Issue date:
January 30-February 2, 1998
Can you avoid diabetes?The rules have changed, so use these new ploys to help you beat the odds.
 he right way to eat if you have diabetes or want to avoid it is controversial. There's no "ideal" diet for the nation's 21 million diabetics or the millions of adults whose abnormal blood sugar puts them at risk of diabetes, says the American Diabetes Association; it depends on a person's blood sugar, cholesterol and triglycerides. To help you, here's the latest on "adult" Type 2 diabetes, in which the hormone insulin is too weak to handle blood sugar.
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What's at stake Diabetics are at greater risk for clogged arteries, high blood pressure, foot and leg amputations, kidney failure, cataracts, blindness. Diabetes is the sixth leading cause of death for women.
"Best" diabetic diet Percentages of carbohydrates and fat urged by diabetes experts over the years: 1921: 20% Carbos, 70% Fat1950: 40% Carbos, 40% Fat1971: 45% Carbos, 35% Fat1986: 50-60% Carbos, 30% Fat1998: Depends on status of individual's glucose, fat
What about sugar?
It's OK for diabetics, says the American Diabetes Association, when substituted for other carbohydrates. Plain sugar boosts insulin and blood sugar about the same as eating white bread and potatoes, notes the group. John P. Bantle, M.D., of the University of Minnesota School of Medicine says to count carbohydrates. "If you want chocolate cake for dessert, you can give up the mashed potatoes." It's either/or, not both.
But Harvard researcher Walter Willett disagrees. He says a regular diet of fast-acting carbo foods may predispose a person to diabetes, especially if he or she also eats little fiber, especially cereal fiber.
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Eat Protein. Most diabetics can eat the normal amount of protein -- 10 to 20 percent of daily calories, says the diabetes association. Preliminary research at the University of Minnesota suggests that replacing some carbos with high-protein, low-fat foods, such as lean meat or fat-free dairy, may boost insulin production. But restrict protein if you have kidney problems. And don't eat high-fat protein, such as cheese or marbled steaks. Hold the Carbos. "It's impossible to normalize your blood sugar with a high-carbohydrate diet," says Richard K. Bernstein, M.D., a New York diabetes specialist and author of The Diabetes Solution. Why: Carbos drive up blood sugar, triglycerides and cholesterol, and worsen insulin deficiencies. Several studies find high-carbo diets can increase the risk of getting diabetes and worsen existing diabetes.Does the type of carbohydrate make a difference? Experts disagree. To some, most dangerous are fast-acting carbos that quickly raise blood sugar and insulin. They are called "high-glycemic foods." New Harvard research on 100,000 health professionals shows that men and women who ate lots of fast-acting carbos (white bread, white rice, potatoes, cola drinks) and low-fiber cereals (corn flakes, puffed rice) were twice as apt to become diabetic as those on a low-carbo, high-fiber cereal diet. Walter Willett, the study's key author, says eating unrefined grains, particularly high-fiber cold cereals, may help prevent diabetes. Slow-acting carbos (low-glycemic foods) are least apt to cause blood sugar and insulin jumps. Excellent examples: dried beans, legumes, peanuts, barley, yogurt, milk, apples, broccoli, oranges. Go for the Good Fat. How much fat to eat depends on the type, many experts say. Worst: animal fat, which increases insulin levels and tends to clog arteries. Best: monounsaturated fat (olive and canola oil, avocados, almonds), which protects cells through antioxidant activity, benefits blood cholesterol and insulin levels and may help counter fatty acid abnormalities found in diabetics.Omega-3 fat in fish (salmon, mackerel, sardines, herring) can help control diabetes, prevent vascular disease and lower triglycerides. A Dutch study found fish eaters (1 ounce daily of any fish) were half as likely to develop diabetes as non-fish eaters. Avoid omega-6 fat in corn oil, regular safflower oil, soybean oil; avoid trans-fatty acids in margarines and commercial baked goods. They damage arteries. Most important: the ratio of fat types. In a recent Australian study, 48 diabetics ate either a high-carbo, low-fat diet or a high-fat diet (35 percent of calories) low in animal fat, trans-fatty acids and omega-6 but high in olive oil-type fat and fish fat. Those on the high-carbo, low-fat diet got worse while those on the higher-fat diet improved: Triglycerides, blood pressure and fasting blood sugar all went down.
Watch Your Weight. A sure way to combat diabetes is to lose excess
pounds. In a recent study, moderately obese diabetics who lost 18
pounds over three months improved blood pressure as well as blood
sugar and insulin responses. The best way to avoid diabetes, experts
say, is to restrict calories and fat, exercise and keep lean.
Good-for-You Bean Stew
2 Tbs. extra virgin olive oil
3 large garlic cloves, minced
2 cups chopped onions
1 green pepper, diced
1 28-ounce can crushed tomatoes
4 cups white beans, drained(navy, pea, cannellini)
2 bay leaves
1 tsp. dried oregano
1/2 cup pitted black Greek olives,
preferably Calamata
Dash hot chili sauce
In a large pan, sauté garlic, onions and pepper in oil
till soft, about 10 minutes. Add all other ingredients, except
olives, and simmer, covered, 30 minutes. Add olives, simmer 5
minutes. Makes 7 cups.
Adapted from diabetes researcher David Jenkins, University of
Toronto.
Per 1 cup: 285 calories, 12.7g protein, 45g carbohydrates, 1.8g
fiber, 7.4g fat (1g saturated), 369mg sodium.
Scientific sources
for diabetes research
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