Type 2 Diabetes and Beyond - Reducing Risks of the Metobolic Syndrome
Some 85-90% of those with diabetes have Type 2 and many hundreds of thousands more remain undiagnosed. Type 2 diabetes is also a growing problem in developing countries (Asia, Africa, South America) as traditional dietary and activity patterns rapidly change to mimic those of more “developed” countries. It is also now being detected in children, whereas it was previously thought to be an adult onset condition.1
Wherever it occurs, Type 2 diabetes is generally linked to obesity and increased risks of cardiovascular disease (CVD) and stroke. Together with hypertension, imbalances in blood lipids (reduced HDL cholesterol, raised triglyceride levels), and insulin resistance (“pre-diabetes”), this collection of conditions constitutes what is now termed the “metabolic syndrome”. Preventing and treating these related health threats should be much more closely coordinated, rather than seeing them as separate problems.2 Sustained lifestyle changes are the key to reducing overall population risks from the metabolic syndrome.
Generally speaking those who are overweight or obese, physically inactive and have a family history of diabetes are at increased risk of developing diabetes. In addition, ethnicity is a strong predisposing factor. Type 2 diabetes is up to six times more common in people of South Asian descent and up to three times more common in those of African and African-Caribbean descent, compared with the white European population. It is also more common in people of Chinese descent and other non-white groups. The prevalence of diabetes rises steeply with age, especially where ageing is associated with weight gain and sedentary lifestyles. Diabetes can have other serious consequences such as vascular disease and even amputation, blindness, and renal failure. Aside from the personal misery, there are enormous medical and economic burdens associated with this disease. Yet for many, its onset can be avoided or at least delayed.
One key factor for diabetes prevention is appropriate eating habits, which should go hand in hand with weight control and increasing levels of physical activity. Recent research has demonstrated that eating nuts and peanut butter frequently as part of a balanced diet may help lower the risk of Type 2 diabetes in women and probably in men as well. Nuts including peanuts are high in unsaturated fat (monounsaturated and polyunsaturated), magnesium and dietary fibre, which all have a beneficial effect on reducing diabetes risk. In this Harvard study, the researchers found that eating nuts and eating peanut butter was inversely associated with risk of Type 2 diabetes after adjusting for age, body mass index (BMI), family history of diabetes, physical activity, smoking, alcohol use, and total calorie intake. Women who consumed peanut butter five or more times per week (the equivalent of 150g or 5 ‘golf ball-sized spoonfuls’ a week) had a 21 percent lower risk of developing Type 2 diabetes compared to women who never or almost never ate peanut butter.3
Health professionals are often concerned about the fat content of nuts and peanut butter and the presumed dangers of over-consuming such energy and nutrient dense foods, even though they are nutritionally beneficial. It’s worth knowing that nutrition experts now recommend a daily 30g serving size for peanuts as this is associated with increased protection from CVD. This equates to a small handful of kernels or a spoonful of peanut butter no bigger than a golf ball. The 30g recommended serving size does not contain excessive calories. In addition, the high satiety factor
associated with peanuts clearly helps reduce temptations to over eat.4
A wealth of recent research demonstrates that consumption of nuts, including peanuts and peanut butter, can help to reduce blood cholesterol levels and contribute to reducing risk of coronary heart disease5,6. Another study from the Harvard Medical School Group demonstrated the value of nuts and daily peanut butter in successful weight reduction diets, where subjects maintained their weight loss even after two and a half years follow up.7 The authors concluded: "There have been concerns that frequent nut consumption may result in weight gain and increased risk of coronary heart disease because of the high fat content. However, in our cohort, we did not find an appreciable association between nut consumption and weight change." 7
Regular or daily consumption of nuts and peanut butter as part of a balanced lifestyle can play a beneficial role in reducing risk of CVD, obesity and Type 2 diabetes, all of which are major constituents of the metabolic syndrome linked to avoidable mortality and morbidity in Europe and other regions.
May 2005
References:
1. Stumvoll M, Goldstein BJ, van Haeften TW (2005). Type 2 diabetes, principles of pathogenesis and therapy Lancet 365: 1333-46.
2. International Diabetes Federation (2005). The IDF Consensus Worldwide Definition of the Metabolic Syndrome. Brussels.
3. Jiang R et al (2002). A prospective study of nut consumption and risk of type II diabetes in women. Journal of the American Medical Association 288: 2554-2560.
4. Kirkmeyer M, Mattes, RD (2000). Effects of food attributes on hunger and food intake. International Journal of Obesity 24:1167-1175.
5. Kris-Etherton PM et al (2001). The effects of nuts on coronary heart disease risk. Nutrition Reviews 59, 4: 103- 111.
6. Hu FB, Manson JE, Willett WC (2001). Types of dietary fat and risk of coronary heart disease: a critical review. Journal of the American College of Nutrition 20(1):5-19
7. McManus K, Antinoro L, Sacks F (2001). A randomised controlled trial of a moderate fat, low- energy diet with a low fat, low- energy diet for weight loss in overweight adults. International Journal of Obesity 25(5): 1503-1511
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