Relationship between lifestyle and diabetes

The Relationship between Diabetes and Lifestyle

Introduction

Diabetes has dramatically risen to epidemic levels in recent years. The estimated prevalence of diabetes increased by 600 % from 1958 to 1993 (ADA, 1996) and has continued to rise (Roberts, Barnard, 2005). It is estimated that the lifetime risk of developing diabetes in individuals born in the year 2000 at 32.4% for men and 38.5% for women with a 50 % risk in Hispanic women (Narayan et al, 2003). Traditionally, diabetes was regarded as a chronic illness for the adults but this has changed. Currently as it stands children and teens are been diagnosed with type 2 diabetes. These trends are worrying and disturbing. Can we just sit down and do nothing? Our action is needed now than ever.  

Evidence Indicating the Relationship of lifestyle and Diabetes

As early as 1935, lifestyle factors were implicated to play a role in diabetes when Himsworth, (1935) pointed out that the rates of diabetes were higher in those whose fat intake was higher. Further evidence implicating lifestyle and diabetes was from two studies of Eaton and Konner, (1988) which pointed out a prevalence 1-2% of diabetes in hunter-gatherer societies compared to a 10 % prevalence in industrialised countries. Moreover, migration studies have confirmed the contributing of lifestyle factors in chronic illness as revealed by Japanese migrants living in Hawaii had an elevated risk of diabetes compared to their counterparts living Hiroshima. Although their caloric intake was not different, consumption of animal fat and simple carbohydrates was greater and high fibre intake and physical activity were lower in the migrants (Kawate et al, 2003). Evidence from Seventh day Adventist studies have indicated that Adventists have approximately 50% reduced risk of diabetes and that vegetarian Adventist have a reduced risk compared to the non-vegetarian Adventist (Snowdon and Phillips, 1985). Robert and Barnard, (2005) said that “Diabetes is a good model of how lifestyle can decrease the time desired to present with chronic disease, independent of the increase in life expectancy”

All the above evidence put more point out the role of lifestyle and diabetes. With the increase of chronic illness in a magnitude which we have not experienced in former days can be directly linked to lifestyle factors which are often light regarded. My intention in this article is to help you understand that lifestyle has a direct impact to your health and it requires you to take action when it is favourable before it is too late. I hope you will take this information serious and you will take more responsibility of your health. Why? Because your health is in your hands. It cannot be solely left to the health care providers to decide for you on what to do for your health.

Understanding Diabetes and Lifestyle in a nutshell                    

Your body needs glucose (sugar) for it to function properly. This glucose (sugar) is obtained from the food we eat. The body works on the carbohydrates through the process of digestion to form a simple sugar called glucose. This glucose gets absorbed into the bloodstream. Once the glucose is in the blood stream a gland called the pancreas to produces a hormone called insulin. Insulin floods into your blood stream to take out the glucose into the cells such as liver or the muscles. Glucose is first converted to glycogen, a short term form energy. When the glycogen stores are filled the rest of glucose is converted into fat a long term form of energy for future use. Diabetes occurs when this metabolic process is affected in one way or another are affected. In type 1 diabetes there is inadequate production of insulin as a result of destruction of insulin producing cells. In type 2 diabetes, insulin is sufficiently produced but it cannot used effectively. This is called insulin resistance. The result of this is that glucose builds up in the body because it cannot be absorbed into the cells.

How does lifestyle contribute to the development of diabetes?

Lifestyle and Environmental factors and Type 1 diabetes

Evidence from studies have pointed out several lifestyle and environmental factors which can predispose a child to type 1 diabetes. Some factors that have been pointed out are cow’s milk, viral.

Cow’s milk and Diabetes

A child who genetically susceptible an environmental trigger is the key which opens the door to diabetes but if the trigger is avoided, diabetes may never develop. The development of type 1 diabetes can be contributed with cow’s milk as summarised below (Campbell and Campbell, 2006).

·         A susceptible baby feed with cow’s milk early in life

·         Milk protein reaches the small intestines where it is digested into amino acids.

·         Some milk protein may not be fully digested and some remains in the intestine.

·         These undigested fragments may be absorbed into the bloodstream

·         The immune system recognises the fragments as intruders and it destroys them.

·         Coincidentally, the structure of these fragments is similar to that of the insulin producing cells ( beta cells)

·         The body cannot differentiate between the insulin producing cells and the fragment and both of them end up been destroyed. Knip et al, (2005) says that the destruction of the beta cells may be very fast and aggressive leading to early manifestation of type 1 diabetes. However, fast progression is rare (Knip, 2002).  

·         The infant become a diabetic type 1 and lives with it for life.     

Bovine serum albumin and beta Casein as the two milk proteins responsible for this drastic autoimmune reactions (Karjalainen et al, 1992, Cavallo et al, 1996).

Diet and Type 1 diabetes

 An extensive study conducted in 2000 pointed out that the relationship of diet and type 1 diabetes (Muntoni et al., 2000). The study set to examine the relationship between dietary energy from major food groups and type 1 diabetes. The study found a significant association of diabetes from foods from animal products and inverse association of diabetes with foods from plant sources. This is a clear indication that the animal foods such as meat, diary, and eggs among others can significantly increase the risk of type 1 diabetes and plant based foods lower the risk.  

Exclusive breastfeeding and Type 1 Diabetes

The risk of your baby developing type 1 diabetes is high with early weaning. A study that followed infants from birth pointed out that exclusive breastfeeding for a short period followed by introduction of cow’s milk predisposes your child to diabetes type 1 by inducing formation of four culprit autoimmune antibodies (Ȧkerblom et al., 2002). Another study queried the safety of milk formula and found out that cow’s insulin is present in milk formula and it is responsible for increase in the formation of these antibodies. A study also found out that genetic susceptible child if weaned too early and introduced to cow’s milk- based formula had a 13.1 times greater risk of developing type 1 diabetes compared to non-susceptible children who are breastfeed for at least  up to three months (Perez-Bravo et.al, 1996).

Lifestyle Factors and Type 2 Diabetes

Obesity and Diabetes

Type 2 diabetes is the commonest form of diabetes and accounts for 85% of all diabetes cases. It is often associated to obesity, particular abdominal obesity and over 80 % of people with diabetes are overweight or obese (U.S Department of Health and Human Services, 2007). Evidence is indicating the association of abdominal obesity and diabetes (Paek and Chun, 2010). 

Diet and diabetes

Evidence reveal that when the intake of carbohydrates goes down and fat intake goes up the numbers of diabetes case went up (Campbell, 2004, Barnard, 2007). This difference cannot be ascribed to genetics because evidence has shown as migrants move to countries where western diets are predominant and as they adopt these eating habits, the rates of diabetes go up above national average (Tsunehera et. al., 1990). Evidence from an extensive 21- year study in the US found that diabetes is less frequent among vegetarians and vegans. The study also found that those on meat free diets had a 45% reduced rate of diabetes compared to the population as whole. Consumption of meat was positively associated to diabetes (Snowdon and Phillips, 1985). Vang et.al, (2008) found that one serving of meat per week can increase significantly the risk of diabetes. Fat in these animal products has been found out to be detrimental to health. Evidence indicates that microscopic fat accumulated in muscle cells and liver cells over time and which interferes with the cells’ ability to react correctly with insulin (Petersen et.al., 2004; Phillips et.al, 1996; Delarue and Magnan, 2007; Morino et.al., 2006). When insulin resistance sets in eventually one will end up developing type 2 diabetes.

Physical inactivity and Diabetes

Continuous high secretion of insulin overtime encourages more fat deposition both from dietary carbohydrates and fat. Fat gets accumulated in vital organs such as the liver, the pancreas and the muscles. Over time this accumulation of fat in these vital organs causes the development insulin resistance. Insulin resistance prevents entry of glucose into the cells. When this happens, your levels of blood sugar remain and your pancreas responds by producing more insulin to try to cope with the situation. Too much glucose and insulin, damage all kinds of body tissues such as the kidneys, the brain, the eyes, the arteries just to mention a few. Over time your insulin producing cells within your pancreas gets damaged due over production of insulin. This worsens the situation.  Fig. 1 illustrate how lifestyle can significantly contribute to diabetes and its progression.

Figure 1: The relationship between lifestyle and diabetes. 

                                                            

	Which is this lifestyle repeatedly keeps you blood sugar too high?

By now you understand that diabetes and lifestyle have some relationship. Holford, (2011), clearly described diabetes as the end result of a lifestyle that repeatedly keeps your blood sugar at too high level. Holford’s description of diabetes simply means your lifestyle can slowly and gradually keep your blood sugar high without your knowledge. Your blood sugars can repeatedly remain high for months or years before you are diagnosed with diabetes. Diabetes will take time before its full development. However, a lifestyle that repeatedly keeps your blood sugar levels will accelerate the development of insulin resistance will finally leads to the development of type 2 diabetes. Poor dietary and lack of physical exercises have been implicated as the major contributing factors that causes diabetes. Other factors like cigarette smoking, alcohol intake, sleep problems, some medications have also be said to cause insulin resistance which leads to the development of diabetes.  

·         Poor dietary Intake. Studies have pointed out that poor diet is a key factor contributing to high incidence and prevalence of diabetes. A western diet characterised by high intake of processed and red meat, high- fat dairy, refined grains, sweets and desserts has been implicated to high risk of diabetes. When such a diet is combined with lack of physical exercise, the risk of diabetes increased further (Van et. al, 2002). In addition, foods high in simple sugar and fat and lower in fibre were associated to increased rates of diabetes (Gittelsohn et.al, 1998). Poor diet have contributed to increase in obesity, hypertension, increased cholesterol and triglyceride levels which increase the risk of diabetes (CCHRC, 2014, Hu et al, 2003). The bottom line is that a good diet can delay or prevent or mitigate the development of diabetes and its related complications.

·         Lack of exercise. Many studies have linked lack of physical activity to insulin resistance which leads to type 2 diabetes.  In the body, up to 75 % of glucose is cleared in the muscles (Davi et.al, 1999). Normally, the muscles utilise glucose with them to form energy. Glucose is usually taken from the bloodstream to refill the glucose reserves in the muscles. This helps in keeping your blood glucose levels in balance. Evidence indicate that sensitivity of the muscles increases after exercising. This increases the uptake of glucose from the blood stream lowering blood sugar levels. Exercise also helps the muscles to absorb more glucose without the need of insulin. It also helps in building more muscles. The more the muscles the more the glucose uptake (NIDDK, 2014).  

·         Others. Other factors that have been pointed out to contribute to the development of diabetes include cigarette smoking, alcohol intake and stress.