Diabetes is a chronic illness that, when not managed, can cause a lot of serious health complications. A strong connection exists between diet and type 2 diabetes. This includes the effects of specific nutrients but also the overall impact of being overweight or obese.
Help your nutrition clients understand the risks of type 2 diabetes and how diet contributes to it. With a healthy diet and other factors, you can significantly reduce the risk of developing this disease. Doing so is particularly important for your clients with other diabetes risk factors, such as family history.
Diabetes is a group of diseases that impacts the way the body uses blood sugar, or glucose (1). Glucose is one of the body's most important sources of energy, but issues arise when levels in the blood are too high. This is what happens in diabetes and what can cause so many symptoms, complications, and long-term health problems.
Two main types of diabetes are chronic. They have different causes and some differences in symptoms, but both occur when the hormone insulin is no longer available for or effective at keeping blood sugar levels normal:
Type 1. This type of diabetes likely has a genetic component but otherwise has unknown causes. It occurs when the immune system attacks the cells in the pancreas that produce insulin. Also known as juvenile diabetes, type 1 diabetes usually starts in childhood, but onset can be at any age.
Type 2. In type 2 diabetes, the body becomes resistant to insulin, leading to an increased blood sugar level. Exact causes are unknown, but genetics and environmental factors likely play a role. Being overweight or obese are strong risk factors but do not always indicate type 2 diabetes. Not everyone with this condition is has an excessive body weight.
Diabetes conditions can also be short-term and reversible. For instance, prediabetes is when blood sugar is too high but still reversible before becoming diabetes. Pregnant women can develop gestational diabetes, which often resolves after delivery.
Motivation is essential for all clients, but your postpartum moms may need special attention. Here's how to get them back into a workout routine.** **
Type 1 diabetes is thought to be largely genetic and environmental. The real causes are unknown. The causes of type 2 diabetes are also unknown, but the risk factors are well understood. A poor diet and carrying extra body weight—which are, of course, connected—are major factors in increasing the risk of developing type 2 diabetes (2).** **
A study that involved more than 20,000 participants in Europe showed that diets with a lot of junk food correlated with a 70% increase in type 2 diabetes risk. The study characterized junk food as things like fried foods and sugary drinks (3).
Exactly how specific foods may contribute to diabetes is not perfectly understood. The main connection is likely weight. Being overweight or obese is a huge risk factor, and eating poorly often leads to weight gain.
There are other factors too. High-sugar diets have long been associated with diabetes risk, but the reasons go beyond weight gain. Studies have found that excessive sugar consumption contributes to diabetes even when controlling for weight and other factors (4). Sugar may specifically lead to diabetes through fatty liver, inflammation, and insulin resistance. All of this can lead to poor insulin production.
Food choices play a big role in inflammation in the body. Help your clients make good diet choices to reduce inflammation and the risk of resulting health problems.
Junk foods are also typically high in salt and saturated fats. These foods can raise your blood pressure and triglyceride levels, both of which are additional risk factors for type 2 diabetes.
A healthy diet low in added sugars and saturated fat, high in fibers, and rich in lean proteins, whole grains, vegetables, and whole fruits is a simple way to reduce the risk of developing type 2 diabetes. Use these four specific guidelines based on research to develop an anti-diabetes diet (5):
Eat whole grains and limit refined carbs. Eating more whole grains can help protect against type 2 diabetes. Too many refined grains, on the other hand, can increase the risk. Whole grains break down into glucose more slowly, whereas a refined carbohydrate will rapidly break down, causing high blood sugar levels after eating. Whole grains put less stress on the insulin system in the body.
Limit added sugar, especially in drinks. Too much added sugar in any form can increase diabetes risk, but many Americans take in this extra sugar through drinks. It's an easy target for a healthier diet. Replace soda and sugary coffees with black coffee, water, and tea. While big intakes of sugar can spike blood glucose levels, the main connection to diabetes seems to be that these drinks promote weight gain.** **
Choose healthier fats. Too many saturated fats, especially trans fats, can increase your risk of diabetes. Choose healthier fats for prevention. These include the unsaturated fats found in vegetable oils, nuts, seeds, and avocados. Fatty fish are good for heart health but are not shown to impact diabetes.
Limit red meats. Limit red meat in your diet and completely cut out processed red meats, like hot dogs, deli meats, and bacon, to reduce diabetes risk. One study found that eating just one three-ounce serving of red meat per day can increase the risk of developing diabetes by 51% (6). Swapping out red meat for lean poultry, fish, and plant-based proteins can significantly lower diabetes risk.
One reason that diet can contribute to the development of type 2 diabetes is that diet contributes to weight gain. If you have a poor diet that leads to obesity, you increase your risk of developing diabetes. Eating well should naturally reduce the risk but focusing on a healthy weight can too. Researchers have found that modest weight loss does help prevent type 2 diabetes (7).
A good diet is the best tool for weight loss, but physical activity is important too. Being active regularly can help you reduce the risk of diabetes because it helps you maintain a healthy weight. Exercise also helps to reduce blood sugar levels.
Avoiding smoking and limiting alcohol will also add to your prevention efforts. Smoking causes many health problems, but it is also associated with type 2 diabetes. Moderate alcohol intake reduces the risk of both heart disease and type 2 diabetes, but don't start drinking if you don't now. Excessive drinking increases the risk of many health problems.
There is plenty of evidence from research to indicate that a healthy diet can prevent type 2 diabetes (8). Good nutrition, especially with a focus on maintaining a healthy weight, reduces the risk of an individual developing the chronic condition.
Other factors, like exercise, are important, but diet with an emphasis on weight maintenance seems to be the most crucial factor in preventing type 2 diabetes.
Nutrition therapy for diabetes is different from prevention. It's a therapeutic tool for managing existing diabetes. Recommending a diet for managing a chronic condition is outside the scope of practice of a personal trainer, nutrition coach, or health coach.
However, coaches should be aware of what it is and can encourage their clients to see their doctors for more information. They can also see a registered dietician for a meal plan to control or manage diabetes.
In general, the guidelines for a preventative diet also apply to someone already diagnosed with diabetes. A more specific, individualized diet is beneficial, though. Studies indicate that there is no single diet that works best for all patients (9). The best results are seen when therapy is tailored to each person.
Nutrition therapy for diabetes puts special emphasis on sugar and other carbs. Because these impact blood sugar levels the most, patients need to be vigilant about how many grams of carbohydrates they eat and when. Limiting sugar and refined carbs is essential, but they do not need to be totally eliminated in most cases.
Diet plays a huge role in diabetes development and prevention. Keeping your clients informed is important in helping them make better choices.
Nutrition is important to prevent chronic disease and improve quality of life. Be a part of that journey for your clients by becoming an ISSA Certified Health Coach. Learn how to change lives through diet, exercise, and developing habits for life-long wellness, all while studying and learning online.
"Diabetes - Symptoms And Causes". Mayo Clinic, 2021, https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444.
staff, familydoctor.org. "Diabetes: Symptoms, Diagnosis, Treatment | Familydoctor.Org". Familydoctor.Org, 2021, https://familydoctor.org/condition/diabetes/.
Bauer, F., Beulens, J.W.J., van der A, D.L. et al. Dietary patterns and the risk of type 2 diabetes in overweight and obese individuals. Eur J Nutr 52, 1127-1134 (2013). https://doi.org/10.1007/s00394-012-0423-4
Basu, Sanjay et al. "The relationship of sugar to population-level diabetes prevalence: an econometric analysis of repeated cross-sectional data." PloS one vol. 8,2 (2013): e57873. doi:10.1371/journal.pone.0057873
"Simple Steps To Preventing Diabetes". The Nutrition Source, 2021, https://www.hsph.harvard.edu/nutritionsource/disease-prevention/diabetes-prevention/preventing-diabetes-full-story/.
An Pan, Qi Sun, Adam M Bernstein, Matthias B Schulze, JoAnn E Manson, Walter C Willett, Frank B Hu, Red meat consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis, The American Journal of Clinical Nutrition, Volume 94, Issue 4, October 2011, Pages 1088-1096, https://doi.org/10.3945/ajcn.111.018978
Franz, Marion J et al. "Evidence-based diabetes nutrition therapy recommendations are effective: the key is individualization." Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy vol. 7 65-72. 24 Feb. 2014, doi:10.2147/DMSO.S45140
Wyness, Laura. "Understanding the role of diet in type 2 diabetes prevention." British Journal of Community Nursing vol. 14,9 (2009): 374-9. doi:10.12968/bjcn.2009.14.9.43803
Franz, Marion J et al. "Evidence-based diabetes nutrition therapy recommendations are effective: the key is individualization." Diabetes, metabolic syndrome and obesity : targets and therapy vol. 7 65-72. 24 Feb. 2014, doi:10.2147/DMSO.S45140
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