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Nutrition for Diabetes Managment

Nutrition for Diabetes Managment

By Kristen LaStofka, Master of Science in Nutritional Sciences student at UT Austin


Health Promoting Foods for Type 2 Diabetes

Diabetes is the seventh leading cause of death in the United States with 30.3 million people having diabetes and of that 90 to 95% of cases are type 2 diabetes.1 Type 2 diabetes is the most common form of diabetes and is the result of your body not using insulin properly to control blood glucose leading to insulin resistance and high blood sugar.2 The risk factors for developing type 2 diabetes include physical inactivity, high blood pressure, hyperlipidemia, smoking, family history, poor diet and overweight or obesity.3 Research shows that many different foods contain specific bioactive components that impact your risk of disease. Incorporating such foods into your diet along with remaining physically active can help you prevent or manage your diabetes!


Whole Grains

Research shows that whole grain consumption, specifically oats, rye and barely, is associated with a reduced risk of type 2 diabetes related to the bioactive compound beta-glucan. Beta-glucan is a soluble fiber that slows the rate of carbohydrate absorption leading to improved insulin sensitivity and smaller rise in glucose after a meal. Studies show that consuming rye bread or bread enriched with beta-glucan decreased glucose response, insulin resistance, LDL (bad) cholesterol levels and increased satiety.4,5 Researchers conclude that a diet high in fiber and whole grains, at least 2 servings per day, with reduced consumption of refined grains is associated with a reduced risk of type 2 diabetes and overall better health.6


Vegetables

Research shows that increased vegetable consumption is associated with a reduced risk of developing type 2 diabetes.7 Certain cruciferous vegetables, such as broccoli and Brussel sprouts, along with certain allium vegetables, such as leeks and onions, contain the bioactive component quercetin, which is known to have antioxidant and anti-inflammatory properties. Inflammation and oxidative stress are hallmarks of diabetes and studies have shown consumption of onions and broccoli result in substantial decreases in levels of oxidative stress and inflammation, which in turn leads to decreased insulin resistance.8,9

Other vegetables have also been shown to be beneficial for diabetes, specifically tomatoes as they contain the bioactive compound lycopene, which gives them their red color and is known for its antioxidant properties. Studies have shown that tomato consumption is associated with decreased inflammation, oxidative stress and fasting plasma glucose, deeming them a diabetes friendly food that should be incorporated into the diet for diabetes prevention and management.10,11


Fruits

Research shows an inverse relationship between fruit consumption and type 2 diabetes risk.6 Many fruits contain fiber and phenolic compounds, such as the flavonoids anthocyanin and quercetin, that have powerful antioxidant and anti-inflammatory properties. Blueberries have one of the highest antioxidant capacities among fruit related to the high anthocyanin content that decreases your glucose response after a meal, reduces oxidative stress and reduces inflammation, all of which are beneficial for diabetes management.12

Apples are also a good source of fiber and contain the bioactive compound quercetin that has antioxidant properties. Studies have shown apple consumption slows starch breakdown to decrease glucose response as well as decrease oxidative stress, all of which are factors that decrease your risk of developing type 2 diabetes.13


Legumes

A variety of legumes, such as soybeans, chickpeas and black beans, are high in antioxidants and fiber that reduce the risk of type 2 diabetes. Soybeans and chickpeas contain isoflavones, which have antioxidant properties, that reduce oxidative stress and decrease insulin resistance.14,15 Black beans are high in fiber and the antioxidant anthocyanin that has been shown to decreases your glucose response after a meal, reduces oxidative stress and reduces inflammation, all of which are beneficial for diabetes management.16


Nuts & Seeds

Nuts contain many bioactive and health promoting components.16 Pistachios, walnuts, almonds and pecans have some of this highest level of polyphenols, which act as antioxidants to reduce oxidative stress.17,18, 19 They are also rich sources of omega 3 fatty acids that act to reduce inflammation.17,18,19 Nuts a good source of healthy fats that should be included in the diet to improve cardiovascular risk factors that are implicated in diabetes.

Chia seeds and flax seeds both have a high soluble fiber content that beneficially affects glucose control by slowing carbohydrate digestion and also contain high levels of the anti-inflammatory omega-3 fatty acids, that reduce inflammation. Studies have shown consumption of flax seed or chia seeds leads to decreased glucose response after the meal and decreased inflammation, with greater beneficial effects seen for ground chia seeds compared to whole chia seeds and flax seeds.21,22


Kristen LaStofka wrote this article as part of her study in the Master of Science in Nutritional Sciences degree program at UT Austin. Learn more about this program here.

References:

  1. Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2017. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2017.
  2. American Diabetes Association. (n.d.). Type 2. Retrieved from http://www.diabetes.org/diabetes-basics/type-2/
  3. National Institute of Diabetes and Digestive and Kidney Diseases. (2016, November 01). Risk Factors for Type 2 Diabetes. Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/risk-factors-type-2-diabetes
  4. Sandberg, J. C., Björck, I. M. E., & Nilsson, A. C. (2017). Effects of whole grain rye, with and without resistant starch type 2 supplementation, on glucose tolerance, gut hormones, inflammation and appetite regulation in an 11–14.5 hour perspective; a randomized controlled study in healthy subjects. Nutrition Journal, 16(1). https://doi.org/10.1186/s12937-017-0246-5
  5. Liatis, S., Tsapogas, P., Chala, E., Dimosthenopoulos, C., Kyriakopoulos, K., Kapantais, E., & Katsilambros, N. (2009). The consumption of bread enriched with betaglucan reduces LDL-cholesterol and improves insulin resistance in patients with type 2 diabetes. Diabetes & Metabolism, 35(2), 115–120. https://doi.org/10.1016/j.diabet.2008.09.004
  6. Aune, D., Norat, T., Romundstad, P., & Vatten, L. J. (2013). Whole grain and refined grain consumption and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies. European Journal of Epidemiology, 28(11), 845–858. https://doi.org/10.1007/s10654-013-9852-5
  7. Wu, Y., Zhang, D., Jiang, X., & Jiang, W. (2015). Fruit and vegetable consumption and risk of type 2 diabetes mellitus: a dose-response meta-analysis of prospective cohort studies. Nutrition, Metabolism, and Cardiovascular Diseases: NMCD, 25(2), 140–147. https://doi.org/10.1016/j.numecd.2014.10.004
  8. Taj Eldin, I. M., Ahmed, E. M., & Elwahab H M, A. (2010). Preliminary Study of the Clinical Hypoglycemic Effects of Allium cepa (Red Onion) in Type 1 and Type 2 Diabetic Patients. Environmental Health Insights, 4, 71–77. https://doi.org/10.4137/EHI.S5540
  9. Bahadoran, Z., Tohidi, M., Nazeri, P., Mehran, M., Azizi, F., & Mirmiran, P. (2012). Effect of broccoli sprouts on insulin resistance in type 2 diabetic patients: a randomized double-blind clinical trial. International Journal of Food Sciences and Nutrition, 63(7), 767–771. https://doi.org/10.3109/09637486.2012.665043
  10. Zheng, Z., Yin, Y., Lu, R., & Jiang, Z. (2019). Lycopene Ameliorated Oxidative Stress and Inflammation in Type 2 Diabetic Rats. Journal of Food Science. https://doi.org/10.1111/1750-3841.14505
  11. Bose, K. S. C., & Agrawal, B. K. (2006). Effect of long term supplementation of tomatoes (cooked) on levels of antioxidant enzymes, lipid peroxidation rate, lipid profile and glycated haemoglobin in Type 2 diabetes mellitus. The West Indian Medical Journal, 55(4), 274–278.
  12. Bell, L., Lamport, D. J., Butler, L. T., & Williams, C. M. (2017). A study of glycaemic effects following acute anthocyanin-rich blueberry supplementation in healthy young adults. Food & Function, 8(9), 3104–3110. https://doi.org/10.1039/c7fo00724h
  13. Song, Y., Manson, J. E., Buring, J. E., Sesso, H. D., & Liu, S. (2005). Associations of dietary flavonoids with risk of type 2 diabetes, and markers of insulin resistance and systemic inflammation in women: a prospective study and cross-sectional analysis. Journal of the American College of Nutrition, 24(5), 376–384.
  14. Chang, J. H., Kim, M. S., Kim, T. W., & Lee, S. S. (2008). Effects of soybean supplementation on blood glucose, plasma lipid levels, and erythrocyte antioxidant enzyme activity in type 2 diabetes mellitus patients. Nutrition Research and Practice, 2(3), 152–157. https://doi.org/10.4162/nrp.2008.2.3.152
  15. Nestel, P., Cehun, M., & Chronopoulos, A. (2004). Effects of long-term consumption and single meals of chickpeas on plasma glucose, insulin, and triacylglycerol concentrations. The American Journal of Clinical Nutrition, 79(3), 390–395. https://doi.org/10.1093/ajcn/79.3.390
  16. Thompson, S. V., Winham, D. M., & Hutchins, A. M. (2012). Bean and rice meals reduce postprandial glycemic response in adults with type 2 diabetes: a cross-over study. Nutrition Journal, 11, 23. https://doi.org/10.1186/1475-2891-11-23
  17. Alasalvar, C., & Bolling, B. W. (2015). Review of nut phytochemicals, fat-soluble bioactives, antioxidant components and health effects. British Journal of Nutrition, 113(S2), S68–S78. https://doi.org/10.1017/S0007114514003729
  18. Hernández-Alonso, P., Salas-Salvadó, J., Baldrich-Mora, M., Juanola-Falgarona, M., & Bulló, M. (2014). Beneficial effect of pistachio consumption on glucose metabolism, insulin resistance, inflammation, and related metabolic risk markers: a randomized clinical trial. Diabetes Care, 37(11), 3098–3105. https://doi.org/10.2337/dc14-1431
  19. Li, S.-C., Liu, Y.-H., Liu, J.-F., Chang, W.-H., Chen, C.-M., & Chen, C.-Y. O. (2011). Almond consumption improved glycemic control and lipid profiles in patients with type 2 diabetes mellitus. Metabolism: Clinical and Experimental, 60(4), 474–479. https://doi.org/10.1016/j.metabol.2010.04.009
  20. Liu, J.-F., Liu, Y.-H., Chen, C.-M., Chang, W.-H., & Chen, C.-Y. O. (2013). The effect of almonds on inflammation and oxidative stress in Chinese patients with type 2 diabetes mellitus: a randomized crossover controlled feeding trial. European Journal of Nutrition, 52(3), 927–935. https://doi.org/10.1007/s00394-012-0400-y
  21. Vuksan, V., Choleva, L., Jovanovski, E., Jenkins, A. L., Au-Yeung, F., Dias, A. G., … Duvnjak, L. (2017). Comparison of flax (Linum usitatissimum) and Salba-chia (Salvia hispanica L.) seeds on postprandial glycemia and satiety in healthy individuals: a randomized, controlled, crossover study. European Journal of Clinical Nutrition, 71(2), 234–238.
  22. Nieman, D. C., Gillitt, N., Jin, F., Henson, D. A., Kennerly, K., Shanely, R. A., … Schwartz, S. (2012). Chia seed supplementation and disease risk factors in overweight women: a metabolomics investigation. Journal of Alternative and Complementary Medicine (New York, N.Y.), 18(7), 700–708. https://doi.org/10.1089/acm.2011.0443

By Kristen LaStofka, Master of Science in Nutritional Sciences student at UT Austin

Health Promoting Foods for Type 2 Diabetes

Diabetes is the seventh leading cause of death in the United States with 30.3 million people having diabetes and of that 90 to 95% of cases are type 2 diabetes.1 Type 2 diabetes is the most common form of diabetes and is the result of your body not using insulin properly to control blood glucose leading to insulin resistance and high blood sugar.2 The risk factors for developing type 2 diabetes include physical inactivity, high blood pressure, hyperlipidemia, smoking, family history, poor diet and overweight or obesity.3 Research shows that many different foods contain specific bioactive components that impact your risk of disease. Incorporating such foods into your diet along with remaining physically active can help you prevent or manage your diabetes!

Whole Grains

Research shows that whole grain consumption, specifically oats, rye and barely, is associated with a reduced risk of type 2 diabetes related to the bioactive compound beta-glucan. Beta-glucan is a soluble fiber that slows the rate of carbohydrate absorption leading to improved insulin sensitivity and smaller rise in glucose after a meal. Studies show that consuming rye bread or bread enriched with beta-glucan decreased glucose response, insulin resistance, LDL (bad) cholesterol levels and increased satiety.4,5 Researchers conclude that a diet high in fiber and whole grains, at least 2 servings per day, with reduced consumption of refined grains is associated with a reduced risk of type 2 diabetes and overall better health.6

Vegetables

Research shows that increased vegetable consumption is associated with a reduced risk of developing type 2 diabetes.7 Certain cruciferous vegetables, such as broccoli and Brussel sprouts, along with certain allium vegetables, such as leeks and onions, contain the bioactive component quercetin, which is known to have antioxidant and anti-inflammatory properties. Inflammation and oxidative stress are hallmarks of diabetes and studies have shown consumption of onions and broccoli result in substantial decreases in levels of oxidative stress and inflammation, which in turn leads to decreased insulin resistance.8,9

Other vegetables have also been shown to be beneficial for diabetes, specifically tomatoes as they contain the bioactive compound lycopene, which gives them their red color and is known for its antioxidant properties. Studies have shown that tomato consumption is associated with decreased inflammation, oxidative stress and fasting plasma glucose, deeming them a diabetes friendly food that should be incorporated into the diet for diabetes prevention and management.10,11

Fruits

Research shows an inverse relationship between fruit consumption and type 2 diabetes risk.6 Many fruits contain fiber and phenolic compounds, such as the flavonoids anthocyanin and quercetin, that have powerful antioxidant and anti-inflammatory properties. Blueberries have one of the highest antioxidant capacities among fruit related to the high anthocyanin content that decreases your glucose response after a meal, reduces oxidative stress and reduces inflammation, all of which are beneficial for diabetes management.12

Apples are also a good source of fiber and contain the bioactive compound quercetin that has antioxidant properties. Studies have shown apple consumption slows starch breakdown to decrease glucose response as well as decrease oxidative stress, all of which are factors that decrease your risk of developing type 2 diabetes.13

Legumes

A variety of legumes, such as soybeans, chickpeas and black beans, are high in antioxidants and fiber that reduce the risk of type 2 diabetes. Soybeans and chickpeas contain isoflavones, which have antioxidant properties, that reduce oxidative stress and decrease insulin resistance.14,15 Black beans are high in fiber and the antioxidant anthocyanin that has been shown to decreases your glucose response after a meal, reduces oxidative stress and reduces inflammation, all of which are beneficial for diabetes management.16

Nuts & Seeds

Nuts contain many bioactive and health promoting components.16 Pistachios, walnuts, almonds and pecans have some of this highest level of polyphenols, which act as antioxidants to reduce oxidative stress.17,18, 19 They are also rich sources of omega 3 fatty acids that act to reduce inflammation.17,18,19 Nuts a good source of healthy fats that should be included in the diet to improve cardiovascular risk factors that are implicated in diabetes.

Chia seeds and flax seeds both have a high soluble fiber content that beneficially affects glucose control by slowing carbohydrate digestion and also contain high levels of the anti-inflammatory omega-3 fatty acids, that reduce inflammation. Studies have shown consumption of flax seed or chia seeds leads to decreased glucose response after the meal and decreased inflammation, with greater beneficial effects seen for ground chia seeds compared to whole chia seeds and flax seeds.21,22


Kristen LaStofka wrote this article as part of her study in the Master of Science in Nutritional Sciences degree program at UT Austin. Learn more about this program here.


References:

  1. Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2017. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2017.
  2. American Diabetes Association. (n.d.). Type 2. Retrieved from http://www.diabetes.org/diabetes-basics/type-2/
  3. National Institute of Diabetes and Digestive and Kidney Diseases. (2016, November 01). Risk Factors for Type 2 Diabetes. Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/risk-factors-type-2-diabetes
  4. Sandberg, J. C., Björck, I. M. E., & Nilsson, A. C. (2017). Effects of whole grain rye, with and without resistant starch type 2 supplementation, on glucose tolerance, gut hormones, inflammation and appetite regulation in an 11–14.5 hour perspective; a randomized controlled study in healthy subjects. Nutrition Journal, 16(1). https://doi.org/10.1186/s12937-017-0246-5
  5. Liatis, S., Tsapogas, P., Chala, E., Dimosthenopoulos, C., Kyriakopoulos, K., Kapantais, E., & Katsilambros, N. (2009). The consumption of bread enriched with betaglucan reduces LDL-cholesterol and improves insulin resistance in patients with type 2 diabetes. Diabetes & Metabolism, 35(2), 115–120. https://doi.org/10.1016/j.diabet.2008.09.004
  6. Aune, D., Norat, T., Romundstad, P., & Vatten, L. J. (2013). Whole grain and refined grain consumption and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies. European Journal of Epidemiology, 28(11), 845–858. https://doi.org/10.1007/s10654-013-9852-5
  7. Wu, Y., Zhang, D., Jiang, X., & Jiang, W. (2015). Fruit and vegetable consumption and risk of type 2 diabetes mellitus: a dose-response meta-analysis of prospective cohort studies. Nutrition, Metabolism, and Cardiovascular Diseases: NMCD, 25(2), 140–147. https://doi.org/10.1016/j.numecd.2014.10.004
  8. Taj Eldin, I. M., Ahmed, E. M., & Elwahab H M, A. (2010). Preliminary Study of the Clinical Hypoglycemic Effects of Allium cepa (Red Onion) in Type 1 and Type 2 Diabetic Patients. Environmental Health Insights, 4, 71–77. https://doi.org/10.4137/EHI.S5540
  9. Bahadoran, Z., Tohidi, M., Nazeri, P., Mehran, M., Azizi, F., & Mirmiran, P. (2012). Effect of broccoli sprouts on insulin resistance in type 2 diabetic patients: a randomized double-blind clinical trial. International Journal of Food Sciences and Nutrition, 63(7), 767–771. https://doi.org/10.3109/09637486.2012.665043
  10. Zheng, Z., Yin, Y., Lu, R., & Jiang, Z. (2019). Lycopene Ameliorated Oxidative Stress and Inflammation in Type 2 Diabetic Rats. Journal of Food Science. https://doi.org/10.1111/1750-3841.14505
  11. Bose, K. S. C., & Agrawal, B. K. (2006). Effect of long term supplementation of tomatoes (cooked) on levels of antioxidant enzymes, lipid peroxidation rate, lipid profile and glycated haemoglobin in Type 2 diabetes mellitus. The West Indian Medical Journal, 55(4), 274–278.
  12. Bell, L., Lamport, D. J., Butler, L. T., & Williams, C. M. (2017). A study of glycaemic effects following acute anthocyanin-rich blueberry supplementation in healthy young adults. Food & Function, 8(9), 3104–3110. https://doi.org/10.1039/c7fo00724h
  13. Song, Y., Manson, J. E., Buring, J. E., Sesso, H. D., & Liu, S. (2005). Associations of dietary flavonoids with risk of type 2 diabetes, and markers of insulin resistance and systemic inflammation in women: a prospective study and cross-sectional analysis. Journal of the American College of Nutrition, 24(5), 376–384.
  14. Chang, J. H., Kim, M. S., Kim, T. W., & Lee, S. S. (2008). Effects of soybean supplementation on blood glucose, plasma lipid levels, and erythrocyte antioxidant enzyme activity in type 2 diabetes mellitus patients. Nutrition Research and Practice, 2(3), 152–157. https://doi.org/10.4162/nrp.2008.2.3.152
  15. Nestel, P., Cehun, M., & Chronopoulos, A. (2004). Effects of long-term consumption and single meals of chickpeas on plasma glucose, insulin, and triacylglycerol concentrations. The American Journal of Clinical Nutrition, 79(3), 390–395. https://doi.org/10.1093/ajcn/79.3.390
  16. Thompson, S. V., Winham, D. M., & Hutchins, A. M. (2012). Bean and rice meals reduce postprandial glycemic response in adults with type 2 diabetes: a cross-over study. Nutrition Journal, 11, 23. https://doi.org/10.1186/1475-2891-11-23
  17. Alasalvar, C., & Bolling, B. W. (2015). Review of nut phytochemicals, fat-soluble bioactives, antioxidant components and health effects. British Journal of Nutrition, 113(S2), S68–S78. https://doi.org/10.1017/S0007114514003729
  18. Hernández-Alonso, P., Salas-Salvadó, J., Baldrich-Mora, M., Juanola-Falgarona, M., & Bulló, M. (2014). Beneficial effect of pistachio consumption on glucose metabolism, insulin resistance, inflammation, and related metabolic risk markers: a randomized clinical trial. Diabetes Care, 37(11), 3098–3105. https://doi.org/10.2337/dc14-1431
  19. Li, S.-C., Liu, Y.-H., Liu, J.-F., Chang, W.-H., Chen, C.-M., & Chen, C.-Y. O. (2011). Almond consumption improved glycemic control and lipid profiles in patients with type 2 diabetes mellitus. Metabolism: Clinical and Experimental, 60(4), 474–479. https://doi.org/10.1016/j.metabol.2010.04.009
  20. Liu, J.-F., Liu, Y.-H., Chen, C.-M., Chang, W.-H., & Chen, C.-Y. O. (2013). The effect of almonds on inflammation and oxidative stress in Chinese patients with type 2 diabetes mellitus: a randomized crossover controlled feeding trial. European Journal of Nutrition, 52(3), 927–935. https://doi.org/10.1007/s00394-012-0400-y
  21. Vuksan, V., Choleva, L., Jovanovski, E., Jenkins, A. L., Au-Yeung, F., Dias, A. G., … Duvnjak, L. (2017). Comparison of flax (Linum usitatissimum) and Salba-chia (Salvia hispanica L.) seeds on postprandial glycemia and satiety in healthy individuals: a randomized, controlled, crossover study. European Journal of Clinical Nutrition, 71(2), 234–238.
  22. Nieman, D. C., Gillitt, N., Jin, F., Henson, D. A., Kennerly, K., Shanely, R. A., … Schwartz, S. (2012). Chia seed supplementation and disease risk factors in overweight women: a metabolomics investigation. Journal of Alternative and Complementary Medicine (New York, N.Y.), 18(7), 700–708. https://doi.org/10.1089/acm.2011.0443