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Special

Diet Diabetes and Disease: Reduce Your Risk by Eating Right

by Amy Lemen

What if all you had to do to avoid chronic disease was eat a healthy diet? “Surely,” you’re thinking, “it can’t be that simple.” Well, in some cases, it just might be.

Most people know that if you maintain a healthy lifestyle — avoid smoking, control your waist size, exercise regularly and manage stress — chances are, your general health will improve.

But if you change your diet, you’ll also drastically reduce your risk factors for a myriad of chronic diseases. Because bad foods often equal bad diseases, including coronary heart disease/heart attacks, obesity, hypertension, some forms of cancer and colon/bowel problems like diverticular disease.

“Diet is at the top of the list when it comes to disease prevention,” says Alexa Sparkman, R.D., a dietitian with Sparkman and Ivester Nutritionists. “Nutrition is a big component of keeping our bodies pliable and healthy.”

But perhaps the most insidious of these “lifestyle” illnesses is diabetes - specifically, type 2 diabetes. And while there are some people who have a genetic predisposition to type 2 diabetes, the disease, in nearly every case, can be prevented by cleaning up your diet.

The Centers for Disease Control and Prevention (CDC) estimate that 18.2 million people in the US have diabetes, and 90 percent of those cases are of the type 2 variety. What’s worse, the percentage of adult Americans with diabetes increased by 65 percent between 1990 and 2001. And the number of children and young adults with type 2 diabetes is also increasing nationwide.

In fact, in Austin (Travis County), seven percent of the population has diabetes. And based on CDC statistics, that equates to approximately 59,000 who suffer from type 2. (Note: Austin statistics don’t break down the number of diabetes cases by type.)

“It’s a big problem, and it’s increasing,” says Dr. Adolfo Valadez, medical director for the Austin and Travis County Health and Human Services Department. “Given the rise in obesity and how closely these two diseases correlate, I wouldn’t be surprised to see even more cases in the future.”

Type 1 and 2: What’s the Difference?
It’s important to understand that having diabetes doesn’t always mean having type 2 diabetes. Type 1 diabetes, which occurs much less often, is a biochemically complex series of events in which the body doesn’t make insulin — a hormone secreted by the pancreas that helps cells access glucose from the calories we eat and use as energy to feed the body.

“Type 1 is not lifestyle-related, but genetically determined,” says Terri Knox, R.N., certified diabetes educator and diabetes education program coordinator for South Austin Hospital. “Type 1 is an auto-immune response in the body where the body sees insulin as foreign, so it destroys it.”

Those with type 1 require daily insulin injections or an insulin pump to maintain their metabolic balance, as well as hyper-awareness of their diet.

“The patient must learn the balancing act between food and insulin,” says Knox. “Type 1 is type 1; all the exercise and diet changes in the world won’t make a difference.”

Type 2, on the other hand, is a much different story. The body doesn’t use its natural insulin effectively, says Knox, and the result is elevated blood sugar levels. Over time, the pancreas also has a reduced ability to provide insulin.

“This usually occurs over a long period of time, then people start to notice symptoms of high blood sugar levels,” says Knox. “People are usually diagnosed either because of the symptoms, or it’s picked up with a blood test in those who aren’t symptomatic.”

Symptoms include excessive thirst, frequent urination, unexplained weight loss, fatigue, blurred vision and infections that are slow to heal. Those at risk include those who are overweight, sedentary, have a family history of the disease and certain ethnic groups (Hispanic, African American and Pacific Islanders).

Predisposed to Type 2? You Don’t Have To Be
Dr. Valadez says it’s an important misconception that a genetic predisposition to type 2 diabetes means you’ll automatically end up with the disease. That’s not always the case if your diet is healthy.

“Genetics is the bullet in the gun, but the environment pulls the trigger,” he says. “If you eat healthy, exercise and watch your weight, you may never get it.”

Results of a recent study revealed that type 2 diabetes could actually be prevented in people at risk for developing the disease. Changes like moderate weight loss (average 12 to 15 pounds), moderate exercise (30 minutes of exercise, 5 times per week), and a low-fat diet reduced the number of at-risk people that went on to develop type 2 diabetes by 58 percent.

“People over 40 used to be a big risk group, but that’s changing,” says Knox. “The type 2 epidemic is really in younger people — children, adolescents and young adults. We weren’t seeing that 15 years ago, but now it’s pretty common.”

Eat Right, Not Refined
Unfortunately, the reason type 2 is becoming so common is because the American diet of refined, processed fast foods in giant-size portions has struck a chord — they’re cheap, convenient and tasty. The problem is that most of these foods are lacking in real nutritional value and, for the most part, are high in both fat and calories — definitely not what we need to eat to stay healthy.

“We eat more than we need to eat,” says Knox. “The food industry has steadily increased portion sizes, and we haven’t balked and pushed away the plate. Getting our money’s worth is really working against us.”

And ironically, the more we indulge in these kinds of foods, the more our bodies crave them, leaving natural, lower caloric alternatives by the wayside.

The Power of a Healthy Diet A study of postmenopausal women found that eating at least one serving of whole grains daily reduced the risk of heart and blood vessel disease by almost 30 percent.   A study by Harvard researchers in 2000 showed that eating one serving of whole grain cereal every day can reduce the risk of developing type 2 diabetes by as much as 34 percent.   Whole grains can reduce the risk of many different types of cancers, including colon, stomach and other digestive tract cancers, as well as gallbladder, bladder, kidney and breast cancer. A consistent, protective effect has been observed when whole grains are eaten three to four times a week.   A Norwegian study found that people who ate the highest amounts of whole grains reduced their risk of death from cancer and heart disease by almost a quarter.   A study by the Mayo Clinic in 2001 found that those who ate the highest amount of fiber were less likely to develop cancer at the juncture between the esophagus and the stomach.

“People need to learn about food, accept portion sizes and put more time into food preparation at home,” says Knox. “We’ve lost our taste for fresh things because our taste buds have become acclimated to high-carb, high-fat things.”

So why are refined foods so unhealthy? According to the consumer Web site World’s Healthiest Foods (whfoods.com), we lose 60 to 95 percent of most of the heart-healthy nutrients during food processing, such as when making noodles or flour. We also lose the plant structure and fiber that slow digestion.

Since refined carbohydrates have little fiber (the good stuff) after processing, the body steals the nutrients from its own stores if it has them to lend; if not, we end up with symptoms of disease — like type 2 diabetes and others. The refined carbohydrates are usually the “simple” ones (sugars) as opposed to the “complex” ones (starches — usually most vegetables). Most breads, flours and pastries fall into the refined category — unless they’re whole grain. In fact, a Harvard study found a 250 percent greater diabetes risk in women who ate the most rapidly absorbed, low-in-fiber carbs.

Refined sugars are also a problem — and are sometimes harder to identify. Sugar, corn syrup, high-fructose corn syrup, sucrose, concentrated fruit juices (or any fruit juice, as opposed to the whole fruit), plus anything containing them is not only bad for your diet, they also don’t help you to avoid these lifestyle diseases, especially if you’re not exercising or are overweight.

“Refined foods themselves don’t cause diabetes — it’s not a cause and effect thing,” says Sparkman. “It’s the effect from weight gain (from eating refined foods) and lack of exercise that do.”

Choose Foods Wisely and Move Around!
A fascinating study in the American Journal of Clinical Nutrition used data from the U.S. Department of Agriculture and the CDC to show dietary trends over the last century. Interestingly, it showed that people today consume on average the same amount of carbohydrates each day — approximately 500 grams — as their ancestors did, dating back to 1909. But instead of whole grains and vegetables, we are getting more and more of our carbs in the form of processed grains and sugars.

The bottom line
Science shows that a healthy diet is one with relatively unprocessed foods, veggies and fruits, along with rice and grains that retain much of their original structure. Throw a little protein in there — lean beef, chicken, fish or beans/tofu — and you’re good to go.

A good rule of thumb? If you can’t recognize part of the original food, or can’t pronounce the ingredients, the item is probably heavily processed or refined and it’s best to avoid it.

“It doesn’t mean you can never go to McDonald’s again,” says Knox. “It just means you don’t get the Big Mac, large fry AND large shake. Also look at frequency — if you’re eating fast food five times a week, that’s not good.”

It’s also not good to exercise five times a week — and think you can ignore your diet. It all works together.

“Patients who increase their activity — especially weight-bearing exercises — and adopt a healthier diet tend to lower their insulin resistance,” says Sparkman. “Type 2 is very controllable, and avoidable, with diet and exercise if it’s caught in time.”

Luckily, we live in a city with ample opportunities for exercise. And TV shows re-runs during the summer anyway. So turn off the box and get outside. You don’t have to run a marathon. Walk. Jog. Swim. Play Frisbee. Anything to get that body moving.

“There’s plenty of formal programs at local gyms, but even finding ways to incorporate everyday activity into your life is crucial,” says Knox. “Park further away, take the stairs, take the grocery cart back into the store. You don’t need that parking spot in front.”