FEATURE OPINION — Eating right and exercising ranks right up there with flossing and helmets as the most neglected common sense on the planet.

Unfortunately our sedentary culture has caused an increasing incidence of obesity and related diseases like Type 2 diabetes, which now threaten to reverse the scientific advances that have tripled our life expectancy over the past 100 years. Research published in the New England Journal of Medicine indicates that the rising generation may not live as long as their parents due to life threatening weight gain.

As if reverting to the fat ages isn’t enough to scare you off the couch, consider the pending diabetic pandemic that will emerge in the next decade if trends continue. The number of people with diabetes worldwide is projected to increase from 171 million in 2000 to 366 million by 2030.

Before attributing that to population growth or some other factor, consider the fact that being overweight or obese is the biggest risk factor for the development of Type 2 diabetes in youth, and excess weight is thought to be the cause in 90 percent of those diagnosed.

Sadly, the greatest consequences will fall to our children. One in three Utah children have a body mass index classified as overweight or obese. According to the Journal of the American Academy of Pediatrics this will result in earlier onset of type 2 diabetes and a list of tragic maladies including neuropathy, blindness, chronic kidney failure, heart disease, heart attack, stroke, and sudden death.

This only accounts for the physical hardships not the economic, social, and psychological impact.

The good news? Unlike other deadly diseases, no scientific breakthrough or magic serum is necessary to combat this global diabetic crisis.

Evidence of societal and economic factors — processed and fast food, desk jobs, electronic devices, housing, and transportation — can be linked to the problem, but at the root of every cause are two simple solutions: diet and exercise.

Evolving into a healthy society isn’t as daunting as it might seem. Even when genetics stack the diabetic odds against you, there is significant evidence that even small changes can yield results. The YMCA Diabetes Prevention Program states that every 2.2 pounds of weight loss reduces risk of type 2 diabetes by 13 percent.

The prescription for exercise initiative championed locally by Intermountain Healthcare enlisted providers to prescribe 150 minutes of exercise a week to at-risk patients. In the past year the average patient increased physical activity by 20 minutes weekly and dropped 2.2 pounds.

The biggest change came in inactive patients starting some type of exercise program. Currently 65 percent of patients report weekly exercise, which is a 10 percent increase from the 2013 benchmark.

Beverly Goold, who was diagnosed with Type 2 diabetes in October after reoccurring gestational diabetes and a prevalent family history, is a poster child of how far diet and exercise can go in managing disease. Nearly a year ago her A1C test, which indicates a person’s average blood glucose level, hit the diabetic range, so she took steps, literally.

“I made sure I was exercising everyday — mostly walking,” Goold said. “I had a diabetic friend who gave me great advice to walk after dinner. It really helps me feel better if I exercise in the morning and then go for a 10 or 15 minute walk after dinner.”

She was also a quick study on how food affected her.

“At first I checked my blood sugars every day, or sometimes more to figure out what certain meals would do,” Goold said. “Now I have a better understanding, I check it about once a week.”

At her last doctor’s appointment her A1C levels were normal without any insulin intervention.

Goold also credits the Fitness Pal app and her Fit Bit with helping her stay on track, but the majority of the credit is hers. It turns out that willpower is the most crucial tool when sticking to a 1000 calorie a day diet, or passing up breadsticks.

“I’ll admit it was easier at the start. Working in the health care industry, I know what diabetes can do and it’s scary,” Goold said. “It’s a little harder when you remind yourself this is something I have to do forever.”

But improvement in every aspect of how she feels is the dangling carrot that keeps her moving forward.

“I have more endurance when I exercise,” she said. “I’ve lost weight and that makes me feel good about myself. I’m also more aware of how sugar is going to affect me, and knowing in advance that I’m not going to feel good makes it easier.”

Diabetes

Two thirds of those with diabetes report having high blood pressure or taking medication to regulate it. If your blood pressure is 140/90 or higher, you’re at increased risk for stroke or heart attack.

Three things you can do right away to reduce your blood pressure:

1. Eat whole grain breads and cereals
2. Try herbs and spices instead of salt to flavor foods
3. Lose weight or take steps to prevent weight gain

Physical activity can keep your blood glucose, blood pressure, HDL cholesterol and triglycerides on target. It also relieves stress, strengthens heart and bones, improves blood circulation, and keeps joints flexible.

Four types of exercises to include in your daily exercise routine (30 minutes at least five days a week):

• Action | walking, using the stairs, moving around throughout the day
• Aerobic | brisk walking, swimming, or dancing
• Strength | lifting weights, resistance bands
• Flexibility | stretching for warm up and cool down

Eating well to maintain a healthy weight is one of the most important things you can do to lower your risk for Type 2 diabetes. Some ideas for building a healthier plate:

• Use a grocery list when you shop | buy leaner meats and lower fat dairy products, save money by buying less soda, sweets and chips or other snack foods
• Plan your meals in advance | fresh fruits and vegetables are usually healthier than canned or frozen, take a list, and never shop hungry
• Cut down on your sodium | start meals with a broth or salad to fill you up before the big calorie courses, grill your meats, or even share a restaurant entrée.

Did you know?

In Utah, one in seven people goes hungry, and one in five is obese. It seems like strange bedfellows, but scientific evidence is proving that people in developed countries, especially children, who are food insecure are more vulnerable to obesity and therefore, diabetes.

In fact, children from lower income homes are two times more likely to be obese than their higher income counterparts. Possible reasons include:

• Money to buy or places to access healthy food | Their neighborhoods are more likely to have a gas station than grocery store which offer fewer, sub-par produce. There’s also more access to fast food which can be less money and hassle than fresh food.
• Fewer places to play safely outside | These children are also less likely to participate in organized sports or recess.
• Feast or famine eating habits | Because tomorrow does not always bring another meal, food insecure children develop an unhealthy preoccupation with food. They also experience metabolic changes that promote fat storage compounded by overeating when food is available.
• High levels of stress | These children live in uncertain circumstances, and their stress may trigger hormonal and metabolic changes as well as unhealthful habits from coping with anxiety and depression.
• The wrong messages | These children have greater exposure to media marketing obesity-promoting products, and less access to health care and education.

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Written by Amber M. Rich and Teri Koenig for St. George Health and Wellness magazine and St. George News.

Amber M. Rich is the community benefit coordinator at Dixie Regional Medical Center, and Teri Koenig is the gerontologist and certified health and wellness coach at Dixie Regional’s LiVe Well Center.

For more information on diabetes and how you can prevent or control it, contact Dixie Regional Endocrinology, Diabetes Clinic at 435-251-2888 or go online to the American Diabetes Association website or call 1-800-342-2383.

St. George Health and Wellness website

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