EB 2016 San Diego

Healthy Eating: an important part of Diabetes Prevention

EB 2016 Constance Brown

Today, eighty-six million Americans have prediabetes – that’s 1 out of 3 adults! Without more effective prevention, 15% to 30% of people with prediabetes will develop type 2 diabetes within 5 years. Constance Brown-Riggs, a Registered Dietitian and Certified Diabetes Educator, recalled the role of prevention through a healthy diet to delay the progression of the disease.

Several randomized clinical trials shows that individuals, at high risk for developing diabetes, can be given interventions that significantly decrease rate of onset of diabetes.

Action is needed at young age

According to Brown, a compelling body of evidence now unveiled that many of the risks, leading to type 2 diabetes, originate at the very early stages of life and they were influenced by maternal under- or over-nutrition, by diabetes in the mother and by the fetal and post-natal environment. Early life influences, such as maternal under- or over-nutrition, low birthweight and newborn over- feeding, increase the risk of obesity and associated diseases, such as diabetes and cardiovascular disease in the offspring later in life. Therefore, the prevention of diabetes will also start with a healthy pregnancy.

Long term studies showed that prevention is effective

The three largest diabetes prevention studies in the United States have shown beneficial effects of lifestyle interventions. In China, the Da Qing study, including a 20-year follow-up, assessed the long-term effect of lifestyle interventions of diet and exercise. Compared with the control arm, combined lifestyle interventions resulted in a 51% lower incidence of diabetes during an active intervention and a 43% lower incidence over 20 years.
In a similar manner, the Finnish Diabetes Prevention Study concluded that type 2 diabetes can be prevented by changes in the lifestyles of high-risk subjects, defined as those with impaired glucose tolerance, which represented an intermediate category between normal glucose tolerance and diabetes.
In the US, the Diabetes Prevention Program (DPP) indicated that millions of high-risk people can delay or avoid developing type 2 diabetes, by losing weight through regular physical activity and by following a diet low in fat and calories. Weight loss and physical activity lower the risk of diabetes by improving the body’s ability to use insulin and process glucose. The DPP also suggests that metformin can help to delay the onset of diabetes.

Diabetes guidelines and yogurt

Consistent with this modern science, the 2015 Dietary Guidelines Advisory Committee Report emphasizes food-based, healthful diet patterns, as a primary recommendation to address obesity and associated diseases. Evidence also suggests that healthful diet patterns that include yogurt, like the DASH and Mediterranean diets, may be associated with a reduced risk of type 2 diabetes. The explanation is that several different macronutrient distributions in such diet may lead to improvements in glycemic and/or CVD risk factors.

Key-learnings

  • Individuals at highest prediabetes risk must be identified
  • Delaying or preventing type 2 diabetes will help to turn the tide on the diabetes epidemic
  • Diabetes Prevention starts with a healthy pregnancy
  • Large clinical trials provided strong evidence that prediabetes can be reversed by almost 60% through weight loss, healthy eating and increased physical activity.
  • Yogurt can play a positive role in diabetes prevention as part of healthy diets

Watch now the slideshow from Constance Brown-Riggs (MSED, RD, CDE, CDN):

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