The number hit you like a slap in the face: Nearly half of Americans have diabetes or likely will soon, according to a recent crunching of national data in the Journal of the American Medical Association. If you just mentally counted yourself out of that half because you aren’t fat, or you think you’re pretty fit, heads up: You’re not immune. Twenty percent of Americans with prediabetes are at a normal weight — double the percentage from two decades ago.
What’s going on? “Our food supply has become flooded with sugar, which has exposed a latent metabolic vulnerability in an awful lot of people,” says Dr. Tim Church, a researcher with the Pennington Biomedical Research Center. In other words, evolution hasn’t had the chance to catch up with the way we eat. From 1977 to the present, the amount of added sugar we consume has soared 30 percent, and our metabolism is losing its ability to process the onslaught.
This means that if you eat a lot of refined carbs and added sugars — which, let’s face it, most of us do — and you aren’t blessed with the genes that can handle them, your pancreas has to produce an overload of insulin to clear sugars from your bloodstream. That excess insulin cues more fat to be stored in your gut. This “visceral fat,” explains Dr. Samar Hafida of the Joslin Diabetes -Center, “produces inflammatory hormones that can cause diabetes as well as heart disease and strokes.” Worse, you may not even know this is happening. The added fat can wind its way around and inside organs and muscles without ever producing a telltale beer belly or an alarming number on the bathroom scale.
We need a collective wake-up call. Diabetes is a nasty disease that, over decades, can age virtually every system in the body before you arrive at grim late-stage symptoms like numbness, pain, and infections in the extremities. That’s why it’s imperative that all of us know exactly how well — or how poorly — our bodies handle the sugar and carbs we consume.
The first sign is at your waist. If it measures 35 inches or more, you’re at risk. But even if you’re relatively slender, ask for a blood test the next time you see your doctor. You want hemoglobin A1c (HbA1c), which provides the most sophisticated reading of sugar levels. Ideally, you want a score of 5.5 or below. A range of 5.7 to 6.4 means you’re prediabetic; anything above 6.4 is diabetes.
Another warning sign: metabolic syndrome. This is when all or most of your lab numbers — LDL cholesterol, triglycerides, blood pressure, waist size — are high, but your blood sugar may be normal. Because of that fact, many primary-care doctors overlook metabolic syndrome’s connection with diabetes. But the condition suggests that excess insulin, and the inflammation that follows, is gumming up your metabolism. Those with metabolic syndrome, Church says, have a seven times greater risk of developing diabetes. And if one of the bad numbers in your metabolic syndrome diagnosis is high blood sugar, that risk jumps to 21 times greater.
So, if you have diabetes, or you’re on the road to it, what do you do? The biggest pay-off comes from attacking your diet. Church’s prescription: “Go low-carb, all-in.” This approach can also help you shed weight, recent studies confirm. Here’s what such a diet looks like:
MEALS To fill the carb void, nutritionist Kathie Madonna Swift recommends three things: first, lean protein, like chicken and fish, along with legumes — such as beans and peanuts — which are a great source of plant protein and full of stomach-filling fiber. Second, nonstarchy vegetables like broccoli, peppers, and greens, which have tons of fiber and phytonutrients and few carb calories. Finally, healthy fats, like those found in avocados and olive oil.
Limit grains, even brown rice and whole-wheat pasta. “They’re not as healthy as you think,” Hafida says. Yes, they have fiber, but they also pack a lot of carbs, which can keep blood sugar and insulin levels high.
Also, keep in mind that pretty much any packaged food — in a can, bottle, or box, organic or not — is a likely and avoidable source of added sugar: Campbell’s soups, Wonder whole-grain bread, Triscuit crackers. Same goes for condiments like ketchup, salad dressing, and even hot sauces.
SNACKS Do you eat a carb-infused sports gel or bar during or after a long bike ride or run? Replace it with an apple and a packet of almond butter, suggests Hafida. The fruit will boost energy, and its fiber will slow carb absorption, while the fat and protein in the almond butter will help satiate you for hours. For snacks around the office, be mindful of nutrition labels: A package of trail mix can be doused with added sweetener, creating a faux-healthy sugar bomb.
DRINKS Avoid bottled teas, sodas, and sports drinks that list sugar as one of the first three ingredients. And no more fruit juices: They can be three times as sugar-laden as eating the whole fruit. As for
alcohol — which is basically sugar in a glass — you may want to hedge to one drink a day, less if possible.
TIMING It’s not only what you eat, but when. A new study from the University of Pennsylvania found that snacking and dining as late as 11 pm raises blood sugar more than eating the same food earlier. This may be because food eaten right before you lie down for the night isn’t metabolized as quickly and efficiently. Try to give yourself a cutoff of 8 pm.
PLUS: THE IDEAL WORKOUT COMBO Avoiding diabetes is a two-part process: First you eat the right kind of calories, then you burn them up. That means doing more than just running, cycling, or weightlifting. Studies show that hitting both cardio and strength buys you the most metabolic bang for your buck — “like combating a disease with two different drugs,” Church says. The cardio steadily eats sugars as you keep your heart rate elevated, while resistance exercise builds the muscle mass that will burn sugars all the time, not just when you’re training. Shoot for strength work twice a week, and cardio three or four days a week. If you can combine the two — circuits that mix heart-pumping exercises with strength work, for example — so much the better.