The latest research into Type 2 diabetes shows that for some people, it’s actually possible to put diabetes into remission.
Lifestyle factors are the primary cause of type 2 diabetes, and also your main tools to manage the disease.
To learn more about reversing diabetes, the Pre-Porter team caught up with Dr Alan Barclay, Accredited Practicing Dietitian with over 20 years of clinical experience and nearly 16 years at Diabetes Australia.
Dr Alan Barclay explores the latest research and how can people put in in practice in their daily lives in his latest book Reversing Diabetes.
Pre-Porter: Diabetes is a lifestyle disease. In your book you bust some myths about what is healthy eating with evidence-based research not just opinion. Can you talk about that in a bit more detail?
Dr Alan Barclay: Current eating recommendations for people with diabetes are based on food's Glycemic Index – not all sugary foods are going to raise your blood glucose levels more quickly and not all savoury foods are going to make it go up more slowly. It is not necessary to completely rule out specific ingredients from your diet like sugar or flour - unless you eat them in spoonfuls by themselves, they are going to be ingredients in other foods. It is more important to understand a whole food’s GI to see if it is more or less suitable for diabetes, instead of each ingredient on its own.
Another fad is replacing all carbohydrates with protein. In Australia we already eat almost double the amount of protein that we need on average and any excess protein that can’t be stored is broken down and converted to glucose anyway.
Pre-Porter: How do you feel about diets that recommend quitting sugar? Is sugar really the villain?
Dr Alan Barclay: You don’t need a sugar free diet to manage diabetes, and you certainly need to be mindful of savoury starchy foods as well.
Many highly nutritious foods like fruits and dairy products are sources of sugars and do not have an adverse effect of blood glucose when eaten in moderation. On the other hand, heavily processed savoury snacks, like potato chips and savoury crackers are full of refined carbohydrates and have a high glycemic index and therefore, a high impact on blood glucose.
Pre-Porter: Why do very specific diets tend to fail?
Dr Alan Barclay: Diets tend to fail in the long term when they require a person to radically change their social habits in order to stick to it. Diabetes is just part of your life, it is not the dominating factor, and you should be able to adjust your diet to fit your lifestyle rather than the other way around.
One size fits all generally doesn’t work. You need to identify what is the problem with your diet – too much snacking, too many sugary drinks, too much alcohol - to understand what modification will have the biggest impact for you.
Changes may include cutting some items out completely, but it is usually more sustainable to cut consumption to moderate levels that can be maintained in the long term.
Pre-Porter: How can a dietitian help reversing diabetes?
Dr Alan Barclay: A dietitian can help you set achievable healthy eating goals. The dietitian' role is to identify specific problem areas within a person’s diet, and negotiate with them which areas to focus on initially. Prioritising and setting up achievable goals are essential to avoid setting the person up for failure.
Changing long term habits is very difficult – much harder than taking medication. A dietitian can work with you to figure out what options are going to be the most sustainable and achieve the best health outcomes in the long run.
Pre-Porter: We talked about the three main weapons to treat diabetes - healthy eating, regular physical activity and medication. Can you talk a bit more about physical activity?
Dr Alan Barclay: It is important to understand that physical activity involves more than just exercise.
Overall, we are less physically active at work and at home than what we used to be 20-50 years ago. Physical activity that can help fight diabetes includes reducing screen time, standing and walking more, and everyone should aim to incorporate these in to their regular routine.
Exercise is also very important, as it increases muscle mass, which is the primary metabolic engine of the body and will help decrease insulin resistance. Two weight training sessions per week are a good starting point.
Pre-Porter: Your book Reversing Diabetes includes some great recipes that have been reviewed and approved by Diabetes Australia. But for people who work long hours and need to juggle family and work commitments, cooking at home can be a hard task. Any tips on how to eat healthy on the go?
Dr Alan Barclay: My key tip is to plan ahead – shop and prepare meals that you can easily reheat for the week over the weekend.
Also, you can buy pre-prepared ingredients at the main supermarkets that you can assemble quickly at home to prepare a healthy meal. Think pre-packaged salad leaves, frozen vegetables and pre-cut lean meats.
Eating healthy may require more planning, but doesn’t necessarily cost any more than eating out.
And some good foods are worth the investment. One example that comes to mind is bread. Supermarket bread can sometimes retail for $1 and authentic sourdough bread costs $6 – but you can’t compare the quality and this is a food that is worth the investment. A dietitian can help you make these decisions on where you should invest in food.
Pre-Porter: Thank you for your time, Alan. Any final remarks?
Dr Alan Barclay: Enjoy your food! Remember that food is not toxic – you need to have a balance and reduce the quantity of some foods, but you don’t need to permanently exclude anything from your diet to lead a healthy lifestyle.