QYour interesting article on pre-diabetes did not indicate what are normal and what are pre-diabetes blood-sugar levels. I would appreciate knowing.
J.G.G.
Fredericksburg
AThe normal levels depend on which pre-diabetes test you take. There are two types of pre-diabetes--impaired fasting glucose and impaired glucose tolerance--and your doctor can do blood tests for both.
Impaired fasting glucose means a person's blood sugar is higher than normal, even after they haven't eaten overnight. In general, a fasting blood sugar less than 100 is normal, 100 to 125 is impaired fasting glucose, and 126 and higher may be diabetes, according to the American Diabetes Association.
The test for impaired glucose tolerance involves a person drinking a special sugary solution and having blood drawn before the test, and then again one and two hours after the drink. In this case, blood glucose less than 140 is normal; 140 to 199 indicates impaired glucose tolerance; and blood glucose of 200 or above may indicate diabetes. Usually, abnormal results are confirmed by repeating the test on another day.
The treatment for both types of pre-diabetes is the same: physical activity, excess weight loss and a balanced diet. Meals with moderate amounts of high-fiber carbohydrates, healthy fats and proteins can reduce the risk of developing full-blown diabetes.
QDo you know the glycemic index numbers for maltitol, soy flour, soy protein and chickpeas?
J.G.
Brooklyn, N.Y.
AThe glycemic index measures how quickly 100 grams of carbohydrates from a food raise blood sugar.
Chickpeas have a low glycemic index, between 10 and 43, depending on the brand and preparation. Maltitol, an artificial sweetener, has a glycemic index of 73, according to glycemicindex.com, powered by the University of Sydney in Australia.
I could not find glycemic index lists for soy flour. I would not expect soy protein to be listed, since protein and fats do not significantly affect blood sugar.
That said, I don't think the glycemic index is useful alone. Some healthy foods, such as carrots, have a high glycemic index. However, since carrots aren't particularly high in carbohydrates, you'd have to eat a few cups of carrots to raise your blood sugar as much as a slice of white bread would raise it.
If you multiply glycemic index by the amount of digestible carbohydrates in a serving, you get glycemic load, which is a more useful concept.
Glycemicindex.com also lists glycemic load. Carrots (and chickpeas) have a low glycemic load.
QMy doctor recently advised me to take fish oil daily, but he gave me no specific amount. How much do I need? I had quadruple bypass surgery and recently had a very good stress test.
In your recent column on fish oil supplements, you said to check the back of the bottle. In my capsules with 1,000 milligrams of fish oil, there are 180 milligrams of EPA and 240 milligrams of DHA. How much do I need of each? Please advise.
E.A.M.
Locust Grove
AIt depends on why your doctor recommended the fish oil.
If it is just because you have a history of heart disease, the American Heart Association recommends 1,000 milligrams of DHA plus EPA per day, preferably from fatty fish. If you also have high trigylceride levels, the Heart Association recommends taking 2,000 to 4,000 milligrams per day.
DHA and EPA are two of the trio of heart-healthy omega-3 fats, which have been shown to reduce blood pressure, triglycerides and the risk of strokes, among other things.
To figure out how many capsules of the fish oil brand you selected, just add the 180 milligrams of EPA and 240 milligrams of DHA in your capsules: The total is 420 milligrams. If you need 1,000 milligrams, you'd need about 2 capsules of the brand you selected; since you can't cut a capsule, you can take three capsules.
If you need to take a higher dose to lower triglycerides, you would need a minimum of five capsules of the brand you have selected. The recommendations are for about 2,000 milligrams per day total of EPA and DHA combined. Do check with your doctor to make sure he is OK with this amount, since he knows your medical history more thoroughly than I do.
QI would like you to send me a good nutritious diet for breakfast, lunch and dinner.
E.B.
Fredericksburg
AWithout knowing anything about you, it is difficult to suggest anything specific beyond eating at least a cup of fruits and vegetables at each meal, plus whole-grain foods, and to be sure to include foods rich in calcium and protein at least twice a day.
If you want a tailored plan, you might consider meeting with a registered dietitian. The dietitian can take into account your favorite foods, lifestyle, height, age, weight, medical history and many more details.
JENNIFER MOTL, a registered dietitian, welcomes reader questions via her Web site, brighteating.com, or mailed to Nutrition, The Free Lance-Star, 616 Amelia St., Fredericksburg, Va. 22401.