Tuesday, November 02, 2010

Lifestyle Changes reduce Diabetes Risk

   Lifestyle changes like losing weight, reducing fat intake, eating more fibre and exercising 30 minutes a day help reduce the incidence of diabetes.

Researchers from the National Public Health Institute in Helsinki, Finland found that lifestyle changes not only reduce the odds of high-risk people developing type 2 diabetes but can also postpone the onset of the illness. An intensive lifestyle intervention lasting for a limited time can yield long-term benefits in reducing the risk of type 2 diabetes.

   About 194 million people worldwide suffer from diabetes and public health experts predict the number could reach more than 300 million by 2025. Most cases are of type 2 diabetes, which occurs due to the inability to regulate glucose (sugar) in the body. Diabetes also raises risk of heart disease, stroke, blindness and kidney damage, so preventing or delaying the illness can have huge health benefits.

   The researchers compared the effects of lifestyle changes on more than 500 men and women in Finland with impaired glucose tolerance, a precursor to full-blown diabetes. Half were given intensive diet and exercise counseling while the other half acted as a control group.

   During a 7-year follow up of the patients, the researches found a significant difference between the two groups. There was about a 15-20 percent reduction in diabetes risk in the intervention group. The lifestyle intervention alone, even if successful, does not necessarily prevent type 2 diabetes in all individuals, but it does postpone the onset of the disease.

Stressing on the importance whole grains, experts have claimed that incorporating them in the diet can lower the risk of heart disease, diabetes, stroke and certain cancers.

Lona Sandon, assistant professor of clinical nutrition at UT Southwestern Medical Center and spokesperson for the American Dietetic Association, says that it’s important for people to keep whole grains in their daily diet.

"Research shows that whole grains are good for your heart, lower risk of diabetes and stroke, and may help prevent certain cancers. They also help in managing weight," she said.

Sandon said that whole grains are chock full of good-for-you nutrients including fiber, folate and niacin, vital B vitamins, and magnesium.

"The phytochemicals found in whole grains have been shown to have health promoting and disease prevention benefits," she added.

Sandon recommended that adults aim for three servings, or 48 grams, of whole grains a day.

She advised that people should by rule look for the words "Made with whole grain" and "100 percent whole grain" on packages.

She gave other going-with-the-grain tips, which include swapping whole wheat breadstuffs for white rolls and breads, using whole wheat bread crumbs for stuffing.

Adding wild rice or brown rice to dishes as well as serving whole wheat crackers with hors d’oeuvres can also ensure that there is a good amount of whole grains in your diet.

Dietary considerations can present a Hobson's choice in diabetes. Even when the intake is nutritious, assimilating it can be another matter. Then there is the problem of progression of diabetic complications if one ends up with excess glucose or fat in the system. Excess carbohydrates in a meal, and the resulting uncontrolled blood sugar levels can be detrimental to any number of tissues, from the lens of the eye, to the neurons, small blood vessels and the kidneys. Fat is also a problem with increase incidences of atherosclerosis, large vessel disease and cardiac complications. What, then is the appropriate macronutrient for the diabetic population? Enough medical literature exists to suggest that in diabetes, proteins are probably the best bet.

Proteins are the natural choice of the body when faced with diabetes. In uncontrolled diabetes, muscle protein is broken down into amino acids to be converted into glucose by the liver. If left to fend for itself, this can create a commotion within the body. Since proteins have to supply enough energy to substitute for carbohydrates, proteins are broken down faster than they are made. The body ends up with a protein deficit, a situation with subtle, yet far-reaching effects on normal body functions. Importantly, for diabetics, a protein deficit has been shown to impair resistance to infections (Ganong WF). Replenishing the depleting protein stores is a vital requirement of all diabetic diets.

Importance of proteins in a diabetic has been well documented. The American Associations of Clinical Endocrinologists have made it clear that not much evidence exists to indicate that the patients with diabetes need to reduce their intake of dietary proteins. The AACE recommends that 10-20% of the calorie intake in diabetes should come from proteins (AACE Diabetes Guidelines). It is in fact believed that this is one nutrient that does not increase blood glucose levels in both diabetics and healthy subjects (Gannon et al).

Nutrition therapy for diabetes has progressed from prevention of obesity or weight gain to improving insulin's effectiveness and contributing to improved metabolic control (Franz MJ). In this new role, a high protein diet (30% of total food energy) forms a very pertinent part of nutrition therapy. One of the most important causes for type II diabetes is obesity. Excess body fat raises insulin resistance and higher levels of insulin are required to bring down blood sugars as the weight increases (Ganong WF).

Another problem with excess fat is the clogging of arteries with atherosclerotic plaques that is responsible for a wide range of diabetic complications. Any mechanism that reduces body fat decreases insulin resistance and improves blood glucose control. Parker et al have also shown that a high protein diet decreased abdominal and total fat mass in women with type II diabetes.

Other studies by Gannon et al. and Nuttall et al have verified that blood glucose levels and glycosylated hemoglobin (a marker of long term diabetic control) reduce after 5 weeks on a diet containing 30% of the total food energy in the form of proteins and low carbohydrate content. It is speculated that a high protein diet has a favorable effect in diabetes due to the ability of proteins and amino acids to stimulate insulin release from the pancreas. Thus, a high protein diet is not only safe in diabetes, but can also be therapeutic, resulting in improved glycemic control, and decreased risk of complications related to diabetes.

The benefits of a high protein diet do not end here. Individual protein components of such a diet, when aptly chosen, can have other advantages as well. Dietary supplements containing proteins like whey and casein come highly recommended. Casein is a milk protein and has the ability to form a gel or clot in the stomach. The ability to form this clot makes it very efficient in nutrient supply. The clot is able to provide a sustained, slow release of amino acids into the blood stream, sometimes lasting for several hours (Boirie et al. 1997). A slow sustained release of nutrients matches well with the limited amount of insulin that can be produced by the pancreas in diabetes. A protein supplement containing casein can thus increase the amount of energy assimilated from every meal and, at the same time, reduce the need for pharmacological interventions to control blood sugar.

Whey proteins and caseins also contain "casokinins" and "lactokinins', (FitzGerald) which have been found to decrease both systolic and diastolic blood pressure in hypertensive humans (Seppo). In addition, whey protein forms bioactive amine in the gut that promotes immunity. Whey protein contains an ample supply of the amino acid cysteine. Cysteine appears to enhance glutathione levels, which has been shown to have strong antioxidant properties -- antioxidants mop up free radicals that induce cell death and play a role in aging.

Thus, development of a protein supplement containing casein and whey can provide an apt high protein diet and its health benefits to individuals suffering from diabetes, obesity and hyper-cholesterolemia.

By the time many type 2 diabetics (and often their doctors) realize action is necessary, the disease, with its destructive high blood sugars, has been silently damaging their body for years.

Complications to the blood vessels and tissues of your eyes, feet, heart, kidneys, and other organs, are likely well underway.

You visit the doctor because you feel bad, and you wish to feel better. You react to the symptoms of perceived illness. This is understandable, but does not allow much room for prevention or early detection of diabetes.

Of course this idea, "Don't see the doctor 'til it hurts," comes from our "busier-then-ever" lifestyles. But to blame, to point fingers after the damage has started is as pointless as is the leaping bungee-jumper's complaint that his equipment has just failed. It's a little late to talk about why. Some problems are better prevented.

If you have type 2 diabetes, you know most of the time you don't feel very bad. You might think that because you don't feel very bad, it isn't very serious, and you don't have to do anything about it just now. "I'll wait 'til it hurts" ...You couldn't be more wrong.

Diabetes damages your body with high blood sugars. It doesn't care whether your sugars are high from type 2, type 1, or some other cause - if they're up, they're doing damage. Type 2 diabetics who let their sugars run "because they don't feel bad" are doing serious damage to their eyes, kidneys, hearts, and nervous systems.

Suppose you have diabetes, and don't want the complications. Suppose you don't know you have diabetes, but you're from a high-risk group (maybe someone in your family has or had diabetes), and you want to cut the risks. Or, suppose you just want to feel better.

It's all the same - Your early detection, education, and prevention work best.

Don't wait 'til it hurts. Ask your doctor about diabetes and have your blood sugar checked several times a year.

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