5 Strategies to Prevent Diabetes

Submitted by Amy Sercel MS RD CD

Edited by Marcia Bristow MS RDN CSSD CD

Diabetes is a health problem that has greatly increased over the past 20 years.  More and more people are diagnosed with Type 2 Diabetes each year, and an estimated 25% of people with the disease don’t even know they have it.  Type 2 Diabetes occurs when your blood glucose is consistently higher than it should be, either because your pancreas is not producing enough insulin or your cells aren’t able to respond to insulin’s signals. 

In addition to the increases in Type 2 Diabetes, another 1 in 3 people have prediabetes, or blood glucose higher than normal but not high enough to be diagnosed with diabetes.¹ People with diabetes and prediabetes are at a higher risk for heart disease, stroke, vision loss, and amputations, and they pay almost twice as much in healthcare costs as people without diabetes.¹ The good news is that both prediabetes and Type 2 Diabetes are preventable.  There are several dietary and lifestyle changes you can make today to help reduce your risk for diabetes, keep your blood glucose within a healthy range, and reverse the progression of the disease even if you already have prediabetes or Type 2 Diabetes.

1.  Maintain a healthy body weight. 

People who are overweight and obese are more likely to develop Type 2 Diabetes.  Although the exact relationship between weight gain and diabetes is unclear, researchers believe that excess fat tissue produces signals that cause cells to become insulin-resistant.  At the same time, it's likely that obesity causes the pancreas to produce so much insulin in response to high blood glucose that the pancreas becomes damaged and is eventually not able to produce enough insulin.² Either way, studies have shown that blood glucose levels improve when people who are overweight or obese lose just 7% of their initial weight.³ To find out how much weight you would need to lose to reduce your risk for diabetes, simply multiply your weight in pounds by 0.07.

2. Be physically active.

All adults should get at least 150 minutes of moderate-intensity physical activity every week, or about 30 minutes every day.  During exercise your cells take glucose from your blood to use for energy, leading to an immediate drop in blood glucose and improving blood glucose levels throughout the rest of the day.  One study found that people who engaged in 45 minutes of high-intensity exercise experienced high blood glucose levels about 2 hours per day less than sedentary people.  Even taking a 15-minute walk after a meal can help by causing a short-term drop in blood glucose, but may not lead to the same long-term blood glucose control that vigorous exercise can cause.⁴ It’s important to note that you should check your blood glucose levels before and after exercise if you are already taking diabetes medication because combining that medication with exercise can cause your blood sugar to fall dangerously low. 

3. Choose foods with a low glycemic index.

A food’s glycemic index is an estimate of how that food will impact your blood glucose levels after you eat it.  In general, foods with a high glycemic index are made up of refined carbohydrates and sugar, which are digested and absorbed quickly and do not include much protein, fat or fiber.  Some foods with a high glycemic index include white bread, sugar-sweetened drinks, sweetened breakfast cereals, cookies, and cakes.   

Foods with a low glycemic index tend to be higher in fiber or protein, so they take longer to digest and therefore cause your blood glucose to rise more slowly. Whole grains, fruits, vegetables, nuts, and legumes are all carbohydrate-rich foods that tend to have lower glycemic indexes.  The fiber in whole grains may be especially helpful for reducing the risk of Type 2 Diabetes.³ Protein and fat do not impact blood glucose, and since they slow digestion adding them to a meal will decrease the meal’s overall glycemic index.

4. Eat yogurt.

Although overall dairy intake is not associated with Type 2 Diabetes, people who eat yogurt are less likely to develop the disease.  One study of nearly 195,000 people found that eating one serving of yogurt per day is associated with a 4% lower risk of developing Type 2 Diabetes.  People still saw this benefit regardless of whether the yogurt was plain, flavored, full fat, or low fat.⁵   

One possible reason for this is yogurt’s high magnesium content.  Studies have shown that people who do not eat enough magnesium are at a higher risk for diabetes,³ and increasing magnesium intake by 100 mg per day can decrease that risk by 15%.⁶ Taking magnesium supplements alone has not been shown to help prevent Type 2 Diabetes, so there could be some other benefit to eating whole foods that are naturally high in magnesium.  Instead of relying on supplements, meet your daily need for magnesium with foods like yogurt, as well as whole grains and leafy vegetables, which are also high in fiber.

5. Eat less red meat.

Both processed and unprocessed red meats are associated with the development of Type 2 Diabetes.^3,7 There are lots of possible explanations for this relationship.  Red meat is high in heme-iron, a pro-oxidant that can damage pancreatic cells.  Red meat also tends to contain nitrites, which your body converts into nitrosamines that are toxic to the pancreas.  Eating a lot of red meat is also linked with future weight gain, which could independently lead to Type 2 Diabetes.  Try substituting poultry, fish, beans, or low-fat dairy for one serving of red meat to reduce your risk for Type 2 Diabetes.⁷

Overall, the keys for diabetes prevention are not much different from the recommendations for a healthy lifestyle.  Engaging in regular physical activity, choosing whole grains and fiber-rich fruits and vegetables, limiting sugary foods and drinks, and replacing a few servings of red meat each week with lean protein or yogurt will help you reduce your risk for many other diseases as well as Type 2 Diabetes.

References:

1.         CDC Features - Diabetes Latest. http://www.cdc.gov/Features/diabetesfactsheet/. Accessed January 20, 2017.

2.         Eckel RH, Kahn SE, Ferrannini E, et al. Obesity and Type 2 Diabetes: What Can Be Unified and What Needs to Be Individualized? Diabetes Care. 2011;34(6):1424-1430. doi:10.2337/dc11-0447.

3.         Association AD. 4. Prevention or Delay of Type 2 Diabetes. Diabetes Care. 2016;39(Supplement 1):S36-S38. doi:10.2337/dc16-S007.

4.         Dijk J-W van, Venema M, Mechelen W van, Stehouwer CDA, Hartgens F, Loon LJC van. Effect of Moderate-Intensity Exercise Versus Activities of Daily Living on 24-Hour Blood Glucose Homeostasis in Male Patients With Type 2 Diabetes. Diabetes Care. 2013;36(11):3448-3453. doi:10.2337/dc12-2620.

5.         Chen M, Sun Q, Giovannucci E, et al. Dairy consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. BMC Med. 2014;12:215. doi:10.1186/s12916-014-0215-1.

6.         Office of Dietary Supplements - Magnesium. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/. Accessed January 20, 2017.

7.         Pan A, Sun Q, Bernstein AM, et al. Red meat consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. Am J Clin Nutr. 2011;94(4):1088-1096. doi:10.3945/ajcn.111.018978.

Recipe Review: Spinach & Pearl Barley Risotto

Submitted by Amy Sercel MS RD CD

Edited by Marcia Bristow MS RDN CSSD CD

Prep time: 30 minutes

Cooking time: 15 minutes

Ingredients:

1 Tbsp vegetable oil

2 small red onions, chopped

2 cloves garlic, minced

1 cup pearl barley

3 1/3 cups vegetable stock

1 pint cherry tomatoes, halved

7 oz fresh spinach or 4 cooked beets

2 oz coriander

1 Tbsp lemon juice

1 15-oz can garbanzo beans, drained and rinsed

Instructions:

1.     Add oil, onions, and garlic to a large sauté pan and cook over medium heat until onions have softened.  Add all of the pearl barley and stir around the pan for about a minute, or until the barley starts to become translucent.  Add the stock one ladle-full at a time, stirring until the barley absorbs the stock before adding another, until about 1 ½ cups of stock remain.

2.     Pour the remaining stock into the pan, cover, reduce heat to medium-low, and allow the barley to cook for 15 minutes.  Stir occasionally.

3.     While the barley cooks, put the spinach or cooked beets into a blender or food processor and puree until smooth.  If no blender is available, chop spinach or beets finely.

4.     When the barley is cooked and the liquid has been absorbed, add the puree along with the halved cherry tomatoes, garbanzo beans, lemon zest, and coriander.

5.     Serve warm.

Yield: 6 Servings

Nutrient Facts:

275 calories, 10 g protein, 51 g carbohydrate, 5 g fat, 10 g fiber

92 mg calcium, 633 mg potassium, 584 mg sodium, 4 mg iron, 83 mg magnesium

169 mcg vitamin A, 20 mg vitamin C, 1 mg vitamin E, 162 mcg vitamin K, 145 mcg folate

This risotto was quick, flavorful, and satisfying.  I made a few changes to the original recipe and was very happy with the result.  The original recipe says to roast the tomatoes in the oven while the barley cooks, but I wanted to make the meal a little simpler.  Cutting the tomatoes in half and adding them directly to the risotto allowed them to cook a little and also helped the flavor of the tomatoes blend with the rest of the dish.  This was a great way to still include cooked tomatoes without having to worry about them burning in the oven while I concentrated on the barley.

I also modified the recipe by adding garbanzo beans.  Usually a risotto might be served as a side dish to accompany chicken or fish, but I wanted to make this a one-pot meal.  Using garbanzo beans increased the risotto’s protein and fiber content.  It also added a little depth to the meal’s flavor, and the softer texture of the beans complemented the chewiness of the barley.  These changes ultimately streamlined my cooking process because I didn’t have to turn on my oven or make a side dish to serve as a protein source.

The last modification I made was to chop the spinach by hand and add it earlier in the cooking process since I didn’t have the means to puree it.  This didn’t appear to change the texture or flavor of the dish, but I believe it did change the color.  Cooking the spinach for longer made it come out a duller green, and the color might have been brighter and more interesting if I had pureed the spinach and added it after the barley was cooked instead.  If you plan to serve the dish to children who would be excited by a brightly colored meal, I would recommend adding the spinach at the end so the color stays vibrant.

Although I had never cooked with barley before making this dish, it is definitely going to become a staple in my kitchen.  People have been depending on barley for a long time.  In 1324, the King of England declared an inch to be equal to “three grains of barley, dry and round, placed end to end lengthwise.”¹ Barley is similar to rice because it is a small, hard grain that has to be cooked in water or broth before you can eat it, but whole grain barley (also known as hulled barley) has more protein and fiber than brown rice.  Hulled barley has also been shown to help with blood sugar control because it is high in the soluble fiber beta-glucan.  Unfortunately, pearl barley is not a whole grain.  You could easily substitute hulled barley to get more fiber out of this meal, but you might end up cooking it for 15-20 minutes longer.   In the grocery store, you can find barley either in the bulk section or in the rice aisle.

Overall, this was a wonderful dinner.  It was a great way for me to learn how to cook barley, and I will be enjoying the leftovers for a few days!

Recipe Source: http://www.honestlyhealthyfood.com/blogs/honestly-healthy-food/17968997-spinach-pearl-barley-risotto

References:

1.         Barley – February Grain of the Month | The Whole Grains Council. http://wholegrainscouncil.org/whole-grains-101/easy-ways-enjoy-whole-grains/grain-month-calendar/barley-%E2%80%93-february-grain-month. Accessed January 13, 2017.

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