of their total energy intake (1).

Consider Tommy’s breakfast table...On one end is an orange and on the other is a glass of orange juice.

Constituents	OJ/Orange Juice (100ml)	The Orange (Fruit diameter: 8 inches)
Calories	47	62
Sugar	8.81 grams	12.25 grams
Dietary Fibre	0.2 grams	3.1 grams
% of Recommended Daily Intake	4%	3%

The Orange is roughly 8 inches in diameter, a proportionate fruit carrying 62 calories, 3.1g of fiber and 12.25g of sugar (2). The glass holds 100ml of Orange juice carrying 8.81g of sugar, 0.2g of dietary fiber and 47 calories (3). Now the brand of the juice has a direct impact on the exact caloric constituents. Given the above stated values, one could assume that after consuming one orange you are more likely to feel fuller. On the other hand after one 100ml glass of orange juice, you are more likely to seek out the fridge for a second serving.

So it’s like that at breakfast Tommy could have just one orange which makes up for 3% of his Recommended Daily Intake (RDI) (2). Or he could have about two 100ml glasses of orange juice which accumulates to 4% of his RDI (3). It is important to note that we are still referring to his breakfast table and that additional juice may be consumed at lunch and dinner. However the juice is more accessible and easy to consume. The orange on the other hand requires peeling and additional preparation.

The director of the World Health Organization’s Department of Nutrition for Health and Development had this to say about free sugars...

“We have solid evidence that keeping intake of free sugars to less than 10% of total energy intake reduces the risk of overweight, obesity and tooth decay,” (4)

As human beings we have a tendency to assume that “more” is always better. This is not always the case. Too much of anything is not great for your body. In fact your mantra should be “everything in moderation”. Take sugar for example, too much of sugar in your diet can increase your risk of becoming overweight. This in turn may result in chain reactions that could lead to Type II Diabetes, Atherosclerotic heart disease or a predilection for cancerous outcomes. The orange in its natural state harbors additional constituents such as fiber etc that aid your digestive system’s motility while facilitating a gradual absorption of sugar.

This case is a bit murky, that I am aware of. The choice remains among individuals like Tommy who may go for the healthier fruit option or go for the more accessible glass of OJ. Statistics even show that with increasing age, the consumption of sweetened drinks increases among children and young adults (4). Given this trend and all this information, the question remains... Is there enough evidence to find this glass of OJ guilty?

References

(1) World Health Organization. (2015, November 26). Media Centre; WHO calls on countries to reduce sugars intake among adults and children. Retrieved from World Health Organization : http://www.who.int/mediacentre/news/releases/2015/sugar-guideline/en/

(2) Fatsecret . (2015, November 26). 1 Fruit Orange. Retrieved from Fatsecret: http://www.fatsecret.com/calories-nutrition/usda/oranges%3Fportionid%3D33208

(3) Fatsecret. (2015, November 26). 100ml Orange Juice . Retrieved from Fatsecret: http://www.fatsecret.com/calories-nutrition/usda/orange-juice?portionid=1137131&portionamount=100.000

(4) Home - Health Reports - Beverage consumption of children and teens. (2015, November 27). Retrieved from Statistics Canada: http://www.statcan.gc.ca/pub/82-003-x/2008004/article/10715/6500232-eng.htm