Type 2 diabetes is not inevitable even if you’re at high risk for it. Keep it at bay with these prevention strategies
Change Your Future
Today, more than 100 million Americans are living with diabetes or prediabetes. By 2050,one in three adults could have the condition, according to recent projections from the Centers for Disease Control and Prevention (CDC). Sounds scary, but there’s plenty you can do to avoid diabetes in your future.
Start with a healthy diet and exercise, experts say. In a major National Institutes of Health study of more than 3,000 people at risk for diabetes, those who lost 5 to 7 percent of their body weight and got at least 150 minutes per week of moderate physical exercise reduced their chances of developing the disease by 58 percent.
Next time you sit down for a meal, look at the food on your plate. How colorful is it? If it’s meat or refined pasta, white potatoes or rice, white bread and milk, that’s a recipe for diabetes. Eating colorful foods is “my number one diabetes prevention tip,” says Yi-Hao Yu, M.D., Ph.D., Medical Director of Endocrinology at Greenwich Hospital in Connecticut and a member of the Northeast Medical Group, Yale-New Haven Health System. That’s because naturally colorful foods like red peppers, blueberries and leafy greens contain antioxidants, substances that protect cells against free radicals, which trigger inflammation in the body that can contribute to insulin resistance, Dr. Yu explains. Instead of meat, go for pink salmon; swap white potatoes for butternut squash; and garnish with slices of mango or apricot. Another bonus, says Dr. Yu: “Colorful meals means that you’re eating a variety of nutrient-dense food, lots of veggies and fruits, and less calorically dense foods, which are good ways to prevent obesity.”
You really can outrun diabetes. Aerobic activity lowers insulin resistance and helps with weight loss and maintenance. The standard dose is 30 minutes of moderate activity most days of the week. But it doesn’t have to be all at once or at the gym. Sprinkle it over the course of the day in 10-minute bursts of exertion, suggests Nora Saul, nutrition manager at the Joslin Diabetes Center, affiliated with Harvard Medical School. Organize your day so you can do as many errands by walking at a brisk pace instead of driving. “If the post office is five minutes away, walk there,” says Saul.
Act Like Jack Spratt
If you recall the nursery rhyme, Jack was the lean one who ate no fat. His corpulent wife could eat no lean — and could have been on her way to diabetes just like the 85 percent of people with type 2 diabetes who are overweight or obese. Keep your weight in check by swapping high-fat food sources like red meat and full-fat dairy with leaner options such as fish, skinless poultry and low-fat milk, cheese and tofu. Lean proteins help you stay full longer, so you eat less, and they slow down the conversion of carbohydrates to glucose in the bloodstream, reducing spikes in blood sugar, says Saul.
Say Goodnight Early
Recent research shows that poor sleep is associated with diabetes, but the mechanism is not fully understood, Dr. Yu says. The body’s circadian rhythms are believed to influence the release of cortisol, a stress hormone that raises blood sugar levels artificially. When sleep is disturbed and circadian rhythms are thrown off, the body may release too much cortisol at the wrong time, which may lead to insulin resistance and glucose intolerance, precursors of diabetes. The bottom line:Getting enough sleep (seven to nine hours a night, according to the National Sleep Foundation) at as regular a time as possible may help prevent diabetes.
Eat More of the Right Carbs
Your body uses the sugar and starch in carbohydrates to produce glucose for energy, but carbs can spike blood sugar and insulin levels. Instead of cutting out carbs completely, most experts recommend eating “good” carbs (fruits and vegetables, including beans; whole-grain bread, cereal and other grains; low-fat dairy products) and spreading them out over the course of the day to keep blood glucose levels steady. Good carbs provide both energy and vital nutrients, such as fiber, vitamins and antioxidants. Foods containing added sugar, like sweets and sodas, are often packed with calories, and they usually don’t contain enough nutrients (if any) to make them worth having in small portions more than occasionally as a treat. To make your carbs work better, Saul suggests combining them with a healthy protein or fat. Fruit, for example, goes well with a handful of nuts, and tortilla chips benefit from guacamole — in moderation, of course.
Walk This Way
Being too sedentary can lead to diabetes. That’s why it’s better to walk and move around most of the day than work out at the gym for 30 minutes and spend the rest of the day sitting. To figure out just how much you’re walking, strap on a pedometer. “With a pedometer, you can see the number of steps you’re taking and find a way to increase it,” says Dr. Yu. The goal is 10,000 steps or more per day and no fewer than 4,000. Surround yourself with healthy friends who encourage you to be active (or even join you on your walks). People often revert to unhealthy practices because they don’t have a support system, says Dr. Yu.
Say No to Deprivation
Skipping meals or banishing your favorite foods when you’re trying to lose weight can backfire. The effect may be threefold. First, instead of losing weight, you overeat when you do sit down for a meal, or you binge later on forbidden foods. Second, people who skip breakfast or lunch but eat a big evening meal appear to have higher blood sugar levels in the morning, which may result from the body’s inability to secrete insulin correctly. What’s worse, skipping meals may stress the body and affect certain hormones that normalize blood glucose levels when you aren’t eating, possibly leading to insulin resistance, says Dr. Yu. It’s also possible that skipping meals, alternated with eating big meals, may change the way your body uses energy, creating excess fatty acids and other compounds that can affect the function of insulin-secreting cells in the pancreas. Your body may then secrete insufficient amounts of insulin when you eat, putting you at risk for diabetes. The bottom line: Don’t skip meals or cut any foods out of your life — just practice portion control.
Make New Friends
There’s a strong association between depression and diabetes: While 6 percent of Americans suffer from depression, the rate is three times higher in people with diabetes. Reaching out to friends and meeting new people is a powerful way to relieve depression — experts say it’s just as effective as medication. Maintaining connections with other people won’t necessarily prevent diabetes, but it will keep you in a better place to control your health, Saul says. Call a friend, join a club or strike up a conversation in the grocery store. It could be good for your health.
Quench Your Thirst
If you worry about overeating at every meal, start drinking more water. It helps keep your stomach feeling full, and it may curb hunger pangs and reduce your desire to wolf down too much. Rather than waiting until you’re thirsty, Dr. Yu suggests drinking a glass of water every two hours, whether or not you feel you need it. Develop the habit now and you’ll avoid problems when you’re older. As you age, your thirst mechanism is impaired, which is why elderly people often end up in the hospital for dehydration.
Aerobic activity helps prevent diabetes, but increasing your muscle mass is also important. Strengthening your muscles improves your sensitivity to insulin in two ways: First, when your muscles contract during exercise, they don’t need insulin as much. Second, insulin attaches to receptors in muscle cells, so the more active your muscles are, the more receptors you have, which enhances insulin sensitivity. “Being more sensitive to insulin means the glucose moves from your bloodstream into your cells, where it’s used for energy,” Saul says. Start training at home with resistance bands, she suggests.
Slow Down and Savor
It takes 20 minutes or more for your brain to register that you’ve eaten a sizeable amount of something, so if you gobble up your food, you’ll eat more than you actually need to be full. But aside from helping with portion control, eating slowly can also help you develop a taste for healthy foods you may not have always enjoyed. “Some people hate vegetables, but you need to find a way to develop a taste for them,” Dr. Yu says. “Try chewing them well and truly tasting them. You may develop a liking for them. Tastes are acquired and can be developed. If you never chew it or taste it, you will never know if you like it.”