We’ve come a long way in our understanding of diabetes over the past few decades. Rather than cutting down on sugar, the prevention and management of diabetes hinges on weight control and a balanced diet.
But as rates of diabetes have doubled over the past 10 years and are likely to double again in the next decade, it seems we need a litte extra help remembering this advice when we’re in the supermarket aisle or kitchen.
Diabetes epidemic
The growth in diabetes is very closely linked to the rise in obesity. On the flip side, significant weight loss can reduce the impact of diabetes, or even eliminate the disease.
In terms of prevention, even simple lifestyle changes can stop pre-diabetes (high glucose levels) from turning into full blown diabetes.
This has been proven in Chinese, Finnish and the US studies over the past 20 years. The problem is, this knowledge has not been transfered into practical lifestyle advice to inform overweight and obese individuals’ diets.
Healthy weight reduces diabetes risk
The Finnish Diabetes Prevention program - the most influential diabetes lifestyle study - asked participants with pre-diabetes to achieve five goals to decrease their risk of developing diabetes.
The goals were: reduce body weight by 5% or more, reduce total body fat to less than 30%, cut fat to less than 10% of food intake, increase fibre to about 30-35g a day and do 30 minutes of exercise a day.
Over four years the rate of pre-diabetes was reduced by an astonishing 58%. If the volunteers achieved four or five of these goals, they did not develop diabetes.
Those who failed to achieve their weight goal but maintained their exercise regime were 70% less likely to develop type two diabetes, when compared with a sedentary control group.
To change their diet, the volunteer participants met with a nutritionist seven times in the first year and quarterly over the following four years.
This strategy was effective, but the time and expense of engaging a dietician would put this method out of reach for most Australians.
The right diet
To translate the principles of the Finnish study and allow a mass audience to improve their lifestyle without intensive intervention, the organisation I work for, Baker IDI, and the CSIRO have developed a diet and exercise plan.
Whether or not you need to lose weight, and how much you need to lose, depends on your Body Mass Index and your level of physical activity, and this is catered for in the diet book.
Massive weight loss is not required to prevent diabetes. Eating well is about establishing a workable routine so it can become part of everyday life.
The diet has higher protein and higher carbohydrate options and is based on lowering saturated fat and increasing fibre intake.
For people who already have diagnosed diabetes or require medication for diabetes, the same lifestyle principles can dramatically lower glucose levels.
More complex regimes such as an Atkins or Zone diet can also have a good effect on glucose control in type 2 diabetes but are more complicated. Because they are radically different from a normal diet, they tend to be less sustainable after 12 months.
Moreover, the high levels of saturated fat in the Atkins diet may actually increase cholesterol levels and the risk of heart disease.
Lots of diets make claims and fail miserably. So what’s our grand claim? If you have pre-diabetes follow the diet faithfully - which is not hard - you will not develop diabetes.
The CSIRO and Baker IDI Diabetes Diet and Lifestyle Plan, Penguin, $35.00