Nutrition, fitness and healthy lifestyle choices have been found to improve (and in some cases reverse) Type 2 diabetes.
Dietary treatment goals for Type 2 diabetes include improvement in glucose levels, blood pressure and serum lipids to optimal levels. In addition, dietary improvements should lead to a healthy weight. When Type 2 diabetics consistently follow a healthy diet, exercise regularly (at least 150 minutes per week) and use medications as needed, their blood glucose levels are controlled, which drastically decreases risk for complications.
The American Diabetes Association recommends that Type 2 diabetics receive individualized medical nutrition therapy by a registered dietician, monitor carbohydrate intake, consume lower-glycemic index foods, increase fiber intake to at least 14 grams per day, limit saturated fat intake to less than 7 percent of total calories, minimize trans fat intake, maintain a healthy weight or lose weight if overweight and limit alcohol to one drink per day for women and two drinks per day for men.
A recent meta-analysis revealed that consumption of a vegetarian diet is associated with improved glycemic control in Type 2 diabetes, with a significant improvement of hemoglobin A1c levels. Additionally, a low-fat, plant-based diet has been found effective in improving blood glucose levels and decreasing cardiovascular risks by lowering cholesterol levels better than the diet recommended by the American Diabetes Association. The low-fat, plant-based diet also has greater reductions in body weight, LDL cholesterol and urinary micro-albumin levels. The low-fat, plant-based diet removed all animal products, avoided added oils and aimed for low-glycemic index foods.
A low-fat, plant-based diet improves insulin sensitivity in several ways:
1) This type of diet is low in fat and high in fiber, which results in a lower caloric intake and significant weight reduction. An increase of 14 grams of dietary fiber per day decreases calorie intake by 10 percent. A reduction in body fat allows insulin to be utilized more effectively in the body, thereby increasing insulin sensitivity or decreasing insulin resistance.
2) Reducing total fat intake — and saturated fat, in particular — increases insulin sensitivity. Saturated fats are derived from animal sources like meat and dairy products (beef, butter, cheese, etc.).
3) Increased carbohydrate intake improves insulin sensitivity in healthy individuals and blood sugar control in Type 2 diabetics.
4) Lower-glycemic index carbohydrates reduce A1c concentrations in Type 1 and 2 diabetics.
5) High-fiber diets lower post-meal blood glucose levels when compared to low-fiber diets and improve glycemic control in Type 2 diabetics.
6) Meat and dairy products have been shown to increase risks for Type 2 diabetes, potentially due to the increased saturated fat content, resulting in an increase in intramyocellular lipid concentration and subsequent lipotoxicity. Intramyocellular lipid is the fat deposition in our muscle that leads to insulin resistance.
The glycemic index is a list of carbohydrate-containing foods ranked according to how much they raise blood glucose levels when compared to oral glucose. Examples of low-glycemic index foods include dried beans and legumes, non-starchy vegetables, some starchy vegetables like sweet potatoes, fruit and whole grains.
Counting carbohydrates is a method used to manage carbohydrate consumption for optimal control of blood sugar concentration, especially after meals and for pre-meal insulin dosing. Suggested goals of carbohydrates per meal are 30 to 45 grams for meals and 15 to 20 grams for snacks and a total of 45 to 55 percent of calories for the day.
There are two methods for carbohydrate counting: reading food labels for specific carbohydrate amounts per serving and then adjusting the food amount to meet the predetermined goal, or using the exchange system where foods groups are broken down to a predetermined amount of carbohydrates.
Physical inactivity is associated with increased risk for impaired glucose tolerance and Type 2 diabetes. Weight loss through exercise and a healthy diet significantly decrease the risk for Type 2 diabetes. In Type 2 diabetics exercise lowers blood glucose and cholesterol levels and improves insulin sensitivity, regardless of actual weight loss.