Diet, one of the 3Ds of diabetes management has become the focus of diabetes prevention this time. Diabetes is considered as a multifactorial ailment. There are multiple studies regarding the prevention and management of type 2 diabetes. There is a publication in Lancet 2014:383:1999-2007, which was the first in the series of two papers discussing about the dietary and the nutritional strategies for prevention and management of type 2 DM. I will highlight the preventive aspects mostly.
Dietary transition and decreased physical activity due to urbanization and environmental changes has contributed to weight gain. Higher body-mass index (BMI) is supposed to be the strongest risk factor for diabetes, but Asian populations may develop diabetes at a much lower BMI than do those of European origin. One study suggests that risk associated with a higher waist circumference is stronger than the risk associated with a higher BMI. So, both BMI and waist circumference are important. Weight gain since young adulthood is another separate predictor of diabetes risk, even after adjustment for existing BMI.
Total dietary fat was linked to weight gain and induction of insulin resistance. But several studies have denied it. The quality of fat is strongly linked to causation of diabetes than do total fat intake. Omega-6 polyunsaturated fatty acids (PUFA) were found to be advantageous than saturated fats. Nevertheless, the association between omega-3 PUFA and diabetes risk has been unpredictable in several studies. Plant based fats proved superior to the animal based fats for prevention of type 2 diabetes.
The relative amount of carbohydrates in a diet does not affect diabetes risk tremendously. But diet rich in fiber, especially cereal fiber is inversely related to type 2 diabetes risk, whereas the fruit fibers are less inversely associated. Glycemic index (GI) and the glycemic load (GL, a product of GI and the amount of carbohydrates of a food) are used to measure the carbohydrate quality of a food. Higher GI and GL foods were associated with greater risk of diabetes.
Magic vitamins and minerals:
Higher intake of magnesium was associated with lower risk of diabetes. This finding was astonishingly more pronounced in over weight participants than the normal weight participants. Circulating
25-hydroxyvitamin D concentrations were also inversely related to diabetic risk. However, vitamin D supplementations did not improve the situation (HbA1C, FBS or insulin sensitivity). On the other hand, higher haeme-iron intakes convey greater risk of diabetes. Higher iron stores or increased ferritin concentration also put a risk of diabetes equally.
Individual food staffs:
Wholegrain intake was inversely related to diabetes risk, whereas white rice was directly related. Red meats were strongly associated with greater diabetes risk. Green leafy vegetables, blue berries, grapes, walnuts and apples reduce the chance of developing diabetes. Coffee consumption was found to be beneficial for diabetes risk reduction. Alcohol was shown to follow a U-shaped fashion in causation of diabetes. Beverages that are sugar-sweetened are associated with higher diabetes.