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How Can Dietary Factors Mitigate Type 2 Diabetes Risk Factors?

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How Can Dietary Factors Mitigate Type 2 Diabetes Risk Factors?

— By Dawn Sweet, Ph.D.

Transitioning to a balanced diet that includes nutrient dense foods can mitigate type 2 diabetes risk factors.

While there is a genetic component to type 2 diabetes, there are lifestyle factors such as a suboptimal diet that can elevate one’s risk for developing or exacerbating type 2 diabetes. A suboptimal diet — a diet that is primarily comprised processed foods, refined sugars, unhealthy fats, and simple carbohydrates in excess — can lead to insulin resistance, unwanted weight gain, and elevated blood glucose levels, each of which can increase one’s chances of developing type 2 diabetes. By transitioning to a nutrient-dense diet — a diet that is comprised of lean proteins, fruits, vegetables, whole grains, and healthy fats — patients with (or without) obesity can reduce their chances of experiencing the negative health consequences associated with type 2 diabetes.

Dietary Factors: A Suboptimal Diet is Attributable to Type 2 Diabetes

There is a robust etiologic effect on incident type 2 diabetes relative to dietary factors.1 For example, direct effects include changes in blood glucose levels, insulin resistance, hepatic steatosis, and inflammation. Type 2 diabetes is also mediated through weight gain and BMI.2

Using data from the Global Dietary Database (GDD), NCD Risk Factor Collaboration (NCD-Ris-C), the Global Burden of Disease demographics from the United Nations, and population demographics from the United Nations, a recent study developed a comparative risk assessment model to estimate the impact of 11 dietary factors. 1 The data modeling estimates that that seven in 10 (70.3 percent (95 percent UI: 68.8-71.8 percent) or roughly 14.1 million (95 percent UI: 13.8-14.4 million) new type 2 diabetes cases across the globe are attributable to a suboptimal diet.1

The suboptimal diet was measured in terms of insufficiencies or excesses of the following food:

 

Insufficient Intake Excess Intake
Whole grains Refined grains
Yogurt Processed meats
Fruit Unprocessed red meat
Nuts and seeds SSBs (Sugar Sweetened Beverages)
Non-starchy vegetables Potatoes
Fruit juices

 

According to the 2023 study1, the 2018 global mean of these 11 factors, which was estimated by the GDD, were suboptimal:

 

Dietary Factor Observed Means

(measured in grams per day)

Optimal

(measured in grams per day)

Insufficient Intake
Whole grains 50.1 g 90.0 g
Yogurt 21.2 g 87.1 g
Fruit 87.9 g 300 g
Nuts and seeds 8.6 g 20.3 g
Non-starchy vegetables 209.8 g 300 g
Excess Intake
Refined grains 302.9 g 0.0 g
Processed meats 16.8 g 0.0 g
Unprocessed red meat 56.5 g 14.3 g
SSBs (Sugar Sweetened Beverages) 95.6 g 0.0 g
Potatoes 47.8 g 0.0 g
Fruit juices 151.1 g 0.0 g

 

Excesses in the consumption of refined rice and wheat, processed meats, unprocessed red meat, SSBs, potatoes, and fruit juices accounted for 60.8 percent of the diabetes burden compared to insufficient intake of whole grains, yogurt, fruits, non-starchy vegetables, and nuts and seeds, which accounted for 39.2 percent. Poor carbohydrate quality was implicated as the primary driver of type 2 diabetes cases attributed to diet. Given that seven in 10 global cases of type 2 diabetes can be attributed to dietary factors, the role of diet cannot be understated as a risk factor of developing type 2 diabetes.

Preventing Diabetes through Lifestyle Changes

Lifestyle changes such as consuming a nutrient-dense diet can mitigate one’s risk of developing type 2 diabetes and can promote weight loss. Working with patients to ensure they are meeting daily recommended allowances for nutrient-rich foods3:

 

Food Group Adults 19 – 59 Adults aged 60 and older
Vegetables (dark green vegetables, orange and red vegetables, beans, peas, lentils) 2 – 4 cups per week 2 – 3.5 cups per week
Fruits 1.5 – 2.5 cups per day 1.5 – 2 cups per day
Grains (e.g., whole grains, refined grains) 5 – 10 ounces per day 5 – 9 ounces per day
Dairy 3 cups per day 3 cups per day
Protein (e.g., lean meat, poultry) 23 – 33 ounces per week 23 – 31 ounces per week
Seafood 8 – 10 ounces per week 8 – 10 ounces per week
Nuts, seeds, soy products 4 – 6 ounces per week 4 – 5 ounces per week

 

Supporting a nutrient-rich diet with nutritionally designed meal replacements can help patients meet their RDA for vitamins and minerals. Nutritionally formulated meal replacements are a prepared liquid (for example, pudding shakes or drinks) or discrete foods (for example, protein bars) that are used in place of one or two daily meals. Although several meal replacements exist, nutritionally-formulated meal replacements are designed to deliver nutritional benefits to patients with obesity, providing them with the vitamins and minerals needed as part of a healthy diet.4 Nutritionally designed meal replacements can provide 15-25 grams of protein, three to six grams of dietary fiber, vitamins, and minerals to ensure daily nutritional needs are being met and weight loss is happening at a healthy, sustainable pace.

Implications for Clinical Practice: Developing a Healthy Eating Plan

Dietary factors can lead to type 2 diabetes. Consequently, it is important to work with patients to develop a sustainable healthy eating plan, particularly for your patients with obesity who have not yet developed type 2 diabetes. To ensure nutritional needs are being met, pre-packaged, nutritionally formulated meal replacement offer convenience and satisfy daily recommendations for vitamins and minerals. A Low Calorie Diet (LCD) or Very Low Calorie Diet (VLCD) should also be considered as part of an overall healthy eating plan.

Sources:

1 Incident type 2 diabetes attributable to suboptimal diet in 184 countries

2 IDF Diabetes Atlas

3 U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020

4 A systematic review and meta‐analysis of the effectiveness of meal replacements for weight loss

About the Author: Dr. Dawn M. Sweet has over 20 years of experience in the field of communication. Dr. Sweet has given several invited talks to and workshops for academic and private sector audiences on the role of nonverbal and verbal communication in achieving positive outcomes and mitigating bias. Her research has been published in several top ranked peer-review journals, and it has been featured on NPR’s River to River / All Things Considered, Buzzfeed, and Science Daily. Her research has also been used to inform expert testimony.

About Robard: For 45 years, Robard Corporation’s medical obesity treatment programs and nutrition products have been utilized by physicians, surgeons and hospitals across the United States to successfully treat patients living with obesity. To learn more about us and how we can help your practice and patients, visit us online at www.Robard.com, email us at info@robard.com, or call (800) 222-9201.

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