Maintaining a healthy bodyweight can help control the risk of type-2 diabetes.
Staying physically active can help reduce the risk of several health conditions
The prevalence of diabetes is rising exponentially across the world, and India is one of the worst affected countries. Recent data indicate that India has over 10 crore people with diabetes. Another 13 crore Indians fall in the zone of prediabetes. Many young individuals- in the 20s or even their teens- are being diagnosed with type 2 diabetes. The key lies in prevention. While diabetes is strongly inherited, this rise is diabetes is largely related to changes in our lifestyle- mainly diet and exercise, although stress and sleep also play a role.
How can you avoid the onset of diabetes? All of us, but those diagnosed with prediabetes need to ensure that they do not progress rapidly into the diabetes zone. Often people do not realise that their body weight drives diabetes. Being overweight increases your risk of diabetes drastically. Losing excess body fat is therefore a primary goal in all diabetes prevention strategies. Losing 7 to 10% of one's body weight significantly cuts the risk of diabetes by more than half. Further weight reduction yields even more substantial advantages.
How does one achieve weight loss?
One can approach weight loss in different ways. One approach involves severe diet restriction through very low-calorie diets (approximately 800 calories per day), under medical supervision, resulting in rapid weight loss. However, it is wise to aim for sustainable weight loss.
The other, time tested approach is moderate calorie restriction and increased fibre in diet. Substitute refined carbohydrates such as various sweets, white flour/maida, cakes, and pastries with fiber-rich millets or whole wheat preparations, oats, quinoa, and rice with bran, among other alternatives. Dietary fibre helps control the absorption of sugars and this helps in maintaining lower blood sugar levels and cholesterol. Foods high in fiber provide a sense of fullness, aiding in reduced calorie intake and facilitating weight loss. Include vegetables like leafy greens, broccoli, cauliflower, as well as beans and lentils in your diet. Fruits (but not fruit juices) are good options too, so long as we consume them in recommended amounts.
What about fat and protein?
Fat intake should always be in moderation .Avoid trans-fats and limit saturated fats. For effective weight loss, it is advisable to incorporate good fats such as monounsaturated and polyunsaturated fats. Seeds and nuts like flaxseed, pumpkin seeds, almonds, walnuts, peanuts are good as well as oily fish like salmon and tuna - although such fish are not often eaten up by Indians.
A typical food plate should consist of:
• One-half: fruit and non-starchy vegetables
• One-quarter: whole grains
• One-quarter: protein-rich foods like legumes, white fish, yoghurt, cheese
Choose a diet that you will be able to sustain. Quit smoking and keep alcohol intake within prescribed limits. One study showed that smokers may have a 50% greater risk of developing diabetes.
Role of activity and exercise
Inactivity promotes the development of type-2 diabetes. Physical activity plays a significant role in preserving muscle mass during weight loss diets and is crucial for weight maintenance. Physical activity also lower blood glucose and significantly lower insulin. Aim for 30 minutes or more of moderate to vigorous aerobic exercise - such as brisk walking, swimming, biking or running -for a total of at least 150 minutes a week. Adding resistance exercise twice a week like push-ups, sit-ups, squat thrusts and step-ups - helps as does yoga. Choose an exercise you enjoy! During your working hours, increase your activity. Walk around, use stairs, and avoid prolonged sitting, for more than 30 minutes.
With effective management with these measures, it is possible to manage type-2 diabetes for prolonged periods even if you have prediabetes.
(Dr Ambrish Mithal is Chairman, Endocrinology and Diabetes at Max Healthcare, and Advisor, HCL Healthcare)
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