Rising incidence of diabetes

According to the WHO, the number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014. The global prevalence among adults over 18 years of age rose from 4.7% in 1980 to 8.5% in 2014 and has been rising more rapidly in middle- and low-income countries.

Diabetes is a major cause of heart attacks, stroke, blindness, kidney failure and lower limb amputation. One death every six seconds can be attributed to Type 2 diabetes.

Worldwide, approximately 1 in 10 adults has Type 2 diabetes mellitus. A significant fraction of the population has some degree of insulin resistance – approximately 40% in the US. The projection the WHO makes is that diabetes will be the seventh leading cause of death in 2030.

The incidence of diabetes is expanding extremely quickly and is a legitimate cause of worry. This is particularly because – as the WHO fact sheet reminds us – diabetes can be prevented or delayed with a healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use.

The WHO is actively promoting diabetes prevention and care management. There even is a World Diabetes Day. However, as surprising as it may seem, sugar is still not a definite target in the fight against diabetes.

Fat, sugar and prevention behaviour

With preventable diseases, patients can actually be part of the prevention behaviour. That is one of the most interesting aspects of nutrition as a field of study. Patients are in control of what food they purchase and consume. Provided they understand the consequences of their choices, they can be responsible. They need to understand the impact that the food they eat has on their health.

In previous papers and articles, we have shown that scientific evidence does not support the theory that was seen as the truth for so long. For ages, fat has been considered the cause of metabolic disease – but it obviously is not.

The fact that we have believed it for so long has led to room for concepts like that of Ancel Keys to grow and prosper. This destroyed perfectly good food habits that we used to have, leading to what we might now call the worst food epidemic ever known.

Those beliefs have driven us to take fat off our plates over time. That in itself is not the issue (although the body needs fat to work properly). But since fat and flavours are very closely related, fat-free or low-fat products were literally not edible. Neither were they satiable.

With close to no fat in our food, we had to find a solution; something to replace it in order to make food products palatable. And if that solution could be affordable, then the food industry would thrive.

Sugar was the answer everyone was looking for at the time. It replaced fat, made the food taste good and was inexpensive. It may even have been the easiest and cheapest solution at the time.

More importantly, it generated that strong positive reward in your brain – such a reaction in fact, that one can be addicted to sugar and crave it more and more.

Contrary to popular belief, fat does not make you fat; sugar does. The more sugar we ingest, the fatter we become. We then look for dietary solutions and end up consuming more low-fat, diet-food products. This adds to the problem by providing fewer fats and even more sugar to the body. All the sugar consumed stresses the pancreas; this, in turn, has an effect on insulin resistance.

The assumption that fat is unhealthy is therefore erroneous, as is the assumption that we consume too much of it. As a case in point, palm oil is a healthy source of lipids and vitamins, and is also free of trans fats. Yet, it has suffered a smear campaign over the last few years. As with many ‘low-fat’ products, we have found ‘palm oil-free’ products on shelves.

Fat in general, and palm oil in particular, is not – and never was – the culprit it was made out to be. Palm oil has a balanced composition that makes it one of the healthier options among oils and fats. Studies published over the last 10 years show precisely that we should not worry about palm oil, as it can be part of a balanced diet.

Sugar is not as easy to defend. Fructose – one of the dozens of forms of sugar – has always been present in fruit; but other kinds of sugar added to just about every food product have no particular metabolic benefit. Over-consumed, sugar does more harm than good. It promotes obesity and is responsible for diabetes, two epidemics that are among the leading causes of mortality.


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