Madhav Kudva
As a practising gastroenterologist, many patients seek my advice on a healthy diet, particularly as they enter their golden years. As one age, several medical problems become commonplace – hypertension, diabetes, heart disease, acid reflux, and constipation. The basis of a healthy diet should include the following:
- Adequate fibre, between 25 – 30 grams per day. It is common for fibre to cause bloating in some individuals, so selecting fibre-rich foods could take some time.
- Adequate fluid intake of a minimum of 1.5 l/day to prevent constipation. Sky juice (water) is the best. Avoid fruit juices as they may cause unhealthy spikes in blood sugar.
- Ensure adequate protein intake to prevent age-related muscle wasting. Healthy proteins include tofu, lentils, egg white, Fish, skinless chicken, turkey, and other types of lean meat.
- Avoid carbohydrates with a high GI (glycemic index), as this may cause spikes in blood sugar and consequently increase the risk of diabetes mellitus. Replace it with complex carbohydrates with low GI. This includes oat bran, muesli, granola, parboiled rice, basmati rice, quinoa, multigrain, sprouted grain, or sourdough bread.
- Avoid foods rich in saturated and trans fats and replace them with poly and monounsaturated fat. The latter includes peanut oil and butter, olive and canola oil, nuts, and avocado. Omega-3 fatty acid, a healthy fat, is found in salmon, tuna, and sardines.
- A general rule of thumb is to avoid processed foods, which are often rich in saturated foods and trans fats, low in fibre, and with a high GI Index.
- Keep your gut bacteria happy as an unhealthy flora (called dysbiosis) has been linked to low-grade inflammation, heart disease, and even cancers. Healthy gut bacteria thrive in a diet rich in prebiotics (fresh fruits, vegetables, cereals) and polyphenols (multicoloured fruits and vegetables, black and green tea, coffee, dark chocolate, berries, cherries, spices). Foods that are red, purple, blue, and black are particularly rich in polyphenols.
A sample of a healthy diet is given below:
- Breakfast: Sprouted grain (Ezekiel) or sourdough bread – One slice of bread with peanut butter / Two slices with virgin olive oil and balsamic vinegar, A substitute spread is low-fat extra virgin olive oil margarine. One egg white, Alternative cereals: oat bran, muesli, and granola. One cup of coffee (with or without low-fat milk). If constipation is a problem, add one glass of psyllium or another natural fibre drink.
- Lunch: Servings of two or more types of vegetable, Fish, skinless chicken or lean meat, one serving of lentil, and one small bowl of low GI complex carbohydrate (parboiled or basmati rice). One glass of black or green tea, As a treat, one square (small portion) of a dark chocolate bar.
- Tea: One type of fruit (One green or red apple with skin, one whole orange with pulp, guava, avocado, etc.) and nuts (walnut, almond, cashew nut, peanut, pistachio, pecan, Brazil nuts). As a guide, a maximum of 30 grams of nuts is recommended daily (roughly 20 almonds or nine walnut or 30 pistachio or 15 cashews, or 30 peanuts).
- Dinner (preferably by 7.15 pm at the latest): Similar to what is given for lunch above, dinner should be the lighter of the two main meals.
Additional suggestion:
A sample of any healthy diet like the one above should probably be consumed six days a week. However, on the seventh day (like a Saturday or Sunday), one can try splurging (health permitting and in the absence of diabetes, significant heart disease, food intolerance, etc.) and eat any unrestricted meal in moderation. A conscious indulgence in an “unhealthy lunch and dinner on a Sunday “is good for one’s mental well-being. Regular exercise of at least 150 minutes a week gives overall health benefits, including preventing constipation.
For further information, please view my videos on constipation, acid reflux, fibre, foods with low GI index, gassy foods (FODMAP), and probiotics at www.gastrohepato.com.my
Madhav Kudva has been a consultant gastroenterologist at Pantai Hospital Kuala Lumpur since 1990. Prior to this, he had been an Associate Professor in Medicine and Gastroenterology at the National University of Malaysia. Madhav’s hobbies include creating videos, reading (especially books on economics), photography, and travel – he has been to over 80 countries spanning seven continents.