the results are in and unfortunately your blood sugar’s up.
Chances are you know this elevated level increases your risk of diabetes, and, depending on how high it is, could even land you with a ‘prediabetes’ diagnosis.
Before panicking, know this state can be reversed.
Accredited Practising Dietitian Alan Barclay explains how …
Overweight is the biggest risk factor for diabetes, and something that many of us fall into with age, says Dr Barclay.
“As we age, what we tend to do is gain weight. Men gain it around the middle, and when women reach menopause, they do too.
“Weight gain around the tummy is the primary cause [of diabetes] that we are aware of.”
Assessing your risk is simple, says Dr Barclay: “Grab a tape measure and measure your waist circumference [at belly button level] and divide that by height and if it’s more than 0.5 then you are probably at increased risk.”
If weight loss is required, don’t fret. Most times, it needn’t be dramatic weight loss “like you see on TV”, says Dr Barclay.
For most individuals, “roughly 0.5 to 1.0 kilogram of weight loss per week for around 12 weeks is sufficient to basically … [return to] normal glycemia [blood sugar],” he says.
“To achieve this, cut … 2000 kilojoules each day. The average Australian consumes 8700kj per day, so this is cutting back by about one-quarter.”
Follow this process, and in most cases, blood sugar will drop within 12 weeks, the same amount of time it will take for you to lose the excess weight, he adds.
“The more exercise you can do, the better,” says Dr Barclay, who adds keeping active can aid weight loss, improve fitness and independently reduce diabetes risk.
“Not only does physical activity improve body composition, but the more muscle the body has, the more glucose it can suck up,” he says.
“Once you’ve developed muscle mass, it will uptake glucose even without exercise.”
He recommends starting with walking and jogging to improve cardiovascular fitness, then adding in resistance training to increase muscle mass.
“With age, we start to lose muscle mass (what’s called sarcopenia), but if you can slow that down you will increase insulin sensitivity [require less insulin to normalise blood sugar], reducing strain on the pancreas,” he says.
Dietary sugar is often seen as the ‘bad guy’ when trying to lower blood sugar, but it’s not the only thing we need to be wary of, says Dr Barclay.
“People try to cut back on sugar but overlook highly refined starches, like chips. They’re just as bad, if not worse than soft drink and offer no nutritional benefits.
“Soft drink, lollies and starchy savoury snacks are highly refined sources of carbohydrates and should be avoided.
‘Junk’ protein, like protein balls, bars and powders, with “ingredient lists as long as your arm”, also fall into the highly-refined category and should be relegated to the treat pile, adds Mr Barclay.
“What people don’t understand is that extra protein [and fat] is converted to glucose. If you don’t consume enough carbohydrate, you will convert protein into carbohydrate anyway.”
Indeed, low-carb diets, popular for prediabetics, also are based on a myth, he adds. “The reason low-carb diets often trigger weight loss initially is because we use up all the glycogen [stored carbohydrate] that’s stored in our body, but all the fat remains,” he says.
So, rather than being “sucked in” by marketing claims, such as ‘low carb, high/low fat or high protein’ on products, Dr Barclay states it’s best to avoid all refined products, regardless of “how good they sound”.
Ultimately, a healthy diet is made up of “core foods”, that is, “quality wholegrains, fruits and vegetables, lean meat, seafood and poultry, quality fats and oils (e.g. nuts or seeds) and reduced-fat dairy,” says Mr Barclay. “Most extra kilojoules come from discretionary foods, so by cutting back on refined snacks and drinks and sticking to three main meals per day, most people will [lose weight] without having to change [their diet] too dramatically.”
And, if you’re reluctant to cut out your weekly slice of cake, instead, turn your attention to your glass.
“The real elephant in the room is alcoholic beverages,” says Mr Barclay.
“There are just as many kilojoules in wine or beer than there are in a similar-sized glass of soft drink.
“A bottle of white wine can have 2150 kilojoules, red [wine can have] 2500 – [the number of kilojoules that] needs to be cut out each day to help people lose weight and lower diabetes risk.”
“No more than two standard drinks a day, and two drink-free days during the week is a very good idea,” he says.
Ultimately, Mr Barclay says while a healthy diet is critical for overall health and maintaining healthy blood sugar, “balance is important”.
“Some people treat food as medicine, but it’s actually much more important. You’ve got to enjoy it too … The best way to do that healthily is to see a dietitian to get personalised advice that suits your budget, cultural preferences, and importantly, taste.”
You’ve ditched the wine, started walking at lunchtime and even dropped a few kilos. So, should your blood sugar be right again?
According to Mr Barclay, “depending on how high [your blood sugar level was], you’d expect it to be heading down in three months.”
If your sugar hasn’t dropped, don’t lose hope. Persist with healthy habits and consult an appropriate health professional for individual advice, and consider other risk factors that might be at play, such as age, family history or ethnicity.
Catching diabetes in its early stages is really a blessing, says Dr Barclay.
“Those who have prediabetes often progress to type 2 [diabetes]. Prediabetes is a good point to stop it in its tracks and reverse it.”