So
just how effective is a healthy diet plus exercise in preventing or treating diabetes
in the longer term?
We
should note that trials on lifestyle are much harder to do than trials on
pills, but a good attempt was made by researchers at George Washington
University in Washington DC, who published their findings in 2005.
The
team selected volunteers who had signs of dysglycemia (glucose intolerance) and were therefore at
high risk of developing diabetes then split them into three groups. One
received placebos, the next 850mg of metformin(Glucophage) twice a day, and the
third began to make lifestyle changes designed to lower weight by seven per
cent, including two and a half hours of exercise a week (20 minutes a day).
At
the end of three years, among those who made the lifestyle changes, 41 percent
were no longer glucose intolerant. Among those who took metformin, 17 percent
were no longer glucose-intolerant, compared to the placebo. So
the lifestyle change was more than twice as effective.
What’s
more, despite the prevailing medical view, the dietary approach is likely to be
more cost-effective. This study published in 2006 showed that taking metformin might delay
the onset of diabetes by three years, while diet and exercise change delays it
by 11 years.
The
bottom line is that lifestyle intervention is more cost-effective than a pill.
Another
landmark study, which also found diet and exercise twice as effective
as metformin in preventing at-risk patients from developing diabetes estimated that the
non-drug approach was also very cost-effective. In this study, published in 2002, one
case of diabetes was prevented in every seven people treated for three years.
A
trial published in 2005 and involving obese and overweight people with diabetes
or insulin resistance showed a 50 percent reversal of insulin resistance and
diabetes after only three weeks when placed on a high-fiber, low-fat diet, combined
with 45 to 60 minutes of exercise on a treadmill each day.
The
31 volunteers in this residential trial at the Pritikin Longevity Center in
California took on a diet that didn’t even restrict the amount of food, but
just gave better choices of unrefined carbohydrates, whole foods and low-fat
foods. In only three weeks the volunteers, aged 46 to 76, had lower glucose
levels, better insulin resistance and a lower body-mass index. Not bad for
three weeks!
THE PERFECT DIET FOR
DIABETES PREVENTION
This
kind of trial makes it glaringly obvious that the solution to diabetes is not going
to be drugs. The solution is changing the way of eating, and living, that led
to diabetes in the first place.
Then
we need to find out what the best anti-diabetes diet is along with the best way
to make this change.
The low-GL route
The best diet to recover from type 2 diabetes is the low-glycemic load
(GL) diet. Glycemic load is a measurement
which finds out the amount of carbohydrate in each portion of food, and how it affects
your blood glucose levels.
Currently
this is a very popular and effective way of losing weight but on top of that,
it is the absolute state-of-the-art diet for controlling blood sugar,
preventing diabetes, and also for regaining energy.
This is how it works
The
carbohydrates contained in foods are turned into glucose at different speeds.
For example, the carbohydrates in strawberries are
‘slow-releasing’,
which means they raise your blood sugar level fairly gradually.
But
eat a date, and your blood glucose level will begin climbing within minutes,
they are very fast-releasing. The rate at which a food releases its sugar is known
as it's glycemic
index (GI).
The
fastest-releasing food is pure glucose, which is given a score of 100 on the
index, while apples, which raise blood sugar at less than half the rate of pure
glucose, score 38.
The
GI is a useful way of rating foods if you want to stabilize your blood glucose
because it allows you to choose slow-releasing carbohydrates. But it has one
big limitation. It doesn’t tell you how much carbohydrate there is in a particular
food. Watermelon, for example, has very little carbohydrate in it, as it’s
mostly water; but the carbs in it are fast-releasing, so it does have a very
high GI. Sweet potatoes, on the other hand, have a low-GI carbohydrate, but
lots of it.
Basing
your choice on GI alone, you’d probably opt for sweet potatoes and avoid
watermelons, but in fact, a large amount of sugar in a portion of sweet potato
would push your blood glucose up much more than a large slice of watermelon
would.
This
is where glycemic load comes in. A food’s GL takes into account not just the
type of carbohydrate in it – slow or fast-releasing – but also how much there
is of that carbohydrate in the food. You work it out by multiplying a food’s GI
by the amount of carbohydrate in it.
To
control your blood sugar, you need to eat no more than 65 GLs a day (45 if you
want to lose weight), spread out throughout the day at roughly 10 to 15 GLs per
meal plus 5 to 10 GLs for a snack (you should have two in-between snacks a
day), with 5 GLs to spare for drinks or desserts. The need for diabetic drugs
would become increasingly unnecessary if you stick to this plan.
The
tables below give you an idea of which foods are high and which low GL, what to
avoid, and how a day’s healthy menu might look.
10 GL serving of common foods
Low-GL foods High-GL
foods
2
large punnets of strawberries 2
dates
6
oatcakes 1
slice of white bread
4
bowls of oat flakes 1 bowl of cornflakes
A
large bowl of peanuts A
packet of crisps
1
pint (550ml) of tomato juice Half glass of Lucozade
6
tablespoons of xylitol (a natural low-GL sugar) 2
teaspoons of honey
10
handfuls of green beans 10 French fries
GOOD LOW GL DAY DIET BAD HIGH GL
DAY DIET
Breakfast GL
Breakfast GL
A
bowl of porridge 2
A bowl of cornflakes 21
Half
a grated apple 3 A
banana 12
A
small tub of yogurt 2 Milk
2
and
some milk 2
Total 9 Total 35
Snack Snack
A
punnet of strawberries 5
Mars
bar 26
Lunch
Lunch
Substantial
tuna salad, Tuna salad baguette 15
plus
3 oatcakes 10
Snack Snack
A
pear and a handful of peanuts 4 Bag
of crisps 11
Dinner Dinner
Tomato
soup, salmon Pizza
with Parmesan and
Sweetcorn,
green beans 12 tomato
sauce and some salad 23
‘GOOD’ DAY’S TOTAL GL 40 ‘BAD’
DAY’S TOTAL GL 110
THE PROTEIN CONNECTION
Another
way to lower the GL of your diet is to eat more protein, fiber and healthy
fats, as well as cutting out refined, sugary carb-rich foods such as biscuits.
The
controversial low-carbohydrate/high-protein
Atkins Diet,
for instance, has recently been shown to lead to both weight loss and improved
glucose control in two small studies.
One,
published in 2005, put ten obese diabetic patients on the Atkins Diet for two
weeks. They spontaneously reduced their calorific intake by 1,000 calories a
day
as
well as improved their insulin sensitivity. While high protein diets,
especially those based on meat, milk and cheese, may create other problems such
as risk of kidney problems, osteoporosis, breast and prostate cancer, it seems
that eating protein with low-GL carbohydrates does help stabilize blood-sugar
levels.
So
choosing the best low-GL carbs and combining those with quality proteins is the
cornerstone of diabetes treatment and prevention, and is also now recommended
by most diabetes associations.
THE BEST ANTI-DIABETIC
FOODS AND NUTRIENTS
Here are some of the best foods and nutrients which will help you
control your blood sugar levels and help you in managing and controlling this
chronic condition.
A DOZEN ANTI-DIABETIC FOODS
- Apples
- Berries
- Buckwheat
- Cherries
- Chickpeas
- Cinnamon
- Green tea
- Lentils
- Oat bran and flakes
- Oatcakes
- Pears
- Plums
A spoonful of
cinnamon
It’s
now been found that just
half a teaspoon of cinnamon a day significantly reduces blood sugar levels in diabetics, and could also benefit millions of non-diabetics who have
blood-sugar problems but are unaware of it.
The
discovery was initially made by accident by a Doctor in the US who was
researching the effects of common foods on blood sugar. He was surprised to
discover that apple pie (spiced with cinnamon) was actually not bad for blood
sugar.
The
main ingredient found in cinnamon was a water-soluble polyphenol compound
called MHCP. In the lab, MHCP mimics insulin, activates its receptor, and works
synergistically with insulin in cells, improving glucose metabolism twentyfold.
It helps insulin do its job of getting excess sugar out of the bloodstream and
into the cells.
To
see if it would work in people, volunteers with type 2 diabetes were given 1, 3
or 6g of cinnamon powder per day, in capsules after meals. The research paper
showed that all the volunteers responded well to the cinnamon within weeks,
with blood-sugar levels 20 percent lower on average than those of a control
group.
Some
of the trial participants taking cinnamon even achieved normal blood sugar levels.
Blood
sugar levels started rising up again after the diabetics stopped taking
cinnamon.
Cinnamon
has other significant benefits. In the diabetic volunteers, it lowered blood
levels of fats (triglycerides) and ‘bad’ LDL cholesterol, both also partly
controlled by insulin. Luckily, cinnamon
is a versatile spice. You’ll need about
half a teaspoon a day, added perhaps to oatmeal, fruit salads, marinades, stews
or curries.
Get your oats and xylitol
Oats,
or specifically, oat bran, are filled with a nutrient that keep your blood sugar
level at normal. It’s called beta-glucan. Diabetic patients given oatmeal or oat bran rich foods experienced much lower rises in blood sugar compared to
those who were given white rice or bread. In fact, it’s been known for nearly a
decade that having ten percent of your diet as beta-glucans can halve the
blood-sugar peak of a meal.
This
level of effect is far greater than you’ll get from taking metformin (Glucophage),
at a fraction of the price and with none of the side effects.
All
you need to do is to start eating oat flakes, oat bran, whether cold or hot as porridge,
with fruits such as berries, pears or apples, and snacking on oatcakes. There
are many studies done by researchers on beta-glucans, so there is enough
evidence to prove this.
Other
big contenders for anti-diabetic
foods include buckwheat, green tea, cherries, plums and other fruits high
in a very low-GL (Glycemic Load) sugar called xylitol. Xylitol has a ninth of
the GL of sugar or honey; so switching to it and using it sparingly will
certainly, help you maintain your blood sugar levels and also help your sweet
cravings as well.
Chromium – the forgotten mineral
While
drugs like metformin increase sensitivity to insulin, there’s a mineral that
does the same thing and has minimum side effects. It’s called chromium. Insulin
can’t work properly without chromium.
Trivalent
chromium was discovered to be an essential mineral back in the 1960s. This form
of chromium, the kind found in foods, is completely different from the kind you
find in old car bumpers. (This is called hexavalent chromium and can be quite
toxic.) In the 1970s, chromium was proven to be essential for insulin to do its
job properly, but the mechanism hadn’t been discovered. Now we know how it
manages the job.
Chromium
does two things. Firstly, insulin has to dock on to cells to open them up for
the next delivery of glucose. Chromium is part of the docking port, or
receptor, for the insulin. It also helps stop insulin from being changed in a
way that stops it working. Both of these improve your sensitivity to insulin.
Today
we also know that many of us are deficient in this mineral, which is absolutely
essential for good health. In
other words, your doctor should really check that you are not chromium
deficient, since this alone can cause blood-sugar problems and insulin
resistance.
But how do you know if
you’re chromium deficient?
Without
testing, this isn’t easy to ascertain.
Some
signs are low energy, especially in the morning, craving sweet foods and
depression. The more sugar or refined food you eat the more likely you are to
be deficient, not only because processed foods are low in chromium, but also
because they rob the body of chromium. Every time your blood sugar goes up, whether
due to sugar, stress or a stimulant such as coffee or a cigarette, you lose
chromium. The older you are and more stressed you are, the lower your levels.
So what’s the evidence
for all claims?
Now
let’s look at the evidence for all these claims, from low-GL diets to chromium
supplementation as a way of regulating blood sugar levels.
The lowdown on low GL
There
is no question that low-GL is pushing back the boundaries in terms of safe,
rapid and permanent weight-loss diets and for diabetes. Many studies have shown
that low-GL diets cause rapid weight loss and improve insulin resistance and
fasting blood sugar levels. In animal studies, it’s well known that a low-GL
diet rapidly improves blood-sugar control and pancreatic function.
All
of this translates into a massive reduction in risk of developing diabetes, as
well as the ability to stop and even reverse the condition, especially for
those in the early stages of type 2 diabetes.
Researchers
in the US with the help of a trial conducted found out that those who ate a
high-GL diet were more likely to develop diabetes than those who ate a low-GL
diet.
There’s
a lot of evidence available with researchers that a low-GL diet improves blood
sugar and helps manage the symptoms of diabetes. Some of the benefits of a
low GL diet are:
- Increased energy
- Better sleep Better mood
- Less craving for carbohydrates
The effects of chromium on blood
sugar and insulin resistance
Those
taking the chromium and biotin supplement had a 26mg/dl (1.43mmol/l) drop in
fasting blood glucose with more than 70 percent of the supplement group
experiencing significant drops. LDL (bad) cholesterol levels also decreased
substantially.
There’s
also good evidence that chromium can help prevent diabetes in people at risk.
What are chromium’s
side effects?
Fortunately,
it is remarkably safe.
Up
to 1,000mcg is perfectly safe, even in pregnancy. Long-term studies of up to five years,
published in 2004, have shown this to be the case.
Food or drugs? The verdict
For
diabetes and its precursor’s dysglycemia and insulin resistance, there is no doubt
that making the right diet and lifestyle changes is essential. Eating a low-GL
diet, taking supplements, staying away from sugar and taking regular exercise
can both prevent and significantly reverse insulin resistance and diabetes, at
least in the early stages, far more so than currently available medication. For
those with more advanced diabetes these changes are highly likely to reduce the
need for medication and, in the case of insulin-dependent diabetes, for insulin
too.
What works
- Eat a low-GL diet (roughly 45 to 65 GLs a day)
- Combine protein foods with carbohydrate foods, which stabilize blood sugar levels even further
- Avoid all sugar, except Xylitol
- Sprinkle half a teaspoon of cinnamon on your food daily
- Eat oats with oat bran for breakfast and snack on rough oatcakes
- Exercise every day – for at least 30 minutes
- Take a supplement of a high-strength multivitamin and mineral, plus 2g of vitamin C and 200mcg of chromium (400 or 600mcg if you have diabetes, taken in the morning or at lunch – chromium can over-energize so it’s best not taken in the evening)
Working with your
doctor
If
you’re lucky, your doctor will be delighted straightaway at your wish to pursue
a low-GL diet and exercise.
It’s
particularly important to work with your doctor if you’re on drugs for your
diabetes. Your doctor will be invaluable for helping you keep within safe
blood-sugar limits.
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