Health check: beat di­a­betes

CityPress - - News - ZINHLE MAPUMULO zinhle.mapumulo@city­

Some 5 mil­lion peo­ple in South Africa are on the verge of de­vel­op­ing di­a­betes. A fur­ther 2 mil­lion are liv­ing with this chronic dis­ease, which can lead to death if not treated prop­erly. But re­vers­ing this trend is not as hard as you might think. A sim­ple diet such as the 5:2 in­ter­mit­tent fast­ing one can re­verse a di­a­betes prog­no­sis. This diet ad­vo­cates a daily caloric in­take of 2 500 for men and 2 000 for women for five days, and fast­ing for two days (600 calo­ries on th­ese days for men and 500 for women) ev­ery week.

The 5:2 diet has be­come one of the more pop­u­lar plans in re­cent years. Stud­ies have shown it helps with weight loss and re­duces in­sulin re­sis­tance, which are of par­tic­u­lar in­ter­est for peo­ple with type 2 di­a­betes or pre­di­a­betes.

Here’s how it works: Pick two days a week to fast – they do not have to be con­sec­u­tive, but can be. On those days, eat a diet of pro­tein and fi­bre (meat and veg­eta­bles), but a quar­ter of your usual in­take. You can eat one big meal on those days, two smaller ones or a se­ries of snacks through­out the day – whichever one you can stick to. Th­ese days should be al­co­hol-free too.

On the other five days of the week, ban­ish white foods – white sugar, white bread and other re­fined car­bo­hy­drates – and fizzy drinks, in­clud­ing fruit juice. Stick to car­bo­hy­drates that do not spike your sugar: brown rice, veg­eta­bles and bar­ley.

The ba­sic rules are to eat more fi­bre and pro­tein, and fewer re­fined car­bo­hy­drates, while tak­ing a 30-minute brisk walk ev­ery day.

Pro­fes­sor Larry Dis­tiller, man­ag­ing di­rec­tor of the Cen­tre for Di­a­betes and En­docrinol­ogy in Jo­han­nes­burg, said the only way to pre­vent or re­verse di­a­betes was to live a healthy life­style.

“Clin­i­cal stud­ies have shown a per­son can re­duce the risk of di­a­betes by ex­er­cis­ing reg­u­larly and cut­ting out un­healthy eat­ing habits. Any diet – be it 5:2, Atkin­son or bant­ing – can help re­duce the risk of di­a­betes or re­verse the prog­no­sis. Foods that should be cut out are fizzy drinks and other sweet­ened bev­er­ages, as they con­tain re­fined car­bo­hy­drates,” said Dis­tiller.

Karen Hof­man, as­so­ciate pro­fes­sor at Wits Univer­sity, agreed, adding high sugar in­take was the rea­son South Africa was fac­ing a di­a­betes pan­demic.

“Di­a­betes is like a tick­ing time bomb in this coun­try and no­body is tak­ing no­tice of it. If we al­low it to ex­plode, it will have a detri­men­tal im­pact on the health sys­tem,” she said.

Dis­tiller agreed: “South Africa, like the rest of the world, is fac­ing a di­a­betes tsunami and if some­thing is not done now, this coun­try will face the con­se­quences in fu­ture.”

Govern­ment has been on a drive to raise aware­ness about di­a­betes, propos­ing the proper la­belling of sugar con­tent in food items as part of its ef­forts. Hof­man said this was a step in the right di­rec­tion, but “in­di­vid­u­als have to take ini­tia­tive as well. It is all good and fair to say pol­i­cy­mak­ers must ban ad­verts pro­mot­ing the con­sump­tion of sug­ary bev­er­ages and de­mand proper la­belling of sugar con­tent in foods, but it is up to the in­di­vid­ual to choose to lead a healthy life­style,” said Hof­man.

Dis­tiller said: “We are not say­ing you should cut out sugar com­pletely, but re­duce con­sump­tion to ac­cept­able lev­els.

“Also, re­duc­ing sugar alone will not solve the prob­lem. You have to fol­low a healthy, bal­anced diet and ex­er­cise reg­u­larly. By that, we don’t mean in­tense or vig­or­ous ex­er­cise. Rather, 30 min­utes of brisk walk­ing for five days is ben­e­fi­cial and helps main­tain a healthy weight.

“Be­ing over­weight in­creases your risk of di­a­betes, es­pe­cially if you have lots of fat around the stom­ach,” said Dis­tiller.

Belly fat pro­duces hor­mones that dam­age beta cells – which pro­duce and se­crete in­sulin, the hor­mone re­spon­si­ble for reg­u­lat­ing lev­els of glu­cose in the blood. When th­ese cells are dam­aged, their abil­ity to pro­duce enough in­sulin for blood sugar con­trol is af­fected, lead­ing to type 2 di­a­betes. This is the most com­mon type of di­a­betes in South Africa, ac­count­ing for 90% of all di­a­betic cases.

How­ever, many suf­fer­ers go un­di­ag­nosed as pa­tients, as they of­ten do not show symp­toms un­til the later stages of the dis­ease.

Di­a­betes screen­ing, how­ever, is a pain­less and sim­ple, life-sav­ing test.

“If you know you are over­weight and have a fam­ily his­tory of di­a­betes, you should be tested at least once a year,” said Dis­tiller. “If tests show you are pre­di­a­betic, you can re­duce your chances of be­ing di­a­betic by at least 50% by lead­ing a healthy life­style.”

Dis­tiller said that while he would not rec­om­mend any par­tic­u­lar diet, he ad­vised pa­tients to go on a good diet to re­verse pre­di­a­betic symp­toms or cure the ill­ness. “As long as the diet is healthy and within the rec­om­mended daily in­take of calo­ries, fol­low it,” said Dis­tiller.

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