If we have to mention a single most effective way of preventing or reversing diabetes, that would be weight loss. Studies show that one does not need to lose considerable weight to improve insulin sensitivity. Even a slight weight loss of 5-7% may help considerably. Studies show that both obesity and diabetes are on the rise. People living with obesity are more likely to develop diabetes. Still, they are also more likely to have severe and fast progressing diabetes. Not only that, obesity increases the risk of chronic diabetes complications like neuropathies, heart diseases, and other health issues. Obesity is now a significant health threat globally. Studies show that two-thirds of all adults are overweight in developed nations like Australia, and one-third of all adults are obese. It means that most of the population is at risk.
When it comes to diabetes, it is readily visible that there is a significant association between obesity and diabetes. Studies show that the prevalence of diabetes varies considerably at various geographical locations and among different ethnic groups. For example, about little more than 10% of South Asians or Americans live with diabetes. However, the prevalence of diabetes is relatively lower in Australia at about 5%. However, the prevalence of diabetes also depends on many other factors like age group. For example, studies show that almost one-fifth of Australians aged 75 years live with diabetes. Similarly, the prevalence of diabetes is more significant in urban areas or among ethnic minorities.
What is diabetes, and how is it related to obesity?
Before looking at how weight loss may help prevent diabetes, it is essential to understand what exactly diabetes is.
The two most common types of diabetes are type 1 and type 2 diabetes. However, studies show that more than 90% live with type 2 diabetes. Thus, when people use the term diabetes, they often mean type 2 diabetes.
Type 1 diabetes is an uncommon autoimmune disorder with well-understood pathogenesis. The body’s immunity starts attacking insulin-producing beta-cells in the pancreas in this condition. This causes absolute insulin deficiency. Since, in type 1 diabetes, the pancreas cannot produce insulin anymore, this kind of diabetes is only treated with insulin. However, most people (above 90%) live with type 2 diabetes. Type 2 diabetes is a lifestyle disorder. It is a condition caused by high-calorie intake, glucotoxicity, and a sedentary lifestyle. Insulin resistance means glucose cannot enter the cells, and thus they start starving. As one can see, in type 2 diabetes, the body is still producing some insulin. However, due to insulin resistance, this insulin stops working. The pancreas starts producing more insulin until it cannot cope with the increasing demand. Since, in type 2 diabetes, not all beta cells in the pancreas are dead, it is still possible to reverse or prevent the condition through lifestyle intervention. What weight loss does is renew insulin sensitivity. It especially sensitizes skeletal muscles and liver cells to insulin and thus helps prevent diabetes. Therefore, exercise and weight loss are the most effective ways of diabetes prevention.
Does weight loss help prevent diabetes?
Some of the early physicians in India and Greece noticed that diabetes was considerably associated with obesity. Thus, for centuries, physicians have been asking people to reduce calorie intake and body weight to prevent diabetes. However, observation is one thing, but evidence from controlled clinical studies is another. Interestingly, no one tried to find how much weight loss helped prevent diabetes until the 1990s. In the 1990s, experts realized an urgent need to understand how much weight loss can help prevent diabetes.
Since then, almost all countries have done multiple diabetes prevention studies. Experts were surprised by many of these studies. They were amazed to see that even a slight reduction in body weight helps considerably. It means that one does not need to reduce body weight much, and just small efforts are more than enough to make a difference. Finland is the first country to show that weight loss is the best way to prevent diabetes. As a result, Finnish Diabetes Prevention Study is now regarded as a turning point in our understanding of diabetes. The Finnish study showed that even a minor weight loss of 4-5 kgs achieved over the period of 2-3 years could help prevent diabetes in most people or more than 50% of cases. This is amazing and unbelievable, as almost anyone can lose 4-5 kg body weight in 3 years, though very few do it in practice.
Similarly, the Australian Greater Green Triangle (GGT) diabetes prevention study showed that 2-3 kg of weight loss during 12 months could make a significant difference. However, the astonishment of experts did not end here. What was surprising was that weight loss is an even much more effective way than using medications for diabetes prevention. Studies show that weight loss through lifestyle intervention is a better way of diabetes prevention than weight loss pills. One of the most extensive studies in 3234 adults living without diabetes found that weight loss through lifestyle interventions (diet and exercise) can prevent diabetes in 58% over the course of 2.8 years. However, using 850 mg metformin twice daily could only help prevent diabetes in 31% of cases. So, we now know that the most effective diabetes prevention is through weight loss. Moreover, it is better to do it with the help of lifestyle interventions. Of course, weight loss pills also help considerably, but they are still not that effective.
Ways of weight loss for diabetes prevention
There is no doubt now that the best way to prevent diabetes is through weight loss achieved through lifestyle interventions. Thus, one should take steps accordingly. Lifestyle interventions work better than pills or supplements, as it is about managing the underlying cause. However, any intervention would help only when one sticks to such an intervention for long enough. One should notice that most diabetes prevention studies were for 12 months or more. It means that there is no quick-fix solution to diabetes prevention. Instead, one needs to implement certain things in life and then practice them for years until they become a part of life.
Below are the four things to do that may help prevent diabetes in 60-70% of individuals.
Start by reducing total calorie intake
One needs to understand that diabetes (type 2 diabetes) mainly occurs due to calorie excess. Therefore, when there is a continuous high-calorie intake, it also means that there is a continually high blood glucose level. However, body cells do not need so much glucose, and they stop refusing its intake, and insulin resistance develop. Insulin is a hormone or messenger that knocks on the doors of every cell and offers them glucose for their needs. However, if insulin knocks too frequently, cells merely stop listening to it -this is insulin resistance. In response, the body produces more insulin, which means even more knocking on doors of the cells (receptors and gateways), causing even more insulin resistance. Thus, the only way to reduce insulin resistance is to reduce the insulin upsurge. Insulin upsurge is a result of high-calorie intake. Therefore, reducing calorie intake helps with weight loss and reduces insulin resistance. Additionally, it is a good idea to reduce the intake of saturated fats. Thus, consume less baked products and ultra-processed foods. Also, reduce the intake of fatty animal meat. Saturated fats are not only high in calories, but they also accumulate as fatty cells. As a result, they cause visceral fat accumulation. These fat cells are not just a source of fat but also produce inflammatory enzymes, causing widespread damage to health.
Consider low carb diet
As one can see that cutting down total calorie intake and reducing body weight is the most important way of diabetes prevention. However, it is also necessary to reduce the total carb intake. Experts have started recommending a very low-carb diet (VLCD) to prevent diabetes and lose bodyweight faster in recent years. Thus, cut down the intake of wheat products, rice, baked foods, pasta, packed juices, and potatoes and eat high starch vegetables. One example of a low-carb diet is the keto diet. However, it is vital to understand that for diabetes prevention and weight loss, one does not essentially need to switch to a keto diet and just needs to reduce the intake of carbs. One of the issues with carbs is that they are highly addictive. Moreover, the most readily available foods in supermarkets are high in carbs. Carbs are also consumed in large amounts due to their low cost compared to healthy or well-balanced foods.
Add exercise to a daily regime
Exercise is not just about weight loss, though many people start doing exercise for weight loss. However, it is vital to understand that exercise has many other health benefits. Thus it can help prevent diabetes in multiple ways. Exercise increases glucose intake by body cells, resulting in reduced insulin resistance. Similarly, exercise can stimulate the working of the liver and make it less resistant to insulin. Exercise also mobilizes fats, which also results in lower inflammation. Exercise can also help counter inflammation directly, reduce stress, improve mood, enhance self-esteem. In addition, people who exercise regularly are more likely to make other healthy lifestyle choices like consuming less alcohol, not smoking, and much more. People need to understand that a sedentary lifestyle is an independent risk factor for diabetes. Even if a person does not lose body weight much, exercise can still help prevent diabetes. When starting exercise, begin with 30 minutes of exercise a day, and then gradually progress to 60 minutes a day. Of course, one may rest for two days a week; however, one should avoid rest for more than two days.
Increase dietary fiber intake
It is one of the secret weapons in the fight against diabetes. But unfortunately, increasing dietary fiber intake is the most under-utilized way of weight loss and diabetes prevention. It means consuming large portions of whole fruits and vegetables, nuts, and whole grains can all help reduce the risk of diabetes. In addition, cruciferous vegetables, beans, and legumes are excellent dietary fiber sources. However, one can also increase dietary fiber intake by supplementing the diet. Thus, consider taking psyllium husk, oats fiber, the fiber of greens, inulin, and other high fiber supplements. It is worth noticing that high dietary fiber intake would also reduce cholesterol and thus help improve metabolic health.
So, if one asks what the single most effective way of diabetes prevention is? The reply would be weight loss. It is good that even very little weight loss of 2-5 kg over 1-3 years may help cut the risk of diabetes by almost half. The benefit of weight loss is massive. It is now proven beyond doubt with the help of many diabetes prevention studies done in almost every nation. But regretfully, many people are not yet aware of the findings of these studies. Thus they are unclear about the role of weight loss in diabetes prevention. Many people do not start their weight loss journey because they think that it would only help if they shed 20-30 pounds. However, this is not true, as 5-7% weight loss is quite good in most cases. However, it is essential to understand that lifestyle interventions like dietary measures and exercise are the best and healthier ways of weight loss. These methods are superior to other forms like using pills or supplements. It is vital to understand that pills and supplements help lesser than lifestyle interventions. Pills and supplements can only partially help counter the ill effects of wrong lifestyle choices. To conclude, those living with obesity, prediabetes, and a family history of diabetes are at considerable risk of developing diabetes soon. Studies show that the single most effective way to reduce this risk is weight loss.