Sugar is directly linked in everyone’s mind with diabetes and as a qualified dietitian-nutritionist, specialized in autoimmune diseases and inflammation, educated in plant-based nutrition, as well as the former head of the Immunology and Diabetes Department at Newcastle University Hospital, I have met and still see people who feel that sugar consumption will lead to diabetes and need guidance. It is indeed a certainty that controlling and avoiding processed white sugar in your diet can only do good and my advice is always to avoid it as much as you can and replace it with healthier options such as molasses, agave syrup, maple syrup, coconut sugar or even brown sugar. Diabetes, though, is a bit different story.
Research has shown that sugar is not so much the culprit for pre-diabetes. Researchers reviewed data from the National Health and Nutrition Examination Survey (2013-2018) and found that adults with both pre-diabetes and normal blood sugar levels did not show a significant increase in risk with additional sugar consumption. Previous studies have shown that pre-diabetes and type 2 diabetes are associated with insulin resistance, which in turn is associated with a high-fat diet, leading to fat accumulation in muscle and liver cells.
We should note here that pre-diabetes is not something to be taken lightly just because sugar levels are not yet too high. If ignored at this point, the risk of type 2 diabetes increases.
According to the American Diabetes Association, pre-diabetes is defined as any of the following:
What can we do to prevent the risk?
-A fasting glucose value of 100 – 125 mg/dl
-Glycosylated hemoglobin (HbA1C) value of 5.7 – 6.4 %
-Glucose value in glucose tolerance test 140-199 mg/dl at 2 hours after administration of 75 g of glucose
First of all, it is important to lose weight and start regular physical activity, which automatically reduces the risk. An average weight loss means 5-7% of body weight, i.e. about 5-7 kg for a 100 kg person, while average physical activity is defined as at least 150 minutes a week of brisk walking or similar activity (i.e. 30 minutes a day, 5 times a week).
Nutritionwise, the main concern is to reduce saturated fats from our diet, which are mainly found in meat, dairy and generally in foods of animal origin, sweets and processed foods. To achieve this in the best possible way and with a significant benefit to your overall health, a shift to a vegetarian diet rich in fruits, vegetables, legumes, nuts and seeds guarantees a reduction, even elimination of the risk –and a life with less medication and better cardiovascular health.
Contact me if you have morbid obesity and type 2 diabetes, or are predisposed to diabetes and metabolic syndrome, for a personalized nutrition program aimed at mild weight loss, balancing glucose levels and reducing insulin resistance while reducing your risk for long-term health problems. This programme follows the dietary recommendations of the British Diabetes Association.
Resources
https://www.pcrm.org/news/health-nutrition/sugar-not-driver-prediabetes
https://www.pcrm.org/news/health-nutrition/sugar-not-driver-prediabetes
Sneed NM, Azuero A, Moss J, Goss AM, Morrison SA. Total added sugar consumption is not significantly associated with risk for prediabetes among U.S. adults: National Health and Nutrition Examination Survey, 2013-2018. medRxiv. Published online August 8, 2022. doi:10.1101/2022.08.22.22279065
Petersen KF, Dufour S, Befroy D, Garcia R, Shulman GI. Impaired mitochondrial activity in the insulin-resistant offspring of patients with type 2 diabetes. N Engl J Med. 2004;350(7):664-671. doi:10.1056/NEJMoa031314