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Excerpts from an article by Jane Brody in the NY Times:

Beating Back the Risk of Diabetes

This year, nearly two million American adults and more than 5,000 children and adolescents will learn they have a potentially devastating, life-shortening, yet largely preventable disease: Type 2 diabetes. They will join 29.1 million Americans who already have diabetes.

Diabetes and its complications are responsible for nearly 200,000 deaths a year; the fatality rate among affected adults is 50 percent higher than among similar people without diabetes. Alarmingly, recent studies even have linked diabetes to an increased risk of dementia and Alzheimer's disease. Even people with above-average blood glucose levels, but not diabetes, have an elevated risk.

The Diabetes Prevention Program study, conducted among about 3,800 people who had pre-diabetes, found that moderate weight loss — an average of 12 pounds —  reduced the odds of progression to diabetes by nearly 50 percent.

An excellent discussion of what is known about the effect on diabetes of various foods and supplements appeared recently in Nutrition Action Healthletter at cspinet.org/iceberg.pdf. Some highlights:

Carbohydrates - breads, grains, cereals, sugary drinks and sweets of all kinds — are most problematic for people with diabetes or at risk of developing it. Carbohydrates are eventually metabolized to glucose, which raises the body’s demand for insulin. Consume less of them in general, and choose whole-grain versions whenever possible.

If you must have sweet drinks, select artificially sweetened ones. In two huge studies of nurses and other health professionals who were followed for 22 years, those who drank one or more sugary soft drinks a day had about a 30 percent higher risk of developing diabetes than those who rarely drank them, even after their weight was taken into account.

But there’s good news about coffee. Two or three cups of coffee (but not tea) a day, with or without caffeine, have been consistently linked to a lower risk of Type 2 diabetes. 

For protein, limit consumption of red meat, especially processed meats like sausages, hot dogs and luncheon meats, which are linked to a higher diabetes risk. Instead, choose fish, lean poultry (skinless and not fried), beans and nuts. Low-fat dairy products, including yogurt, and even fatty ones may lower the risk of diabetes; the reason is unclear.

Most protective are green, leafy vegetables — spinach, chard, kale, collards, mustard greens and even lettuce — as well as cruciferous vegetables like cabbage, broccoli and cauliflower. But all vegetables are good and should fill at least two-thirds of your dinner plate.

The nutrients magnesium and vitamin D are also potentially protective. In fact, the preventive value of leafy greens, whole grains, beans and nuts may lie in their high magnesium content. In a well-designed clinical trial of 32 overweight people with insulin resistance, the prelude to diabetes, blood glucose levels and insulin sensitivity improved in those who took a daily magnesium supplement for six months. Don’t go overboard: More than 350 milligrams of magnesium daily can cause diarrhea. 

Vitamin D, long known to be crucial to healthy bones, may also be helpful. In one study of 92 overweight or obese adults with prediabetes, those who took a supplement of 2,000 international units of vitamin D daily had better function of the pancreatic cells that produce insulin..

Of course, how much you weigh and what you eat are not the only concerns. Regular, preferably daily, physical exercise is a vital component of any prevention and treatment program for Type 2 diabetes, or most any chronic ailment. Weight loss can reduce diabetes risk by about 50 percent, but adding exercise to that can lower the odds by 70 percent, compared with people who remain overweight and inactive, according to a study that followed nearly 85,000 female nurses for 16 years. Women who were active for seven or more hours weekly had half the risk of developing diabetes as did women who exercised only a half-hour a week.

Great reason to add more rosemary and oregano to your diet. From Science Daily:

Rosemary, oregano contain diabetes-fighting compounds

The popular culinary herbs oregano and rosemary are packed with healthful compounds, and now lab tests show they could work in much the same way as prescription anti-diabetic medication, scientists report. In their new study, researchers found that how the herbs are grown makes a difference, and they also identified which compounds contribute the most to this promising trait.

Elvira Gonzalez de Mejia and colleagues point out that in 2012, type-2 diabetes affected more than 8 percent of Americans and cost the country $175 billion. ... Recent research has shown that herbs could provide a natural way to help lower glucose in blood. So Gonzalez de Mejia's team decided to take a closer look.They tested four different herbs, either greenhouse-grown or dried commercial versions, for their ability to interfere with a diabetes-related enzyme, which is also a target of a prescription drug for the disease.

They found that greenhouse herbs contained more polyphenols and flavonoids compared to the equivalent commercial herbs. But this didn't affect the concentration required to inhibit the enzyme. Commercial extracts of Greek oregano, Mexican oregano and rosemary were better inhibitors of the enzyme, required to reduce risk of type-2 diabetes, than greenhouse-grown herbs.

Research reports and articles on the benefits of exercise have been piling up. Here are some worth looking at. From Science Daily:

Sitting too much, not just lack of exercise, is detrimental to cardiovascular health

Cardiologists have found that sedentary behaviors may lower cardiorespiratory fitness levels. New evidence suggests that two hours of sedentary behavior can be just as harmful as 20 minutes of exercise is beneficial.

From Science Daily:

Out of shape? Your memory may suffer

Here's another reason to drop that doughnut and hit the treadmill: A new study suggests aerobic fitness affects long-term memory. "The findings show that lower-fit individuals lose more memory across time," said a co-author. The study is one of the first to investigate young, supposedly healthy adults. 

From Science Daily:

Less exercise, not more calories, responsible for expanding waistlines

Sedentary lifestyle and not caloric intake may be to blame for increased obesity in the US, according to a new analysis. A study reveals that in the past 20 years there has been a sharp decrease in physical exercise and an increase in average body mass index (BMI), while caloric intake has remained steady. 

From Science Daily:

Older adults: Build muscle and you'll live longer

The more muscle mass older Americans have, the less likely they are to die prematurely, new research shows. The findings add to the growing evidence that overall body composition -- and not the widely used body mass index, or BMI -- is a better predictor of all-cause mortality. "In other words, the greater your muscle mass, the lower your risk of death," said the study's co-author. "Thus, rather than worrying about weight or body mass index, we should be trying to maximize and maintain muscle mass."

From Medical Xpress:

Keeping active pays off in your 70s and 80s

Older people who undertake at least 25 minutes of moderate or vigorous exercise everyday need fewer prescriptions and are less likely to be admitted to hospital in an emergency, new research has revealed.

Researchers from the Universities of Bath, Bristol and UWE-Bristol looked at data from 213 people whose average age was 78. Of people studied, those who carried out more than 25 minutes of moderate to vigorous physical activity per day – such as walking quickly, cycling or swimming - received 50 per cent fewer prescriptions than those who were more active over a four to five year period.

Such physical activity leads to a higher metabolism and better circulation, reducing the risk of conditions and diseases common in older age such as high blood presure, type 2 diabetes, coronary heart disease, and strokes.

From Everyday Health:

The Best Anti-Aging Medicine? Exercise

Everyone knows that exercise is good for you — it helps manage weight, improves muscle and bone strength, and even lifts your spirits. It can also add years to your life.“People have been looking for the secret to a long and healthy life for millennia,” said Neil Resnick, MD, chief of the division of geriatrics and director of the University of Pittsburgh Institute on Aging. “It turns out the most powerful intervention is exercise.”

A recent study conducted at Harvard found that exercise can be at least as effective as prescription drugs when it comes to preventing common conditions such as heart disease, stroke, and diabetes.

Exercise at any age is beneficial. From Science Daily:

Seniors who exercise regularly experience less physical decline as they age

Older adults in retirement communities who reported more exercise experienced less physical decline than their peers who reported less exercise, although many adults -- even those who exercised -- did not complete muscle-strengthening exercises, which are another defense against physical decline.

The study talked specifically about 3 types of bacteria that were different among the groups (severely obese, diabetics, healthy) studied: Firmicutes, Bifidobacteria, Clostridium leptum. From Science Daily:

Gut microbe levels are linked to type 2 diabetes and obesity

People with Type 2 diabetes or obesity have changes in the composition of their intestinal micro-organisms -- called the gut microbiota -- that healthy people do not have, researchers from Turkey have found.

The study lends support to other recent reports that have found an association between specific bacterial species in the human digestive system and obesity and diabetes, according to lead investigator Yalcin Basaran, MD, an endocrinologist from Gulhane Military Medical Academy School of Medicine, Ankara, Turkey.

The human digestive system contains an estimated 10 trillion to 100 trillion bacteria and other microscopic organisms, with each person housing at least 160 different species of organisms, according to Basaran. 

Basaran and his fellow researchers sought to identify the relationship between the gut microbe composition and obesity and Type 2 diabetes. Their study included 27 severely obese adults (20 men and seven women) whose body mass index, or BMI, exceeded 35 kg/m2, as well as 26 adults (18 men and eight women) with newly diagnosed Type 2 diabetes and 28 healthy control subjects (22 men and six women). 

Fecal analysis using a molecular biology technique showed that several of the most common types of bacteria in the gut were present at considerably lower levels in the obese and diabetic groups, compared with healthy controls. These reductions ranged from 4.2 to 12.5 percent in the obese patients and 10 to 11.5 percent in the diabetic patients, Basaran reported.

"Manipulation of intestinal bacteria could offer a new approach to manage obesity and Type 2 diabetes."

Excellent reason to enjoy coffee every day. From Science Daily:

Increasing consumption of coffee associated with reduced risk of type 2 diabetes, study finds

New research published in Diabetologia (the journal of the European Association for the Study of Diabetes) shows that increasing coffee consumption by on average one and half cups per day (approx 360ml) over a four-year period reduces the risk of type 2 diabetes by 11%. 

The authors examined the associations between 4-year changes in coffee and tea consumption and risk of type 2 diabetes in the subsequent 4 years.

The authors used observational data from three large prospective, US-based studies in their analysis: the Nurses' Health Study (NHS) (female nurses aged 30-55 years, 1986-2006), the NHS II (younger female nurses aged 25-42 years 1991-2007), and the Health Professionals Follow-up Study (HPFS) (male professionals 40-75 years, 1986-2006). The final analysis included 48,464 women in NHS, 47,510 women in the NHS II, and 27,759 men in HPFS.

The authors documented 7,269 incident type 2 diabetes cases, and found that participants who increased their coffee consumption by more than 1 cup/day (median change=1.69 cups/day) over a 4-year period had a 11% lower risk of type 2 diabetes in the subsequent 4-years compared to those who made no changes in consumption. Participants who decreased their coffee intake by 1 cup a day or more (median change=-2 cups/day) had a 17% higher risk for type 2 diabetes. Changes in tea consumption were not associated with type 2 diabetes risk.

Those with highest coffee consumption and who maintained that consumption -- referred to as "high-stable consumers" since they consumed 3 cups or more per day -- had the lowest risk of type 2 diabetes, 37% lower than the "low-stable consumers" who consumed 1 cup or less per day.

While baseline decaffeinated coffee consumption was associated with a lower type 2 diabetes risk, the changes in decaffeinated coffee consumption did not change this risk. 

Great news for chocolate lovers. Some other beneficial foods in the study that offer protection from type 2 diabetes: berries, tea, red grapes, wine, parsley, celery, oranges, peppers. From the January 20, 2014 Science Daily:

Ingredients in chocolate, tea, berries could guard against diabetes

Eating high levels of flavonoids including anthocyanins and other compounds (found in berries, tea, and chocolate) could offer protection from type 2 diabetes -- according to research from the University of East Anglia and King's College London. 

Findings published today in the Journal of Nutrition reveal that high intakes of these dietary compounds are associated with lower insulin resistance and better blood glucose regulation.

A study of almost 2,000 people also found that these food groups lower inflammation which, when chronic, is associated with diabetes, obesity, cardiovascular disease, and cancer.

 According to a new report, exercise can be as effective as many frequently prescribed drugs in treating some of the leading causes of death. This is a major finding! From the Dec.11, 2013 NY Times:

Exercise as Potent Medicine

For the study, which was published in October in BMJ, researchers compared how well various drugs and exercise succeed in reducing deaths among people who have been diagnosed with several common and serious conditions, including heart disease and diabetes.

They ended up with data covering 305 past experiments that, collectively, involved almost 340,000 participants, which is an impressive total. But most of the volunteers had received drugs. Only 57 of the experiments, involving 14,716 volunteers, had examined the impact of exercise as a treatment.The researchers compared mortality risks for people following any of the treatment options.

The results consistently showed that drugs and exercise produced almost exactly the same results. People with heart disease, for instance, who exercised but did not use commonly prescribed medications, including statins, angiotensin-converting-enzyme inhibitors or antiplatelet drugs, had the same risk of dying from — or surviving — heart disease as patients taking those drugs. Similarly, people with diabetes who exercised had the same relative risk of dying from the condition as those taking the most commonly prescribed drugs.

On the other hand, people who once had suffered a stroke had significantly less risk of dying from that condition if they exercised than if they used medications — although the study authors note that stroke patients who can exercise may have been unusually healthy to start with.

Only in chronic heart failure were drugs noticeably more effective than exercise. Diuretics staved off mortality better than did exercise.

Over all, Dr. Ioannidis said, “our results suggest that exercise can be quite potent” in treating heart disease and the other conditions, equaling the lifesaving benefits available from most of the commonly prescribed drugs, including statins.