Here are some of the factors that make you more inclined to develop type 2 diabetes, plus tips on lifestyle and dietary changes that may significantly lower your risk.
By Andrew Postman
First, the good news about diabetes: The rate of new cases among adults has decreased, according to the CDC’s most recent Diabetes Report Card. That solid little B+ piece of news, alas, pales next to some of the surrounding D’s: The rate of new cases among children and teens has increased. Thirty million Americans are diabetic, up to 95% of whom are type 2. One-third of adults are prediabetic, meaning they have an elevated blood sugar level. It’s worth understanding the major risk factors for developing the disease because—and here’s some good news—with dietary and lifestyle changes, type 2 diabetes may be able to be prevented or in some cases even reversed, says Louis Philipson, MD, professor in the departments of medicine and pediatrics at the University of Chicago, and president for medicine and science at the American Diabetes Association.
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What's your risk?
Here are some of the factors that make you more inclined to develop type 2 diabetes.
Your genes and epigenetics
If one of your parents or siblings has type 2 diabetes, your chance of also developing it goes up—that’s your genetic makeup at play. But your epigenetic makeup—when genes get triggered by external forces—may be just as influential. “There’s no question that genetics play a role, but why do we have such a huge rise in type 2 diabetes? We have the same general genetics that we did 50 years ago, yet there wasn’t rampant type 2 diabetes. That’s where the environment comes in,” says Sarah Hallberg, DO, founder of Indiana University Health Arnett’s Medically Supervised Weight Loss Program,
medical director at Virta Health, and lead author on numerous studies on obesity, diabetes and dietary influence. “It may be that 100% of us are potentially at risk for getting diabetes—but not everyone’s environmental exposures cause that to happen.” The epigenetics link remains unclear—“we’re still not certain how these genes get turned on,” Hallberg says—but researchers have hypothesized that type 2 may be related to (among other factors) what your mom ate while she was pregnant, whether she had gestational diabetes, and even what your mom and dad ate before you were conceived.
Sugary drinks
Studies have shown the link between sugary drinks and type 2 diabetes. Beverages with added sugar or high-fructose corn syrup—whether they’re sodas, energy drinks or bottled coffee drinks—have lots of calories and virtually zero nutritional benefit. Maybe most sneaky: fruit juice. It tends to contain as much sugar as soda, but because the sweetness comes from fructose, a natural sugar, we all grow up thinking it’s somehow more virtuous...and then serve it daily to our kids.
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Too many simple carbs
Diabetes means your pancreas doesn’t make enough insulin, the hormone your body needs to convert the glucose from carbohydrates into glycogen (aka stored energy). Hallberg points out that eating lots of carbs for energy is based on a faulty principle: “Our body can only store a little over 2,000 calories of carbohydrates as glycogen,” she says. “Once we max that out, the rest just gets turned into fat”—which happens to be another type 2 risk factor.
Belly fat
Carrying excess weight increases resistance to insulin. In particular, visceral fat—the kind found in your abdomen and around your organs, including your liver and pancreas—especially ups your risk of developing type 2.
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Environmental factors
It’s possible that exposure to air pollutants, plastic and chemicals in our drinking water could affect your risk, Hallberg says. “We believe these exposures play a role, but we don’t quite understand the exact mechanisms,” she says. “We can almost confidently say there’s a problem with them—but what is it, specifically? Is it just the BPA? Do you need to have five different exposures happening? Is it leading to insulin resistance or weight gain or heart disease? There’s a lot more we need to figure out.”
Healthy approach
With these lifestyle and dietary changes, you can control—and may significantly lower your risk of developing—type 2 diabetes.
Eat fresh
Of course, you want to eat healthier and lay off processed foods. But when you’re busy with everything else on your to-do list, that can seem impossible. Philipson says, “The single most common question to the ADA call center, which fields over 100,000 calls a year, is, What should I eat?” Balance is crucial. To an extent, “we all have the ability to control our insulin levels with the food choices we make,” Hallberg says. It may not always be easy, and it may be somewhat pricier—but it’s possible to help turn things around. We can’t say that about every disease. One tip: Frozen fruits and veggies can be a cheaper, more convenient substitute for fresh.
Focus on vegetables
Yes, fruits and veggies are often suggested in the same breath. If you’ve been diagnosed with metabolic syndrome, however, you’ll need to restrict your fruit intake since it can increase blood sugar significantly.
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Don’t be afraid of fat
Stop demonizing the fat we eat just because diabetes is often associated with the fat our bodies have accumulated. The thing with low- or no-fat foods like yogurt or granola bars is that removing the fat takes away much of the flavor—which is then compensated for with excess sugar. “The low-fat diet is dead,” says Hallberg, who instead recommends a lower-carb diet. “The problem is, almost no one is aware of this.”
Drink clean
Drink lots of water, and don’t sweeten your tea or coffee. Avoid sugary beverages, soda and juice. Hallberg calls the elimination of sugar-sweetened drinks and juices “the number one change parents can make to curb the risk of metabolic disease and obesity in their kids.” Consider using stevia, erythritol or xylitol, which are all derived from naturally occurring substances. Try to steer clear of sweeteners like Splenda (sucralose) and Equal (aspartame).
Move more
The best workout is the one you do today, whatever it might be. Keep your goals sustainable: You don’t have to train for a marathon—just try lifting weights, Hallberg says. It’s an effective way to keep weight down and build muscle.
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