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Lower your risk of diabetes

Although type 2 diabetes is on the increase, experts say it’s never too late to lower your risk.

Type 2 diabetes occurs when the amount of glucose in the blood is too high as the body cannot use it properly. This is because the pancreas is not producing enough insulin to help glucose enter the body’s cells, or the insulin that is being produced does not work properly (this is known as insulin resistance).

Type 1 diabetes – where no insulin is produced at all because the insulin-producing cells in the pancreas have been destroyed – cannot be prevented or cured, although it can be treated using daily insulin injections. Cases of type 2, however, can be easier to predict, avoid and manage.

There are nearly three million cases of diabetes in the UK, with another 850,000 believed to be suffering but as yet undiagnosed, the vast majority of which are type 2.

According to charity Diabetes UK, type 2 tends to develop in adults over the age of 40, or over the age of 25 for those with a south-Asian or African-Caribbean heritage. Risk factors include a family predisposition to the condition, a history of high blood pressure or heart disease, and being overweight — especially around the middle.

The International Chair on Cardiometabolic Risk (ICCR), an international academic group based in Canada, confirmed this in February, revealing the results of the largest, standardised study ever conducted on abdominal obesity as a risk factor for cardiovascular disease and type 2 diabetes.

Diabetes

Diabetes

The study shows that individuals with prediabetes have more abdominal fat than those without the condition, and that even when their body mass indexes (BMIs) are low, people with Asian ethnicity are more prone to abdominal fat accumulation. ICCR scientific director Jean-Pierre Després says: “Waist circumference is a simple but effective way to assess abdominal fat.”

Diabetes UK clinical advisor Deepa Khatri agrees: “If your waist size is greater than 37 inches for a man (35ins for a male of south Asian ethnicity) or 31½ inches for a woman, then your chance of getting type 2 notably increases,” adding that our increasingly sedentary lifestyles, fewer home cooked meals and increased junk food consumption are to blame.

Type 2 is a serious issue, because although you can control the condition through diet, exercise and medication, as Halle Berry does, if left unchecked, it can lead to permanent nerve damage in the eyes and limbs, in some cases leading to blindness, amputation or coma. It is also a risk factor for heart disease and stroke.

So how can we all reduce our risk? “Look at the way you eat,” says Deepa Khatri. “Keep your diet low in sugar and fat, take regular exercise, and keep your weight and waistline at a healthy level.”

“Eat three meals a day spaced regularly: you need to keep blood sugar levels stable,” says Boots nutritionist Vicky Pennington. “And don’t be afraid of carbohydrates or starchy foods – they contain essential nutrients. Just opt for those high in wholegrain or high fibre, or vegetable-based sources, such as potato.

“If you have foods with added sugar, keep these as a treat; that also applies to any specially labelled ‘diabetic’ foods. These are not for everyday consumption.


“You need to think of your whole lifestyle – not just daily blood sugar levels – as people with diabetes are at higher risk of heart disease. So cut down on saturated fat — go for monounsaturates such as olive or rapeseed oil — and eat lots of fruit and veg, watching the portion size of sweeter fruits such as grapes.

“Include more peas and beans, reduce salt, and try to eat fish twice a week, one portion of which should be oily fish. Alcohol should only be taken in moderation and never on an empty stomach, as it can make blood sugar levels drop.”

As part of any lifestyle changes, those with type 2 need to quit smoking. Harmful to all, smoking leads to complications in diabetes sufferers as they already have impaired circulation. In patients with diabetes smoking can increase nerve damage and raise blood pressure, contributing to increased risk of heart attack and stroke.

It’s also crucial to know the symptoms of diabetes, explains Deepa Khatri. “Diabetes comes on silently: by the time you notice changes in your body, it will be under way,” she warns. “Sufferers feel tired, urinate frequently at night, suffer thirst and blurred vision. Simple wounds may be slow to heal. If any of these signs rings a bell, see your GP and ask for a test.” Researchers at the Peninsula Medical School in Devon have developed a home urine test which should make detection faster and easier in future.

The good news is that, although the condition is not curable, with careful management, glucose levels can be brought to normal. Says Vicky: “Think of the overall health picture: you’ll manage blood sugar levels and reduce your general risk of ill health.”

Dash diet encouraged for youngsters

An eating plan designed to reduce high blood pressure in adults is being encouraged to help keep tweens and teenagers trimmer.

Researchers found that girls aged between 9 and 19 whose food intake most resembled the Dietary Approach to Stop Hypertension (DASH) diet had the smallest gains in body mass index (BMI) over 10 years, and the lowest BMIs at the end of the follow-up period.

The findings indicate that educating people about healthy eating is still one of the most effective ways to tackle obesity.

The DASH diet focuses on a higher consumption of low-fat dairy products; fish, chicken and lean meats; and nuts, fruits, whole grains, vegetables.

The eating plan, which is being pushed by the American Heart Association, leads to significant blood pressure reduction.

‘I think these were the results we were hoping to find,’ said study author Dr. Jonathan Berz, an assistant professor of medicine at Boston University School of Medicine.

Acknowledging that eating healthily – as the DASH diet encourages – is likely to help keep the weight off, Berz said that this dietary study differed from previous ones because it looked at overall eating plans rather than individual foods.

It also took place over a longer timescale than many other studies.

dash-diet-lancastria

The dash diet

Berz and his team looked at data from 2,237 girls, starting at age 9, who had participated in the National Growth and Health Study.

The girls were followed for up to a decade and they logged their food intake once a year in three-day diet records extending for two weekdays and one weekend day.

They were trained by a nutritionist to record the information using standard household measuring instruments to estimate portion sizes.

Each participant was then given a DASH food group score by Berz’ team which documented how closely their diet resembled the DASH diet.


Those with the highest DASH score were found to have gained the least weight at the end of the collection of data.

Conversely, more girls in the lowest DASH score group had a BMI score that indicated that they were underweight.

The study is published in the Archives of Pediatrics & Adolescent Medicine’s June issue.

Dr. Mitchell Roslin, from Lenox Hill Hospital in New York, said young people tend to be better at controlling their weight if they receive behavioral therapy and dietary education.

But he feels the message of the study is still lost on most Americans, who are still getting heavier despite the abundance of information about eating healthily. Teaching people to eat healthily needs to be combined with other measures.

Dr Roslin said: ‘I don’t necessarily feel the results are earth-shattering or incredibly impressive, but I think people have to give up on the (idea) that we can educate ourselves out of the obesity epidemic.’