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Diabetes: Know Your Risk and What You Can Do

Karen Collins, MS, RD, CDN
American Institute for Cancer Research

With nearly 24 million Americans now affected with diabetes (roughly a third of whom are unaware of their condition) and another 57 million estimated to have pre-diabetes, we are in the beginning of a diabetes epidemic. Though these diagnoses put millions of people at increased risk for heart disease and cancer, there is hope. Research now clearly shows that lifestyle changes can significantly reduce the odds of developing the largely preventable disease.

A new questionnaire, the Diabetes Risk Calculator, has been developed to help identify those most at risk of having or developing diabetes. The simple screening test relies on just 10 questions that most people can readily answer. While the risk calculator can’t diagnose diabetes, it can help identify those most at risk, allowing for more careful medical screenings that can treat problems before much damage is done.

Developing diabetes is not inevitable, even for people with pre-diabetes (a condition marked by blood glucose levels that are higher than normal, but not high enough to be classified as diabetes). The Finnish Diabetes Prevention Study and the Diabetes Prevention Program – two landmark population studies – both report that lifestyle changes could decrease incidence by 58 percent. In addition to lowering diabetes risk, participants in these studies also showed improvements in heart-related problems and decreased markers of inflammation throughout the body.

The benefits that are seen with lifestyle changes are owed, at least in part, to improving the effectiveness of insulin in the body and allowing high insulin levels to return to normal. In addition to improving blood sugar, reducing high insulin levels can halt metabolic changes that promote increased growth and development of cancer cells. The potential health benefits of implementing lifestyle changes are enormous, as they could possibly lower risk of diabetes, cancer and heart disease, too.

So what do we mean by lifestyle changes? For starters, research shows that weight loss is one of the most important steps for people who are overweight. According to published data from the Nurses’ Health Study, participants who were overweight were 5 to 10 times more likely to develop diabetes than those with a healthy BMI; women who were obese were 30 times more likely to get the disease.

But reaching what you might consider an ideal weight is not necessary to see benefits. A modest loss of 5 to7 percent of body weight (10 to 14 pounds for someone who weighs 200 pounds) is enough. And it’s a goal that can be achieved by simply reducing baseline calorie consumption by about 450 calories a day.

A second crucial step in diabetes prevention programs is establishing a pattern of regular physical activity. Most programs ask participants to aim for at least 150 minutes a week, the equivalent of at least 30 minutes of walking or other moderate activity five days a week. Several studies show that even without weight loss, insulin resistance can be reduced 30 to 85 percent after just three to four months of daily aerobic activity. Decreased insulin resistance means lower circulating levels of insulin in the body and less inflammation, which can lower risk of other disease states like cancer and heart disease.

Diabetes prevention is one case where weight control seems to matter even more than the specifics of what we eat. However, studies do suggest that diets low in saturated fat, high in fiber and rich in vegetables and whole grains may offer the most benefit.

You can complete the Diabetes Risk Calculator in minutes at the American Diabetes Association’s Web site. Regardless of the results, though, moderate daily physical activity and a modest reduction in calories to facilitate weight loss (if you are overweight or gaining weight) are two lifestyle choices that belong at the top of everyone’s to-do list.

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The American Institute for Cancer Research (AICR) is the cancer charity that fosters research on the relationship of nutrition, physical activity and weight management to cancer risk, interprets the scientific literature and educates the public about the results. It has contributed more than $86 million for innovative research conducted at universities, hospitals and research centers across the country. AICR has published two landmark reports that interpret the accumulated research in the field, and is committed to a process of continuous review. AICR also provides a wide range of educational programs to help millions of Americans learn to make dietary changes for lower cancer risk. Its award-winning New American Plate program is presented in brochures, seminars and on its website, www.aicr.org. AICR is a member of the World Cancer Research Fund International.

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