This week is National Diabetes Week and this year the focus is on diabetes related amputations. You can find out more about this campaign at Diabetes Australia.
Around 1.7 million Australians have diabetes. This includes all types of diagnosed diabetes (1.2 million known and registered) as well as undiagnosed type 2 diabetes (up to 500,000 estimated).
All types of diabetes are increasing in prevalence:
Type 1 diabetes is an auto-immune condition in which the immune system is activated to destroy the cells in the pancreas which produce insulin. We do not know what causes this auto-immune reaction. Type 1 diabetes is not linked to modifiable lifestyle factors.
Type 2 diabetes is a progressive condition in which the body becomes resistant to the normal effects of insulin and/or gradually loses the capacity to produce enough insulin in the pancreas. Type 2 diabetes is associated with modifiable lifestyle risk factors. Type 2 diabetes also has strong genetic and family related risk factors.
In type 1 diabetes, symptoms are often sudden and can be life-threatening; therefore it is usually diagnosed quite quickly. In type 2 diabetes, many people have no symptoms at all, while other signs can go unnoticed being seen as part of ‘getting older’. It is wise to have your blood glucose checked as part of an annual medical check up with your general practitioner.
Often, by the time symptoms are noticed, complications of diabetes may already be present.
Currently type 1 diabetes cannot be prevented. However, researchers are looking into the autoimmune process and environmental factors that lead to developing type 1 diabetes so that we may be able to prevent type 1 diabetes in the future.
Many cases of type 2 diabetes can be prevented, or the onset delayed, through positive lifestyle changes.
It is estimated that the risk of developing type 2 diabetes can be reduced by up to 58% by maintaining a healthy weight, being physically active and following a healthy eating plan. We have written before about the importance of an active lifestyle for diabetes sufferers.
What constitutes a healthy diet has become increasingly controversial in the last few years with growing popularity and promotion of the Paleo diet and Low Carb High Fat diets however there is little research into these diets or evidence of long term benefit with these diets. The growing popularity of these diets has been accompanied by criticism of the Australian Dietary Guidelines. Population studies show that very few people actually follow the Australian Dietary Guidelines especially with regard to getting enough vegetable serves every day.
We are yet to discover the one “right” diet for each and every person. However evidence from areas around the world known as “Blue Zones” tells us that a healthy diet has a high intake of plant foods (vegetables, fruits, leaves, roots, seeds, nuts, legumes and grains), small amounts of animal protein and mostly minimally processed foods. Blue Zones are regions in the world where people live healthy active lives over the age of 100 years old at rates 10 times higher than other areas of the world. This dietary guidance could be adapted to fit many of the popular diet trends – Mediterranean, Paleo, as well as our own national dietary guidelines.
How we eat is as important to our health as what we eat.
Anticipation and pleasure are important and often overlooked or dismissed aspects of eating. Small studies have shown better nutrient absorption from meals we enjoy over meals we don’t. Pleasure is the factor that differentiates satisfaction from fullness, how often have you found yourself full after a meal but still looking around for that extra something? Chances are your meal was filling but not satisfying. It’s generally easier to eat moderately if we factor pleasure as well as nutrition into our meals and snacks.
Honouring hunger and fullness and using these fundamental signals to guide our start and stop signals for eating is essential. Taking our time, savouring and staying present while eating is also really valuable. Both of these are difficult in our fast paced lives. If we are attentive we are able to notice approaching or gentle satisfaction and make our decision to stop eating before we become overfilled. If we are attentive to our bodies signals of hunger we will also be able to make our eating decisions more often when we are gently hungry. Gentle hunger is a much more manageable beast than ravenous hunger, wise choices are far easier to make when we are gently hungry.
Regularly eating more than we physically require can make a significant impact on energy intake, weight and those extra nutrients need to be metabolised and utilised or stored and so can put extra pressure on the pancreas. Eating beyond fullness causes physical discomfort too and for many people is a source of guilt and shame. Stress of this sort is not helpful in managing or preventing diabetes. Guilt and shame can lead to a cycle of restriction and bingeing, which is strongly associated with progressive weight gain, an associated risk for developing diabetes.
If you want support to modify your diet or your eating behaviours please get in touch.
Susan Williams is an Accredited Pracitising Dietitian and Health Counsellor. She is an advocate of the HAES movement, and believes that we are deserve to feel good.
