The Impact of selected Vegetable Juice Consumption in the management Of Diabetes Among Patients In Enugu Metropolis Of Enugu State.
Background to the Study
In the world today man is faced with a lot of problems and diseases which tend to weigh him down and at most kill him. The challenges of what to eat and what not to eat has become a major problem today, triggering the say you are what you eat. Diet and Disease appear to be inseparable, because when diet is not a cause of a disease or health problem it is linked to poor health. Diabetes has long been with man and its effect now posses more danger. Diabetes is a chronic degenerated disease which is caused by the disturbance of the metabolism of the body and of its harmonic balance to (Bakhru,2010).
According to Kuku (2005), diabetes is caused by the inability of body tissues to carry out normal metabolism of carbohydrate and fats due to lack of insulin. The disease occurs in two major forms; diabetes insipidus (DI) and diabetes mellitus (DM). Diabetes insipidus is a rare metabolic disorder caused by a deficiency of a certain hormones normally secreated by the posterior part of the pituitary gland. It is characterized by an excess of fluid loss by the body.
Diabetes insipidus is a condition in which the kidneys are unable to conserve water as they perform their functions of filtering blood. The amount of water conserved is controlled by Antidiuretic hormone (ADH) and in some cases it could be referred to as vasopressin. Diabetes mellitus is commonly called diabetes. It is a group of disease in which a person is said to have high blood sugar “too much sugar” in the blood stream (Orakwue, 2014). Diabetes mellitus is one of common problem in our society today, it can be said or defined as a nutritional problem, disorder characterized by an abnormally elevated level of blood glucose in the urine.
Diabetes mellitus has been known to mankind from prehistoric times. It was identified 3500 years ago and the Egyptians were the first to record it (Bakhru,2010). This disease has been described in the medical texts of the ancient civilizations of Egypt, Greece, India, Roma and China at first. The Egyptian papyrus of Ebers (1500Bbc) a medical compilation mentioned the disease associated with polyuria. The Greece, who knew about it as manifestation of persistent polyuria or excessive urination, named the disease diabetes meaning to flow through.
According to WHO (2011) Body mass index (BMI) is a good measure of general adiposity. It is defined as the weight in kilograms, divided by the square of the height in meters (kg/m2). A person can be categorized as underweight if his/her BMI is ≤18.5, as normal weight if his/her BMI is in the range of 18.5–24.9, as overweight if his/her BMI is between 25 to 29.9 and as obese if his/her BMI is ≥30. A raised BMI value is an established risk factor for ischaemic heart disease, stroke and carcinomas.
The people with BMI of 29.9 and above, stands the chance of developing diabetes type two later in their life. This is to say that the BMI of a person has to do with has a connection with diabetes mellitus (WHO,2011). The increased incidence of diabetes around the world is directly linked to the rate of weight gain globally, but research shows even modest weight loss can make a big difference,(Weight Watchers Research Department in 2011).
Juicing is the process of extracting from plants such as vegetables and fruits. Juicing is a great avenue for supplement support, especially if you are not able to consume adequate amount of fruits and vegetables. Nwobi (2013), noted that vegetable juice contains more than 40 flavonoids. The favounoids combine to offer antioxidants and anti-inflammatory which benefits the body. Some selected vegetable extracts can help in the reduction of sugar in their blood stream such as
Fluted pumpkin leaves (Ugu in Igbo)
The Nigerian Society of Endocrinology and Metabolism (NSEM) and the Diabetic Association of Nigeria (DAN) recommend traditional foods such as fluted pumpkin leaves to beat diabetes and heart diseases including hypertension.
Fluted pumpkin leaves like all dark green vegetables are rich in dietary properties such as calcium, iron, potassium, folic acid and manganese. The leaves equally contain high levels of vitamins A, K and also vitamin C, B2 and E, The leaves have a lot of chlorophyll and are great antioxidants, helping in the restoration of damaged cells.
Bitter leaf (vernonia amygdaline) Onugbu in lgbo, Ewuro in Yorubas
Bitter leaf is known to help regulate the blood sugar level. It also repairs the impaired pancreas. The pancreas is the organ responsible for the production of insulin for glucose to reach each cell to use by the body as energy. An impaired pancreas does not release the right amount of insulin to maintain the right sugar level in the blood. You can benefit from this amazing plant by squeezing its Leaves and drinking the juice.
Research findings at the Danfo University declared that
the consumption of the above leaves can lead to a reduction
in blood sugar levels as well cause higher insulin-sensitivity in diabetics.
Basil leaves (ocimum basillion) nchuanwu in Igbo, efiri in Efik, efirin in Yoruba)
Basil leaves contain many notable plant-derived chemical compounds that are known to have disease preventing and health promoting properties, they contain essential oils and polyphenolic-flavonoids are known to have and -inflammatory effects on the body. They are very low in calories and contain no cholesterol, but are a rich source of many essential nutrients, minerals and vitamins that are required for optimum health. They contain vitamin A, vitaminK, potassium, and manganese, copper, Iron, and magnesium ( Nwobi,2013).
Lettuce (lactuca sativa)
Lettuce has a number of beneficial micronutrients, but the most important are iron, and magnesium. Iron is used in the body for blood cells, magnesium is vital for cell building and regeneration. Magnesium is supported by calcium in maintaining the necessary levels of alkalinity of body fluids. Lettuce also has calcium, Lettuce is eaten as salad (American diabetes association,2010).
Spinach (spinacia oleracea)
W.H.O Foods Recommendations state that “among the world’s healthiest vegetables, spinach comes at the top of our ranking list for nutrients richness”. Rich in Vitamins and minerals it is also concentrated in health-promoting phytonutrients such as carotenoids and Flavonoids to provide powerful antioxidant protection. Spinach can be eaten raw in salads.
Plantain leaves (plantago major): Plantain leaves contain fibre, potassium, calcium, magnesium, sodium, phosphorous, zinc, and copper, as well as vitamins A, C and K. It is a source of numerous phyto-chemicals, including allantois, glycosides, phenols, salicylic, acid and tannins. Phytochemicals are antioxidant compounds found naturally in plants that prevent free radical induced damage in the body, and thereby help to prevent and treat diseases in humans. The International College of Herbal Medicine states that plantain leaf has anti-inflammatory, analgesic, antibiotic and immune-stimulating properties.
Waterleaf (Talilum triangulare):This is the most widely used green leafy vegetables especially among the Efiks and Ibibio people. It is rich in iron, calcium, vitamin A and C and it is best eaten slightly cooked in soups and stews. Spinach can be substituted in recipes where water leaf is used.
Other leafy vegetables which can be added in the juicing
Such common vegetables like Utazi (crogromena ratifolia),(corchoros olitoriuo), Afang/ Ukazi (gnetumAfricana), Uziza or Ikong Etinkirin and any other edible green vegetable can be added to produce a nutrient dense
perfect food with low calorie.
Collect all the above listed vegetables and blend them together to have a juice and then feed the participants about 15cl or more specifically in the morning and night depending on the patients response to the treatment giving.
The PH for diabetic patient`s bodies is constantly in acidic state and they need foods that are alkaline to achieve a good PH balance for the body to function well (CDC,2011), so They recommended juicing and consuming green vegetable to balance the acidity of the body.
According to Gilbert (2006), nutritionists agree that sensible eating habits and nutritious foods are the way to good health, energy and vitality. Paying attention to what you eat is not starving yourself. Diet is an essential part of diabetes treatment. But today in our society everyone claims to have the knowledge of dietary and this gives rise to what we call dietary/dieting deception.
Having looked into the matter researchers found out that some people have this disease running in their family and some others, due to their life style develop this disease. The more they try to manage and control this disease the more it gets complicated. On this note that the researcher to look into the system. Hence, it could be said that no single food provides all the necessary nutrients in the amount needed (Nwagbo, 2004).
According to Paterson (2009), carbohydrate foods should be taken in regular amount over six or seven meals a week. For a successful manage and control (healing) of these disease, it is essential to understand the individuals body’s daily food and nutritional requirements, then know how to select foods which helps in controlling and preventing diabetes from the chart which is called the diabetes food pyramid which has the six sections or food groups.
Statement of the Problem
In Nigeria, many researches have been conducted by different agencies at different times, to ascertain the incidence of diabetes in the country. It has been estimated that as at 1995, there was 9million diabetic patients and since then, it has been estimated that the number by 2025 would have increased up to a staggering 25million (American Diabetes association 2007).
The latest estimates according to WHO (2011), indicates that there are already over 15million cases of diabetes in the country, of which 90 percent are believed to be over forty years of age. It was observed in the hospitals in Enugu state the major problems of patients in and out of the hospitals are linked to diabetes and these diseases compound the other health challenges of the patients giving rise to the number of death role in diabetes. The hospitals way in which they treat diabetes is to the pills, the insulin injections after diagnoses and lastly the change in diet.
Nwobi, (2013) suggested that leaves and vegetable are better alternatives. Hence this study was set out to establish the impact of selected vegetable juice consumption in the management of diabetes among patients in Enugu metropolis Enugu state.
Purpose of the Study
The purpose of the study is to ascertain the impact of selected vegetable juice extract consumption on management of diabetic patients, using Enugu metropolis in Enugu state as a study. Specifically, the study tends to:
- Determine if the selected vegetable juice extract could help in the controlling the body weight fat of diabetic patients.
- Determine the extent in which the selected vegetable juice extract, could go in reduction of the body mass index (BMI) of diabetic patients.
- Determine if the selected vegetable juice extract could be a better alternative in controlling a diabetic person’s blood sugar.
Significance of the Study
This study will provide information about the impact of the selected vegetable juice consumption in the management of diabetes among patients in Enugu metropolis, Enugu state. This study will be beneficial to the individuals and families with diabetic history, nurses and doctors in the hospital and mostly the government of the countries affected. The findings of this study will benefit:
Individuals with diabetic cases: the findings will help to determine another way of improving the health status of these individuals. This will help the nutritionists and dieticians: the studies will help the food doctors to have alternative way of managing diabetics’ patients. Other health practitioners’ like nurses and general doctors: the study will give more knowledge on natural medicine and alternative to the management of diabetes in the hospital environment.
The families with diabetic’s history: it will help the families to have a better view in the management and control of diabetes among themselves.
The government: when an individual and families are healthy the government will have less of health challenges to meet up with. This study will also go a long way to tell the relationship between malnutrition and diabetes mellitus. For example, by enlighten people about propel nutrition and how it could be used to checkmate diabetes in individuals.
Scope of the Study
This study focuses on the impact of selected vegetable juice consumption in the management of diabetes among diabetic patients in Enugu metropolis, which consist of young adults and older adults living with diabetes mellitus among inhabitants, in Enugu metropolis, Enugu state. The study tends to determine if the selected vegetable juice extract could help in controlling the body weight fat of a diabetic patient, also to determine if the selected vegetable juice extract, could help in reduction of body mass index of the patients and also if it could be a better alternative in controlling the blood sugar. The respondent of this study are individuals living with diabetes in Enugu metropolis of Enugu state.
The following research questions were developed to guide the study:
- Can the selected vegetable juice extract help in controlling the body weight fat of a diabetic patients?
- What are the effects of the selected vegetable extract, in the body mass index (BMI) of diabetic patients?
- What are the effects of the selected vegetable juice extract as an alternative in of controlling a diabetic person’s blood sugar?
The following null hypotheses were tested at 0.05 level of significance to guide the study
HO1: There is no significant difference in the mean rating of pre body weight and post body weight among the diabetic patients following the 21day local juicing treatment.
Ho2: There is no significant difference in the pre BMI calculation and the post BMI calculation following the 21day local juicing treatment.
Ho3: There is no significant difference in the pre fasting blood sugar level and post fasting blood sugar level following the 21day local juicing treatment.