NAVIGATION

Diabetes Prevention: Principles for Diet and Exercise

Jean-Pierre DHENIN, Family Medicine Physician

A recent news article talked about the dramatic socioeconomic shift that has occurred in China in the past few decades. People went from barely having enough food to developing what the article termed “nobleman diseases,” of which diabetes was the most notable example. Over the past 15 years, the Family Medicine Department at Beijing United Family Hospital and Clinics (BJU) has certainly seen a rise in the number of diabetic patients. Though diets have become richer, there is no reason that diabetes has to affect you if you don’t have a family history of the condition.

Diabetes and dieting

There are two types of diabetes: Type 1 is genetically inherited and unpreventable; Type 2 is developed in people who didn’t have the disease at birth. You can prevent or delay the onset of Type 2 diabetes through a healthy lifestyle. Change your diet, increase your level of physical activity and maintain a healthy weight. With these positive steps, you can stay healthier longer and reduce your risk of developing diabetes.

All diets must adhere to a few foundational rules concerning nutrition:
•    Eliminate as many processed carbohydrates as possible. These generally include foods or products that are artificially sweet and contain lots of sugar.
•    Don’t eat carbohydrates within two hours before bedtime.
•    Balance your fat/carbohydrate/protein intake in a roughly 30-50-20 ratio.
•    Eat at least three meals a day and don’t shy away from snacking between meals if you’re hungry.
•    Ensure having a good source of protein in your breakfast.

Stay away from fat-free processed foods. They are probably not as good as claimed. Healthy sources of fat actually help us because fat satisfies our appetites and keeps us from eating too much or too often.

White flour, bleached flour, enriched flour, or any other kind of hyper-processed wheat flour are not as nutritionally dense as their whole-grain counterparts. The glycemic effects of such flours will work against you. Opt for whole grain flours, and try to get a variety. In short, get your grains in the least-processed form you can.

What also holds true for everyone is: drink lots of water! Sodas do not count as a source of water. Such beverages are unhealthy. They contain sugar, chemical and/or artificial sweeteners that might be harmful for our bodies.

I would recommend eating a few small meals rather than one big one. Doing so levels out your insulin and your blood sugar. Eat slowly. Take your time with each meal/snack to allow your brain to register fullness. Stop eating when you start to feel full. That comfortable, satiated feeling will come later.

If you find yourself overeating out of anxiety or boredom, fix the underlying problem – don’t add to it by mindless eating.

Exercise

Everyone could probably build a little more muscle and burn a little more fat. How many lean, muscular people do you know with diabetes? Live a lean lifestyle, and you will be way ahead in the diabetes game.

Walking is great exercise. Do it every day, and you’ll raise your metabolic rate, as well as level out your blood sugar. This means you will burn extra calories even while you are sitting in front of your computer or sleeping in your bed. Corollaries to this principle include the following:

  • Take the stairs instead of the elevator.
  • Park farther away from your destination.
  • Pay attention to what you do and think of how you can burn more calories while doing it.

As with any other medical condition, prevention is much better than cure. Because there is no known cure for diabetes – the sixth leading cause of death in the United States – taking steps to prevent diabetes becomes critical, especially if you have certain risk factors that make you a likely candidate for the disease.

Principles for Diabetes Prevention

Principle 1: Maintain a healthy weight. The majority of people diagnosed with Type 2 diabetes are overweight. Excessive weight and body fat increase your risk of developing diabetes.

Principle 2: Know your family history. Your chances of developing diabetes later in life increase if you have one or more family members with the disease.

Principle 3: Stay physically active. Regular exercise can help to prevent diabetes by controlling weight and improving blood flow. Exercise is especially important if genetics put you at risk for developing the disease.

Principle 4: Eat a balanced diet. Increase your intake of vegetables and fresh fruits. Since diabetes involves impairment in the body’s ability to either produce or utilize insulin (insulin helps to convert sugars into energy), it’s important to monitor the amount of glucose and starches consumed. A nutritionist could be very helpful if you need dietary advice and glucose monitoring recommendations.

Principle 5: Get checked. Everyone over the age of 45 should schedule a blood glucose measurement test with their doctor every three years. However, if there are risk factors present, such as family history or obesity, regular testing should begin at an earlier age.

Pre-diabetes is the state of a person who is highly likely to develop diabetes if lifestyle changes are not made. Their blood glucose tests usually come back with higher-than-average results. Pre-diabetes is a serious medical condition that can be treated.

The good news is that the recently completed Diabetes Prevention Program[1] study conclusively showed that people with pre-diabetes can prevent the development of Type 2 diabetes by making changes in their diet and increasing their level of physical activity. They may even be able to return their blood glucose levels to the normal range.

Some medications may delay the development of diabetes, but lifestyle changes involving diet and exercise are a better, longer-lasting solution. Just 30 minutes a day of moderate physical activity, coupled with a 5-10% reduction in body weight can produce a 58% reduction in the likelihood of developing diabetes (from the American Association of Diabetes[2] ).

References:
– National Diabetes Education Program www.ndep.nih.gov
– American Diabetes Association www.diabetes.org
– About diabetes prevention programs http://diabetes.niddk.nih.gov/dm/pubs/preventionprogram/DPP.pdf

[1] The Diabetes Prevention Program (DPP) was a major multicenter clinical research study aimed at discovering whether modest weight loss through dietary changes and increased physical activity or treatment with the oral diabetes drug metformin (Glucophage) could prevent or delay the onset of Type 2 diabetes in study participants. The DPP found that participants who lost a modest amount of weight through dietary changes and increased physical activity sharply reduced their chances of developing diabetes. The researchers published their findings in the February 7, 2002, issue of the New England Journal of Medicine.
[2]
American Diabetes Association www.diabetes.org