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Do you go to the gym after sitting at your desk all day? Run or bike outside regularly? Are you watching your weight? If you answered yes to any of these questions, you may be at risk for type 2 diabetes.
What the...? Turns out that the disease is a hidden threat to otherwise healthy women. "Even those who are slim and physically fit may be at risk," says Leonid Poretsky, MD, director of the Friedman Diabetes Institute at Beth Israel Medical Center in New York City. That's something many people, and even some doctors, are not aware of.
In fact, the majority of us don't really understand what diabetes is and the havoc it can cause. So here's the deal: Type 2 diabetes occurs when the body doesn't produce enough insulin, a hormone that helps cells convert both sugars and starches (aka glucose) into energy, and doesn't respond properly to the insulin it does make. Glucose then builds up in the blood, which can lead to a host of complications, including heart disease, stroke, and kidney failure. Even scarier is that nearly 24 million people in the United States have diabetes, and almost 6 million of them are undiagnosed, according to the Centers for Disease Control and Prevention. The incidence is expected to rise significantly: Some experts estimate that the number of Americans with type 2 diabetes will double in the next 25 years. "Diabetes is an epidemic," Dr. Poretsky says.
Fortunately, you can help protect yourself. We're not talking about difficult, time-consuming lifestyle changes, but simple, everyday tweaks to your routine that can help reduce your risk of the disease and boost your overall health. Make these nine smart moves today.
Think you can cross this one off your list because you work out daily? Not so fast. The truth is, the average person -- even one who is active and fit -- sits for a whopping nine hours a day. (You can thank your desk job for that.) An hour-long workout is not enough to offset all that chair time to keep you disease-free, according to a number of recent studies. "When you sit too long, your body stops producing lipoprotein lipase, an enzyme that essentially vacuums fat out of your bloodstream," says Marc Hamilton, PhD, director of the inactivity physiology department at the Pennington Biomedical Research Center in Baton Rouge, Louisiana. "The more you sit, the more your levels of lipase plummet. If you're glued to your computer all day, you probably won't be able to metabolize fat properly." That, combined with other factors, can eventually lead to insulin resistance, a precursor to diabetes in which your body is unable to use the insulin it produces.
It's hard to say exactly how much time on your behind is too much because the research is so new, says Stuart Biddle, PhD, a professor at the School of Sport, Exercise, and Health Sciences at Loughborough University in the United Kingdom. But it's a good idea to get up as much as possible. "Aim to stand at least five minutes every hour," Biddle suggests. Move around more often by placing your trash can on the other side of your cubicle and your phone steps away from your computer. Instead of meeting with coworkers at the conference table, do a group walk-and-talk around the block or at a nearby park. Chances are, you'll be more focused and creative, too, because activity has been shown to rev up brainpower.2. Take vitamin D.
In addition to protecting you against breast and colon cancer and depression, this wonder vitamin can also help prevent diabetes. In a study at G.V. (Sonny) Montgomery VA Medical Center in Jackson, Mississippi, people with low levels of D were more likely to have poor sugar control, a marker for diabetes. "Vitamin D stimulates the production of insulin, which helps the body utilize blood sugar," explains Michael F. Holick, MD, PhD, director of the Heliotherapy Light and Skin Research Center at Boston University Medical Center. Because it's tough to get D from food, most women are deficient, Dr. Holick says. He recommends taking a supplement of 2,000 IU of vitamin D every day.3. Run or bike off-road.
You know that air pollution is bad for your lungs. Now a study has found that it can also contribute to diabetes. "The ultrafine dust emitted from cars as they burn gasoline contains minute bits of chemicals and metals that appear to cause chronic inflammation," says study coauthor, Ursula Kramer, PhD, professor of environmental epidemiology at the Environmental Health Research Institute at Heinrich Heine University in Germany. Our bodies then release anti-inflammatory proteins that make us less responsive to insulin, increasing our diabetes risk. The danger is highest for people who live within about 110 yards of busy roads. But fitness buffs also need to beware. If you exercise near a high-traffic area, the deeper breaths you take while doing cardio mean you'll inhale more dust. The healthy solution is to find a path less traveled for your workout -- in a residential neighborhood, for instance, or along a trail. Check out mapmyrun.com for routes in your area.4. Skip the deli turkey sandwich.
It's a no-brainer that fatty bacon and bologna are bad for you. But research shows that even low-fat processed deli meats can pose a significant danger when it comes to diabetes. "On average, eating one 1.8-ounce serving of processed meat every day is associated with a 19 percent higher risk of the disease," says lead study author Renata Micha, PhD, a research fellow in the department of epidemiology at Harvard School of Public Health. The possible culprits are the nitrate preservatives used in your favorite sandwich fixing: Micha and her colleagues found that processed meat contains about the same amount of saturated fat and cholesterol as unprocessed red meat, but 50 percent more nitrate preservatives, which have been shown to reduce glucose tolerance. If you eat processed meat more than once a week, consider a smart swap. Make your sandwich with fresh chicken or turkey, or veg out and eat a pita with hummus, carrots, tomato, and a little avocado.5. Watch your sugar intake.
Foods containing added sweeteners are typically higher in calories, so if they're a regular part of your diet, you're more likely to pack on extra pounds and increase your chances of getting diabetes. "Not only that, these foods are digested quickly, making you hungry again soon and likely to eat even more," says Christine Tobin, a certified diabetes educator and president of health care and education for the American Diabetes Association. Even "healthy" choices like yogurt, peanut butter, and energy bars can contain high amounts of the sweet stuff. At the supermarket, be sure to read labels before putting foods in your cart, and steer clear of anything that lists sugar, sucrose, corn syrup, or other sweeteners, such as evaporated cane juice or molasses, as one of the first ingredients.6. Bulk up.
Your diet, that is. Certain foods that are high in fiber take longer to break down during digestion; as a result, glucose is released into the bloodstream more slowly," Tobin says. You'll stay full longer, which helps keep you slim and gives your body plenty of time to produce all the insulin it needs. Aim for 25 grams of fiber every day. Have a bowl of oatmeal with sliced bananas for breakfast, eat black bean soup and a whole-grain roll for lunch, and cook whole-grain pasta with veggies for dinner.7. Ditch the deprivation diet.
It's true that dropping pounds if you're overweight can help protect you against diabetes. But a recent study indicates that people who slash their intake too much -- to 1,200 calories a day -- had higher levels of stress hormones, which can ultimately increase the risk of developing the disease. "When you cut calories to very low levels, your body perceives it as a type of stress, which is probably what leads it to produce more stress hormones like cortisol and adrenaline," explains David Kendall, MD, chief scientific and medical officer for the American Diabetes Association. This in turn can send your blood sugar soaring. If you want to lose weight and keep it off, try the slow and steady approach rather than resorting to a crash diet. "Eat about 1,500 calories a day as part of a sensible weight-loss plan," advises Susan Weiner, RD, a certified diabetes educator in Merrick, New York. And, of course, exercise regularly to help fight the flab.8. Flee from smoke.
Cigarettes have long been linked to diabetes, and new research shows that breathing in secondhand smoke may also lead to an increased risk of the disease. In a study, nonpuffers who were exposed to smoke at home or work were about twice as likely to develop type 2 diabetes as those who weren't in similarly smoky environments. Though experts don't yet fully understand the reason, they suspect that smoke may affect insulin. "Tobacco smoke has the potential to increase the demand for insulin in the body and possibly to reduce the amount of insulin our bodies release," Dr. Kendall says. If you live with a smoker, tell him that his bad habit is affecting your health. If he won't quit, insist that he smoke outside. At work and in public, avoid areas where groups of smokers tend to congregate.9. Sleep better.
Like many of us, you're probably sleep deprived. (On average, we snooze just six to seven hours a night.) But it's not only the quantity of zzz's that can hurt your health; it's also the quality. In a meta-analysis of 10 studies published this year, researchers found that people who had trouble falling or staying asleep had an increased risk of type 2 diabetes. "Your body needs deep sleep to metabolize glucose properly," says Phyllis C. Zee, MD, PhD, director of the Sleep Disorders Center at Northwestern Memorial Hospital in Chicago. "That's why people who suffer from insomnia -- whether it's tossing and turning for 30 minutes before falling asleep or waking up during the night -- have a greater chance of developing the disease." How can you tell if you're getting the proper amount of rest? The general rule is to aim for seven to nine hours a night, but exactly how much we need varies from person to person. "Sleep enough so that you feel alert throughout the day," Dr. Zee suggests. "If your brain gets fuzzy or your mood turns cranky, you probably need more." Also, practice good snoozing habits: Hit the sack and wake up at about the same time every day (yes, even on weekends), avoid caffeine up to six hours and alcohol up to four hours before bed, and keep your bedroom as dark and quiet as possible. Invest in blackout shades and a white-noise machine if you have to. "Make sleep as much of a priority as exercising and eating right, and it will go a long way toward keeping you healthy," Dr. Zee says.
See your doc right away if you have any of these symptoms of type 2 diabetes.
Originally published in FITNESS magazine, November/December 2010.