Wednesday, November 14, 2012

thoughts on diabetes prevention

Crash by Images by John 'K', on Flickr
Diabetes: Protect our Future,
by International Diabetes Foundation

November 14 is World Diabetes Day.

The overall theme for the years 2009-2013 is "Diabetes Education and Prevention" with this year's slogan being "Diabetes: Protect our Future."

diabetes education

I see no point in educating directly, as I know of two outstanding sources.

Jennifer's advice to the newly diagnosed
If you only read one page about blood glucose control, this should be it, even if you are not yet diabetic. Jennifer discusses how to use a blood glucose meter to learn about managing your bG.
Blood Sugar 101
If you want to learn about diabetes and controlling blood glucose, but don't want to get a biochemistry degree, Jenny Ruhl's site is for you as she translates what is known for laymen very comprehensively.

diabetes prevention

My thoughts on prevention are varied. Though I've been actively studying the research literature for about half my life now, my understanding changes constantly, as does the research.

We used to have 2 types of diabetes, but as research has continued, the classifications have expanded to include LADA and MODY and other types.

However, there are two primary two things that can go wrong resulting in diabetes:

  • insufficient insulin production by the beta cells of the pancreas and
  • insulin resistance, beginning in the liver and spreading to other tissues over time.

We've always known that though both issues are caused in part by a genetic predisposition. But the precipitating event in the death of beta cells tends to be caused by an autoimmune event (which can be caused by a leaky gut) and we've recently discovered that insulin resistance seems to be caused by autoimmune issues due to zonulin-moderated gut permeability.

Until recently, my thoughts about diabetes have been centered on liver health and avoiding inflammation, both of which I still believe are contributing factors and important. But now I think the most important thing is gut health.

gut health
  • taking probiotics, eating fermented foods and eating dirt are probably the most important thing you can do to prevent diabetes - nondiabetics have significantly different gut bacteria than diabetics
  • a gluten-free diet is likely the second most effective strategy to reduce the chances of intestinal damage and hence diabetes, wheat is especially to be avoided
liver health
  • avoiding fructose seems to be key to preventing the fatty liver and elevated triglycerides that lead to metabolic syndrome - this means greatly limiting fructose itself (yes, I know it has a low GI!), sugar (whether processed or not), HFCS and agave syrup - it does NOT mean skipping fruit, which contains a lot of useful nutrients
  • avoiding toxins as much as possible - toxins ingested as food ingredients, toxins in food containers, toxins in hygiene products and household cleaning products
  • eat more organ meats
  • remove manufactured trans fats from your diet - this means no vegetable oils (especially soy and canola), but also includes margarines, salad dressings and mayonnaise - this step itself pretty much wipes out most processed food
  • limit polyunsaturated fats entirely, preferring more saturated fats such as butter, cream, lard, tallow, schmaltz, coconut oil and palm oil
  • monounsaturated fats like olive oil and avocado oil are always good, especially raw
  • of the PUFAs you do consume, aim at a much higher intake of omega 3s rather than omega 6s; this means eating a lot of fish, considering supplementing with fish oil (or better yet, cod liver oil), and limiting nut and seed consumption