Spotlight

Better diet against diabetes

13 November 2020

One in every fifteen Dutch inhabitants has diabetes. This chronic condition is linked to our eating habits. That is why Wageningen scientists study how nutrition can contribute to preventing or treating diabetes. Cutting back on processed meats and increasing the intake of vegetables is proven to be effective. This fact has now been included in the latest dietary guidelines. Do you know how eating habits can help prevent or cure diabetes?

 ‘There is no single optimal diet to prevent or treat diabetes. Many roads lead to Rome’, says Edith Feskens, a professor with the Nutrition and Health department. The Diabetes Fund recently stated it expects over 1.4 million diabetes patients in the Netherlands in twenty years, compared to the current number of 1.1 million.

“We are able to prevent and treat type 2 diabetes with healthy nutrition”

Edith Feskens, hoogleraar Global Nutrition

Diet plays an essential part in treating diabetes types 1 and 2. A healthy eating pattern can also help prevent diabetes type 2, also known as late-onset diabetes. ‘With late-onset diabetes, a healthy diet and lifestyle can make the use of medication redundant’, Feskens says.

Risk factors

What diet works best depends, among other things, on the individual’s risk factors—for example, genetic predisposition, hypertension, a high cholesterol level or increased body weight. A relatively little-known diet called “DASH” appears to benefit people with hypertension. Feskens: ‘This diet consists of lots of vegetables and fruits, quite some dairy, which contains magnesium and calcium, and grains that contain potassium. The diet contains very little salt.’

Vegetables and exercise

The best advice that applies universally is still: stick to the food pyramid. Thus, eat lots of vegetables, fruits and fibres such as wholewheat grains. Don’t snack too much and beware of sugars and sweetened beverages, which includes fruit juices. Besides, it is essential to get sufficient exercise. ‘And, if you need to lose a substantial amount of weight, you may wish to follow a diet that restricts your calorie and carbohydrate intake for some weeks’, Feskens adds.

Man jogging

It is important to get sufficient exercise, for example through sports, hiking or gardening (photo: Shutterstock).

Personal preferences play a crucial role, Feskens stresses. ‘People will adhere to nutrition guidelines more easily if they are motivated.’ It is thus essential that recommendations are aligned with the individual’s lifestyle and personal preferences. ‘Many studies show that a Mediterranean diet with plenty of vegetables and fish and limited meat is beneficial. But not everyone likes olive oil.’

Climate

A healthy choice is often also a sustainable choice. ‘Following a vegetarian diet is no problem if you have diabetes. People are sometimes worried, but their concern is unfounded. Research shows that people who eat a lot of red meats such as beef, pork and lamb, as well as processed meat such as sausage, have an elevated risk of getting type 2 diabetes.’

Eating less meat also benefits the climate and environment, Feskens says. ‘Some people may be extra motivated to follow a specific diabetes diet if they are aware of the consequences their eating behaviour has in climate or animal welfare.’

The best advice is still: eat lots of fruits and vegetables and avoid red meat (photo: Shutterstock).

Consistent recommendations

Feskens and her colleagues at Human Nutrition in Wageningen conduct a great deal of research on the role of food in diabetes. Based on the most recent insights, they formulate recommendations for diabetes in collaboration with the Dutch Diabetes Federation. These guidelines aim to help health care professionals such as dieticians, health care practitioners and diabetes care specialists to provide unambiguous recommendations. ‘Some of these professionals completed their training years ago, while insights have changed. There are instances where a dietician recommends one approach, while the nurse recommends something different. This may confuse patients, which is why it is important to have a clear directive.’

Help in decision making

The guidelines that have been released are very comprehensive and scientific. The most recent studies and meta-analyses that span multiple studies have been included, Feskens says. ‘The guidelines are not very concrete yet. We aim to further develop these with decision-making tools so that dieticians are provided with precise tools. Researcher Van Damme is involved in this further effort.’

Foodstuffs

Feskens began her research on nutrition and diabetes over three decades ago. Since then, there has been a significant shift in the research. ‘When I started out, we focussed on particular foodstuffs such as saturated fat and fibres. However, people don’t consume saturated fat, but, rather, meat, which also contains iron, or dairy, which is a source of calcium. Key is that people must eat a combination of healthy products and maintain a healthy diet to ensure they get enough nutrients on a daily basis.’

If the food contains a high number of calories, or energy, per gramme, this increases the risk of weight gain. The best approach is to eat food with a high nutritional density: food that contains many nutrients, Feskens stresses. ‘This applies universally, not just to prevent diabetes.’

Diabetes

One in every fifteen Dutch inhabitants has diabetes (photo: Shutterstock).

Personal health care

Another development is that there is increased attention for personal healthcare, such as tailored advice from a dietician. Previously, patients suffering from type 1 diabetes who had to inject insulin, all followed the same diet prescribed by a physician. ‘There, too, we see a shift towards individual guidelines.’ Feskens notes that it is not yet possible to provide personal guidelines based on blood sugar levels or intestinal bacteria. ‘However, much is already known about the general prevention of diabetes.’

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Edith Feskens

Edith Feskens · Professor of Global Nutrition

Edith Feskens studies nutrition, obesity and type 2 diabetes. After completing her studies on Human Nutrition in Wageningen, she obtained her PhD in Leiden in 1991 on nutrition and diabetes. After this, she worked for the RIVM. In 2008 she was appointed professor at Wageningen University & Research. Her research domain has currently expanded to include national nutrition and sustainability. 'I have had a fascination with nutrition since childhood. Because food tastes good, but also because of what it does in the body. My grandmother and father suffered from diabetes. I studied diabetes for my PhD and later discovered I too have an elevated hereditary risk of diabetes. That makes it all the more real, particularly because you want to postpone or prevent the disease for as long as possible. Diabetes is a chronic condition that is closely linked to food, and thus, can be easily influenced. In developing countries, diabetes is an increasing problem. I hope those countries can learn from our experiences and prevent diabetes from becoming the common issue it is in our country.'

There are 6 comments.

  1. By: Maria · 16-11-2020 at 12:30

    Can nutrition contribute to preventing type 1 diabetes?

    1. By: Yngve · 16-11-2020 at 12:32

      Maria ask a question that I to would like to know more about.

  2. By: Esther · 16-11-2020 at 16:01

    I understand this article is only oriented towards researching and preventing the onset of type 2 diabetes, however, the article does not emphasize it enough. The welcoming paragraph talks about help preventing or curing diabetes with eating habits.
    The global population already has a very wrong, mislead picture of diabetes; people do not know the difference between type 1 (autoimmune disease, where your own immune system, more specifically, your own cytotoxic CD8+ T-cells attack and destroy insulin-producing beta cells in the islets of Langerhans, found in the pancreas) and type 2 diabetes (metabolic disease linked to obesity and other lifestyle factors, causing insulin resistance). Thus, completely different diseases.
    The news are always discussing and talking about ”diabetes”, when actually only type 2 diabetes is being talked about. And that causes the society to create a stigma, and a stamp to type 1 diabetics, who in fact have nothing to do with lifestyle choices or obesity, and cannot certainly be cured by diet. It’s very unfortunate that even in 2020, these 2 different diseases still get mixed to one another.

    For the other commentors, Maria and Yngve:
    Type 1 diabetes cannot be cured nor prevented with nutrition or diet. It’s a life-long disease caused by your ”faulty” immune system that destroyed your own insulin-producing cells. Left untreated without insulin, a type 1 diabetic will end up in a diabetic ketoacidosis, coma, and death. A type 2 diabetic can never develop a diabetic ketoacidosis as their insulin-producing cells have not been destroyed, like a type 1 diabetic’s have.

    1. By: Maria · 18-11-2020 at 08:16

      Esther, thank you for your answer, it was really interesting!

  3. By: Dr.Basma Mohamed Rashad · 19-11-2020 at 15:44

    An interesting article, thank you, hopping to add more detailed information about diet-gene interaction which belongs to type 2 diabetes

  4. By: Jenny Louis · 23-11-2020 at 10:00

    I was diagnosed of Type 2 DIABETES about 4 years ago. I was constantly dehydration and gained weight. I was placed on metformin but worsened over time. My doctor introduced me to Herbal HealthPoint and their successful Diabetes treatment, i immediately started on the herbal treatment. The Diabetes treatment reversed my Diabetes and i lost weights.  Go to ww w. herbalhealthpoint. c om. The severe thirst and dehydration stopped. I am diabetes free

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