Can Diet Prevent Diabetes?

There is unequivocal evidence that whole grains protect against diabetes, while diets rich in refined or highly processed carbohydrates increases the risk of getting diabetes. Eating an extra two servings of whole grains a day decreases the risk of type 2 diabetes by 21%. Whole grains offer a ‘total package’ of health benefits, unlike refined grains, which lose their valuable nutrients during the refining process. A food product high in 100% whole grains lists it first or second in the ingredient list. Better yet, choose unprocessed whole grains: Brown rice, Wild rice, Quinoa, Buckwheat, Barley, Oats, Corn, etc. They offer nutritional benefits of whole grains without any additional ingredients. Whole-grain foods that are high in fiber are even better. Be careful when choosing foods labeled as whole grains: ‘Whole grain’ does not always mean healthy, unfortunately, due to inconsistent labeling. The USDA has laid out the following criteria that identify whole grains in a food product.

·         any whole grain as the first ingredient

·         any whole grain as the first ingredient, and added sugars not being one of the first three ingredients in the ingredient list

·         the word ‘whole’ before any grain ingredient

·         a carbohydrate-to-fiber ratio of less than 10:1

·         industry-sponsored Whole Grain Stamp.

Whole grains don’t contain a magical nutrient that fights diabetes and improves health. It’s the entire package—elements intact and working together—that’s important. The bran and fiber in whole grains make it more difficult for digestive enzymes to break down the starches into glucose, which leads to lower, slower increases in blood sugar and insulin and a lower glycemic index. As a result, they stress the body’s insulin-making machinery less, and so may help prevent type 2 diabetes. Whole grains are also rich in essential vitamins, minerals, and phytochemicals that may help reduce the risk of diabetes.

In contrast, white bread, white rice, mashed potatoes, donuts, bagels, and many breakfast cereals have a high glycemic index and glycemic load. They cause sustained spikes in blood sugar and insulin levels, which in turn may lead to increased diabetes risk. The researchers estimated that replacing 50 grams of white rice (just one-third of a typical daily serving) with the same amount of brown rice would lower the risk of type 2 diabetes by 16%. The identical replacement with other whole grains, such as whole wheat and barley, was associated with a 36% reduced risk.

Skip the sugary drinks and choose water, coffee, or tea instead Avoid sugar-sweetened beverages. Water is your friend.

Like refined grains, sugary beverages have a high glycemic load, and drinking more of this sugary stuff is associated with an increased risk of diabetes. For every additional 12-ounce serving of sweet beverage that people drink each day, their risk of type 2 diabetes rises by 25%. Fruit drinks— powdered drinks, fortified fruit drinks, or juices—are not healthy choices.  Women who drank two or more servings of fruit drinks a day had a 31% higher risk of type 2 diabetes compared with women who drank less than one serving a month in a study. 

How do sugary drinks lead to this increased risk? Weight gain may be an obvious explanation. Several studies show that people who drink soda or other sugar-sweetened beverages are more likely to gain weight than those who don’t and that switching from these to water od unsweetened drinks can reduce weight. But weight gain caused by sugary drinks doesn’t fully explain the increased diabetes risk. It is becoming increasingly apparent that sugary drinks contribute to chronic inflammation, high triglycerides, decreased “good” cholesterol, and increased insulin resistance, all of which are risk factors for diabetes.

What can one substitute in place of the sugary stuff? Water is an excellent choice. Coffee and tea are also suitable as calorie-free substitutes for sugary beverages. There’s convincing evidence that coffee may help protect against diabetes. There’s been some controversy over whether artificially sweetened beverages are beneficial for weight control and, by extension, diabetes prevention. Some studies have found that people who regularly drink diet beverages have a higher risk of diabetes than people who rarely drink such beverages. Still, there could be another explanation for those findings. People often start drinking diet beverages because they have a weight problem or a family history of diabetes; studies that don’t adequately account for these other factors may make it wrongly appear as though the diet soda led to the increased diabetes risk. A long-term analysis of data from 40,000 men in the Health Professionals Follow-up Study found that drinking one 12-ounce serving of diet soda a day did not appear to increase diabetes risk. So, in moderation, diet beverages can be a sugary-drink alternative for adults.

Choose healthy fats.

The type of fat one consumes can also affect the development of diabetes. Healthy fats, like the polyunsaturated fats found in liquid vegetable oils, nuts, and seeds, can help prevent type 2 diabetes. Trans fats work the opposite. Eating polyunsaturated fats from fish—also known as “long-chain omega 3” —does not protect against diabetes, even though there is much evidence that it does help prevent heart disease. If a person has diabetes, eating fish can help protect against a heart attack or dying from heart disease. 

Limit red meat but avoid processed meat; choose nuts, beans, whole grains, poultry, or fish instead.

Red meat (beef, pork, lamb) and processed red meat (bacon, hot dogs, deli meats) increase the risk of diabetes. Studies indicate that eating just one 3-ounce serving of red meat daily— like a steak that’s about the size of a deck of cards—increases the risk of type 2 diabetes by 20%. Eating just two slices of bacon, one hot dog, or the like—increased diabetes risk by 51%.

These studies also reveal that exchanging red or processed red meat with a healthier protein source, such as nuts, low-fat dairy, poultry, or fish, or whole grains lowers diabetes risk by up to 35%. 

Studies do indicate that people who most frequently ate meats and chicken cooked at high temperatures are not only at a higher risk of developing obesity but are also at 1.5 times more chance to develop type 2 diabetes, compared with those who ate the least.  

The high iron content of red meat blunts insulin response and or damages the islet cells that produce insulin. Processed red meats have high levels of sodium and nitrites as preservatives, which may also be worsening it.  Red and processed meats seem to trigger diabetes in people who are already at genetic risk.

There is no doubt in the scientific literature that plant-based diets may help lower type 2 diabetes risk. Those who adhere to predominantly healthy plant-based foods may have a lower risk of developing type 2 diabetes than those who follow these diets with lower adherence.

Don’t smoke

Smokers are roughly 50% more likely to develop diabetes than nonsmokers, and heavy smokers have an even higher risk.

Take the American Diabetes Association Diabetes Risk Test:   https://www.diabetes.org/risk-test

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About Us

Dr. Amar Singh, MD, and Dr. Poonam Singh, MD, are board-certified by the American Board of Internal Medicine and American Board of Obesity Medicine. They specialize in preventing, treating, and reversing chronic diseases using an evidence-based holistic approach. They are specifically interested in weight management, hormone rebalancing, and longevity. The American College of Physicians has recognized them as Fellows, FACP,  for their excellence and contributions made to both medicine and the broader community. They enjoy teaching, volunteering, and advocating for their patients

What to do to gain up to 10 extra years of disease-free life

There is a consensus that a healthy lifestyle can stave off chronic disease. But just how many additional disease-free years might one get from that healthy lifestyle? We know the answer now.

Across the world, people are, on average, living longer. But as populations age, individuals often live with disabilities and chronic diseases like cancer, heart disease, and diabetes.

Lifestyle choices affect both overall life expectancy and the likelihood of chronic diseases. Only a few studies have looked at how a combination of lifestyle factors may relate to life expectancy free from such conditions. To address this evidence gap, researchers analyzed retrospective data on 73,196 US registered female nurses from the Nurses’ Health Study and 38,366 US male health professionals (dentists, optometrists, osteopaths, podiatrists, pharmacists, and veterinarians) from the Health Professionals Follow-up Study, who were free of cancer, cardiovascular disease, and diabetes at enrollment. Five low-risk lifestyle factors - never smoking, healthy weight (BMI), at least 30 minutes of daily physical activity, moderate alcohol intake, and a good quality diet - were used to calculate a healthy lifestyle score. The sum of these five scores together gave a final low-risk lifestyle score ranging from 0 to 5, with higher scores indicating a healthier lifestyle. Participants were assessed regularly for more than 20 years. During this time, new diagnoses and deaths from cancer, cardiovascular disease, and type 2 diabetes were recorded.  

Serving size of alcohol in wine is 5 ounces, beer is one glass, can, or bottle and liquor is one drink or shot daily. The amount of alcohol in grams per specified portion size was multiplied by servings per day, determined the midpoint of the frequency category, and summed across all beverages to estimate the average alcohol consumption (g/day). Moderate alcohol consumption was defined as 5-15 g/day for women and 5-30 g/day for men, consistent with the guidelines for moderate alcohol intake in the US. Quality of diet was assessed using the Alternate Healthy Eating Index (AHEI) score, which is significantly associated with the risk of cardiovascular disease and other chronic diseases in the general population. A healthy diet was defined as an AHEI score in the top 40% of each cohort distribution. Physical activity levels were assessed using a validated questionnaire and updated every two to four years. The number of hours per week spent in moderate to vigorous activities (including brisk walking) requiring the expenditure of at least three metabolic equivalents of task (METs) per hour was estimated. Low risk was classified as at least 30 minutes of moderate or vigorous activity daily (3.5 h/week). 

After adjusting for age, ethnicity, family medical history, and other potentially influential factors, life expectancy free of cancer, cardiovascular disease, and diabetes at age 50 was 24 years for women who adopted no low-risk lifestyle factors, and 34 years for women who chose four or five low-risk factors. Similarly, life expectancy free of any of these chronic diseases was 24 years among men who adopted no low-risk lifestyle factors, and 31 years in men who chose four or five low-risk lifestyle factors. 

Women with four or five low-risk lifestyle factors had 10.6 years’ longer life expectancy free of the major chronic diseases than did women with zero low-risk lifestyle factors. At the same time, men gained 7.6 years’ longer life expectancy free of major chronic disorders over those with zero low-risk lifestyle factors.

Men who smoked heavily (15 or more cigarettes a day) or men and women with obesity (body mass index of 30 or over) had the lowest proportion (75% or less) of disease-free life expectancy at age 50.

The elements of a healthy lifestyle come as no surprise. The surprise is just how many additional disease-free years a healthy lifestyle can add.

Bottomline

Women can add up to 10.6 years, and men can add up to 7.6 years of healthy life by doing the following:

• Don’t smoke

• Exercise at least 30 minutes daily.

• Maintain a healthy weight.

• Limit alcohol intake

• Eat a healthy diet.

Reference

Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: prospective cohort study. BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.l6669

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About Us

Dr. Amar Singh, MD, and Dr. Poonam Singh, MD, are board-certified by the American Board of Internal Medicine and American Board of Obesity Medicine. They specialize in preventing, treating, and reversing chronic diseases using an evidence-based holistic approach. They are specifically interested in weight management, hormone rebalancing, and longevity. The American College of Physicians has recognized them as Fellows, FACP,  for their excellence and contributions made to both medicine and the broader community. They enjoy teaching, volunteering, and advocating for their patients

Regaining Calm During Crisis

If you’re feeling stress during the Coronavirus pandemic, you’re not alone. During these uncertain times, it’s normal if you’re feeling anxious, scared or overwhelmed. You might be feeling the domino effect of stress on your eating habits, exercise or even sleep.

COMMON SOURCES OF STRESS DURING THIS TIME MIGHT INCLUDE:

• Fear of the unknown

• Feeling a loss of control

• Fear of yourself or loved ones getting sick

• Isolation and disconnection from social distancing

• Limited food and supplies

• Financial concern due to loss of job or income

• Working from home

• Caring for families and children while at home

• Fear for the economy and impact on businesses

Here are a few tips and strategies for coping during this time of uncertainty

LIMIT EXPOSURE TO THE NEWS

First and foremost, have a plan in regards to listening to the media to stay informed. If you want to watch the news, choose a specific time to watch and listen to reliable sources. Continue to follow health and safety recommendations, and feel empowered to share with others without spreading more fear and panic.

ESTABLISH ROUTINES AND RITUALS

• Have a consistent bedtime and wake-up time

• Get dressed each morning

• If you’re working from home, set “office hours” and schedule break times

DEVELOP A DAILY MINDFULNESS PRACTICE

• Take time to focus on the present

• Pause and check in with yourself – What thoughts and feelings are you having? What are you experiencing physically?

• Try mindful breathing exercises to relieve tension

• Do mindful movements like yoga, Tai Chi, and stretching

GET OUTSIDE (WHILE FOLLOWING SOCIAL DISTANCING)

• Take a walk

• Walk your dog

• Work in your garden

• Take a drive

• Find a beautiful place to sit

RE-FRAME THE SITUATION

Even when you feel you have no control over a situation, you are in charge of what you focus on. Try seeing this situation as an opportunity to get quiet, learn something new, catch up on things, or make a change.

INCREASE CONNECTION

• Social distancing does not mean emotional distancing

• Nurture close relationships with those in your household

• Work on communication and set boundaries as necessary

• Reach out to loved ones virtually (text, calling, social media, video)

BUILD A SELF-CARE BUFFER ZONE

• Pay attention to body, mind, heart, and spirit

• Eat a balance of nutritious foods

• Engage in enjoyable physical activity

• Get rest and adequate sleep

• Keep up with good hygiene

• Engage in art, music, crafts, hobbies, cooking, etc.

• Seek out support and acknowledge your feelings

• Find humor and opportunities where you can

HAVE A PRODUCTIVE QUARANTINE

• Learn to cook or try a new recipe

• Spring clean your house, yard, and/or car

• Organize your photos

• Work on your business or hobbies

• Finish your taxes

• Look for things you always wish you had time to do

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About Us

Dr. Amar Singh, MD, and Dr. Poonam Singh, MD, are board-certified by the American Board of Internal Medicine and American Board of Obesity Medicine. They specialize in preventing, treating, and reversing chronic diseases using an evidence-based holistic approach. They are specifically interested in weight management, hormone rebalancing, and longevity. The American College of Physicians has recognized them as Fellows, FACP,  for their excellence and contributions made to both medicine and the broader community. They enjoy teaching, volunteering, and advocating for their patients

Tips for Healthy Eating When Routines Drastically Change

A change in routine and heightened stress levels during the COVID-19 pandemic have created the perfect storm for stress eating. Instead of working and eating a planned lunch, you may be taking repeated kitchen breaks with kids at home that lead to unplanned snacking. Instead of managing stress by working out at the gym, joining friends for a fun night out together, or going to a movie, you may be self-soothing with food.

And unfortunately, the chips, sweets, and other tempting treats that may quiet your kids end up sabotaging your good intentions.

As we all try and manage coronavirus-related anxiety and boredom, eating can and should still be a pleasurable activity. We don’t want food to be our go-to self-soother. 

Here are some tips to keep a healthy relationship with food:

Plan in advance

• Whether you’re making infrequent grocery store runs or ordering online, this is the time to ensure you have the right foods at home, not just for your children but also for you.

• One of the surest ways to reduce the consumption of high calorie, fatty, salty, and sugary snack foods is to keep them out of the house – or off the counter and out of sight.

• Your shopping list should include the nutritious foods that boost your health and satisfy hunger, such as fruits and vegetables, whole grain items, lean proteins, and non-sweetened beverages.

• Include healthy, grab-and-go snacks such as nut packs, light string or Babybel cheese, low-fat Greek yogurt cups, cut up veggies such as bell peppers, cauliflower, broccoli, cucumbers, cherry tomatoes, baby carrots, or fruit such as berries, oranges, apples or grapes.

• Look online for new healthy recipes your kids and you will love. Try a portion-controlled sweet snack such as no-bake energy bites or a crunchy snack like roasted chickpeas.

Set simple guidelines for mindful eating at home

At work, you have certain routines and guidelines you follow. Maybe eating is only done in the lunchroom or during your break. With your home being your new makeshift workplace, it’s easy to apply similar rules here, too. Try to eat only when you have these three things – a table, a plate, and a chair. Avoid eating food out of a bag, off your child’s plate, or while at your workstation.

If a certain time of day is difficult for you, such as after-dinner snacking, consider tracking your after-dinner snacks for a week. Just the simple act of tracking can make you feel more in control and motivate healthier eating.

Identify non-food related coping strategies.

We are all experiencing an increased sense of stress during this challenging time. It is important to deliberately schedule activities that will reduce stress and replenish your mind and body.

Try making a list of go-to activities that help improve your mood, such as: 

• Call a friend 

• Listen to music

• Do some deep breathing

• Journal your thoughts

• Go for a walk

• Play a game with your smartphone or watch funny videos

With social distancing in mind, look for new ways to participate in activities you used to enjoy.

No more lunch out with friends? Schedule regular zoom meetings or cocktail hour virtual ‘gatherings’ instead.

No more group lessons or events? Find virtual alternatives for things you enjoy, such as an exercise class, dance lesson, card games, or a book group.

The bottom line is you need to give yourself a break and do the best you can with the current situation.

Progress is better than perfection.

Published 5/31/2020

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About Us

Dr. Amar Singh, MD, and Dr. Poonam Singh, MD, are board-certified by the American Board of Internal Medicine and American Board of Obesity Medicine. They specialize in preventing, treating, and reversing chronic diseases using an evidence-based holistic approach. They are specifically interested in weight management, hormone rebalancing, and longevity. The American College of Physicians has recognized them as Fellows, FACP,  for their excellence and contributions made to both medicine and the broader community. They enjoy teaching, volunteering, and advocating for their patients