STUDENT CONTRIBUTOR: Julianna Bennett | Nutrition & Food, Ryerson University
December 3, 2020
There are many different factors in a person’s life that could contribute to their likelihood of developing type 2 diabetes; weight being one of them. This article will discuss various steps that can be taken to manage weight and prevent or improve symptoms of diabetes. The relationship between weight and diabetes is a controversial one, so an analysis of available research will be highlighted throughout.
Can diabetes be 'reversed' if weight is within the 'ideal range'?
This question is unavoidable when the topic of type two diabetes comes up. Many people still believe it can be reversible, but is that really the case? Truthfully, no, once a person has reached a certain blood glucose level to be diagnosed with diabetes, the diagnosis will remain; therefore, both type 2 diabetes and type 1 cannot be reversed. The symptoms that come with diabetes can however be managed. The management of these symptoms can at times be classified as “reversing” diabetes as the symptoms disappear. Being within a healthy weight range can often help to lower these symptoms.
Many studies have shown a 5-10% loss of body weight to bring about significant positive changes in diabetic symptoms. Insulin sensitivity has been known to improve, allowing the body’s cells to be more responsive when insulin is secreted - leading to the uptake of glucose into the cells. Blood sugar levels have also been shown to be more stable (glycemic control) along with blood pressure readings falling closer to normal levels.
The main effect a high body weight has on diabetes is causing an individual to have excess adipose tissue (fat), particularly around the abdomen. Evidence has shown this fat to contribute towards insulin resistance, via hip to waist ratio testing and positive correlation between those with a higher ratio and increased insulin resistance. Insulin resistance prohibits the body’s cells from being able to take in glucose and use it for energy.
This inability for glucose to be used causes it to remain in the blood stream which brings about many physiological consequences if untreated overtime, such as: retinopathy (can cause poor vision), neuropathy (nerve damage or dysfunction), and vascular disease – affecting the respiratory system. More frequent less serious symptoms include: feeling thirsty, urinating frequently, overwhelming fatigue, headaches and blurred vision.
With less fat cells to contribute towards this insulin resistance, these problems will be less prevalent. Losing excess fat or maintaining and ideal body size can be a challenge within itself, especially when factoring in the complications of diabetes.
What dietary changes can a person with diabetes make to reduce weight?
There are many different weight loss diets out there however not all of them would fall in line with the specific dietary needs of a person with diabetes. Some examples of diets that wouldn’t contrast with diabetes would be a ketogenic diet or a calorie restricted diet. Diets can however be problematic which will be discussed further-on. A great lifestyle change however would be to increase fibre intake which has many physiological advantages.
Fibre
A high fibre diet can be very beneficial when attempting to lose weight. Fibre enhances satiety as it takes longer to digest and has the ability to thicken and can almost be likened to a viscous gel, that sits inside the gut. There are two types of fibre, soluble and insoluble; both have been found to help regulate blood sugar. Insoluble and soluble fibre can increase insulin sensitivity as well as lower the glycemic load of food, meaning insulin spikes will not be as high. Fibre does this by adding bulk to the food, slowing down the digestion of sugars which would be broken down into glucose. For reference here is the fibre content of several common foods:
As is evident, fibre content varies widely, and it can be difficult to know which foods should be included in the diet when looking to increase intake. An easy rule of thumb to go by is, both meat and milk products do not contain fibre, whole wheat/whole grain starches are a better source than white or refined starches and the harder a fruit/vegetable is to chew, likely, the higher it is in fibre. Below is a list of foods that are good sources of fibre.
Fruits Lentils & Legumes
Raspberries Kidney beans
Avocado Split peas
Apples Chickpeas (Garbanzo)
Pears Black beans
Bananas
Vegetables Grains
Broccoli Quinoa
Artichoke Oats
Brussel Sprouts Brown Rice
Carrots Barley
Beets Bulgar
Collard Greens Brown breads
Sweet Potato
Currently the recommended total dietary fibre intake per day is 25 to 30 grams amongst adults. It is important to avoid exceeding this limit as too much fibre can cause negative consequences such as, bloating, cramping and constipation. Since fibre draws water into the digestive tract it is essential to accompany it with plenty of water. Therefore, whenever fibre intake is increased, water intake must be as well. Essentially, weight loss requires an individual to be in a caloric deficit, however this can be achieved without calorie counting and with slight diet changes like including more fibre. The fuller a person is, the less food they will be able to take in. As high fibre foods are generally low in calories themselves, it can be a very effective weight loss technique.
Strategies to Help Manage Weight
There are several weight management strategies that can also help improve the impact of diabetes on the body. Two of the most effective ways include exercising for at least 10 minutes a day for a minimum of 150 mins per week. physical activity and limiting alcohol.
Physical Activity
It is recommended that adults (age 18-64 years old) get at least 150 minutes of aerobic exercise per week. Adding bone and muscle strengthening activity is also beneficial. Some common aerobic exercises could include cycling, jogging, walking, hiking and swimming. Maintaining this level of physical activity can reduce the likelihood of developing diabetes and becoming overweight/obese. Physical activity can help with weight loss by increasing likelihood of falling into a caloric deficit (more calories burned then taken in) and by encouraging muscle growth – boosting the metabolism (muscle cells use more energy, that being the food we consume, at rest). Exercise can also help to manage blood sugar levels by increasing the body’s sensitivity, too, making it especially beneficial for those who have type 1 diabetes.
Alcohol
Alcohol can be problematic when attempting to maintain weight as it in of itself is quite high in calories, those of which are very empty calories entirely lacking nutrients. In order for a person who often consumes high amounts of alcohol to meet their daily nutrient requirements they would likely need to eat enough food to be in a caloric surplus leading to weight gain. Alcohol can also dehydrate the body which is very dangerous for those who are already experiencing high blood sugars (hyperglycemia). It is advised to limit consumption to a maximum of 10 drinks a day for women and 15 for men.
Understanding the Risks
Weight management can have negative consequences when not done correctly. It can lead to the development of eating disorders, weight being regained, hormonal changes, disturbances in women’s menstrual cycle and can also lower a person’s resting energy expenditure. These issues can occur when weight management is done through restrictive dieting, overindulging, weight cycling (constant loss and gain of weight), over exercising and creating unrealistic goals. It is important to focus on making sustainable lifestyle changes for long-term sustained weight loss or maintenance as opposed to looking for quick solutions that will only be beneficial in the short term.
Consult your doctor, diabetes educator and/or Registered Dietitian for support in managing your weight and blood sugars for optimal long-term health.