Nutrition for Life - 2017


November is American Diabetes Month

By Parul Kharod

Diabetes is one of the leading causes of disability and death in the United States. One in 10 Americans have diabetes — that's more than 30 million people. And another 84 million adults in the United States are at high risk of developing Type 2 diabetes.

Each November communities across the country observe National Diabetes Month to bring attention to diabetes and its impact on millions of Americans.

November 14 is also marked as World Diabetes Day.

World Diabetes Day is the world's largest diabetes awareness campaign reaching a global audience of over 1 billion people in more than 160 countries. The campaign draws attention to issues of paramount importance to the diabetes world and keeps diabetes firmly in the public and political spotlight.

World Diabetes Day was created in 1991 by IDF and the World Health Organization in response to growing concerns about the escalating health threat posed by diabetes. World Diabetes Day became an official United Nations Day in 2006.

Studies have shown that Asians are at higher risk of developing Type 2 diabetes, when compared with people of European ancestry. Asians are more likely to develop the disease even at a lower BMI. This means that even though some Asian populations currently have a lower prevalence of overweight and obese individuals than populations in the West, they have a disproportionately high percentage of people with diabetes. Currently, 60 percent of the world's diabetic population is Asian.

This higher risk may be because Asians, especially South Asians, are more likely to have less muscle and more abdominal fat, which increases insulin resistance. For example, even though Indian newborns have a lower average body weight compared to white newborns, Indian newborns have higher levels of body fat and insulin. Imaging technology that measures fat in humans has shown that Asians of a healthy BMI have more fat around organs and in the belly area than Europeans with the same BMI.

Here are some staggering figures!

• 60 percent of diabetics in the world live in Asia.
• 113.9 million adults have diabetes in China, 11.6 percent of the adult population.
• In 1980, the percentage of Chinese adults with diabetes numbered less than 1 percent.
• 65.1 million adults have diabetes in India.
• In some South Indian cities, nearly 20 percent of the population has diabetes.
• By 2030, without intervention, both China and India combined will have almost half a billion diabetics.
• Asians have a higher percentage of body fat at the same BMI as Caucasians.
• In Caucasians, a BMI of 30 means a body fat percentage of about 25 percent in young adult males and 35 percent in young adult females.
• A study in China showed that males with a BMI of only 23.7 had 25 percent body fat and females with a BMI of only 21.2 had 32 percent body fat.
• For the same BMI, Asians have 3-5 percent higher body fat compared to people of European ancestry. For the same body fat percentage, Asians have a BMI of 3-4 units lower compared to Caucasians.

I know I have written about diabetes in earlier articles. However, diabetes is an epidemic that is affecting more and more people around the world. It is good to review and remind ourselves of this threat to personal and global health, and what we can do about it.

Depending on your age, weight, and other factors, you may be at higher risk of developing Type 2 diabetes. The good news is that making healthy changes can greatly lower your risk.

So, what should we do?

If you are overweight, work towards getting closer to a healthy weight. If you have high blood pressure, work towards lowering your numbers.

There are several specific diet-related strategies that have been proven to help control blood sugars and lower triglycerides.

• Increase foods rich in fiber: Fiber helps keep us full for a longer time so we avoid getting hungry and limit snacking. Fiber also helps lower cholesterol and improves the gut environment. Eat foods naturally rich in fiber such as whole intact grains, beans and lentils and plenty of colorful non-starchy vegetables.

• Limit fat: Avoid fried foods, avoid snacks made with shortening, and avoid full fat milk, cream and cheese/paneer.
• Limit milk and meats: There is new evidence linking animal protein, specifically milk protein with increased insulin resistance.
• Include sources of omega fats such as walnuts and flax seeds.
• Don't overdo fruit: Although fruit is healthy, it is still sugar. Be mindful of portion sizes.

Here are some other general tips:

• Eat real food!
• Limit eating out: Restaurant foods, especially fast food, is very high in sodium, saturated fat, trans fat, and artificial additives and chemicals.
• Limit processed and packaged food: Watch out for a long list of ingredients that include enriched flour, hydrogenated fat or vegetable shortening, food coloring, artificial flavors, and/or additives.
• Practice mindful eating; be aware of why, what, where, and how much you are eating.
• Move more; avoid sitting for long periods even when at home.
• Rethink your drink. Drink adequate amount of water; avoid drinks with sugar, and/or artificial chemicals.
• Practice mindful living; learn strategies to cope with stressful situations.

If you feel you need further help, consult a registered dietitian. Avoid getting information from unreliable sources.

References:

Asian Diabetes Prevention Initiative: http://asiandiabetesprevention.org/
National Institute of Diabetes and Digestive and Kidney Diseases: https://www.niddk.nih.gov/
International Diabetes Federation: https://www.idf.org/

-- Parul Kharod, MS, RD, LDN is a registered dietitian and licensed nutritionist and works as a Clinical Dietitian with Outpatient Nutrition Services at WakeMed Hospital in Cary and Raleigh. She can be reached at parulkharod@gmail.com