November is American Diabetes Month and according to The American Diabetes Association, diabetes is one of the leading causes of disability and death in the United States. One in 12 Americans has diabetes (that’s more than 25 million people!) and another 79 million adults in the United States are at high risk of developing type 2 diabetes. People who are at high risk for type 2 diabetes can lower their risk by more than half if they make healthy changes. “Take action now,” says dietitian Hope Warshaw1. “The earlier you act and continue to act, the more likely you are to prevent or delay progression of the disease. Prediabetes and type 2 diabetes are progressive diseases.”
Are you at risk? According to Warshaw, the following are the key risk factors: Age 45 or older, family history of type 2 diabetes (parent or sibling), member of an ethnic group with increased risk: African-American, Hispanic/Latino, Asian American or Pacific Islander, American Indian or Alaska Native, diagnosed with gestational diabetes or given birth to a baby weighing more than nine pounds, diagnosed with high blood pressure, sedentary lifestyle, overweight or obese, smoke cigarettes, snore loudly, brief pauses in breathing during sleep, poor-quality sleep, and/or sleep apnea. You can use the ADA risk test as a self- screening tool.
Want to start making smart choices now? Here are the five lifestyle changes to help you take action.
1. Watch your weight. Lose 5 – 7 % of initial body weight and keep as much of this weight off as possible over time. The common myth is that you need to limit/avoid carbohydrates--this is simply not true, explains Warshaw. “Reality is research shows what’s most important in type 2 diabetes prevention is weight loss or bottom-line reduced calorie intake,” she says. “Research shows that people can achieve weight loss and keep weight off in myriad ways, anywhere along the gamut from eating a vegan intake to eating lower carbohydrate and higher protein. What’s most important is finding a healthy eating plan that one can follow long term and make their new way of eating. This isn’t about what one can follow for two weeks.”2
2. Get and stay physically active regularly. This means nearly every day get about 30 minutes of aerobic physical activity, says Warshaw. Walking may be the easiest and also doing some resistance training (pushing against your own body weight) is also valuable. “Exercise is powerful medicine!” says Warshaw. “Exercise helps the body make better use of the insulin a person continues to make and uses it better. But, exercise alone is not enough. Weight loss is key.”
3. Watch your liquid calories. Find out how much sugar is hiding in your morning cup of coffee or in your afternoon beverage, suggests Bev Carson, a Canadian-based registered dietitian and certified diabetes educator. Become a sugar super sleuth and read the labels or ask for nutritional information. Carson offers a good tidbit to remember: 4 grams of sugar = 1 teaspoon. Some large designer coffees have 270 calories with more than 6 teaspoons of sugar! “You might want to consider opting for plain coffee, herbal teas or water,” she says. “There are even some delicious sparkling waters with natural flavors or add a splash of juice to flavor your own water. Consider some of these options when you’re looking to wet your whistle.”
4. Choose healthier foods. Even without significant weight loss (or any weight loss), Warshaw says just eating more fruits and vegetables, whole grains, legumes and low/no fat dairy foods while cutting back on added sugars, skimming and trimming the fats (particularly saturated fat which seems to promote insulin resistance) are all valuable positive actions.
5. Catch up on sleep. A new study3 finds you can even use “catch up” sleep on the weekends to ensure you get the sleep you need to avoid Type 2 diabetes. Dr. Peter Liu, a researcher at Los Angeles Biomedical Research Institute, recently conducted a study that found men who lose sleep during the work week may be able to lower their risk of developing Type 2 diabetes by getting more hours of sleep. Dr. Liu found that insulin sensitivity, the body’s ability to clear glucose (blood sugar) from the bloodstream, significantly improved after three nights of “catch-up sleep” on the weekend in men with long-term, weekday sleep restrictions.
By Janene Mascarella
1Hope Warshaw is a Washington D.C. based dietitian, diabetes educator and author of best-selling books on diabetes nutrition:
2American Heart Association Journals:
3Los Angeles Bio Medical Research Institute:
Slim-down successfully by setting realistic goals and making your weight-loss journey an enjoyable trip.Read successful slim down
How you sleep, eat, and relax can impact your skin. Learn how to keep it looking youthful.How to keep skin youthful
Yes, you can live to 100! Age healthily by eating well, exercising, and avoiding things that hurt your life expectancy.Read live to 100