Health check: beat diabetes

Some 5 million people in South Africa are on the verge of developing diabetes. A further 2 million are living with this chronic disease, which can lead to death if not treated properly.

But reversing this trend is not as hard as you might think. 

A simple diet such as the 5:2 intermittent fasting one can reverse a diabetes prognosis. This diet advocates a daily caloric intake of 2 500 for men and 2 000 for women for five days, and fasting for two days (600 calories on these days for men and 500 for women) every week.

The 5:2 diet has become one of the more popular plans in recent years. Studies have shown it helps with weight loss and reduces insulin resistance, which are of particular interest for people with type 2 diabetes or predicates.

Here’s how it works: Pick two days a week to fast – they do not have to be consecutive, but can be. On those days, eat a diet of protein and fiber (meat and vegetables), but a quarter of your usual intake. You can eat one big meal on those days, two smaller ones or a series of snacks throughout the day – whichever one you can stick to. These days should be alcohol-free too.

On the other five days of the week, banish white foods – white sugar, white bread and other refined carbohydrates – and fizzy drinks, including fruit juice. Stick to carbohydrates that do not spike your sugar: brown rice, vegetables and barley.

The basic rules are to eat more fiber and protein, and fewer refined carbohydrates, while taking a 30-minute brisk walk every day.

Professor Larry Distiller, managing director of the Centro for Diabetes and Endocrinology in Johannesburg, said the only way to prevent or reverse diabetes was to live a healthy lifestyle.

“Clinical studies have shown a person can reduce the risk of diabetes by exercising regularly and cutting out unhealthy eating habits. Any diet – be it 5:2, Atkinson or Banting – can help reduce the risk of diabetes or reverse the prognosis. Foods that should be cut out are fizzy drinks and other sweetened beverages, as they contain refined carbohydrates,” said Distiller.

Karen Hoffman, associate professor at Wits University, agreed, adding high sugar intake was the reason South Africa was facing a diabetes pandemic.

“Diabetes is like a ticking time bomb in this country and nobody is taking notice of it. If we allow it to explode, it will have a detrimental impact on the health system,” she said.

Distiller agreed: “South Africa, like the rest of the world, is facing a diabetes tsunami and if something is not done now, this country will face the consequences in future.”

Government has been on a drive to raise awareness about diabetes, proposing the proper labeling of sugar content in food items as part of its efforts. Hoffman said this was a step in the right direction, but “individuals have to take initiative as well. It is all good and fair to say policymakers must ban adverts promoting the consumption of sugary beverages and demand proper labeling of sugar content in foods, but it is up to the individual to choose to lead a healthy lifestyle,” said Hoffman.

Distiller said: “We are not saying you should cut out sugar completely, but reduce consumption to acceptable levels.

“Also, reducing sugar alone will not solve the problem. You have to follow a healthy, balanced diet and exercise regularly. By that, we don’t mean intense or vigorous exercise. Rather, 30 minutes of brisk walking for five days is beneficial and helps maintain a healthy weight.

“Being overweight increases your risk of diabetes, especially if you have lots of fat around the stomach,” said Distiller.

Belly fat produces hormones that damage beta cells – which produce and secrete insulin, the hormone responsible for regulating levels of glucose in the blood. When these cells are damaged, their ability to produce enough insulin for blood sugar control is affected, leading to type 2 diabetes. This is the most common type of diabetes in South Africa, accounting for 90% of all diabetic cases.

However, many sufferers go diagnosed as patients, as they often do not show symptoms until the later stages of the disease.

Diabetes screening, however, is a painless and simple, life-saving test.

“If you know you are overweight and have a family history of diabetes, you should be tested at least once a year,” said Distiller. “If tests show you are predictable, you
can reduce your chances of being diabetic by at least 50% by leading a healthy lifestyle.”

Distiller said that while he would not recommend any particular diet, he advised patients to go on a good diet to reverse predictable symptoms or cure the illness. “As long as the diet is healthy and within the recommended daily intake of calories, follow it,” said Distiller.