Diabetes and healthy weight with a twist

Guest Post Sally Marchini, Dietitian

This week I thought it would be good timing to discuss the First of the Five guidelines in the Australian Dietary Guidelines and what having a healthy weight means to us with diabetes.

The twist is that this Monday (today!) marks the start of Australia’s Healthy Weight Week (AHWW) we’ll take a closer look at what the Dietitians Association of Australia has planned for our population to help them achieve a healthy weight, what the Australian Dietary Guidelines say about it and most importantly, why a healthy weight is especially important to work towards when you have diabetes (all types included) as we do.

When you’re at your peak Wellness-wise, chances are you’ll be at the right weight for you too. And of course understanding Food and how it helps you towards wellness, combined with physical activity, makes a big difference. It can be quite a steep learning curve.

Guideline One reads:

“To achieve and maintain a healthy weight, be physically active and choose amounts of nutritious foods and drinks to meet your energy needs.

• Children and adolescents should eat sufficient nutritious foods to grow and develop normally. They should be physically active every day and their growth should be checked regularly.

• Older people should eat nutritious foods and keep physically active to help maintain muscle strength and a healthy weight.”

There is extremely good evidence to support that First guideline. The Australian Dietary Guidelines document explains this well: “Overweight and obesity are associated with increased risk of type 2 diabetes, cardiovascular disease, hypertension, metabolic syndrome, some cancers, musculoskeletal conditions, respiratory conditions, sleep apnoea, gall bladder disease, hernia, reproductive disorders, urinary incontinence, fatty liver disease, and depression and other mental health disorders.  About 70% of people who are obese have at least one established comorbidity, resulting in medical costs that are about 30% greater than those of their healthy weight peers. Compared to having a BMI of 18.5–25 kg/m2, having a BMI of 30–35 kg/m2 reduces life expectancy by 2–4 years, and having a BMI of 40–45 kg/m2 reduces it by 8–10 years. The relative increase in mortality rate attributable to obesity tends to decline with age. Mortality and morbidity are also associated with the amount of weight gained in adult life.”

It goes on to remind us that “Many obesity-related conditions are preventable, and several are at least partially reversible through weight loss achieved by adopting a nutritious dietary pattern and active lifestyle.” which is why this special week has been arranged by the Dietitians Association of Australia.

Australia’s Healthy Weight Week (AHWW)

Fitting in perfectly for our look at Dietary Guideline No. 1, AHWW will be celebrated this week and runs from Monday 17^th to the 23^rd February 2014. You’ll see there are many events being arranged by Dietitians across the country this week designed to help people achieve their own healthy weight. Click here to look out for the ones near you!

 

The AHWW website also offers lots of tools to help you work towards your healthy weight including an e-newsletter, a guide to eating well including strategies to help keep you on track, information about physical activity, a wonderful cook book with easy to cook healthy recipes, a ‘fad-free’ meal plan and a whole lot more!

 

 

Being a healthy weight is beneficial for our diabetes

The American Diabetes Association (2013) lists a key strategy for all people with diabetes as ‘Portion control should be recommended for weight loss and maintenance.’ The main reason for this strategy is that increased body weight can lead to increased insulin resistance and defects in insulin secretion (AIHW 2008).

The Australian Institute of Health & Welfare tells us that ‘in 2007–08, almost 520,000 people with diabetes (58%) also had cardiovascular disease, based on self-reported data from the National Health Survey (NHS)’.  Being overweight dramatically increases your risk of developing a heart condition.  I hope you know that we all need to look after our heart health.

Then there’s grade A (the best) evidence that is recommended by the American Diabetes Association (2013) for those with type 2 diabetes under ‘Energy Balance’ that reminds us, “Modest weight loss may provide clinical benefits (improved glycemia, blood pressure, and/or lipids) in some individuals with diabetes, especially those early in the disease process.”  This relates to increased insulin resistance for those above their healthy weight range.

Sometimes it can be harder for people with diabetes to lose weight for various reasons including some of the medications prescribed, and the American Diabetes Association Nutrition Therapy Recommendations for the Management of Adults with Diabetes (2013) adds, “A number of factors may be responsible for increasing adiposity in people with diabetes,  including a reduction in glycosuria and thus retention of calories otherwise lost as an effect of therapeutic intervention, changes in food intake, or changes in energy expenditure.”

And it should not be forgotten that being underweight can also lead to severe health issues relating to malnutrition, so be careful to let your health care team know if you’re losing weight unintentionally.

Hoping that you benefit from the suggestions made through AHWW over the next week or so, and please let me know if there are any questions or issues that you’d like further clarification on.

Wishing you all good health!  Sally 🙂

Sally Marchini is owner of her private practice (Marchini Nutrition), has had type 1 diabetes for close to 40 years and coeliac disease for many years too.