ReZoom

Changing a few lifestyle patterns can help prevent diabetes, and our expert says, "It doesn’t take as much as you think" …

If you want to avoid developing diabetes as you get older, you must accept responsibility for what you eat and how physically active you are.

As I mentioned in the first installment of this diabetes series, in 2002, the Diabetes Prevention Program showed that lifestyle changes can prevent type 2 diabetes.

In this study, more than 3,000 high-risk participants were randomly assigned to one of three groups: those who received metformin, a medication that makes cells more sensitive to insulin; those who received a placebo; and those who underwent extensive training with a lifestyle coach. The coach taught them how to change their diet to lose weight – mainly by reducing calories and fat intake - and how to become more physically active. When the medical results were tallied over four years later, the lifestyle change group had a 58 percent reduction in the progression to diabetes.

Class Reunions: Almost Everybody Has Gained Weight

I told a college friend of mine about this study when I saw her at our 30th class reunion. In college, Elizabeth had gained the "freshman 20." Through the remaining years of college, she tried this diet and that, but each time she lost weight, she gained more back. By graduation Elizabeth was obese.

At my reunion, many of my classmates were thicker around the middle than they'd been in college, but Elizabeth was one of the heaviest. She told me she was borderline diabetic. To her, the diagnosis came "totally out of the blue" given that she had gotten checkups every year and her blood sugar was normal.

"My dad died of diabetes," she told me. "I'm petrified that I'll get it too, Fran."

When I told Elizabeth about the study, she changed the subject. I didn't press. A year later I saw her again and she had gained more weight and she now had diabetes and the metabolic syndrome. I reached across the table and took her hands. "It's likely not too late to fix this thing," I said. "And it doesn't take as much as you think — 30 minutes of physical activity a day. You could walk with your husband or your kids. It would be good for them, too. Some decent food, nothing fancy." That evening I sent her an email repeating the encouragement. She didn't reply and I felt awful. Maybe she was angry with me for being intrusive.

Two months later, I got a response. Her message was short: "10 pounds gone, off some of my meds. Forget walking 30 minutes a day — I don't stop before 60. Thanks, Fran!"

Defining Success

The true test of a change in lifestyle is not whether it works quickly but whether it can be followed successfully in the long term. Making a commitment to do something active every day, whether it's a 20-minute walk, sprinting up a few flights of stairs at work, or setting the alarm early enough to get to the gym, is part of the building blocks towards creating new habits. Establishing a new lifestyle pattern isn't easy, but if the outcome is health and longevity, it's well worth it.

It is a common experience for each of us to attend a class reunion and see that most of our former classmates have gained weight. Over the past few decades, in this country (and others) the input side of the caloric equation has been going up, while the expenditure side — how many calories we burn — has been going down. In current surveys, 40 percent of American adults report that they are completely sedentary. Of the remaining 60 percent, seven in ten are somewhat active but fail to meet the minimum recommended standard of engaging in 30 minutes of moderate or strenuous activity five or more times a week.

Stacking the Odds in Your Favor

As each of us begins to examine our own lifestyle and considers making needed changes, remember that an activity or exercise regimen is necessary to have a healthy lifestyle. The goal is to lose weight and keep it off and you can't do that unless you have included exercise and physical activity.

The choices are up to each of us. As individuals with free will, we can choose to grab a bag of chips, plop ourselves down in front of the TV, and slurp an extra large soda. Or we can down a glass of water, get on our bikes, and go. It's a matter of resolving to take charge of our lives and doing what is needed to give us the best chance to make those changes. That may include creating a support group. What about agreeing to meet like minded individuals at the gym each day or each morning to walk around the neighborhood? Think of what you need to do to stay committed to a new lifestyle regimen and then take the steps to get started. No matter where you live or what your current condition is, you can make the needed changes.

 

Diabetes Series:

Previously: How diabetes became a silent epicdmic, why the cavemen knew better and a life with diabetes.

Next week: Diabetes and the road ahead.

Francine R. Kaufman, M.D. is a past president of the American Diabetes Association and author of "Diabesity: What You Need to Know If Anyone You Care About Suffers from Weight Problems, Pre-Diabetes, or Diabetes."