Genes play an important role in causing diabetes, but environment and lifestyle factors can be equally significant. This especially holds good for type 2 diabetes, which unlike type 1 diabetes or the rare monogenic diabetes can be prevented. Several evidence-based studies confirm the role of lifestyle interventions such as a healthy diet and regular exercise in preventing or delaying the development of type 2 diabetes.
Genes play an important role in causing diabetes, but environment and lifestyle factors can be equally significant. This especially holds good for type 2 diabetes, which unlike type 1 diabetes or the rare monogenic diabetes can be prevented. A healthy diet coupled with regular exercise is the best way to delay or prevent type 2 diabetes,1 and several studies endorse this.
Diet, Exercise and Diabetes
The Nurses’ Health Study and the Nurses’ Health Study II are large, ongoing investigative studies on the risk factors for chronic diseases among women, with several individual studies contributing to the data. According to one such study by Hu et al. among 84,941 female nurses over a period of 16 years, 90% cases of type 2 diabetes could be attributed to lack of exercise, unhealthy diet, smoking, alcohol, overweight.2
The Finnish Diabetes Prevention Study was among the first studies to correlate lifestyle with the development of type 2 diabetes. The researchers studied lifestyle interventions in terms of diet and exercise behavior and found that these positively impacted clinical and biochemical parameters and reduced the risk of type 2 diabetes.3
The Da Qing Impaired Glucose Tolerance (IGT) and Diabetes Study also found that the combination of diet and exercise interventions led to a significant decrease in the risk of type 2 diabetes in subjects with IGT.4
The Role Of Exercise
Exercise can contribute to improved insulin sensitivity, thus helping tackle the root cause of type 2 diabetes.5 A joint statement by the American College of Sports Medicine and the American Diabetes Association in 2010 confirmed the role of exercise in preventing and controlling insulin resistance, prediabetes, type 2 diabetes, and diabetes-related complications.6 The statement was backed by evidence-based studies which indicated that both aerobic and resistance training could cut down the risk of type 2 diabetes.
The American Diabetes Association recommends 30 minutes of moderate-to-vigorous aerobic exercise at least 5 days a week and some form of strength training at least twice a week.7 Aerobic activities include brisk walking, cycling, swimming, tennis, light jogging, intensive yoga, and rowing. Strength training includes light weight lifting, heavy gardening, calisthenics, and exercises like push-ups and squats. One study even found that just a week of aerobic exercise could improve insulin sensitivity.8 Aerobic and resistance training were found to improve insulin action, blood glucose levels, fuel metabolism, and overall glycemic control. Apart from these benefits, exercise also positively impacted blood pressure, lipids, cardiovascular health, and overall quality of life.
Yoga can also positively impact type 2 diabetes. In a study by Singh et al., biochemical parameters showed remarkable improvements in participants who practiced yoga alongside conventional medication, as against others who only received conventional medication. The study showed that yoga had a positive effect on glycemic control.9
A diet rich in saturated fat, simple carbohydrates, sugars and salt is a sure-fire risk factor for type 2 diabetes. The Harvard School of Public Health has identified four dietary changes which can cut down the risk of type 2 diabetes.10
Consume Whole Grains And Whole Grain Products
Ample evidence shows that whole grains have a definite advantage over simple carbs. The Nurses’ Health Studies I and II followed the whole grain consumption pattern of nearly 160,000 women for about 18 years and concluded that women who had 2–3 servings of whole grain per day were 30 percent less likely to develop type 2 diabetes.11 Whole grains are not as easy to break down as simple carbs, giving grains the low-glycemic index tag. This leads to slower absorption than of white rice, white bread, or other cereals which are quickly absorbed into the blood stream, releasing starch and ultimately glucose. This fast absorption requires increased insulin supply, thereby straining the pancreas and increasing the risk of type 2 diabetes. Whole grains also contain beneficial essential vitamins, minerals, and phytochemicals.
Avoid Sugary Drinks
These drinks have a high glycemic index and instantly increase blood glucose, requiring increased insulin production. In the Nurses’ Health Study II, women who consumed sugary drinks had an 83 percent risk of developing type 2 diabetes as against those who had just one sugary beverage per month.12 Sugary drinks also lead to an increase in body weight, which means increased insulin production that strains the pancreas.
Choose Good Fats
Saturated fats like butter and margarine, and trans-fats increase the risk of type 2 diabetes. Good fats like polyunsaturated fats found in liquid vegetable oils, nuts, and seeds can actually cut down this risk.13
Limit Red Meats And Avoid Processed Foods
Evidence from a meta-analysis by Pan et al. combining data from the Nurses’ Health Study I and II found that eating just one daily 3-ounce serving of red meat increased the risk of type 2 diabetes by 20 percent.14 The high iron concentration in red meat diminishes insulin’s effectiveness and increases insulin resistance. Replacing red meat with lean, white meat such as poultry or fish and low-fat dairy products can bring down the risk of type 2 diabetes. Processed meats and other foods also contain high sodium levels which are unhealthy.
A holistic combination of exercise and diet can prevent or at the least delay the development of type 2 diabetes in individuals with predisposed risks. While we may have no control over the genetics of the disease, lifestyle interventions can go a long way in reining in the chances of diabetes.
References [ + ]
|1.||↑||Diabetes, World Health Organization.|
|2.||↑||Hu, Frank B., JoAnn E. Manson, Meir J. Stampfer, Graham Colditz, Simin Liu, Caren G. Solomon, and Walter C. Willett. “Diet, lifestyle, and the risk of type 2 diabetes mellitus in women.” New England Journal of Medicine 345, no. 11 (2001): 790-797.|
|3.||↑||LINDSTR, JAANA, ANNE LOUHERANTA, MARJO MANNELIN, MERJA RASTAS, VIRPI SALMINEN, JOHAN ERIKSSON, MATTI UUSITUPA, and JAAKKO TUOMILEHTO. “The Finnish Diabetes Prevention Study (DPS).” Diabetes Care 26, no. 12 (2003): 3230-3236.|
|4.||↑||Pan, Xiao-Ren, Guang-Wei Li, Ying-Hua Hu, Ji-Xing Wang, Wen-Ying Yang, Zuo-Xin An, Ze-Xi Hu et al. “Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: the Da Qing IGT and Diabetes Study.” Diabetes care 20, no. 4 (1997): 537-544.|
|5.||↑||Prevention of Diabetes Mellitus, Diabetes.|
|6.||↑||Colberg, Sheri R., Ronald J. Sigal, Bo Fernhall, Judith G. Regensteiner, Bryan J. Blissmer, Richard R. Rubin, Lisa Chasan-Taber, Ann L. Albright, and Barry Braun. “Exercise and type 2 diabetes the American College of Sports Medicine and the American Diabetes Association: joint position statement executive summary.” Diabetes care 33, no. 12 (2010): 2692-2696.|
|7.||↑||What We Recommend, American Diabetes Association.|
|8.||↑||Colberg, Sheri R., Ronald J. Sigal, Bo Fernhall, Judith G. Regensteiner, Bryan J. Blissmer, Richard R. Rubin, Lisa Chasan-Taber, Ann L. Albright, and Barry Braun. “Exercise and type 2 diabetes the American College of Sports Medicine and the American Diabetes Association: joint position statement.” Diabetes care 33, no. 12 (2010): e147-e167.|
|9.||↑||Singh, Savita, Tenzin Kyizom, K. P. Singh, O. P. Tandon, and S. V. Madhu. “Influence of pranayamas and yoga-asanas on serum insulin, blood glucose and lipid profile in type 2 diabetes.” Indian Journal of Clinical Biochemistry 23, no. 4 (2008): 365-368.|
|10.||↑||Simple Steps to Preventing Diabetes, Harvard T.H. Chan School of Public Health.|
|11.||↑||de Munter, Jeroen SL, Frank B. Hu, Donna Spiegelman, Mary Franz, and Rob M. van Dam. “Whole grain, bran, and germ intake and risk of type 2 diabetes: a prospective cohort study and systematic review.” PLoS Med 4, no. 8 (2007): e261.|
|12.||↑||Simple Steps to Preventing Diabetes, Harvard T.H. Chan School Of Public Health.|
|13.||↑||Good Fats, Bad Fats, Diabetes Education Online.|
|14.||↑||Pan, An, Qi Sun, Adam M. Bernstein, Matthias B. Schulze, JoAnn E. Manson, Walter C. Willett, and Frank B. Hu. “Red meat consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis.” The American journal of clinical nutrition 94, no. 4 (2011): 1088-1096.|