Nutrition and Type 2 Diabetes: Etiology and Prevention

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Those taking the supplements were found to have lower markers of autoimmunity and inflammation, as well as more weight loss, compared to people who did not take the supplements [ 16 ]. Adequate intake of omega-3s during pregnancy may also decrease the risk of obesity in the offspring. Higher levels of omega-6 fatty acids in relation to omega-3s in umbilical cord blood has been associated with higher obesity in children at age 3 [ 17 ]. The presence of environmental contaminants in food may also play a role in the effects of nutritional factors.

Some contaminants may interfere with the beneficial effects of foods. For example, in a study linking insulin resistance to persistent organic pollutants, the researchers concluded that beneficial aspects of omega-3 fatty acids in salmon oil could not counteract the harmful effects caused by the persistent organic pollutants in that oil [ 18 ]. Fish is one source of omega-3 fatty acids, but according to an editorial in the American Journal of Clinical Nutrition AJCN , it may be better to rely on plant-based sources instead [ 19 ].

Studies on fish consumption and type 2 diabetes are inconsistent: some show that higher dietary intake of omega 3s decreases the risk of type 2, some show no connection, and some even show that higher fish consumption increases the risk of type 2 diabetes [ 20 , 21 ]. It may be that the chemicals in fish can explain these inconsistencies. A study shows that plant-based omega 3s have different effects than marine-based omega 3s in relation to type 2 diabetes [ 22 ], it was opined that this may be possibly due to the contaminants present in fish.

A high fat diet, especially one high in saturated fats, has been linked to type 2 diabetes and insulin resistance. It appears that saturated fatty acids but not unsaturated fats activate immune cells, which produce an inflammatory protein, which in turn then makes cells more insulin resistant [ 23 ]. Mothers who consumed higher levels of trans fats had an increased risk of excess body fat, and so did their breastfed infants [ 24 ].

Can the effects of a high fat diet be passed down to subsequent generations? In animal studies, a high-fat diet that causes obesity in mothers can affect the metabolism and weight of her offspring. But what about a high fat diet in fathers? In one study, the female offspring of heavier father rats fed a high-fat diet had defects in their insulin and glucose levels, like their fathers.

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Unlike their fathers, they were not heavier than the controls [ 25 ]. Other researchers fed mice a high fat diet with fat composition similar to a standard Western diet, and then bred them and fed them the same diet for multiple generations.

Type 2 Diabetes

Over four generations, the offspring became gradually heavier, and developed higher insulin levels, despite not eating more calories. The diet was associated with changes in gene expression [ 26 ]. The glycemic index GI is a measurement of how high a certain food raises blood glucose levels after it is eaten. Foods that have a high glycemic index will cause blood glucose to rise more, triggering insulin production in people who still produce insulin , then leading to falling blood glucose levels.

One prospective study has found that a higher glycemic index diet leads to a faster progression to type 1 diabetes.

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The group of people on this diet, however, did not have higher levels of autoantibodies, showing that the diet may affect disease progression but not disease initiation. The mechanisms involved may include oxidative stress, caused by high blood glucose levels after meals, or perhaps insulin resistance. Whatever the mechanism, a high glycemic index diet may place additional stress on beta cells that are already under an autoimmune attack [ 27 ].

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High fibre foods has been advocated [ 28 ]. It was highlightedthat, although before detailed advice can be given, comparative data on the physiological effects of carbohydrate foods maybe required. The consumption of sugar-sweetened beverages has been associated with type 2 diabetes, obesity, and metabolic syndrome. High-fructose corn syrup is another sweetener linked to obesity.

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Rats given access to high-fructose corn syrup gained more weight than those given access to sucrose, despite eating the same number of calories [ 30 ]. A few studies have found that higher zinc levels in drinking water may be protective against type 1 diabetes. For example, Zhao et al.

In Norway, a study found that higher zinc levels in water was associated with a lower risk of type 1 diabetes, but the association was not statistically significant [ 32 ]. In Finland, a study found that low zinc levels in drinking water was associated with a higher incidence of type 1 diabetes [ 33 ]. Nicotinamide, is a component of vitamin B 3 that has been shown to protect against diabetes in animals, and prevent beta cell damage [ 34 ].

Even better, one study found that it prevented the development of type 1 diabetes in children with type 1-associated autoantibodies [ 35 ]. On the basis of these and other studies, a large, double-blind, placebo-controlled trial was conducted in Europe, the U. This trial gave nicotinamide to first degree relatives of people with type 1 diabetes who already had developed type 1-associated autoantibodies.

Unfortunately, it found no difference in the development of diabetes between the two groups during the 5 year follow-up period. Another double-blind, placebo controlled study in Sweden gave high doses of anti-oxidants including nicotinamide, vitamin C, vitamin E, Beta-carotene, and selenium to people after they were already diagnosed with type 1 diabetes and also found that they had no effect in protecting the beta cells against the damage of free radicals [ 36 ].

There is no evidence linking the anti-oxidants alpha- or beta-carotene levels and the development of type 1 related autoimmunity in another study as well [ 37 ]. Uusitalo et al.

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Czernichow et al. Yet they also found that the people who had the highest levels of some anti-oxidants beta-carotene, vitamin C, and vitamin E in the beginning of the study, presumably due to a diet rich in plant foods, did have a lower risk of developing metabolic syndrome. While these studies did not find promising results concerning anti-oxidant supplements, they also did not find that these supplements did any harm. Free radicals may play a role in the inflammatory process that destroys the beta cells in type 1 diabetes [ 36 ].

Therefore, anti-oxidants have been thought to protect the body from oxidative stress due to the production of free radicals. But, there is some animal evidence that anti-oxidant supplements may also increase insulin resistance, showing that the relationship may not be so simple. When the researchers gave certain mice an anti-oxidant, they were more likely to become insulin resistant [ 40 ].

Perhaps this finding could help explain why anti-oxidant supplements have not been found to be protective against type 1 diabetes.

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Advanced Glycation End products AGEs are found in heat processed foods and have been linked to type 1 and type 2 diabetes in animal studies. They appear to predispose people to oxidative stress and inflammation, and may affect the fetus if the mother consumes them during pregnancy. A study has found that the level of AGEs that a mother eats are correlated with insulin levels in the baby.

It found that if mothers have high AGE levels, and infant food is high in AGEs, it may raise the risk of diabetes in the offspring [ 41 ]. Researchers fed mother rats a diet that was deficient in protein, and found higher rates of diabetes in the offspring.

They also found that one of the offspring's genes was "silenced"-- a gene associated with type 2 diabetes development. Explore treatment and care. Put the right fuel in your body A huge part of managing type 2 diabetes is developing a healthy diet. You need to eat something sustainable that helps you feel better and still makes you feel happy and fed.

[Full text] Effects of vitamins C and D in type 2 diabetes mellitus | NDS

Work to find helpful tips and diet plans that best suit your lifestyle—and how you can make your nutritional intake work the hardest for you. Eat to win, every day. Get moving with a fitness plan Fitness is a key part of managing type 2. Become part of the conversation today. Join the community. Living with Type 2. A compromised innate and adaptive immune response in diabetes and an endocrine-linked metabolic response to stress suggest a two-way association between diabetes and tuberculosis. The RSSDI advocates adoption of lifestyle modifications including dietary intervention as an essential part of the management strategy recommended for the double burden [ ].

It is recommended that proteins should be the major source of energy in patients with coexisting diabetes and TB without renal or hepatic insufficiency. Intake of dietary fibers and moderate amounts of fats supplemented with appropriate intake of vitamins especially vitamin D, B6 and B12 and minerals are considered beneficial for patients with concurrent diabetes and TB [ ]. Considering the lower protein intake among Indians and increased micronutrient requirements, meal replacements or between-meal protein-rich snacks may be a useful approach to adequate supplementation in patients with T2DM and coexisting TB.

Step-wise approach for implementation of MNT. References: Atkinson et al. This step includes developing meal plans with a focus on nutrient intake and providing nutritional education, counseling and coordination of care. As there are no gold standards or prototypical diets, signature diet plans need to be developed based on individual nutrition goals. Providing healthful food choices, guidance on portion control and regularized eating patterns are common approaches. These approaches include replacement of one or two daily meals PMR or all meals FMR with a healthful single food or a combination of foods such as fortified bars, powders, shakes, frozen foods, dietary supplements, etc.

These meal plans help maintain dietary adequacy by providing acceptable macronutrient distribution and improving the intake of vitamins, minerals and proteins, thereby reducing the risk of deficiencies that are common in patients on restricted diets. Combining low GI, high-fiber foods such as leafy vegetables amaranth, fenugreek, spinach, radish leaves, etc. MNT is an effective and affordable therapeutic approach that should be made an indispensable component of T2DM prevention and management.

Appropriate MNT should be devised and monitored by a team of RDs and diabetologists based on their experience and the patient's previous diet history, blood glucose levels and presence of comorbidities to ensure best care. The recommendations and strategies provided in this document should be adopted within the context of current clinical practice and at the discretion of the RDs and diabetologists.

Overall, MNT should provide convenient and culturally oriented choices that will motivate individuals to engage in healthful dietary habits. Signutra Inc. The authors also thank Dr. All named authors meet the International Committee of Medical Journal Editors ICMJE criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole and have given final approval to the version to be published. Makkar and Shalini Jaggi have nothing to disclose. Data sharing is not applicable to this article as no data sets were generated or analyzed during the current study.

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