The prevalence of diabetes has become more alarming in Singapore over the past decades. It has increased from 4.7% in 1984 to 10.5% in 2015 which is around 1 in 10 Singaporean adults, according to the International Diabetes Federation (IDF). This statistic has made Singapore the 2nd highest proportion of people with diabetes among developed nations, after the United States of America. A study that uses a demographic epidemiological model of Singapore has forecasted the prevalence to continue growing and reach 15% in 2050[i].
These numbers are terrifying but not surprising as Singaporeans are getting less physically active and eating more high-calorie diets now. The consequences behind the statistics are even more worrying. Left untreated or poorly managed, diabetes can lead to heart disease, kidney failure, stroke, blindness and amputations. This disease is also costing the country more than $1 billion a year. The good news is that type 2 diabetes is largely preventable. A 7% of weight loss through making a few lifestyle changes like exercising more and eating a healthy diet can dramatically lower the risk by 58% for those who are at risk[ii]! Are you at risk? Click here to find out. Meanwhile, let’s look at what you can do for your diet to prevent diabetes.
Go Whole Grain
Whole grains are loaded with minerals, vitamins, phytochemicals and fibre. They can contain up to 75% more nutrients than their refined counterparts. The fibre in whole grain makes it more difficult for digestive enzymes to convert the starches into glucose. This slows down the digestion and leads to lower and slower increases in blood sugar. Studies also suggest that whole grain may help reduce the desire to crave for snacks between meals, as whole grain may be more filling compared to refined grains. This can help people manage their weight better. Examples: Brown rice, oats, wholemeal bread, whole-wheat noodles, corn, hulled barley quinoa.
Singapore’s Health Promotion Board recommends that “Out of the 5-7 servings of grains in a day, 2-3 servings should be whole-grain. An easy way to achieve this is by replacing your rened items with whole grain items. E.g. instead of white rice, go for brown rice.” One serving of grains is equal to 2 slices of bread (60g) or ½ rice bowl of rice or noodles or spaghetti or bee hoon (100g), or 4 pieces of plain crackers.
- Don’t Miss Out Your Vegetables and Fruits
They are naturally low in fat but packed with water and beneficial nutrients like vitamins, minerals and fibre. Foods high in fibre and water are more filling. They can satisfy your appetite without adding too many calories to your diet. This is especially helpful when you are watching your weight. Vegetables and fruits are also rich in antioxidants, molecules, which help to clean up the free radicals in your body that can cause damage to your cells. Examples of antioxidants are vitamin A, C, E, Lycopene, Beta-carotene to name a few. In addition, one study found that focusing on increased consumption of nutrient-dense fruit and vegetables result in a significant reduction in fat and sugar intake[iii]. This is making sense when you are replacing your scoop of ice-cream or slice of cheesecake with a serving of fruits as your post-meal dessert.
- Choose Healthy Proteins and Dairy
Seafood, lean white-meat poultry, low-fat and fat-free dairy products, eggs, soy, lentils and beans are some good examples of healthy proteins. They are lower in saturated fats compared to some other processed or red meat. This helps to reduce insulin resistance, meaning your body is more sensitive to insulin and can use it more efficiently. High intake of saturated fats is linked to high level of bad cholesterol (LDL cholesterol) in the body, hence the risk of heart diseases. Plant based protein like soy, lentils and beans are often being under-rated. But in fact, they are rich in fibre, minerals, antioxidants and almost no fat! The American Diabetes Association (ADA) recommends adding a few plant-based protein foods to your meals a couple times per week by replacing them with animal proteins. You can start adding chickpeas to your bowl of salad and cooking vegetable dhal curry using lentils for one of your meals.
- Use Healthy Fats
The types of fats in your diet can also play a significant role in the development of diabetes. Good fats, such as fats found in liquid vegetable oils, avocado, deep sea fishes, nuts, and seeds can help ward off type 2 diabetes. Obviously, you can't simply add lots of nuts or olive oil to an unhealthy diet and expect good outcomes. The main principle is to work right-size portions of healthy fats into the mix of healthy foods you will eat at every meal. You can easily do this by changing your cooking oil from palm oil, coconut oil to olive oil, canola oil, corn oil and spread soft margarine instead of butter on your toast. The American Heart Association recommends eating a variety of fish at least twice a week, especially fish containing healthy fats omega-3 fatty acids like salmon, tuna and some local fishes like Indian mackerel (ikan kembung) and anchovies.
- Put into Practice
Preventing diabetes is not just about adding healthy foods to your diet. Obtaining a balance amount between them and knowing exactly how much to put on the plate are equally important. Take a look at the Healthy Plate to have an idea on how to get the correct food portions from different food groups in a meal.
Aim for half of your plate to be vegetables and fruits, ¼ healthy proteins and ¼ whole grain. That way, you can get your superfood groups in just the right amounts!
There are foods that you need to take less of, to prevent diabetes!
Refined Carbohydrates and Sugar Food
High intake of refined carbohydrate, sugary food, and drinks can cause a sudden spike in your blood sugar, this may stress your pancreas into producing enough insulin to bring down this high sugar level. The rush of insulin usually causes sharp fall in blood sugar, leading to hunger and overeating. Furthermore, sugar is considered as empty calorie, meaning that it has no nutrients other than providing you with energy. Too much sugar in the diet may cause excessive energy intake leading to weight gain, which is one of the major causes of type 2 diabetes.
Refined Carbohydrates: White rice, noodles made from refined flour, white bread.
Sugary food and drinks: Soft drinks, cake, cookies, fruit juices, ice-cream.
Food High in Saturated Fats and Trans Fats
Too much fat in your diet can cause weight gain too. Recent evidence has shown high intake of saturated fats may link to an increased risk of type 2 diabetes. This may be due to saturated fat causing the body to be less sensitive to insulin. Even though there is not much evidence to show trans-fat will increase diabetes risk, but it is very much linked to the development of heart diseases. This is because it will not only increase the bad cholesterol (LDL) but also lower the good cholesterol (HDL) in your body. Hence both saturated fats and trans fats are to be limited in your diet.
Saturated fats: Animal fats, 3-in-1 drinks with creamer, processed meat, fatty red meats, butter
Trans fats: hard margarine, shortening and commercial deep-fried food and pastries
Aim for 150 minutes of moderate physical activity like brisk walking and cycling in a week for a healthy weight. If you are wearing an activity tracker, aim for at least 10,000 steps a day.
Lack of physical activity and being overweight are two main risk factors contributing to the development of diabetes. Make sure you got the right food at the right portion and keep yourself active! If you are overweight and at risk of diabetes, aim for 7% weight reduction in the next 3 months! Don't become part of the statistic.
This article is contributed by Georgen. Georgen is a dietitian with 4 years of clinical experience working at the National Heart Institute of Malaysia. His knowledge of nutrition and dietetics has changed his life, helping him to lose 30kg and keeping it off. Let him show you how you can achieve your health goal without the need to give up your favorite food!
A contribution by GlycoLeap, an effective weight and chronic condition management app that helps users better manage diabetes or pre-diabetes or those looking to prevent it. All done with the help of health experts like qualified dietitians.
[i] Phan TP, Alkema L, Tai ES, et al Forecasting the burden of type 2 diabetes in Singapore using a demographic epidemiological model of Singapore BMJ Open Diabetes Research and Care 2014;2:e000012. doi: 10.1136/bmjdrc 2013-000012
[ii] Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. Diabetes prevention research group. New England Journal of Medicine 2002. http://www.nejm.org/doi/full/10.1056/neJmoa012512#t=article.
[iii] Epstein LH, Gordy CC, Raynor HA, Beddome M, Kilanowski CK, Paluch R: Increasing fruit and vegetable intake and decreasing fat and sugar in families at risk for childhood obesity. Obesity Res 9:171– 178, 2001