What to eat to prevent and control type 2 diabetes

Type 2 diabetes is a metabolic disorder characterized, initially, by insulin resistance, and which progresses towards a decrease in insulin secretion. Despite all the scientific advances in its diagnosis and treatment, the prevalence of diabetes mellitus has grown dramatically in the last 60 years. It must be taken into account that this is a non-communicable disease; just like cancer or cardiovascular conditions, it is not contagious. Although there is a certain genetic predisposition in its onset, the truth is that (a poor) lifestyle — no physical activity and an unhealthy diet — can significantly condition its diagnosis.

Diet can make things worse, but it can also make them better

The dietary profile that people with diabetes should follow is simply that which is associated with a healthy eating pattern (even if this is not very specific). When asked how a diabetic person should eat, the answer must be categorical and without the need for further explanations: well. No need to adjust macronutrients. They just need to eat well.

Best of all: this dietary pattern is exactly the same as the one proposed for prevention. You could say that you have to eat like a diabetic to keep diabetes at bay. Let’s just concentrate on following a healthy diet, as made clear by various institutions that focus their work on this condition.

• The nutrition therapy recommendations of the American Diabetes Association state, with little room to doubt, that there is no conclusive level of evidence that indicates an ideal intake of carbohydrates, proteins and fats in patients with diabetes.
• The Diabetes U.K. Evidence-based nutrition guidelines for the prevention and management maintains that, more than the amount of macronutrients, what is important is the total energy intake, regardless of its source.

In the end, the diet therapy guides for the different non-communicable diseases — cancer, diabetes, etcetera — are virtually identical in their approaches, and so are the most current healthy eating guides aimed at the general population.

Daily life with type 2 diabetes

Patients with type 2 diabetes can do a lot in their day-to-day life. At the risk of being repetitive, it is of utmost importance to follow the recommendations that can improve the prognosis of this disease. Take these tips into consideration:

• Avoid ultra-processed products as much as possible and favor natural options, instead. That is, fresh food, and if it is possible, seasonal foods. A good strategy is to shop at a market; if you must go to a supermarket, look for those products that you would also find in a market.
• Products that claim to be specially made for diabetics are usually not a good option. Their existence responds more to commercial and marketing issues than to a concern for people’s health.
• In each meal you eat throughout the day, include at least one helping of plant foods. From breakfast to dinner, fruits, vegetables and greens must be a common denominator. You can prepare them in countless ways, from raw to any recipe that comes to mind.
• Legumes are very good friends of people with diabetes; don’t hesitate to include them in anything you want. They could be present three or four times a week in your main meals.

• When you want cereal-based foods, such as rice, pasta or bread, try to choose their whole grain versions.
• Meat is not forbidden, but you should think about reducing the amount you eat. You can always resort to other sources of protein, such as eggs or nuts (natural or roasted, with no additions).
• Fish is also a great option to include a healthy source of protein and healthy fats in your diet.
• In the case of dairy products, the problem usually has to do with the things that accompany them (cookies, breakfast cereals and the like). Thus, milk — with coffee, tea and little else –—natural yogurt, plain, and cheese made with milk, rennet and a little salt are fine; the rest… well, the rest is not.

• Exercise: human beings are born to be active, so any strategy that you choose — preferably daily and constant — will produce benefits. Not all jobs or family responsibilities are compatible with a daily visit to the gym, but find a way to move, as much or little as you can.

What if this chronic disease could subside?

Approximately 25 years ago the scientific community felt, as Obi-Wan Kenobi would say, a disturbance in the force: some patients diagnosed with type 2 diabetes no longer met the diagnostic criteria for the disease. The first indication that type 2 diabetes was fully reversible came from bariatric surgery. A study revealed that blood glucose levels normalized in obese people with type 2 diabetes who underwent this surgery and that, 10 years later, almost 90% were still free of diabetes. Later it was confirmed that bariatric surgery was not the cause of such “miracle,” although it was the mechanism that led these patients to eat healthier.

Another study, titled Type 2 Diabetes: Etiology and reversibility, found that in some cases, and without surgery of any kind, the same goal could be achieved with fairly strict management of both diet and physical activity. Time and new research seem to confirm this new approach: type 2 diabetes can indeed be reversed in many patients. Furthermore, even if total remission is not achieved, the same approach to diet and physical activity greatly improves the prognosis and quality of life of patients.

I don’t know why type 2 diabetes, a chronic and, to some extent, degenerative disease with many comorbidities, which has spread enormously in recent years — and will continue to do so — and at the same time is so predictable, is unknown or ignored by most people and health authorities. How many public campaigns have you seen focused on its prevention?

Things get really serious when some health professionals go so far as to maintain that patients with diabetes can eat whatever they want as long as they have insulin and other drugs. I can’t help but wonder: what is the point of people with diabetes being able to continue eating the same things that made them sick in the first place?

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