Can We Stop Diabetes?

A

 lot of people in India are already affected by the condition diabetes. Many studies have shown that Indians are particularly prone to develop diabetes and its complications. Experts have warned that about 9% of our population will soon be affected by this condition. For a country with over a billion population, this forms a huge number. Isn't it important for us to look for solutions?  

A study by Ramachandran and others in India have shown some promising answers. The study tried to understand the benefit of different interventions in preventing diabetes. It was conducted among people aged between 35 to 55 years who have not become diabetic, but shown a relatively high level of sugar in their blood, a condition known as pre-diabetic stage. Among the 531 people who were included in the study by dividing them into four groups, the first group was given medicines to lower their blood glucose levels and the second group was helped though regular classes and counselling to change their lifestyles including adherence to a better healthy diet and consistent moderate daily physical activities. The third group of people received both medicine and help for lifestyle modification. The fourth group was not any intervention.

Then, what happened to them?

After three years of follow-up of all the four groups, the researchers calculated the number of people who moved from a pre-diabetic stage to diabetic condition. The maximum benefit of the interventions was shown by the group which received regular help for their lifestyle modification. Compared to the group which did not receive any intervention, the group which modified their lifestyles had shown 28.5% less chance of developing diabetes. Even the group which had received both medicines and guidance for lifestyle modification had slightly lesser benefit than the group which only modified lifestyles

Though the benefit of lifestyle modification in preventing diabetes has already been established in several populations across the world, this study has confirmed the beneficial effect in the Indian population.  Interestingly, the study also showed that even though there was no overall weight reduction in the group that was helped to change lifestyles, the intervention benefited in terms of reducing their potential to develop diabetes in the future.

What does this study implicate?

The increasing prevalence of diabetes in our population is explained at least partly by the changing lifestyle in recent years in relation to diet and physical activity. These life-style choices are fueled by the development model that we pursue. It is important that we reverse these trends to the extent possible to stop diabetes from crippling more and more people. The core of such a change should be at two levels. The first and foremost is a change at the level of individuals, families and communities who are to embrace healthier choices.  Equally important is the creation of a facilitative environment that helps individuals, families and communities to choose healthier lifestyle choices in relation to diet and physical activities. This requires a stronger political commitment to regulate unhealthy foods and invest in policies and programs that promote healthier habits.

It is always better to turn off the faucet than mopping up the floor when the sink overflows!  

Reference

Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar AD, Vijay V; Indian Diabetes Prevention Programme (IDPP). The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia. 2006 Feb;49(2):289-97. PMID: 16391903.

No Soup for You?!?

Once again BPA is in the news. Or should I say, in the soup?

BPA, or bisphenol A, is an industrial chemical used to make plastics and resins that seems to have been linked to everything from developmental and reproductive effects to obesity, cardiovascular disease and diabetes.  

And over the last few years, headlines have proclaimed BPA to be found in -and on- everything from plastic water bottles, to canned foods, to receipts and even money!

This latest follows a study published in last week's edition of the Journal of the American Medical Association, a team of researchers at the Harvard School of Public Health conducted a study of 75 participants that compared people who were given canned vegetable soup for lunch for 5 straight days  with people who consumed prepared vegetable soup -made without any canned ingredients- for 5 straight days

And what did they find?

That within a few hours after eating, those participants who had eaten canned soup had levels of BPA in their urine that were approximately 12x greater than the participants who had been eating the prepared vegetable soup! Although it's important to note that even though the study utilized Progresso brand soup, this is an industry-wide practice, so these sorts of results would be expected from other companies with canned soup products.

Scary, right?

Well, maybe not...it's important to keep in mind that these levels were still in what our government considers a safe range. But there is still a lot of public concern about potential public health effects of bisphenol A, but not a lot of solid answers. This is why reports of exposures to potential health hazards should always include at least a reference to information on health effects, or potential health effects. And ideally, the same for a method to reduce exposure!

As this type of report leaves me wondering....we know we're exposed to BPA...but what are the realistic health effects? 

Not very clear! But BPA is currently being investigated, by private and public institutions, including the US Food and Drug Administration and the National Toxicology Program at the National Institutes of Health, especially as regards possible effects of BPA on the brain, behavior, and sexual development in infants and young children. Dr. Burcher, Associate Director of the National Toxicology Program, has explained that BPA is considered to be of some concern  because "scientists that have looked at this information recognize that there is something really going on here, but it's not exactly clear".  For more information about the NTP conclusions, see the NIEHS page on the topic.

So, while the jury--or in this case, the science---is out, what can/should you do?

Minimize your exposure to BPA by minimizing your exposure to the products we know are likely to be contaminated! That means in addition to ditching the BPA-containing plastic water bottles, you should think about trying to reduce overall consumption of canned goods. At the least, try to minimize consumption of canned food that is acidic, like canned tomatoes, or salty, because BPA is more likely to leach from the epoxy-resin linings of these cans right into these types of food!

Take the opportunity to try out a few recipes yourself....you never know, you might even enjoy cooking!

And on the bright side, we know that this approach can work...last March the journal Environmental Health Perspectives published the results of a small Silent Spring-sponsored study in which twenty participants from five families eliminated canned and packaged foods for only three days, but were able to reduce their levels of BPA exposure by approximately 60%!

Mary M. is doctoral student at Emory University's Rollins School of Public Health. If you need a little inspiration in the kitchen, she might just have a recipe for you!