Diabetes: The Lifestyle Link
By Alona Pulde, MD
Diet can prevent, and even reverse, one of America’s most common diseases.
Eating a plant-based diet, like the one promoted in the Whole Kids Foundation ® Healthy
Teachers Program, can play an important role in disease prevention.
One of America’s most prevalent diseases, type 2 diabetes, is directly related to diet and lifestyle. Unfortunately, although widely known, diabetes is often misunderstood.
Diabetes is a disease that prevents blood sugar (glucose) from entering cells, and as a result the glucose builds up in the blood.
There are two main types of this disease:
• Type 1 diabetes , also known as insulin-dependent diabetes, is generally caused by the destruction of the pancreas so it can no longer make insulin (the hormone that drives glucose into our cells). This type of diabetes is not caused by diet, is usually diagnosed in children and young adults, and only represents about 5% of people with diabetes. It is treated with the use of insulin.
• Type 2 diabetes , also known as non-insulin dependent diabetes, results in the body being resistant to insulin, and therefore unable to use it efficiently to get glucose into cells. This type can be caused by lifestyle and diet and accounts for more than 90% of diabetes cases in the
United States. It can be controlled through healthy food choices, physical activity and weight loss, as well as with insulin or oral medications.
A small percentage of diabetes cases (less than 5%) are caused by specific genetic or medical conditions or illnesses.
According to the Centers for Disease Control and Prevention , the number of adults diagnosed with diabetes more than tripled from 5.5 million in 1980 to 21 million in 2014. This disease is now affecting our children. Currently, 1 in every 400 children has diabetes and this number is expected to rise. The complications of diabetes are gradual and devastating, and can include organ failure, heart disease, blindness, limb loss and susceptibility to infections.
Opening the Door for Diabetes
Dr. Neal Barnard , physician and founding president of the Physicians Committee for Responsible
Medicine, offers a great analogy to illustrate the connection between diabetes and diet: Imagine the cells in our bodies are little houses with doors. The job of insulin is to open those doors and let the glucose (sugar) into the house, where it is converted into energy the body can use.
Two things can go wrong with the door.
Type 1 diabetes: The body does not make insulin, so there is no insulin to “open up the door” and the glucose gets stuck outside.

Type 2 diabetes: Insulin is produced, but the door can’t open because the doorknob is too greasy, which can be the result of eating a high-fat diet. When this happens, the body releases extra insulin to try to solve the problem, but as the doorknob gets greasier, the insulin keeps slipping off and is unable to open the door, leaving the glucose to build up outside.
A New Notion for Type 2 Treatment
It has been known for some time that type 2 diabetes can be prevented or managed through proper diet and exercise. However, the notion that type 2 diabetes can be reversed, and the idea that fat (not just sugar) is a primary contributor, are relatively new discoveries. (This is liberating news for those of us who enjoy fruit!)
The primary risk factors for type 2 diabetes include:
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Standard American Diet: A diet high in fat and processed foods and low in whole, plantbased foods
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Overweight or obesity: Insulin resistance increases when weight is excessive
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Sedentary lifestyle: Insulin resistance increases with lack of exercise
While family history of type 2 diabetes is also a risk factor, patterns in families may have more to do with passing down traditions of the same lifestyle and eating habits from one generation to the next, rather than an actual genetic link.
The following lifestyle changes can help reduce blood sugar levels and may even return them to the normal range for those who already have type 2 diabetes or are pre-diabetic:

Eat a diet rich in whole plant-based foods (fruits, vegetables, whole grains and legumes such as beans, lentils and peas). This is the most important change one can make to manage and possibly even reverse type 2 diabetes.

Exercise at least 30 minutes a day most days of the week. Every bit of movement counts. Walk during a coffee break, take stairs instead of elevators, park farther from your destination, etc.

Maintain a healthy weight or lose weight if needed. Any reduction in body weight can reduce your chances for diabetes or improve your blood sugar levels if you already have diabetes.