Mindfulness in Relation to Diet Quality in Adults with Type 1 and Type 2 Diabetes: Results from Diabetes MILES-The Netherlands

Liu, S. et al | 2021| Mindfulness in Relation to Diet Quality in Adults with Type 1 and Type 2 Diabetes: Results from Diabetes MILES-The Netherlands| Mindfulness | https://doi.org/10.1007/s12671-021-01754-x

The objective of this research was to investigate the associations between dispositional mindfulness and diet quality in Dutch adults with type 1 diabetes (T1DM) or type 2 diabetes (T2DM). They hypothesized that a higher level of mindfulness is related to greater diet quality. In the light of previous research in other populations (Sala et al., 2020), they theorised that each mindfulness facet is positively associated with diet quality. In addition, they evaluated the potential mediating role of emotional distress in these associations.

The researchers found that a higher level of dispositional mindfulness and a higher score on observing were associated with higher diet quality. The results were more robust in people with T1DM. Their findings also suggest that overall mindfulness and the facet of observing are associated with higher diet quality in people with diabetes, independent of emotional distress.

They conclude that their findings suggest that mindfulness, especially observing facet, may relate to a healthier diet in adults with diabetes (Source: Liu et al, 2021).

The full paper is available to read from Mindfulness

Can DNA-based diets improve blood sugar levels in people at high risk of type 2? New study needs participants to find out the answer

Diabetes UK | August 2021 | Can DNA-based diets improve blood sugar levels in people at high risk of type 2?

Adult over 18 with prediabetes could help contribute to research to test a new type of diet that might improve blood sugar levels and potentially prevent the development of type 2 diabetes in this population. The new diet is tailored to a person’s particular genetic makeup- a DNA-based diet.

Researchers at Imperial College are looking for participants who will be randomised to three different groups: one group will receive special dietary guidelines via an app and wearable wristband or via a dietitian, or usual care which is standard dietary advice for people at risk of developing type 2 diabetes the study will run for 26 weeks.

Further information is available from Diabetes UK
 

BMJ: Low and very low carbohydrate diets for diabetes remission

Goldenberg, J. Z. & Johnston, B. C. | 2021 |  Low and very low carbohydrate diets for diabetes remission| BMJ | 373 | n262| doi:10.1136/bmj.n262

The latest in the series of Fast Facts synthesises evidence around patients who follow a low and very low carbohydrate diet for remission of diabetes. The paper published in The BMJ shows that dietary interventions that restrict carbohydrate intake for the management of diabetes are of particular interest to researchers, healthcare providers, and patients. Based on evidence of moderate to low certainty from 23 randomized trials (n equal to 1 357), evidence synthesis suggests that patients who adhere to low or very low carbohydrate diets for six months might achieve diabetes remission without adverse consequences. But the definition of low and very low carbohydrate diets, the long term health effects of carbohydrate restricted diets, and the working definitions of diabetes remission are debated, requiring further investigation, particularly for longer term health outcomes based on evidence from randomized trials.

Paper available from The BMJ

Diabetes UK: DUKPC research highlights day 2

Diabetes UK | 20 April 2021 | DUKPC research highlights: day 2

Day 2 of this year’s Diabetes UK Professional Conference (DUKPC) saw new research presented that is investigating the role dietary fibre could play in preventing type 2 diabetes. Dr Denise Robertson, from the University of Surrey was discussing her research looking into substituting normal starch with with resistant starch (in foods such as pulses, bananas and can also be added to food), to determine if it can reduce blood sugar levels and help people with type 2 diabetes to manage their condition. The study is still being conducted, the findings will be available from Diabetes UK on completion (Source: Diabetes UK).

Image source: Diabetes UK Visual summary of the lecture

Further details about the project are available from Diabetes UK

See also Dr Robertson’s blog post Will resistant starch change the way we think about carbs?

New study suggests vegan diet could control blood sugar for people with, or at risk of, type 2 diabetes

NIHR | March 2021 | New study suggests vegan diet could control blood sugar for people with, or at risk of, type 2 diabetes

A plant-based lifestyle may help to support control of blood sugar for people with or at risk of type 2 diabetes

Previous research into the causes of type 2 diabetes has found a strong association between a molecule in the blood called TMAO and increased risk of heart disease.  Co- Author of the study Professor Tom Yates said,

“Research has found that TMAO is particularly linked to animal products in the diet such as red meat, eggs and dairy. Due to the increased risk of patients with type 2 diabetes also developing heart disease, research suggests that there is a connection between diet, type 2 diabetes and heart functioning.” 

The Plant Your Health study looked at the impact of a vegn diet in people with or at risk of developing type 2 diabetes. . The researchers looked at whether a molecule which is produced when food, such as that derived from animal products, is digested in the gut. The molecule TMAO (or trimethylamine N-oxide) is a molecule produced when food, particularly from animal sources, is broken down in the gut. Its presence is associated with an increased risk of heart disease, which is often linked to type 2 diabetes.

Over 20 participants with type 2 or at risk of developing it, were recruited, they substituted their regular diet with vegan alternatives and were encouraged to exercise more. At the study’s outset all participants were given a health check, which including TMAO, blood sugar and cholesterol levels

The experts have concluded that a plant-based lifestyle may help control blood glucose levels

NIHR New study suggests vegan diet could control blood sugar for people with, or at risk of, type 2 diabetes

University of Leicester [press release] Vegan diet could control blood sugar for people with type 2 diabetes

[Primary Paper] Evaluation of an 8-Week Vegan Diet on Plasma Trimethylamine-N-Oxide and Postchallenge Glucose in Adults with Dysglycemia or Obesity

Thousands to benefit from soups and shakes diet on the NHS

Thousands of people will be able to access NHS soup and shake weight-loss plans to tackle type 2 diabetes | via NHS England

The diet and lifestyle plans have been shown to put Type 2 diabetes into remission for people recently diagnosed with the condition, and will now be provided to 5,000 more patients in 10 areas as the first stage in an NHS drive to increase access to the life-changing programme.

Diabetes is estimated to cost the NHS £10 billion a year, while almost one in 20 prescriptions written by GPs is for diabetes treatment.

The year-long plans will see those who could benefit provided with ‘total diet replacement products’, such as shakes and soups, for three months, alongside support to increase their exercise levels.

To help people maintain a healthy lifestyle and avoid complications linked to obesity patients will also be offered managed plans for reintroducing ordinary, nutritious food, with ongoing support from clinicians and coaches after that.

Full detail: Thousands to benefit from soups and shakes diet on the NHS

Large international study: at least 2 servings of dairy per day associated with lower prevelance of metabolic syndrome

Bhavadharini, B.,  et al. (2020). Association of dairy consumption with metabolic syndrome, hypertension and diabetes in 147 812 individuals from 21 countries| BMJ Open Diabetes Research and Care| 8 | e000826|  doi: 10.1136/bmjdrc-2019-000826

Research published in the BMJ Open Diabetes Research & Care, reports that higher intake of whole fat (but not low fat) dairy was associated with a lower prevalence of MetS and most of its component factors, and with a lower incidence of hypertension and diabetes. The authors recommend their findings should be evaluated in large randomized trials of the effects of whole fat dairy on the risks of MetS, hypertension, and diabetes.

Abstract

Objective Our aims were to assess the association of dairy intake with prevalence of metabolic syndrome (MetS) (cross-sectionally) and with incident hypertension and incident diabetes (prospectively) in a large multinational cohort study.

Methods The Prospective Urban Rural Epidemiology (PURE) study is a prospective epidemiological study of individuals aged 35 and 70 years from 21 countries on five continents, with a median follow-up of 9.1 years. In the cross-sectional analyses, we assessed the association of dairy intake with prevalent MetS and its components among individuals with information on the five MetS components (n=112 922). For the prospective analyses, we examined the association of dairy with incident hypertension (in 57 547 individuals free of hypertension) and diabetes (in 131 481 individuals free of diabetes).

Results In cross-sectional analysis, higher intake of total dairy (at least two servings/day compared with zero intake) was associated with a lower prevalence of MetS after multivariable adjustment. Higher intakes of whole fat dairy consumed alone, or consumed jointly with low fat dairy, were associated with a lower MetS prevalence. Low fat dairy consumed alone was not associated with MetS. In prospective analysis, 13 640 people with incident hypertension and 5351 people with incident diabetes were recorded. Higher intake of total dairy (at least two servings/day vs zero serving/day) was associated with a lower incidence of hypertension and diabetes. Directionally similar associations were found for whole fat dairy versus each outcome.

Conclusions Higher intake of whole fat (but not low fat) dairy was associated with a lower prevalence of MetS and most of its component factors, and with a lower incidence of hypertension and diabetes. Our findings should be evaluated in large randomized trials of the effects of whole fat dairy on the risks of MetS, hypertension, and diabetes.

BMJ Association of dairy consumption with metabolic syndrome, hypertension and diabetes in 147 812 individuals from 21 countries 

In the news:

Nursing Times Two servings a day of dairy linked to lower risk of diabetes and hypertension

The Telegraph Full fat dairy products help cut risk of obesity and diabetes, study suggests

Draft report on low-carb diets for adults with type-2 diabetes

Public Health England | March 2020 | Draft report on low-carb diets for adults with type-2 diabetes

The Scientific Advisory Committee on Nutrition (SACN) publishes consultation on its draft report on lower carbohydrate diets for people with type 2 diabetes.

The effect of lower compared to higher carbohydrate diets were considered on a range of outcomes including body weight and measures of blood glucose concentrations.

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Following a robust, systematic assessment of the available evidence, the draft conclusions are:

  • for body weight, there is no difference between lower and higher carbohydrate diets in the long-term (at or beyond 12 months). Short term weight change was not considered
  • for blood glucose (sugar) levels, lower carbohydrate diets may have benefits over higher carbohydrate diets in the short term, but their longer-term effects are unclear

Current UK government advice (represented by the Eatwell Guide) is that for the general population, around 50% of total dietary energy should be from starchy carbohydrates (such as potatoes, bread and rice), opting for higher fibre or wholegrain versions where possible. People with type 2 diabetes are currently advised to follow healthy eating advice for the general population.

This is based on recommendations made by SACN following its 2015 review of the evidence on carbohydrates and health.

Dr Adrienne Cullum, head of nutrition science at Public Health England PHE, said:

The Scientific Advisory Committee on Nutrition, with support from a range of partners including Diabetes UK and NHSE, have undertaken a thorough review of the evidence on low-carb diets for adults with type-2 diabetes.

SACN is consulting on the draft report to make sure it has considered all the relevant evidence, and to invite comments on the draft conclusions. All comments on the draft report are welcome (Source: PHE).

Full release available from Public Health England

Losing weight following type 2 diabetes diagnosis boosts chance of remission

People who lose at least 10% of their body weight in the first year after being diagnosed with type 2 diabetes increase their chances of being in remission after five years, compared with those whose weight remains stable. Losing this achievable amount of weight over the next four years also makes remission more likely | Via National Institute for Health Research 

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In this study of 867 people, 257 (30%) achieved remission at five-year follow-up. The participants had been taking part in a trial but had not received intensive lifestyle interventions or been put on extremely calorie-restricted diets.

This NIHR-funded study strengthens the evidence that healthy behaviour change and weight loss can result in remission of type 2 diabetes. This finding may help to motivate people to lose weight soon after a diabetes diagnosis ─ setting realistic and achievable targets can make a difference in the longer term.

Further detail at National Institute for Health research

Full reference: Dambha‐Miller H, Day AJ, Strelitz J et al. | Behaviour change, weight loss and remission of Type 2 diabetes: a community‐based prospective cohort study | Diabetic Medicine

Type 2 diabetes can be reversed with a modest weight loss of 10% or more

NIHR | September 2019 | Type 2 diabetes can be reversed with a modest weight loss of 10% or more

New research led by researchers at the University of Cambridge reports that individuals with a diagnosis of type 2 diabetes who reduced their  weight by one-tenth or more, were able to see their condition go into remission.

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The study followed a cohort (n=867) over time; and found that 257 participants (30%) participants were in remission at five-year follow-up. People who achieved weight loss of 10% or more within the first five years after diagnosis were more than twice as likely to go into remission compared to people who maintained the same weight. The participants in the study who achieved remission did so without intensive lifestyle interventions or extreme calorie restrictions.

“We’ve known for some time now that it’s possible to send diabetes into remission using fairly drastic measures such as intensive weight loss programmes and extreme calorie restriction,” says Dr Hajira Dambha-Miller from the Department of Public Health and Primary Care.

In order to clarify the best way to help patients with type 2 diabetes achieve sustained weight loss, the research team is currently undertaking a study called GLoW (Glucose Lowering through Weight management). The study compares the current education programme offered by the NHS to people after they have been diagnosed, with a programme delivered by WW (formerly Weight Watchers®) (Source NIHR & University of Cambridge)

Read the press release from NIHR 

See also: University of Cambridge Type 2 diabetes remission possible with ‘achievable’ weight loss, say researchers

 

Abstract

Aim

To quantify the association between behaviour change and weight loss after diagnosis of Type 2 diabetes, and the likelihood of remission of diabetes at 5‐year follow‐up.

 

Method

We conducted a prospective cohort study in 867 people with newly diagnosed diabetes aged 40–69 years from the ADDITION‐Cambridge trial. Participants were identified via stepwise screening between 2002 and 2006, and underwent assessment of weight change, physical activity (EPAQ2 questionnaire), diet (plasma vitamin C and self‐report), and alcohol consumption (self‐report) at baseline and 1 year after diagnosis. Remission was examined at 5 years after diabetes diagnosis via HbA1c level. We constructed log binomial regression models to quantify the association between change in behaviour and weight over both the first year after diagnosis and the subsequent 1–5 years, as well as remission at 5‐year follow‐up.

 

Results

Diabetes remission was achieved in 257 participants (30%) at 5‐year follow‐up. Compared with people who maintained the same weight, those who achieved more than or equal to 10% weight loss in the first year after diagnosis had a significantly higher likelihood of remission. In the subsequent 1–5 years, achieving more than or equal to 10% weight loss was also associated with remission.

 

Conclusion

In a population‐based sample of adults with screen‐detected Type 2 diabetes, weight loss of more than or equal to 10% early in the disease trajectory was associated with a doubling of the likelihood of remission at 5 years. This was achieved without intensive lifestyle interventions or extreme calorie restrictions. Greater attention should be paid to enabling people to achieve weight loss following diagnosis of Type 2 diabetes.

Full reference: Dambha-Miller, H et al | 2019|  Behaviour change, weight loss and remission of type 2 diabetes: a community based prospective cohort study|Diabetic Medicine| DOI: 10.1111/dme.14122 

The article is available in full from Diabetic Medicine