What fuels us? October 2014Lesson 5: How does glucose dysregulation lead to disease?

Type 2 Diabetes: Is a preventable (and reversible?) disease!

Diabetes causes more deaths a year than breast cancer and AIDS combined. Two out of three people with diabetes die from heart disease or stroke. The good news is that type 2 diabetes is a preventable disease! Insulin resistance, which results in diabetes, is causes by constant increases in blood glucose levels. But we can control increases in blood glucose with our diet – we just have to choose to eat the right foods and be active. Thus, one should avoid constant increases in blood glucose, unless planning to engage in physical activity. However, since modern humans do not exercise following every climb in blood glucose, we need to be aware of which foods cause increases in blood glucose to avoid the onset of insulin resistance.

Blood glucose raises the most after eating meals that are high in simple carbohydrates. Simple carbohydrates have a chemical structure of only 1 or 2 sugar molecules. Because of their chemical structure, simple carbohydrates are broken down very quickly in the body. This rapid breakdown allows glucose to be absorbed into the blood very quickly causing a rapid rise in blood glucose. High levels of insulin are released in response to this surge of glucose in the blood. High amounts of insulin hastily return glucose levels back to homeostasis, which explains why we feel hungry shortly after a simple carbohydrate meal. Although simple carbohydrates taste good, they generally have little nutritional value and their consumption should be limited. Some examples of simple carbohydrates include: table sugar, high fructose corn syrup (found in candy and soda), white bread, honey, chocolate, milk, and jam. Simple carbohydrates should be avoided in type 2 diabetics because this will worsen the high blood sugar they already regularly experience.

Not all carbohydrates result in large increases in blood glucose. Complex carbohydrates (foods high in fiber) are made up of hundreds to thousands of sugar molecules and take much longer for the body to digest and break down into glucose. Because complex carbohydrates take longer for the body to digest, they will not cause drastic increases in blood glucose. Instead, complex carbohydrates will be absorbed into the blood more slowly over longer periods of time. Slow absorption of blood glucose will lead to less insulin release, which will prevent the feeling of a sugar crash. Instead, the feelings of “fullness” will last much longer. Complex carbohydrates tend to have a higher nutritional value than simple carbohydrates and are recommended for regular consumption. Complex carbohydrates are found in vegetables, whole-grain bread, oatmeal, bran, legumes, nuts and seeds.

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Taken from Wikimedia Commons

Taken from Wikimedia Commons

What fuels us? October 2014Lesson 5: How does glucose dysregulation lead to disease?

Well-balanced meals can also lower the incidence of rapid blood glucose surges. Ideally, each meal we eat does not only include carbohydrates, but fats and proteins as well. When fats are eaten together with carbohydrates, they slow the absorption of glucose into the blood stream. In addition, proteins, which are absorbed into the bloodstream as amino acids, lead to a higher sensitivity of insulin (as opposed to insulin resistance which leads to diabetes). Both fats and proteins will act to lower blood glucose levels when eaten alongside carbohydrates. Thus, there are long-term benefits from always eating a well-balanced meal.

The way food is prepared can also affect the speed at which it is digested and absorbed into the blood stream. For instance, the heat from cooking vegetables acts to “predigest” food by breaking down the large sugar molecules in complex carbohydrates into smaller parts, thus speeding their absorption into the blood stream. Therefore, even though they are complex carbohydrates, vegetables that are cooked or overcooked, breakdown much faster in the digestive system. For example, type 2 diabetes rates in India are rising much faster than in China. Strangely, the diets of Chinese versus Indians are actually very similar (lots of vegetables and rice). However, the food preparation methods in these two countries are very different. In China, vegetables are flash cooked; meaning, they are cooked at a very high heat for a short period of time, so that they are cooked on the outside but still quite raw in the middle, giving them a crunchy texture. While, in India, vegetables are slow cooked; meaning; they are cooked at a low heat for a very long period of time so that they are cooked all the way through, giving them a soft and mushy texture. The Indian cooking method, although healthy in terms of ingredients, is likely to lead to higher increases in blood glucose in shorter periods of time due to the fact that their traditional preparation method is in essence, predigesting their complex carbohydrates for them.

Type II diabetes is preventable, but is it also reversible as well? Eating a high fiber diet has been utilized as a treatment for type 2 diabetes. Several studies have been done, following type 2 diabetics on a high fiber diet (50+ mg/ day) (the daily recommended intake for fiber is 30 mg) and have found this dietary intervention, if followed, decreases resting blood glucose levels and increases insulin sensitivity. If these diets are followed for extended periods of time, the markers of type 2 diabetes decrease, suggesting that a high fiber diet can reverse the symptoms of type 2 diabetes.

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Taken from Wikimedia Commons

Slow cooked Indian food.

Taken from Wikimedia CommonFlash cooked Chinese food.

What fuels us? October 2014Lesson 5: How does glucose dysregulation lead to disease?

References:American Diabetes Association (2014, September 8) Diabetes Myths. Retrieved from http://www.diabetes.org/diabetes-basics/diabetes-myths/

Glycemic index, glycemic load, and glycemic response definitions and consumer tip sheet. Retrieved from http://oldwayspt.org/programs/special-custom-programs/glycemic-index-definitions-and-consumer-tip-sheet

Strand, R.D. (n.d.) Recommended foods. Retrieved from https://www.raystrand.com/recommended-foods.asp

Thompson, R. (2012. February 16) Block sugar from your body in 7 easy ways. Retrieved from http://www.today.com/health/block-sugar-your-body-7-easy-ways-1C9381792

Food images:http://commons.wikimedia.org/

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