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Fiftysomething Diet: Eating to Cure Diabetes Type 2

A new study shows how changes in diet can reverse the disease  — and the 3 surprising foods that help

By Maureen Callahan

Not so long ago a diagnosis of Type 2 diabetes at 50 or 60 seemed final, one of those no-turning-back kind of moments. Chances are the doctor told you the disease could be managed, but a return to a day when blood sugars might fall back into normal range (less than 126 mg/dl) was not on the table. An amazing new study suggests just the opposite. If you’re willing to make changes in what you eat and ramp up your activity levels, diabetes could be put into full or partial remission.
 
How so? It can all be summed up in two words: lose weight.
 
In the new study by the Centers for Disease Control and Prevention, researchers randomly assigned 4,500 overweight Type 2 diabetics to either an intensive diet and exercise boot camp-style intervention or a less stringent weight-loss education program.
 
The group given an intensive lifestyle intervention had weekly group and individual counseling sessions on what to eat and how to exercise for six months straight. (The follow-up dropped to three times a month for the next six months, then twice a month, along with periodic group refresher courses, for years two through four.)
 
The second group received social support, along with advice on diet and physical activity, but only three times a year and as part of a group, not individually.
 
Not surprisingly, the group given intensive diet and lifestyle counseling showed the most success. More important, 11.5 percent of the intensive lifestyle intervention group saw partial or complete remission of diabetes (remission was defined as blood sugars less than 126 mg/dl and hemoglobin A1c of less than 6.5 percent) at the one-year mark. Compare that figure to the other group’s success rate: 2 percent.
 
The researchers, who published their study in December’s Journal of the American Medical Association, are not the first to find that weight loss can turn diabetes around.

(More: Find Out if You Have Diabetes)
 
Maybe you’re heard personal anecdotes like that of Bob Smietana, a reporter from The Tennessean. He wrote an inspiring account in USA Today of how diet and exercise made a dramatic impact on his blood sugar levels after a recent diagnosis of Type 2 diabetes.
 
Then there’s the groundbreaking Why WAIT weight-loss program from the Harvard-affiliated Joslin Diabetes Center. It has helped 450 people with Type 2 diabetes lose an average of 24 pounds and reduce their medication and insulin amounts. In other words, it has changed the course of their diabetes. Dr. Osama Hamdy, assistant professor of medicine and a physician at Joslin, recently told the Harvard Gazette, “You can reverse the cycle if it’s early enough, before there’s significant damage to the pancreas.” Studies show that people with diabetes or prediabetes who lose just 7 percent of their body weight can improve their body’s sensitivity to insulin an astonishing 57 percent.
 
So how do you eat to cure diabetes and achieve this weight loss? Not with one single or magical food, according to the American Diabetes Association. The best strategy is to eat a variety of healthy foods, including vegetables, whole grains, fruits, non-fat dairy, beans, lean meats and fish. “Make sure your choices from each food group provide the highest quality nutrients you can find,” the ADA says, by picking foods “rich in vitamins, minerals and fiber over those that are processed.” (For the ADA's recipies for healthy living, click here.)

And while you’re cleaning up eating habits and working to lose weight, it might not hurt to add these three foods to your weight-loss formula. Preliminary findings suggest they can have a positive impact on managing blood sugar.

Vinegar Sipping water sweetened lightly with a sugar substitute and laced with 20 grams of vinegar a few minutes before meals improved insulin sensitivity in a small group of subjects who either had Type 2 diabetes or were insulin resistant, according to a 2004 study in Diabetes Care. In a video interview with WedMD, lead researcher Carol Johnston, director of the nutrition program at Arizona State University, explains why: “Both the blood glucose and insulin were better managed after the meal when they consumed vinegar. It appears the vinegar mimics the effects of both acrabose and metformin, which are two of the commonly prescribed medications for diabetics.”

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Coffee Over the last decade or so, multiple studies have observed a link between high intakes of coffee and decaf coffee and a reduced risk of diabetes.  A 2012 Japanese study randomized volunteers into two groups for 16 weeks, letting one group drink five cups of decaf per day and another drink five cups of regular coffee. After measuring glucose and insulin concentrations in both groups, researchers suggested both types of coffee might boost glucose tolerance.

A 2011 Harvard study of coffee drinkers suggests that compounds in coffee might indirectly protect against diabetes by helping liver and fat cells function. “Often people think of coffee as just a vehicle for caffeine, but it’s actually a very complex beverage with hundreds and hundreds of different compounds in it,” said Rob van Dam, an assistant professor in the Department of Nutrition at Harvard. So it may take some time for researchers to tease out the helpful ingredients.

Cinnamon Researchers reporting in a 2012 issue of the International Journal of Preventive Medicine found that cinnamon supplements (3 grams per day) helped improve fasting blood glucose levels, hemoglobin A1C levels and other measures of glycemic status in a small group of Type 2 diabetics. That finding goes right along with an earlier 2009 study from the United Kingdom. “More research is needed to confirm these findings and determine how cinnamon supplementation leads to these benefits," said Dr. M. Regina Castro, an endocrinologist at the Mayo Clinic. “One theory is that cinnamon increases insulin action.”
 
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Maureen Callahan is a registered dietitian, recipe developer and lead author of the Health.com diet book review series. She is a two-time James Beard Award winner. Read More
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