The SA Journal Diabetes & Vascular Disease Volume 18 No 2 (November 2021)

28 VOLUME 18 NUMBER 2 • November 2021 Diabetes news SA JOURNAL OF DIABETES & VASCULAR DISEASE ‘Our findings suggest that eating whole- grain foods as part of a healthy diet delivers health benefits beyond just helping us lose or maintain weight as we age. In fact, these data suggest that people who eat more whole grains are better able to maintain their blood sugar and blood pressure over time. Managing these risk factors as we age may help to protect against heart disease,’ said Nicola McKeown, senior and corresponding author and a scientist on the Nutritional Epidemiology Team at the USDA HNRCA. ‘There are several reasons that whole grains may work to help people maintain waist size and reduce increases in the other risk factors. The presence of dietary fibre in whole grains can have a satiating effect, and the magnesium, potassium and antioxidants may contribute to lowering blood pressure. Soluble fibre in particular may have a beneficial effect on post-meal blood sugar spikes,’ said Caleigh Sawicki. Sawicki did this work as part of her doctoral dissertation while a student at the Gerald J and Dorothy R Friedman School of Nutrition Science and Policy at Tufts Fasting as a weight-loss intervention in gestational diabetes: Australian trial T he 5:2, or intermittent fasting diet, is just as effective as a conventional energy-restricting diet, enabling women greater choice and flexibility when it comes to weight loss, found a University of South Australia study in the American Journal of Clinical Nutrition . The 5:2 diet allows five days of normal eating each week while substantially restricting calories over two days a week, as opposed to a typical diet that requires moderate energy restrictions daily. Globally, one in five pregnancies is affected by gestational diabetes, with these women having a 10-fold risk of developing type 2 diabetes later in life. Women who have had gestational diabetes and are also overweight are at an even higher risk. Type 2 diabetes has lifelong consequences and can lead to other chronic diseases such as heart disease and cancer. Lead researcher, UniSA’s Dr Kristy Gray, says the finding will be greatly welcomed by women looking to lose weight. ‘Gestational diabetes is the fastest growing type of diabetes in Australia, affecting 15% of pregnancies,’ says Gray. ‘Healthy eating and regular physical activity are recommended to manage gestational diabetes, with continuous energy- restriction diets, or diets that cut calories by 25 to 30%, being the most common strategy for weight loss and diabetes prevention. ‘The trouble is, however, that new mums often put themselves last: they’re struggling with fatigue and juggling family responsibilities, so when it comes to weight loss, many find it hard to stick to a low- calorie diet.’ The 5:2 diet may provide a less overwhelming option. As it only cuts calories over two days, some women may find it easier to adopt and adhere to, as opposed to a consistently low-calorie diet requiring constant management. ‘Our research shows that the 5:2 diet is just as effective at achieving weight loss as a continuous energy-restricted diet in women who have had gestational diabetes, which is great, because it provides women with greater choice and control. ‘Of course, women should seek advice from a health professional before commencing this type of diet, to make sure that it is suitable for them.’ The research investigated the effects of both the 5:2 diet (five days of normal eating and two days of 500 calories) and a continuous energy-restricted diet (1 500 calories per day) on weight loss and diabetes risk markers in women with a previous diagnosis of gestational diabetes. Both diets restricted energy by approximately 25% each week. MedicalBrief 2021 University and while working with the Nutritional Epidemiology Team at the USDA HNRCA. The greatest contributor to whole- grain intake among participants was wholewheat breads and ready-to-eat whole-grain breakfast cereals. The refined grains came mostly from pasta and white bread. The difference in health benefits between whole and refined grains may stem from the fact that whole grains are less processed than refined grains. Whole grains have a fibre-rich outer layer and an inner germ layer packed with B vitamins, antioxidants and small amounts of healthy fats. Milling whole grains removes these nutrient-dense components, leaving only the starch-packed refined grain behind. ‘The average American consumes about five servings of refined grains daily, much more than is recommended, so it’s important to think about ways to replace refined grains with whole grains throughout your day. For example, you might consider a bowl of whole-grain cereal instead of a white flour bagel for breakfast and replacing refined-grain snacks, entrees, and side dishes with whole-grain options. Small incremental changes in your diet to increase whole-grain intake will make a difference over time,’ McKeown said. Methodology Tomeasure daily grain intake, the researchers used diet questionnaires that participants completed every four years from 1991 to 2014, resulting in a median of 18 years of data. Dietary assessment data came from five study examinations, and observations were only included if participants attended at least two consecutive examinations with accurate dietary data. Participants with diabetes at baseline were excluded. The statistical analysis was adjusted for factors that might influence the results, including other aspects of a healthy diet. Limitations of the study include the fact that food consumption is self-reported, and participants may over- or under-estimate intake of certain foods based on perceived social desirability. Due to its observational design, the study does not reflect a causal relationship. MedicalBrief 2021