By Sheri Colberg, PhD
What causes diabetes? Now that’s a loaded question if I have ever heard one. What doesn’t cause it? That would actually be an easier question to answer.
According to all the research reported in Diabetes In Control, diabetes can be caused by anything from sitting too much to drinking too many sugary drinks to exposure to pesticides to not having enough vitamin K in your diet (that’s a recent new one) — and that’s just touching the surface of all the potential confounding factors. Most of the potential causes ultimately point back to lifestyle choices, though, and that is what worries me. We live in an information age, and most Americans are fortunate to have access to the latest technologies to find out anything they want to know online. If we can so easily find out all the causes of diabetes, then why aren’t we preventing more people from developing it?
The primary underlying cause of diabetes appears to be low-level, systemic inflammation, which can result from myriad lifestyle choices. For example, physical activity itself is known to have an anti-inflammatory effect1. A recent study examined the effects of resistance exercise in women who engaged in thrice-weekly training for 12 weeks2. Resistance training reduced blood markers of subclinical inflammation in these obese, postmenopausal women in the absence of changes in their body composition or weight loss. Even sleep disturbance may influence leukocyte inflammatory gene expression and the risk of inflammation-related disease3. Another evolving area of research is how cardiac autonomic imbalance correlates with the adipose tissue-derived inflammation seen early after diagnosis of type 2 diabetes, suggesting that simply resetting autonomic nervous system balance may reduce inflammation4.
With so many variables to consider, how can we get sustained reductions in inflammation, enough that we can prevent or control diabetes and its potential complications (e.g., heart disease)? That will probably take a multifaceted attack on the different aspects of diet, physical activity, and mental stress that impact metabolism and result in systemic inflammation, not just one or two of them. While resistance training is a good start, as a stand-alone lifestyle change it will likely not be enough to overcome all of the potential contributors to an inflammatory state.
Research would suggest that making positive changes to the following list of variables — even if only small changes are made — can have a big impact on preventing the progression of an inflammatory state to overt diabetes or cardiovascular disease:
- Visceral fat (including fat deposition in the liver and pancreas)
- Micronutrient intake (particularly vitamins D and K, magnesium, and potassium)
- Intake of refined/processed foods (e.g., "white" carbs and processed meats)
- Sedentary behavior/daily sitting time
- Participation in regular aerobic and resistance training
- Adequate sleep (7-8 hours a night for most adults)
- Circadian rhythm and autonomic nervous system balance
- Stress management (particularly with regard to cortisol levels)
- Exposure to pesticides and environmental pollutants
- Eat a small amount of dark chocolate daily (70% or darker cocoa, if possible).
- Stand up or walk around for five minutes after every hour of sedentary activity.
- Make it a priority to get more sleep (aim for 7-8 hours a night).
- Go on diet by cutting out sugary drinks (or cut back by at least one per day).
- Try deep breathing, meditation, or yoga therapy to reduce stress levels.
- Eat more natural, plant-based foods like vegetables, fruits, and nuts and seeds.
- Take time out for yourself every day to relax and unwind.
- Don’t avoid all the desserts you love, but just take a single bite of them instead.
- Do some resistance training 2-3 days per week, just using your body weight or water bottles in your hands for added weight.
- Avoid post-meal spikes in blood glucose by cutting back some on carb portions.
While making these changes may not completely reverse inflammation, they are a good place to start when making lifestyle improvements. Who can say "no" to trying to get more sleep, eating some chocolate, and relaxing more on a daily basis? People need to experience how easily some of these changes can be made to start moving in the right direction.
- Pedersen BK: The anti-inflammatory effect of exercise: its role in diabetes and cardiovascular disease control. Essays Biochem 2006;42:105-117
- Phillips MD, Patrizi RM, Cheek DJ, Wooten JS, Barbee JJ, Mitchell JB: Resistance Training Reduces Subclinical Inflammation in Obese, Postmenopausal Women. Medicine & Science in Sports & Exercise 2012;44:2099-2110
- Irwin MR, Wang M, Ribeiro D, Cho HJ, Olmstead R, Breen EC, Martinez-Maza O, Cole S: Sleep loss activates cellular inflammatory signaling. Biol Psychiatry 2008;64:538-540
- Lieb DC, Parson HK, Mamikunian G, Vinik AI: Cardiac autonomic imbalance in newly diagnosed and established diabetes is associated with markers of adipose tissue inflammation. Exp Diabetes Res 2012;2012:878760
To manage or prevent type 2 diabetes in youth, consult Diabetes-Free Kids: A Take-Charge Plan for Preventing and Treating Type 2 Diabetes in Youth. More information about this book and where to order it online can be found at www.shericolberg.com, along with other tips and books for active and sedentary adults with diabetes or prediabetes.