Coffee, boiled eggs and exercise - ways to reduce the risk of type-2 diabetes

The number of people diagnosed with type 2 diabetes is rising. But key lifestyle changes, including exercise and diet, can help reduce your risk of developing the condition 

Exercising — at any time of the day — can be a preventative measure against type 2 diabetes. Picture: iStock

If there is a ticking timebomb for our health, it’s type 2 diabetes. Ireland is ranked seventh in the world for diabetes-related health expenditure per person, and Diabetes Ireland, estimates that around 270,000 people in Ireland are living with the condition.

One in 10 adults over 50 in Ireland has type 2 diabetes, according to The Irish Longitudinal Study on Ageing (Tilda), which is predominantly linked to lifestyle habits. What’s concerning is that these figures are on the rise. According to the Healthy Ireland survey, more than 850,000 adults over 40 are at increased risk of developing (or already have) type 2 diabetes. Some 300,000 aged 30 to 39 are also at risk due to inactivity and obesity.

Type 2 diabetes occurs when the body loses its ability to produce the hormone insulin responsible for controlling glucose (sugar) in blood. It can lead to dangerously high blood sugar levels and long-term risk of damage to the eyes, nerves, circulatory system, and organs, including the heart and kidney.

Standard treatments include blood-sugar controlling tablets or, when they fail to work, lifelong insulin injections. With supreme effort, the condition can be reversed. In the latest findings from the Diabetes Remission Clinical Trial (DiRECT) study by Roy Taylor, professor of medicine and metabolism at Newcastle University, a radical “soup and shake” diet that involves consuming just 800 daily liquid calories for three months was shown to reverse type 2 diabetes in people diagnosed with the condition even after five years.

The DiRECT results show how strict dietary changes can “slow down” the progress of type 2 diabetes, says Sinead Powell, Diabetes Ireland senior dietitian. “However, it can also be a huge burden to many when they cannot lose the weight required and are often left with a sense of failure when they do not achieve ‘remission’.

“Diabetes is a complex condition that can be managed with a range of treatment options which can include lifestyle, medications and bariatric surgery. While dietary changes can form the basis of this treatment there also needs to be more emphasis placed on health gains that can be achieved easily rather than focusing on weight loss alone.

“Lifestyle modifications around increasing steps to include resistance type of activity, getting sufficient sleep, spending less time sitting, reducing stress levels can all lead to improvements in diabetes management.”

But prevention is better than cure. Among the tactics gaining scientific credibility for type 2 diabetes prevention are forms of intermittent fasting such as time-restricted eating (or TRE), which requires people to consume all of their daily calories within a specified time “window”.

Professor Leonie Heilbronn, a researcher in obesity and diabetes at the University of Adelaide, Australia, recruited 200 people who scored highly on a risk calculator for the condition and asked them to eat in different ways for 18 months.

While some participants consumed all of their calories strictly between 8am and 12pm on three non-consecutive days a week, eating as much as they liked on other days, others were asked to cut calories daily. Results published in Nature Medicine showed that after six months, both diet groups had shrunk their waistlines, in some cases by several inches. However, the TRE group had the most significant improvements in blood sugar control which, Heilbronn says, “should translate to a reduced risk of developing type 2”.

Heilbronn admits this anti-diabetes diet is not easy. So, what else can be done to reduce your risk of type 2 diabetes? Here’s a guide to keeping the condition at bay.

Exercise at any time of day is beneficial

If you are an early riser, exercising before you eat could set you up for the day. Research at the University of Bath has shown that the health benefits of exercise are amplified if performed in the fasted state — before breakfast for most people — leading to better blood sugar control. But being active at any time of the day is beneficial.

Research last year at the University of Limerick showed that just two minutes of walking after a meal can lower blood sugar on average by 9.51% compared to prolonged sitting. Aidan Buffey, a sports scientist and the lead researcher, said the findings were in line with calls from health bodies such as the World Health Organisation to “sit less, move more, and that every move counts”.

Standing and walking involve contractions of your muscles “which prompt muscles to take up glucose, lowering levels in the bloodstream,” Buffey says.

Do you need breakfast?

Some people need to eat breakfast while others don’t — but scientists say whatever your natural preference, it can work towards better blood sugar control.

In Prof Heilbronn’s study, participants front-loaded their calories to eat breakfast but nothing after lunch. “People are more glucose tolerant and secrete more insulin in response to glucose in the morning than in the evening, so it makes sense to have an early eating window if you can,” she says.

“There are plenty of positive results for weight loss and blood sugar control with a daily 8am-3pm window, but that will not suit everyone.”

People who eat before 8.30am have lower blood sugar levels and less insulin resistance, reducing the risk of developing type 2 diabetes, according to a recent study of 10,575 adults at Northwestern University in Chicago.

Have all your eggs in a row when it comes to health

Eat a boiled egg an hour before first meal of the day

Professor Taylor found that for people with type 2 diabetes who consumed a small protein snack — such as some plain yoghurt or a boiled egg — an hour or so before their first meal of the day, their subsequent blood sugar spike after a meal was reduced.

“If you feel you can’t function without breakfast, eat some cheese or a boiled egg first and better still, make the first meal itself one that is high in protein such as scrambled eggs and smoked salmon or a poached egg and some cheese,” says Taylor.

Work your calf muscles

In a recently published study Marc Hamilton, professor of health and human performance at the University of Houston, US, showed how activating the soleus muscle in the calf with repetitive knee bobbing, or what Hamilton calls the soleus press-up, can have a dramatic effect, producing a 52% improvement in blood glucose fluctuations and a 60% reduced insulin requirement after a meal.

The soleus is a muscle that runs down the back of the leg from just below the knee to the heel. Despite being only 1% of your body weight, Hamilton says it can regulate blood glucose as effectively as other forms of exercise, weight loss and intermittent fasting, provided you work it in the right way.

Do it by sitting with feet flat on the floor and muscles relaxed, raising your heel while keeping the ball of your foot in contact with the ground. As the heel reaches the top of its range of movement, release and lower it back down. Alternate both feet in this way.

You would need to keep doing it throughout the day for maximum effect on metabolism and blood glucose levels.

Pic: iStock

Have an extra cup of coffee

Just one extra cup of coffee a day — up to a limit of three to five cups daily — is associated with a 4% to 6% lower risk of type 2 diabetes in participants of two large prospective cohort studies, the UK Biobank and Rotterdam study.

Type 2 diabetes is considered an inflammatory condition and coffee, rich in antioxidants and other beneficial plant compounds, was shown to reduce inflammation biomarkers such as C-reactive protein (CRP) by researchers reporting in the journal Clinical Nutrition.

Measure your waistline

Carrying too much weight around your middle is a risk factor for raised blood sugar and type 2 diabetes. Keeping tabs on your measurements is essential. Wrap a tape measure around your waist at a midpoint — between the bottom of your ribs and the top of your hips.

According to the HSE, men have a higher risk of health problems, including type 2 diabetes if their waist circumference is more than 102cm (40in) and women if their waist measurement is more than 88cm (35in).

Taylor says that any excess fat around the middle is harmful — he believes we should strive to maintain the same healthy waist measurement as we did in our 20s for life — and if your waist measurement is more than half of your height, it is a sign that you have too much belly fat.