The Vegan Guide to Omega-3s

From vegnews.com

Find out how much omega-3s you need to thrive, the best plant-based sources, and why you should avoid fish as a source of the essential fatty acid

Whether it’s from an ad on television or your doctor, you’ve likely heard that omega-3 fatty acids provide many health benefits. According to the National Institutes of Health (NIH), these essential nutrients provide your body with energy, prevent vision loss, support brain health, improve cognitive function, and protect your heart by reducing your risk of cardiovascular disease. However, not getting enough (or too much) omega-3s can have consequences for your health. So, what’s a vegan to do when the most common dietary sources of omega-3s are fish and other seafood, and the vast majority of omega-3 supplements are derived from fish oil? Read on. It is possible to obtain enough omega-3 fatty acids on a vegan diet, but first, you need to understand how much you actually need. Here is how to optimize your omega-3 intake and live your best vegan life.

What are omega-3s?

Omega-3s are essential fatty acids, meaning you need to acquire them through food as your body cannot produce them on its own. Omega-3 fatty acids are vital components of the membranes surrounding every cell in your body. They’re also anti-inflammatory and help support communication between cells.

The three types of omega-3s are alpha-linolenic acid (ALA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA). ALA is the plant-based omega-3, most commonly found in walnuts, chia seeds, flax seeds, hemp seeds, Brussels sprouts, kidney beans, and other whole plant foods. DHA and EPA are found in marine foods such as algae, seaweed, fish, and other seafood.

Each of the omega-3 fatty acids is necessary for staying healthy, but DHA and EPA are of particular importance. A 2012 article published in Advances in Nutrition reports that DHA and EPA are critical for heart health, brain health, cognitive function, and foetal development. The marine omega-3s have also been found to help reduce heart disease risk, prevent macular degeneration (vision loss), and help treat Alzheimer’s disease. Interestingly, our bodies can convert ALA into DHA and EPA. However, this process is ineffective and the conversion rate varies based on the individual. Generally, our bodies cannot convert sufficient amounts of ALA into DHA and EPA; therefore, we need to seek out these two variations through food or supplements.

“Omega-3 fatty acids are essential fats that we must get from food because we don’t produce them in our bodies. Omega-3s are long-chain polyunsaturated fats (PUFAs) typically associated with fish/fish oils, but that’s because of marketing,” Dr. Dana Ellis Hunnes, PhD, MPH, RD, senior dietitian at the UCLA Medical Center and author of Recipe for Survival, tells VegNews.

“We can get all the omega-3s we need from plant-based sources,” says Dr. Dana Ellis. 

The problem with getting omega-3s from fish

Foods such as sardines, salmon, mackerel, and fish oil supplements have long been touted as the ideal sources of omega-3s. However, you may be surprised to learn this is not the case. DHA and EPA aren’t produced by fish but by algae. Fish are high in omega-3s because algae is a significant part of their diets. Algae are plant-based sources of DHA and EPA that are safe for everyone to consume, including vegans and vegetarians.

Besides the ethical and environmental implications of eating fish and using them to produce fish oil supplements, fish are high in mercury—a naturally occurring heavy metal that’s highly toxic and accumulates in the bodies of fish. When you eat fish high in mercury, that mercury can build up in your blood over time and negatively impact your health. In addition, many fish eat microplastics that have chemical residues in them. These microplastics can attach to fatty acids, such as omega-3s. Furthermore, current overfishing practices are a growing environmental and sustainability issue.

“There are a lot of toxins in our environment and many of them often end up in the ocean. For example, eight million metric tons of plastics end up in the ocean each year, and plankton eat them, bigger fish eat them, and so on,” Dr. Ellis Hunnes explains. “These plastics/chemicals get stored in fish fat. In addition, mercury is another toxin in the environment and in larger fish (tuna and sharks). So getting omega-3s from plant-based sources essentially eliminates this risk.”

How much omega-3 do you need?

So what can you do to get adequate amounts of DHA and EPA if you don’t consume fish or their oil? Cut out the middleman. Vegans can supplement their omega-3 intake with plant-based algae oil. Research shows that eating seaweed or taking an algae oil supplement boosts DHA levels more effectively than eating foods rich in ALA.

However, Dr. Ellis Hunnes says supplementing isn’t necessary—if you know what to eat.

“If people eat enough omega-3s from plant sources such as walnuts, chia seeds, flax seeds, and their oils, there’s no need to supplement omega-3. Moreover, a lot of literature suggests a whole food plant-based diet is far healthier and better for you than an unhealthy standard American diet supplemented with omega-3,” explains Dr. Dana Ellis.

Currently, the recommended daily intake (RDA) for ALA is 1.6 grams for men and 1.1 grams for women. As for DHA and EPA, there’s no official RDA. However, most experts and health organizations agree that 250 to 500 milligrams of combined DHA and EPA is adequate for most adults. According to the NIH, the symptoms of an omega-3 deficiency often appear on the skin as rough, scaly patches or a red, swollen, itchy rash. Conversely, if you overdo it and consume too much omega-3, you could experience some unwanted side effects, such as elevated blood sugar, increased risk of bleeding, low blood pressure, diarrhoea, acid reflux, stroke, and insomnia, according to the experts at Healthline.

The bottom line on omega-3s

At the end of the day, don’t stress over your omega-3 intake. Vegans, vegetarians, and omnivores can get enough omega-3 fatty acids through plant sources such as walnuts, brussels sprouts, seeds, seaweed, and algae. It’s a wise decision to take a plant-based algae oil supplement as an insurance policy to ensure you get enough DHA and EPA to protect your heart and brain health. Be cautious and speak with your healthcare provider before taking any new supplements.

https://vegnews.com/2022/9/vegan-guide-omega-3-products

 

Can People with Diabetes Consume Sugar?

From eatingwell.com

You might assume the answer to that question is no, but what experts say should be a sweet surprise 

Sugar is often considered a four-letter word when it comes to diabetes prevention and management. That, of course, makes sense, given that elevated blood sugar is the main marker for diabetes.

Yet what about the sugar that you eat? While many people believe that it causes diabetes, others think they need to eschew sugar from their diets completely. Fortunately, neither is true, and if you have diabetes, the good news is that you can fit a little sugar in your diet. Here's how to do it safely.

How sugar impacts diabetes

As a reminder, there are two types of diabetes—type 1 and type 2—and while type 1 means your pancreas can't produce insulin, type 2 is where your body simply doesn't produce enough insulin. "Not only that, but the amount of insulin your body does produce doesn't always work as it should to help bring sugar, or glucose, into your cells to reduce overall blood sugar, something often called insulin resistance," says Christa Brown, M.S., RD, LDN, a registered dietitian in Woodbridge, New Jersey.

Numerous factors play into the development of type 2 diabetes, including age, family history and other medical conditions like high blood pressure and low HDL (aka bad) cholesterol, but the sugar in your diet isn't one of them. "Eating too much added sugar doesn't directly cause diabetes," says Lauren Harris-Pincus, M.S., RDN, a registered dietitian in Green Brook, New Jersey who's the founder of NutritionStarringYou.com and author of the Everything Easy Pre-Diabetes Cookbook.

Yet added sugar can contribute to issues that lead to diabetes. Take weight gain, for instance. "Extra weight can play a role in the development of insulin resistance and ultimately lead to a diabetes diagnosis," Harris-Pincus says.

It's important to note, though, that Harris-Pincus is referring to added sugar. There are also naturally occurring sugars like those in fruits, vegetables and plain yogurt, but the difference is that these are nutrient-dense foods, meaning that they provide a significant amount of nutrition for the amount of calories they contain. Plus, fruits and vegetables contain fibre, which helps delay the absorption of carbohydrates and temper any rise in blood pressure, she says.

Added sugar, on the other hand, is the problematic type. "Added sugar, which is added during the manufacturing process or at home, contributes calories without beneficial nutrients," Harris-Pincus says. Examples of added sugar include granulated sugar, honey, brown sugar, maple syrup, agave, coconut sugar and sucrose, to name a few. You can find these in everything from cakes and ice cream to breakfast cereal bars, yogurts, coffee drinks and soda.

Why people with diabetes think they can't eat sugar

Whenever you eat carbohydrates, your body breaks them down into their simple forms of sugar (glucose, fructose and galactose), which is why carbohydrate-rich foods are considered sources of sugar. As a result, your blood sugar level will naturally rise, especially if you're eating these foods by themselves. "Because carbohydrates are the easiest macronutrient to digest (compared to protein and fat), your blood sugar will rise within 15 to 20 minutes of eating that food," says Brown, stressing, though, that sugar and carbohydrates should not be considered "bad."

Although this is a normal response to eating carbohydrates, people who want to prevent or manage diabetes often assume they can't eat these foods and try to lop them out of their diet. It doesn't help that this philosophy is embedded in the diet culture, as certain diets like the keto diet advocate for eliminating all carbohydrate-containing foods.

The problem? By eliminating carb-containing foods like fruits, starchy vegetables, beans and whole grains, you're removing important food groups that your body needs. Not only do they contain valuable nutrients, but also the glucose from carbohydrates provides fuel for your body and brain.

So, can people with diabetes eat added sugar?

The good news is that even if you have diabetes, you can enjoy small amounts of higher-added-sugar foods like cakes, cookies and ice cream. "It's rare to find a person who can't tolerate any sugary foods once in a while," Harris-Pincus says. This applies whether you have type 1 or type 2 diabetes, although note that if you have type 1 diabetes, you'll fare better consuming sugar if you're appropriately dosing insulin in response to your carbohydrate intake, she adds.

The one caveat? Individuals who have chronically high blood sugar values of 300 mg/dL or more. "In that case, I would advise against eating sugary foods and drinks," Brown says

This doesn't mean, though, that you have carte blanche to eat sweets in excess, as you still need to be mindful and enjoy them in moderation. For starters, plan accordingly for when you'll be having higher-added-sugar foods. If you know you're going to have a sugary treat in the day, eat a smaller-than-normal portion of carbohydrate-containing foods and a larger amount of non-starchy vegetables, like dark leafy greens, asparagus and zucchini, for dinner. "The non-starchy vegetables are full of fibre that helps slow digestion and ultimately reduces a blood sugar spike, allowing room for a small slice of cake, a little bowl of ice cream or two cookies for a dessert," Brown says. 

Plate your meals so that they contain a balance of protein, carbohydrates, healthy fats and fibre. "Eating a high-sugar food with protein, fibre and fat will help slow the absorption of that sugar," Harris-Pincus says.  

How much added sugar you can eat will then depend on how your body responds to the higher-sugar foods. That's why it's important to monitor your blood sugar. If you're not used to regularly checking your blood sugar levels or foods, keep track of the foods and drinks you eat for two to three consecutive days, including a weekend day, noting how much you've eaten, what your blood sugar readings are and what time you're recording this information, Brown says. Include your medication, too. Each day, track your blood sugar once upon waking (from a fasted state) and two hours after any meal.  

Also, don't get duped into thinking that all foods labelled "sugar-free" or "no added sugar" are carbohydrate-free. "Sugar-free foods, snack foods and desserts are tricky because they can still have a decent amount of carbs even if there is no added sugar," Harris-Pincus says. "You often see net carbs used as a marketing tool for these processed foods, but it's not a recognized term by the American Diabetes Association or the FDA because sugar alcohols and fibres are absorbed differently and may affect blood sugar in different ways." She recommends using these foods sparingly and chatting with a dietitian about how to track them in your diet.

And a quick note about non-nutritive sweeteners, both artificial (think sucralose and aspartame) and naturally derived, like stevia, monk fruit, allulose and erythritol: "Not only do they not count as sugar in the diet, they don't increase your blood sugar," Harris-Pincus says. Yet because they are so sweet, use as little as possible, knowing that a diet soda or a sugar-free snack is OK as long as you eat them only occasionally, she adds.  

The bottom line

In the end, know that added sugar isn't necessarily healthy for anybody, even if you don't have diabetes, which is why the Dietary Guidelines for Americans recommends that you limit your intake to no more than 10% of your total daily calories.  One way to help keep the percentage down? Follow Brown's lead by checking the nutrition label and choosing foods that have less than 5% of added sugar per serving in the Daily Value column, or as close to 0 grams as possible.

https://www.eatingwell.com/article/7998171/can-people-with-diabetes-consume-sugar/

Weight Loss Can Help You Prevent Diabetes Complications

From diatribe.org

If you have type 2 diabetes, reaching and maintaining a healthy weight is crucial for managing your blood sugar and preventing complications.  Find out about the connection between diabetes and excess weight, and which methods you can use for weight management

Though researchers do not fully understand the link between obesity and type 2 diabetes, it is clear that the two conditions are closely linked. According to a study conducted in the United Kingdom, about 90% of people with type 2 diabetes have excess weight or obesity. Also, both conditions are metabolic disorders caused by many different genetic, environmental, and behavioural factors. However, not everyone with diabetes has obesity, and vice versa.

In recent years, researchers have looked at the effect of fat build-up around the liver and pancreas as a potential link between obesity and type 2 diabetes. Fat build-up around the liver and pancreas is known to be associated with insulin resistance – the main characteristic of type 2 diabetes where the body gradually becomes less sensitive to insulin, coupled with reduced insulin production from the pancreas. When the body cannot make enough insulin to overcome this resistance, glucose levels in the blood rise. Over time, these high glucose levels can lead to complications like heart disease, stroke, chronic kidney disease, vision loss, and nerve damage.

Many believe that reducing fat around the liver and pancreas through weight loss helps decrease insulin resistance and restore normal insulin production. A research study called “DiRECT”, published in 2018, was the first trial to demonstrate the effects of weight loss alone on the potential to achieve type 2 diabetes remission. In the DiRECT trial, type 2 diabetes remission was defined as maintaining an A1C below 6.5% for at least two months without taking any glucose-lowering medications. Investigators recruited individuals aged 20–65 years who had been diagnosed with type 2 diabetes within the past six years, had a body-mass index (BMI) of 27–45 kg/m2, and were not receiving insulin. 

Though remission may not be possible for all people with type 2 diabetes, this study found that among participants who lost 15 kilograms (33 lbs) or more, a staggering 86% achieved diabetes remission by the end of the 12-month study. This occurred regardless of the participant’s weight at the start of the trial; the percentage of people achieving remission increased with the amount of weight lost. Additionally, a follow-up study showed that people who saw a return of their diabetes symptoms had a significant rise in fat around the liver and pancreas. The rise in liver and pancreas fat was not seen in people who maintained remission.

This study demonstrated that losing weight significantly improved the chance of achieving diabetes remission, lowering A1C, and, in turn, reducing the risk for complications in the people with type 2 diabetes who were eligible for the study.

Weight Loss Treatments for People with Diabetes

Even small amounts of sustained weight loss (5-10% of body weight) can have a huge effect on A1C and Time in Range and reduce the risk for complications.  While weight loss can be extremely challenging, some medications, technology, procedures, and lifestyle changes can make the goal more attainable.

Weight Loss Medications

Two similar classes of glucose-lowering medications, GLP-1 receptor agonists and dual GLP-1/GIP receptor agonists, have been shown to help people with diabetes manage their weight as well as lower their A1C.  

GLP-1 receptor agonists help people cut down on calories by slowing the emptying of the stomach, which increases the feeling of fullness. Some GLP-1s have also been shown to lower the risk of heart disease. GLP-1 drugs approved for weight loss include Saxenda (liraglutide) and Wegovy (semaglutide). In a clinical trial for Wegovy, over 83% of people taking the drug (coupled with exercise and dietary changes) lost at least 5% of their body weight. Only 31% of people achieved this level of weight loss with exercise and diet alone.

Earlier in 2022, the FDA approved Mounjaro (tirzepatide) as a glucose-lowering drug for people with type 2 diabetes. Mounjaro is a dual GIP/GLP-1 receptor agonist or dual agonist, which affects two different, but related biological pathways, as opposed to just one. Though the drug has not been approved exclusively for weight loss, results of clinical trials have been outstanding. The most recent trial data showed that people taking the highest dose of tirzepatide lost an average of 22.5% of their body weight. Over 63% of people on this dose lost at least 20% of their body weight.

Bariatric surgery

Studies have shown that bariatric surgery can help people achieve long-term weight loss, improve glucose levels, and reduce the risk for heart disease and other complications that affect the eyes, kidneys, and nerves. Bariatric surgery works by altering the digestive system so that food bypasses part of the intestines. Some surgeries also work by reducing the size of the stomach. 

However, bariatric surgery is not for everyone. To learn more about the procedures, read: Bariatric Surgery – Is it the Right Option for You?

Lifestyle Changes for Weight Loss

Changes to diet and exercise can help people improve glucose management and even achieve remission. Though weight loss through diet and exercise alone can be a very difficult task, it is possible. Some strategies include developing a nutrition plan, setting small and incremental weight loss goals, and finding exercises that are enjoyable. 

Talk to your healthcare provider to establish a diet and exercise routine that works best for you, and check to see if you may benefit from one of the weight loss medications. Additionally, you can locate a nutrition expert near you with this resource. For more information about weight-loss strategies, read:

• How to Lose Weight and Keep it Off

• Weight Loss, Keeping Lost Pounds Off – Is there a Recipe for Success

https://diatribe.org/weight-loss-can-help-you-prevent-diabetes-complications

Diabetes: Foods and beverages to avoid if you have high blood sugar

From timesnownews.com

While medications are important to control the rising level, diet and lifestyle too play a crucial role in curbing high blood sugar levels. Therefore, it is a necessity that you keep a check on what you are eating or drinking so that it does not lead to sugar spikes

New Delhi: Diabetes is a health condition wherein the blood sugar level rises. This could be due to less insulin production in the body or the body resisting insulin. Diabetes could be autoimmune, which is also known as Type 1 diabetes, whereas Type 2 diabetes is a chronic health condition. If your blood sugar level isn’t controlled, it can cause damage to the nerves, kidneys and several other organs.

While medications are important to control the rising level, diet and lifestyle too play a crucial role in curbing high blood sugar levels. Therefore, it is a necessity that you keep a check on what you are eating or drinking so that it does not lead to sugar spikes. Take a look at the different foods and beverages that you must avoid if you have diabetes.

1. White bread and pasta: These are foods that are high in carbs and low in fibres. The fibres present in the food help to slow down the absorption of sugar which can stop the rise of sugar levels.
2. Flavoured yoghurt: Flavoured yoghurts have high amounts of sugar present in them which makes it an unhealthy choice for people who suffer from diabetes. Instead, you could choose unflavoured yoghurts or the homemade ones.
3. Flavoured coffee: Coffee might have several health benefits but flavoured coffee beverages are a no-no for people suffering from diabetes. They have added sugar and also the carb content of these beverages is high.
4. Packaged snacks: These snacks are low in nutrients, and they also have fats which can be digested fast leading to sugar spikes.
5. Fruit juice: This is a big no for people with diabetes. These beverages can lead to a rise in the blood sugar levels due to the presence of added sugar in them. Moreover, the fructose present in them makes the condition worse.

Disclaimer: Tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice. Always consult your doctor or a dietician before starting any fitness programme or making any changes to your diet.

https://www.timesnownews.com/health/diabetes-foods-and-beverages-to-avoid-if-you-have-high-blood-sugar-article-93995496

 

Mindfulness and meditation can improve overall health for people with diabetes

From healio.com

BALTIMORE — Practicing meditation and mindfulness can reduce diabetes distress and improve diet, HbA1c, sleep and overall quality of life for people with diabetes, according to two speakers.

During a presentation at the Association of Diabetes Care & Education Specialists annual meeting, Peter Friedfeld and Brooke Cassoff, CHWC, co-founders and facilitators at Diabetes Sangha, an online group dedicated to meditation and mindfulness practices for people with diabetes, described how the practices can be incorporated into diabetes self-management and how diabetes care and education specialists can teach the principles to people with diabetes.

“Mindfulness really involves simply observing our experiences from moment to moment, whatever they may be, and observing those experiences with a sense of care and non-judgement and being attentive to them as they change and flow over time,” Cassoff said. “Mindfulness can also take many different forms. Mindfulness is not simply about sitting still. Mindfulness can be done through movement, through walking, there are many different styles of mindfulness that can be tried.”

Benefits of mindfulness

There are several ways mindfulness practice can help people with diabetes overcome challenges. Importantly, the practice allows people with diabetes to accept the present state of their lives.

Peter Friedfeld

“So much of our lives is about how we can’t eat this or can’t do this at the moment because we have a low blood sugar,” Friedfeld said. “Mindfulness practice works by allowing us to accept the present moment as it is.”

Mindfulness can also help people with diabetes to better understand the root of stress, anxiety and depression; observe their own experience without judgement; let go of impossible expectations; cultivate non-reactivity when facing emotional volatility with diabetes self-management; and connect with others when experiencing social stigma or isolation.

“Mindfulness really helps us be connected with our sense of common humanity; knowing that, just like me, every human being experiences difficulties, stress, ups and downs,” Cassoff said. “And just like me, each human being longs to be happy, healthy and safe.”

Several studies show that meditation is associated with reduced diabetes distress, anxiety and depression; improved eating patterns; a stronger feeling of being “in touch with one’s sensations;” improved social connections; lower HbA1c; better sleep; improved quality of life; and improved psychological well-being in people with diabetes. Cassoff noted two ways that particularly affect people with diabetes in which meditation positively affects the brain.

Brooke Cassoff

“We know based on research that consistent meditation leads to structural changes in the brain, in particular it leads to increased neuroplasticity,” Cassoff said. “For many years, it was believed that the human brain ceases to change or develop at a certain age. What we know today is that, actually, our brains are constantly learning and constantly rewiring to create new neuro connections and pathways based on the experiences that we have.”

Cassoff said meditation can help orient one’s brain in ways that allow a person with diabetes to accept the present and be more self-supportive. Additionally, Cassoff said, meditation has been associated with decreased size and activity of the amygdala, which can improve regulation of emotional responses.

By adopting meditation, Friedfeld said, people with diabetes can establish a sense of safety, learn acceptance, stay calm during stressful situations, develop physical and emotional resilience, work through difficult times, address pain in healthy ways and treat themselves and others with compassion and kindness.

Incorporating mindfulness into practice

There are several ways people with diabetes can practice mindfulness, including performing breathwork and practicing compassion, kindness and gratitude throughout the day. Mindfulness can also be incorporated into activities such as eating, walking, yoga and other movement practices.

Friedfeld said diabetes care and education specialists can take several steps to incorporate meditation into their own practice.

“Consider explaining these concepts to those whom you are working with, your patients and those you can for,” Friedfeld said. “Explain how this is available to them. Also connect to online resources. We are so fortunate to have a wealth of resources we can use to understand these practices and get engaged with them. Share these specifics practices with people with diabetes.”

Friedfeld said diabetes care and education specialists can also join a community-based meditation group and pursue a certification for meditation facilitation.

https://www.healio.com/news/endocrinology/20220901/mindfulness-and-meditation-can-improve-overall-health-for-people-with-diabetes

Diabetes: Warning signs that your blood sugar is out of control

From hindustantimes.com

Sudden weight loss, exhaustion, slow healing and frequent pains are all signs that your blood sugar levels are high

Uncontrolled blood sugar levels over a period of time can lead to many potentially life-threatening complications. People who have diabetes even with their best efforts will have episodes when their blood sugar levels will go haywire, but with regular monitoring, medicines and proper diet, exercise, one can bring sugar levels in control most of the times. When your blood sugars are high your body is likely to warn you with a series of symptoms. If you feel tired constantly even after resting, your mood experiences change, your wounds take more time to heal than before, your vision starts feeling blurry or you experience frequent aches or pains, it may indicate that you need better diabetes management plan. 

When your blood sugars are high your body is likely to warn you with a series of symptoms (Shutterstock)

Eating low GI foods, staying active, regular exercise and monitoring blood sugar levels generally do the trick but one should approach their doctor if things are not in control.

Karishma Shah, Nutritionist and Wellness expert in her recent Instagram post lists out high blood sugar signs that one should not ignore.

Weight loss even after normal diet

If a person suffering from diabetes loses weight even after having normal diet, this means the sugar levels are out of control as a lot of calories are lost in the urine.

Tired even after rest

When the level of glucose increases, its absorption by the body becomes difficult. It leads to extreme fatigue even after having good sleep or rest.

Slow healing of cuts, sores and infections

White blood cells which eliminate infection depend entirely on glucose because if the latter is higher there is slow response from them as well. This results in slow healing of blood gums, small cuts, sores and infections.

Your vision blurs

When the sugar level shoots up, the lens of the eye either shrinks or swells up causing blurry vision due to creation of little spots known as floaters.

Frequent pains

Other crucial symptoms of high glucose levels are frequent pain in shoulders, fainting, shortness of breath and discomfort in the chest, arms or jaw.

https://www.hindustantimes.com/lifestyle/health/diabetes-warning-signs-that-your-blood-sugar-is-out-of-control-101662118773707.html

 

People Who Accumulate More Steps per Day Have Lower Risk of Type 2 Diabetes

From ajmc.com

A population-based cohort study of Hispanic Americans found that people who walked more per day had a lower risk of being diagnosed with type 2 diabetes.

Type 2 diabetes affects nearly 10% of the United States population, with more than 26 million adults having a T2D diagnosis and another 91.8 million (37.6%) who have prediabetes. Because of the morbidity and mortality associated with diabetes, prevention through physical activity has been recommended by the American Diabetes Association, as prevalence of diabetes is projected to double by 2030.

A study published in the International Journal of Behavioral Nutrition and Physical Activity found that there may be an association between increased daily walking and a lower risk of diabetes. The aim of the study was to determine if the number of steps taken by someone each day could affect their risk of diabetes.

The Hispanic Community Health Study/Study of Latinos, which was the source of data about the study cohort, collected data on Hispanic/Latino adults aged 18 to 74 years who were recruited between 2008 and 2011 from the Bronx, New York; Chicago, Illinois; Miami, Florida; and San Diego, California. All participants wore an accelerometer during waking hours for 1 week, only removing it for sleeping, showering, and swimming. Adherence was defined as at least 3 days of 10 hours of wear.

Participants were excluded if they had diabetes at baseline, did not wear the accelerometer at visit 1, were not adherent, experienced an accelerometer malfunction, or were missing any covariates in the analysis. The top and bottom 1% were also removed to remove extreme outliers.

There were 6634 adults who were included in the study. The mean age of the participants was 39 years, half of them were women, 76% were born outside of the United States, and 41% had prediabetes at baseline. The mean wear time of the accelerometer was 15.9 hours per day (95% CI, 15.7-16.0) and adults had a mean of 8164 steps per day (SE = 92; median = 7317).

In a follow-up period of a median of 5.9 (range, 1-9.6) years, there were 1115 (12.5%) and 740 (8.2%) incident events of diabetes, with incidence rates and HRs generally lower with greater steps per day. The risk of diabetes based on 3 criteria was 2% lower (HR, 0.98; 95% CI, 0.95-1.00) per 1000 steps per day.

The predicted risk of diabetes was 8% (HR, 0.98; 95% CI, 0.85-1.01) and 13% (HR, 0.87; 95% CI, 0.74-1.02) lower at 7000 and 10,000 steps per day, respectively, compared with 3400 steps per day. Analyses also found that the risk of diabetes at 10,000 to 12,500 steps per day was 18% lower (HR, 0.82; 95% CI, 0.57-1.18) compared with those who had fewer than 5000 steps per day.

Although adults with obesity had a higher incidence rate of diabetes, those with obesity who had 10,000 steps per day had 0.81 (95% CI, 0.65-1.01) times the risk of diabetes compared with those who had 3400 steps per day (HR, 1.01; 95% CI, 0.81-1.27).

Adults who had 10,000 steps per day and were 50 years and older had 0.69 (95% CI, 0.52-0.90) times the risk of diabetes compared with those who had 3400 steps per day. The HR of diabetes was 0.67 (95% CI, 0.49-0.92) in women taking 10,000 steps per day compared with women who had 3400 steps a day. There was a weaker inverse association in men.

Adults with prediabetes who had 10,000 steps per day had a 26% (HR, 0.74; 95% CI, 0.58-0.95) lower risk of diabetes compared with adults with prediabetes who had 3400 steps per day.

There were some limitations to this study. Reverse causality could not be ruled out due to not knowing when diabetes developed, and it is possible that adults who developed diabetes close to baseline may have had lower steps per day. Activity patterns may change over time, so these results may not be consistent across a long period of time. It is possible that non ambulatory movement (eg, cycling, swimming) could be beneficial for preventing diabetes, but this type of movement was not measured in the current study.

The researchers concluded that frequent walks with more steps and a faster pace could be beneficial in preventing diabetes, with a 2% to 3% lower 6-year risk of diabetes per 1000 steps per day.

Reference

Cuthbertson CC, Moore CC, Sotres-Alvarez D, et al. Associations of steps per day and step intensity with the risk of diabetes: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Int J Behav Nutr Phys Act. 2022;19:46. doi:10.1186/s12966-022-01284-2

https://www.ajmc.com/view/review-examines-traditional-newer-forms-of-cbt-on-diabetes-related-distress