Download Eating to Lower the Risk of Diabetes

Eating to Lower the Risk of Diabetes
Can you prevent a disease with what you do or do not eat? The answer is maybe: Healthy eating may
help reduce your risk of getting certain chronic diseases. As for diabetes, eating healthy probably will
not prevent Type 1 diabetes, but you can delay the onset of Type 2 diabetes with what you eat or don’t
eat. In this lesson, we will give you information on reducing your risk of getting diabetes.
Many chronic diseases are interrelated, that is, if you have one disease, you may be more likely to have
another. The relationship between what you eat and your likelihood of contracting one of these chronic
diseases depends on several factors including obesity, heredity, environmental factors, level of physical
activity, and physical fitness. We know that diabetes can be linked to heredity, and that today, more
people are becoming diabetic due to the obesity epidemic and lack of physical activity.
Type 1 diabetes is usually diagnosed in children and young adults. Sometimes referred to as juvenile
diabetes or insulin dependent diabetes mellitus, the pancreas of individuals with Type 1 diabetes no
longer produce insulin, therefore, these individuals must rely on insulin injections.
Type 2 diabetes has usually been associated with adult-onset diabetes. Current reports, however, are
suggesting that type 2 diabetes is being diagnosed more often in children and adolescents – particularly
in American Indians, African-Americans, and Hispanic/Latino Americans. Current research indicates
that about 90% to 95% of all diagnosed cases of diabetes are type 2 diabetes.
According to the Centers for Disease Control, Type 2 diabetes usually begins as insulin resistance or
insulin insensitivity – a condition where the cells do not use insulin properly. As the body’s need for
insulin rises, the pancreas gradually loses its ability to produce it. Type 2 diabetes is usually associated
with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose
metabolism, physical inactivity, and race/ethnicity.
The treatment for type 2 diabetes is following a healthy meal plan and exercise program, losing excess
weight, and taking oral medication if needed. In addition, many with type 2 diabetes need to take blood
pressure and cholesterol-lowering medications.
Gestational Diabetes occurs in about 4% of pregnant women. This condition can occur in pregnant
women who have never had diabetes. Insulin resistance develops and the body cannot make and use all
of the insulin it needs during pregnancy. Gestational diabetes usually occurs later in pregnancy when
the baby is growing and may result in higher birth weight babies. Having gestational diabetes increases
the woman’s chance of becoming diabetic in later life.
Prediabetes, formerly often referred to as “borderline diabetes,” this condition raises the risk of type 2
glucose levels. Impaired fasting glucose is defined as a blood sugar level of 100 to 125 mg/dL
(milligrams per deciliter after an overnight fast). Impaired glucose tolerance is diagnosed when blood
glucose levels are 140 to 199 mg/dL after a 2 hour glucose tolerance test.
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How prevalent is prediabetes? In a cross-section sample of U.S. adults aged 40 to 74 years tested from
1988 to 1994, 40% had prediabetes. The progression from prediabetes is not inevitable, but those who
lose weight and increase physical activity, can prevent or delay diabetes and they may even return blood
glucose levels to normal.
Information from the U.S. Department of Health and Human Services’ National Diabetes Education
Program (NDEP) indicates that there are steps you can take to lower your risk for type 2 diabetes.
Making healthy food choices that are lower in fat and calories and participating in physical activity on
most days of the week can help you lose weight. Even a modest amount of weight loss can lower your
risk factors.
How much weight? NDEP says that you should aim to lose at least 5% to 7% of your current weight –
that’s 10 to 14 pounds if you weigh 200 pounds. It may be helpful for you to keep a food log and
physical activity log to make sure you are meeting your daily goals.
Metabolic Syndrome – More recent research and publications indicate that metabolic syndrome may be
an earlier predictor of the onset of Type 2 diabetes as well as coronary heart disease, stroke, and
peripheral vascular disease. Metabolic syndrome is diagnosed using several conditions that are
associated with Type 2 diabetes. The biggest factors for metabolic syndrome are overweight and
obesity.
Simply put, weight loss decreases the risk of metabolic syndrome. Research indicates that a loss of 7%
to 10% of initial body weight can result in reduced waist circumference, lowered blood triglycerides,
and increased levels of high density lipoprotein (HDL) cholesterol. Weight loss may also lower blood
glucose readings, decrease fat that has deposited around the mid-section of the body, and lower blood
pressure.
The following chart shows the parameters for the classification of Metabolic Syndrome. A person is
said to have metabolic syndrome when he/she has three or more of the parameters.
Parameters for the Classification of the Metabolic
Syndrome
Parameter
Men
Women
Fasting glucose (mg/dL)
>110
>110
Blood pressure (mmHg)
>130/85
>130/85
Plasma triglycerides (mg/dL)
>150
>150
HDL cholesterol (mg/dL)
<45
<50
Waist circumference (cm)
>102
>88
Follow the 2005 Dietary Guidelines for Americans:
♥ Make smart choices from every food group.
♥ Find your balance between food and physical activity.
♥ Get the most nutrition out of your calories.
Make smart choices from every food group: emphasize fruits, vegetables, whole grains, and fat-free
or low-fat milk and milk products; include lean meats, poultry, fish, beans, eggs, and nuts; eat a diet low
in saturated fats, cholesterol, salt (sodium), and added sugars. Eat as little trans fat as possible.
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Mix up your choices within each food group:
Focus on fruits: eat a variety of fruits whether fresh, frozen, canned, or dried – rather than fruit
juice for most of your fruit choices. For a 2,000 calorie diet, you will need 2 cups of fruit every
day.
Vary your veggies: eat more dark green veggies, such as broccoli, kale, and other dark leafy
greens; orange veggies, such as carrots, sweet potatoes, pumpkin, and winter squash; and beans
and peas such as pinto beans, kidney beans, black beans, garbanzo beans, split peas, and lentils.
For 2,000 calories, you will need 2 ½ cups every day.
Get your calcium-rich foods: get 3 cups of low-fat or fat-free milk – or an equivalent amount of
low-fat yogurt and/or low-fat cheese every day. One and one-half ounces of cheese equals 1 cup
of milk.
Make half of your grains whole: eat 6 ounces of grains every day with at least 3 ounces being
whole-grain cereals, breads, crackers, rice, or pasta. One ounce is about 1 slice of bread, 1 cup
dry breakfast cereal, or ½ cup cooked rice or pasta.
Go lean with protein: choose lean meats and poultry, and use low-fat cooking methods. Every
day you should eat about 5 ½ ounces of protein for a 2,000 calorie meal plan.
Know the limits on fats, salt, and sugars. Read Nutrition Facts Labels on foods and look for
foods that are low saturated fats and trans fats. Choose and prepare foods with little added salt
or sugar.
Find your balance between food and physical activity:
Be physically active for at least 30 minutes most days of the week.
Increasing the intensity or the amount of time that you are physically active can have even
greater health benefits and may be needed to control body weight. About 60 minutes a day may
be needed to prevent weight gain.
Children and teenagers should be physically active for 60 minutes every day, or most every day.
Get the most nutrition out of your calories:
Calories do count and there are a right number of calories for you to eat every day. This number
depends on your age, activity level, and whether you are trying to gain, maintain, or lose weight.
Choose nutritionally rich foods from each of the food groups every day – those that are high in
vitamins, minerals and fiber.
A Word About Eating And Diabetes
For those who have diabetes, the body’s ability to use food energy to power the body in a normal
fashion is impaired. Normally, the body converts some food energy into glucose. Insulin produced by
the pancreas helps the glucose get into muscle cells so the body can do work. When an individual has
diabetes, either the body doesn’t make enough insulin or it has trouble using the insulin that is produced,
or both. When this happens, the glucose stays in the blood and results in high glucose levels.
In this lesson we are focusing on Type 2 diabetes because it seems to be appearing in epidemic
proportions in the United States. The cause of Type 2 diabetes really isn’t known, but experts often
attribute the rise in the incidence of this disease to eating extra calories, overweight, and lack of physical
activity.
You really can’t “catch” diabetes nor is it caused by eating too much sugar. Type 2 diabetes can
be inherited. Ongoing research is being conducted to try to find out what causes diabetes, but we do
know that being overweight is a factor in the onset of the disease. For overweight individuals, the
pancreas has a harder time using the insulin produced in the pancreas so that organ must work harder.
Eventually the pancreas may cease to function.
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If you have been diagnosed with Type 2 Diabetes, prediabetes, or metabolic syndrome, is there
anything you can do to prevent or slow down this disease? Of course, if you are overweight, losing
weight can help delay the onset if you have prediabetes or metabolic syndrome.
When we looked at how the body converts food to blood glucose, you should also remember that
not all food components are converted in the same way. Calories in food come from protein,
carbohydrates, and fat. These three food components are converted differently. Under normal
conditions , about 90% of the carbohydrates in the food you eat is converted to blood glucose by the
body. Between 50% and 60% of the protein you eat is converted to blood glucose, and less than 10% of
the fat is converted to blood glucose.
From this, you can see that consuming foods high in carbohydrates will raise blood glucose more
quickly than other foods. Because of this, it is important for those with diabetes to watch how much
carbohydrates they are eating at each meal and during the day. Food groups that can be rich in
carbohydrates are grains and starchy vegetables, fruit, and milk. For most with diabetes, vegetables like
potatoes, corn, peas, lima beans, and winter squash are counted as part of the “grains” group.
Non-starchy vegetables such as green beans, carrots, broccoli, lettuce, asparagus, beets, etc. are
lower in carbohydrate so more of these vegetables can be eaten. Needless to say, portion control is key
for keeping blood glucose levels in check.
Individuals with diabetes do need to follow an individualized food plan that usually involves
“counting carbohydrates”. They also need to control portions of protein and fats because diabetes is a
risk factor for heart disease. Those with diabetes also need to eat on a regular schedule to help keep
blood glucose levels constant.
If you have family members or friends with diabetes, be aware that what, when and how often
they eat is important for controlling this disease. Diabetes is not curable, but it is controllable, therefore
the individual who has the disease should know what his/her food intake pattern is and which foods they
can consume.
References: A Healthy You, Based on Dietary Guidelines for Americans 2005, USDA and HHS, 2005.
Nutrition Review, Volume 65, No. 6, June 2007.
American Diabetes Association white papers on Type 1 Diabetes, Type 2 Diabetes, Prediabetes, and
Gestational Diabetes, www.diabetes.org
Written by:
Dr. Robert Reber, Extension Nutrition Specialist, University of Illinois, Urbana, IL
Shirley Camp, MS, RD, Extension Educator, Macomb Extension Center
Drusilla Banks, MS, Extension Specialist, Food Science and Nutrition Programming
Northeast Region Office, Wright College Satellite, Chicago, IL
Reviewed by:
Sarah Todd, MS, RD, Extension Educator, Rockford Extension Center
University of Illinois • United States Department of Agriculture • Local Extension Councils Cooperating
University of Illinois Extension provides equal opportunities in programs and employment.
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