The SA Journal Diabetes & Vascular Disease Volume 19 No 2 (November 2022)

36 VOLUME 19 NUMBER 2 • November 2022 diabetes news SA JOURNAL OF DIABETES & VASCULAR DISEASE the modulation of the rise of glucose blood levels after meals and also on the control of appetite and body weight. ‘Protective effects in relation to body weight gain and obesity, drivers of type 2 diabetes development, have (also) been reported for probiotics, which can be found in yogurt, the other dairy item whose consumption is associated with a reduced risk of type 2 diabetes,’ she said. Other low-quality evidence suggested that neither daily 100-g servings of fish nor one egg per day affect T2D risk significantly. Eating to curb diabetes The study adds credence to the belief that limiting or avoiding the consumption of animal-based foods, namely red and processed meat, can help prevent T2D. ‘Our findings on the most suitable intake of animal foods to prevent type 2 diabetes incidence are highly concordant with the features of the Mediterranean diet, which is the plant-based dietary pattern that has more consistently shown over time the potential to reduce the risk of type 2 diabetes and cardiovascular diseases,’ she added. Dr Roy Taylor, a physician, author, professor, and director of Newcastle Magnetic Resonance Centre at Newcastle University in the UK and not involved in the study, argued that the wide availability of ‘cheaper’ and more accessible processed foods is driving the spike in T2D cases. He was especially concerned about the increase in cases among children. T2D is considered a chronic condition, though there is evidence to suggest that it may be reversible through diet and lifestyle modifications, according to the American Diabetes Association. Numerous studies have shown a link between consumption of ultra-processed foods and increased risk of T2D. Other research has shown that interventions such as a low-calorie diet, physical activity, or bariatric surgery, may be effective for reversing T2D. While more research is needed to determine whether a mostly plant-based diet, such as the Mediterranean diet, could reverse T2D, a growing body of evidence shows that a Mediterraneanstyle diet may help prevent or delay the progression of the condition. Call for stronger evidence The Italian researchers acknowledged that the 13 meta-analyses included inferior data in some cases. Therefore they are hesitant to offer ‘solid recommendations’ for T2D prevention based on their study at this time. Nevertheless, Giosuè said: ‘Our study gives further support to the belief that a plant-based dietary pattern including limited intakes of meat, moderate intakes of fish, eggs and full-fat dairy and the habitual consumption of yogurt, milk or low-fat dairy, might represent the most feasible, sustainable and definitely successful population strategy to optimise the prevention of type 2 diabetes.’ Source: MedicalBrief 2022 Canada’s ‘pioneering’ guidelines on adult obesity Pioneering guidelines on obesity management in Canada are challenging doctors to consider the health problem as a complex chronic illness rather than something a little diet and exercise can cure, reports The Guardian. The guidelines, believed to be the first of their kind in the world, were developed over three and a half years by a committee of 62 professionals led by Dr Sean Wharton, a Toronto internist specialising in weight management. The document advocates for approaching obesity as a complex chronic disease, rather than an issue of weight loss. Canadians living with obesity and the healthcare professionals who support them have a new roadmap for quality collaborative care. More than two years in the making, the Canadian Adult Obesity Clinical Practice Guidelines (CPGs) provide amuch-needed evidence- and experience-based, patient-centred framework for healthcare professionals, patients and policy makers. They represent the first comprehensive update in Canadian obesity guidelines since 2007, and perhaps the most extensive review of published evidence yet conducted in obesity worldwide. Developed by Obesity Canada and the Canadian Association of Bariatric Physicians and Surgeons, the new CPGs were authored by more than 60 Canadian health professionals, researchers and individuals living with obesity. Together, they assessed well over 500 000 published peer-reviewed articles and built consensus on a wide range of clinical and scientific issues to identify 80 key recommendations. ‘Science tells us the drivers of weight gain are complicated and unique to the individual, and also that the human body is hard-wired against weight loss. Historically, we have told people whose weight affects their health merely to eat less and move more, which on its own is ineffective and even dangerously simplistic advice,’ says Dr Arya M Sharma, scientific director of Obesity Canada. ‘The CPGs represent a turning point in the way Canada needs to approach the treatment of obesity, and that is to acknowledge obesity as a complex chronic disease requiring lifelong support, as we do for diabetes, heart disease and others – this is the best evidence to date on how to do that.’ The CPGs are rooted in patient-centred care, with patients and providers working together to identify personal drivers of obesity, set realistic goals and maintain healthy behaviours over the long term. In addition to medical nutrition and physical activity, psychological interventions, medications and surgery can be used to support patients as needed. The CPGs also discuss key issues such as weight bias, implications for indigenous communities and more. ‘People who live with obesity have been shut out of receiving quality healthcare because of the biased, deeply flawed misconceptions about what drives obesity and how we can improve health,’ explains Lisa Schaffer, chair of Obesity Canada’s Public Engagement Committee. ‘Obesity is widely seen as the result of poor personal decisions, but research tells us it is far more complicated than that. Our hope with the CPGs is that more healthcare professionals, health policy makers, benefits providers and people living with obesity will have a better understanding of it, so we can help more of those who need it.’ Source: The Guardian, August 2020

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