Cararta's Facts

Sunday, September 18, 2011

Eat and Beat Diabetes

By Leslie Garisto Pfaff

For Lenise Young, diabetes was a gift. Not the disease itself, of course � for the past six years, she�s had to inject herself with insulin twice a day, and she faces a host of potential complications, including an increased risk of cardiovascular disease � but for the changes it�s spurred in her life. Before her diagnosis, the Tinton Falls resident weighed 280 pounds, gorged on chocolate, and led a generally sedentary life. That all changed when routine tests for minor surgery revealed an alarmingly elevated blood sugar level (nearly 700; normal is between 70 and 110).

In addition to placing her on medication, her internist recommended she lose weight, change her diet, and start exercising. She did all three, and last year reaped the results: lowered blood sugar levels, lower dosages of medication, a 60-pound drop in weight, and an overall sense of well-being she hadn�t experienced in years.

If any disease has a �miracle" treatment, it�s type-2 diabetes � the miracle, in this case, being diet and exercise. �We don�t have a true definition of what constitutes a �cure� for diabetes, but profound weight loss will put it into remission," says Marc Sandberg, M.D., an endocrinologist with Hunterdon Healthcare. In fact, Joel Fuhrman, M.D., a family doctor in Flemington and author of Eat to Live, defines type-2 diabetes as �a dietary disease." While not everyone who gains excess weight will develop diabetes (the disease is at least partially genetic in origin), obesity is by far the greatest risk factor.

And that makes it a disease on the rise: Over the past two decades, as the rate of obesity in America has increased by 77 percent, diabetes rates have climbed 61 percent. That�s the bad news. Now, the good: Just as lifestyle factors can trigger diabetes, they can also help to get it under control or prevent its onset. If you have type-2 diabetes, pre-diabetes (a condition characterized by higher-than-normal blood glucose levels), or risk factors for diabetes (family history and/or obesity), here�s how you can work some everyday miracles:

Lose weight. The key to diabetes is insulin, a hormone produced in the pancreas that regulates blood sugar by moving glucose from the blood into the cells, where it�s used as fuel; the more weight you gain, the more insulin your body needs. But for people predisposed to type-2 diabetes, the pancreas, at a certain point, may not be able to produce sufficient insulin, or the cells may no longer recognize it � a condition known as insulin resistance. While extreme weight loss can effectively reverse insulin resistance, �the amount of weight loss necessary to improve insulin resistance is really just about ten percent of your current body weight," says Felice Caldarella, M.D., Sandberg�s colleague at Hunterdon Healthcare. The closer you get to your ideal weight, the more likely it is you�ll be able to control your diabetes without drugs or head off a full-blown case of the disease.

Eat right. Weight loss by any means is likely to help reverse insulin resistance. But research shows that what you eat can also help you control, or prevent, diabetes. A recent study conducted at Brigham and Women�s Hospital in Boston, for instance, indicated that people who ate white rice five or more times a week were almost 20 percent more likely to develop type-2 diabetes than those who ate brown rice. That correlates with the American Diabetes Association�s recommendation that people at risk for type-2 diabetes eat a diet high in fiber and whole grains. In fact, the Mediterranean diet, with its emphasis on complex carbohydrates, good oils, and lean protein, is considered a model for people with � or hoping to ward off � diabetes. The key, says Fuhrman, is to consume foods rich in micronutrients (unprocessed plant foods like vegetables, fruits, and nuts). �Consumption of foods low in micronutrients leads to gross overeating," he notes, which in turn can fuel diabetes.

Control stress. When stress occurs, your body responds by making a lot of stored energy � glucose and fat � available to cells, which are then primed to help your body get away from danger. In people with diabetes, insulin isn�t always able to let the extra energy into the cells, so glucose piles up in the blood. Long-term stress can cause long-term high blood glucose levels. (See pages 13, 34, and 66 for de-stressing ideas.)

Get moving. Exercise in any form can help control diabetes, but Fuhrman recommends a combination of cardiovascular exercise, strength training, and interval training. Research done at Canada�s University of Calgary showed that a combination of cardiovascular activity and weight training helped control blood sugar more effectively than either type of exercise alone.

For Lenise Young, whose goal is to be medication-free, exercise is an essential part of a four-pronged plan that also includes weight loss, healthy eating, and �surrounding myself with positive people" � something, she says, that�s �helped turn a negative into a positive."

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