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FOUR KEY STEPS TO PREVENT & REVERSE TYPE 2 DIABETES

One in ten people over 40 are now living with Type 2 diabetes, and the number of people with diabetes in all its forms in the UK has reached 4.7 million. The number of people affected by diabetes is expected to reach 5.5 million by 2030 (1).


These figures are scary to comprehend, however, the good news is that the onset of Type 2 diabetes can be prevented and in some cases even reversed through nutrition and lifestyle modifications.


What is Type 2 diabetes?


Type 2 diabetes is a chronic disease that affects the way the body metabolises sugar (glucose). It is characterised by a progressive loss of sensitivity to insulin (the pancreatic hormone that regulates blood sugar levels).


In the pre-diabetic stage (early stages) of type 2 diabetes, the body produces more insulin to try to overcome reduced insulin sensitivity; however, in the long run, the pancreas can’t produce enough insulin to maintain blood sugar levels, resulting in high blood sugar or, hyperglycaemia.


Hyperglycaemia contributes to many of the complications of type 2 diabetes, such as kidney, nerve, eye, and vascular damage.


What causes Type 2 diabetes?


The disease is driven by a complex number of contributors. Diet is not only the contributing factor other factors such as a sedentary lifestyle, inadequate sleep, chronic stress, gut dysfunction, and environmental toxins play significant roles.


Below are four key steps that individuals can implement to prevent, and possibly even reverse Type 2 diabetes.


1. DIETARY APPROACHES


Adjust your carb quantity and quality


It has been well established that a high-refined carbohydrate and low-fibre intake increases the risk of type 2 diabetes (2,3).


In addition, large scale studies have compared the effectiveness of low-carb diets with high-carb diets to treat diabetes. Results indicate that low-carb diets consistently outperform high-carb diets for the management of type 2 diabetes (4,5). This is due to low-carb diets producing more significant improvements in blood sugar stability and lipid profiles, which significantly reduce the need for medications.


What can I do?

  • Instead of refined carbohydrates such as pasta, bread, cakes and biscuits; consume good quality complex carbohydrates such as sweet potatoes, carrots, beets, pumpkin, squash, oats (porridge), quinoa, brown, red and wild rice, bulgur wheat and freekah. Check out this article here for more information on carbohydrates.

  • Limiting carbohydrate intake differs from person to person, however, those with blood sugar regulation problems may benefit from limiting carb intake to 15-20% of total calories.

  • Consume more fibre foods. Dietary fibre intake may reduce insulin resistance and improve the body’s response to glucose (6). Also, several studies have indicated that risk of type 2 diabetes decreased with total dietary fibre intake (7 -9). Fibre is only found in plant-based foods such as fruits, vegetables, legumes, grains, and nuts. Check out this article here for more information on fibre.

  • Plan meals in advance. It is easier to stick to a healthy meal plan when you pre-plan each meal, and it helps to avoid spontaneous temptations between meals.

Increasing protein intake


Protein is a powerful tool for managing type 2 diabetes.


High protein diets have been shown to have a stabilising effect on blood sugar levels, and can lead to beneficial changes in a wide range of metabolic, cardiovascular and inflammatory markers (10,11). These include protein such as; eggs, chicken, seafood, red meat, greek yogurt, nuts and seeds, lentils, kidney beans, chickpeas, beans, oats and quinoa. For more information on protein sources check this article out.


What can I do?


  • Include a high-protein food in each meal and in your snacks to get what you need to feel satiated.

  • Consider snacks like nuts, seeds, hard-boiled eggs, or hummus as great healthy snacks rich in protein.

  • Protein is not only in meat. It is vital to also consume plant-based protein mentioned above into your diet.


Fasting


In the modern ‘developed’ society we live in, we have constant access to food sources but this is not in accordance with our evolutionary history when we would likely have had considerable periods of fasting and feasting.


Fasting has been shown to both prevent and reverse type 2 diabetes by improving insulin sensitivity (which means the cells are better able to use the available sugar in the bloodstream) and levels of insulin drop dramatically (12-14).


A study indicated that Ramadan fasting practiced by patients with type 2 diabetes for 15–21 days leads to a statistically and clinically significant reduction in glucose levels suggesting that glycaemic control is improved substantially during Ramadan.


What can I do?


There are a numerous amount of ways to fast, these include:

  1. 5:2 diet (essentially, fasting Mondays & Thursdays) – this entails consuming only 500–600 calories on two non-consecutive days of the week, but eating normally the other 5 days.

  2. 16/8 method - restricting daily eating period to 8 hours only, such as 10 am – 6 p.m. Then fasting for 16 hours in between.


2. GET MOVING


Exercise is a cornerstone of diabetes care and prevention.


Exercise increases insulin sensitivity, which means the cells are better able to use the available sugar in the bloodstream (15). Also, exercise helps muscles pick up sugars from the blood. This can lead to reduced blood sugar levels (17)

.

Research indicates that walking for just 30 minutes a day reduces the risk of type 2 diabetes by approximately 50 % (16).


In addition to exercising more, reducing sedentary time in daily life is also essential. Alternate sitting with working at a standing desk or breaking up prolonged sitting with standing. Also, walking has been shown to improve the blood sugar levels in those at risk for diabetes (18).


What can I do?


The main thing is to find physical activities you enjoy. It’s hard to commit to exercise if you aren’t having fun. If lifting weights or an early morning jog isn’t what you like, then don’t worry. Find something you do enjoy instead. Ask yourself:


  • Do you prefer working out alone or in a group?

  • Where do you prefer to work out? At home or in a gym? Inside or outdoors?

  • What’s most convenient for you? The fewer obstacles you have, the easier it is to commit to exercising.

But remember, discipline and small consistent exercise habits are key to good results.

3. MANAGE YOUR STRESS


Chronic, long term stress is another overlooked but significant risk factor for type 2 diabetes. The hormonal changes such as glucagon and cortisol secretion during stress which can cause blood sugar imbalances (19).


Persistently elevated levels of cortisol can trigger an increase in insulin. Having a higher insulin levels in your body triggers your body to store more calories as fat (especially around your middle). Higher cortisol and insulin levels also cause blood sugar levels to be more irregular, which can trigger hunger and food cravings, especially for sugary foods that raise blood sugar and give you short term energy.


Research indicates that reducing psychological stress can improve blood sugar management in type 2 diabetes. Meditation, yoga, and breathing exercises have been found to decrease fasting blood glucose and post-meal glucose in diabetics (20,21).


What can I do?

  • Deep breathing techniques: When you are driving, working at your desk, or watching Netflix, take deep, abdomen-filling breaths. The more often you practice deep breathing, the more likely it will become your normal way of breathing.

  • Think of things you are grateful for: Doing something as simple as thinking thoughts of gratitude has been shown to reduce stress hormones and slow down and regulate heart rate.

  • Take up yoga: start a yoga class or practice at home with YouTube videos. Yoga decreases the production of cortisol and increases a brain chemical called GABA (gamma-aminobutyric acid) (22). GABA may boost mood or have a calming, relaxing effect on the nervous system.

  • Regular exercise is one of the best stress-reducing activities you can do. If you have time to exercise before work, it will make your entire work day more peaceful and productive.

4. GET GOOD QUALITY SLEEP


A short sleep duration, defined as sleeping less than 7 to 8 hours a night, has been identified as a major risk factor for type 2 diabetes (23).


Sleep loss may promote type 2 diabetes by interfering with energy metabolism and increasing insulin sensitivity (23). Sleep loss also impairs satiety, triggering cravings and overconsumption of sugary processed foods that increase the risk of diabetes.


What can I do?


  • To improve blood sugar control, aim for 7 to 8 hours of sleep a night.

  • Maintaining a regular sleep schedule, even on weekends, creates consistency which can improve the quality and duration of your sleep as our bodies become accustomed to schedule.

  • Avoid caffeine no later than 2pm.

  • Avoid late-night eating.

  • Limiting bright light exposure in the evening (light from laptop screens, televisions, and phones) which can affect the production of melatonin, which means your body isn't preparing the hormones it needs to enter the sleep phase.

  • Sleep in a cool, dark environment makes it much easier to get a good night’s sleep.

Check out this article for more information on healthy habits to adopt for good-quality sleep!


Bottom line:


Type 2 diabetes is easily prevented and in some cases can be reversed through practical lifestyle and nutrition modifications mentioned in this article which could drastically reduce the incidence of Type 2 diabetes.


If you are diagnosed with Type 2 diabetes, or you are pre-diabetic or if you know someone who is, we'd love to help you on this journey of reversing and preventing Type 2 diabetes. Book your consultation now to empower yourself towards optimal health!



References:

1) The British Diabetic Association operating as Diabetes UK. 2019. https://www.diabetes.org.uk/


2) Hala B AlEssa, Shilpa N Bhupathiraju et al. (2015). Carbohydrate quality and quantity and risk of type 2 diabetes in US women. The American Journal of Clinical Nutrition. 102 (6) 1543–1553.


3) Barclay AW, Petocz P, McMillan-Price J, Flood VM, Prvan T, Mitchell P, Brand-Miller JC. (2008). Glycemic index, glycemic load, and chronic disease risk–a meta-analysis of observational studies. Am J Clin Nutr ;87:627–37.


4) Tay J, Thompson CH, Luscombe-Marsh ND, Wycherley TP et al. (2018). Effects of an energy-restricted low-carbohydrate, high unsaturated fat/low saturated fat diet versus a high-carbohydrate, low-fat diet in type 2 diabetes: A 2-year randomized clinical trial. Diabetes Obes Metab. Apr;20(4):858-871.


5) Tay J, Luscombe-Marsh ND2, Thompson CH et al. (2015). Comparison of low- and high-carbohydrate diets for type 2 diabetes management: a randomized trial. Am J Clin Nutr. 102(4):780-90.


6) Malcomson F. (2018). Mechanisms underlying the effects of nutrition, adiposity and physical activity on colorectal cancer risk. Nutrition Bulletin. 43:400-15.


7) Ye, E.Q., Chacko, S.A., Chou, E.L., Kugizaki, M., and Liu, S. (2012). Greater whole-grain intake is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain. J Nutr. 142: 1304–1313.


8) Yao, B., Fang, H., Xu, W. et al. (2014). Dietary fiber intake and risk of type 2 diabetes: A dose-response analysis of prospective studies. Eur J Epidemiol. 29: 79–88


9) Bhupathiraju, S.N., Tobias, D.K., Malik, V.S. et al. (2014). Glycemic index, glycemic load, and risk of type 2 diabetes: Results from 3 large US cohorts and an updated meta-analysis. Am J Clin Nutr. 100: 218–232.


10) Mary C. Gannon and Frank Q. Nuttall. (2004). Effect of a High-Protein, Low-Carbohydrate Diet on Blood Glucose Control in People With Type 2 Diabetes. Diabetes. 53(9): 2375-2382.


11) Gannon MC, Nuttall FQ, Saeed A, Jordan K, Hoover H. An increase in dietary protein improves the blood glucose response in persons with type 2 diabetes. Am J Clin Nutr. 78(4):734-41.


12) Ruth E. Patterson and Dorothy D. Sears. (2017). Metabolic Effects of Intermittent Fasting. Annual Review of Nutrition 37:1, 371-393.


13) Mattson, M. P et al. (2017). Impact of intermittent fasting on health and disease processes. Ageing research reviews, 39, 46–58.


14) Elizabeth F. Sutton, et al. (2018). Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes. Cell metabolism. 27:6:5 -1212-1221.


15) Naufahu, J., Elliott, B., Markiv, A., Dunning-Foreman, P., McGrady, M., Howard, D., Watt, P. & Mackenzie, R.W. (2018) High-intensity exercise decreases IP6K1 muscle content and improves insulin sensitivity (SI2) in glucose-intolerant individuals. The Journal of Clinical Endocrinology & Metabolism. 103(4) pp.1479-1490.


16) Hamasaki H. (2016). Daily physical activity and type 2 diabetes: A review. World journal of diabetes, 7(12), 243–251.


17) Qiu S, Cai X, Schumann U, Velders M, Sun Z, Steinacker JM. (2014). Impact of walking on glycemic control and other cardiovascular risk factors in type 2 diabetes: a meta-analysis. PLoS One. 9(10):e109767.


18) Joseph Henson, Melanie J. Davies, Danielle H. Bodicoat et al. (2016). Breaking Up Prolonged Sitting With Standing or Walking Attenuates the Postprandial Metabolic Response in Postmenopausal Women: A Randomized Acute Study. Diabetes Care Jan. 39 (1) 130-138.


19) M. Loredana Marcovecchio and Francesco Chiarelli. (2012). The Effects of Acute and Chronic Stress on Diabetes Control. Science Signaling. 5 247, pp. pt10.


20) Hartmann M1, Kopf S, Kircher C, Faude-Lang V, Djuric Z et al. (2012) Sustained effects of a mindfulness-based stress-reduction intervention in type 2 diabetic patients: design and first results of a randomized controlled trial (the Heidelberger Diabetes and Stress-study). Diabetes Care. 35(5):945-7.


21) Kim SD. (2014). Effects of yogic exercises on life stress and blood glucose levels in nursing students. J Phys Ther Sci. 2014 Dec;26(12):2003-6.


22) Streeter, C. C., Whitfield, T. H., Owen, L., Rein, T., Karri, S. K., Yakhkind, A. Jensen, J. E. (2010). Effects of yoga versus walking on mood, anxiety, and brain GABA levels: a randomized controlled MRS study. Journal of alternative and complementary medicine (New York, N.Y.), 16(11), 1145–1152.


23) Zhilei Shan, Hongfei Ma, Manling Xie et al. (2015). Sleep Duration and Risk of Type 2 Diabetes: A Meta-analysis of Prospective Studies. Diabetes Care. 38(3): 529-537.