Tuesday 18 April 2023 1:35pm
Three new publications in top international journals demonstrate the potential of changing what we eat to prevent and treat type 2 diabetes, prompting calls for urgent government action.
Type 2 diabetes is a serious but largely preventable disease, and there is now good evidence to show how it can be prevented. A study including data from 184 countries, just published in the prestigious international journal Nature Medicine, found that seven out of every ten cases of type 2 diabetes are attributable to a small list of dietary factors. These same dietary factors are also associated with some cancers and coronary heart disease.
New Zealand scientists at the forefront of diabetes research, Dr Andrew Reynolds and Professor Jim Mann from the University of Otago-based Edgar Diabetes and Obesity Research Centre and the Healthier Lives National Science Challenge, were invited to write a commentary on this study, which has been published alongside the Nature Medicine article.
“This study shows that eating plenty of whole grains, vegetables, fruit, nuts, and seeds reduces the risk of developing type 2 diabetes. On the other hand, having refined grains (white bread, white pasta and white rice), red and processed meats (like salami and bacon), or fruit juices is associated with a higher risk of type 2 diabetes,” says Dr Reynolds.
The number of people with type 2 diabetes has escalated globally and is considered to have reached pandemic proportions. There are estimated to be 483 million people worldwide living with type 2 diabetes. A recent report reveals a “rapidly escalating” diabetes crisis in the UK, and around a quarter of a million New Zealanders now have type 2 diabetes.
Education and individual actions alone are not sufficient to tackle the type 2 diabetes pandemic, which is currently costing NZ taxpayers more than $2 billion per year according to a 2021 PwC report commissioned by the researchers and their partner organisations.
“An all-of-government approach is needed to stem the tide of the diabetes pandemic. There is evidence from a number of countries to show that government-led initiatives for the benefit of the whole population can help to achieve dietary change,“ says Professor Mann.
“Improving the 'food environments' we encounter on a daily basis – such as in schools, workplaces and other public spaces – could help reduce the risk of type 2 diabetes and also prevent heart disease and several types of cancer.”
Research shows that the foods that protect against type 2 diabetes, heart disease and cancer also produce less greenhouse gas emissions, as they have a lower environmental impact.
“Climate change is a big focus for Aotearoa New Zealand right now, and many of the dietary changes that help prevent type 2 diabetes are actually good for the environment too. So we could tackle these two major issues at the same time,” says Dr Reynolds.
Reynolds and Mann have also made a significant contribution to newly updated European Guidelines for the management of type 2 diabetes, published today in the international journal Diabetologia.
“These updated guidelines endorse the importance of dietary fibre (such as from vegetables and fruit) and carbohydrate quality (choosing wholegrains) in the management of people with diabetes and, for the first time, includes the potential of dietary measures aimed at appreciable weight loss to achieve remission of type 2 diabetes,” says Dr Reynolds.
Professor Jim Mann stresses that creating a sustainable and health-promoting food environment to prevent type 2 diabetes requires a strategy and large-scale government action.
“Developing a national food strategy would help us tackle several big problems that are inter-connected – food security in these times of global uncertainty, greenhouse gas emissions caused by food production, and food environments that are compromising the health of New Zealanders,” says Professor Mann.
“We are calling for a Ministerial Taskforce to develop a national food strategy, and to consider the implementation of measures needed to prevent type 2 diabetes. New Zealand is falling behind other countries in addressing these issues and we risk overwhelming our already stretched health system (due to the multiple medical complications of type 2 diabetes) if we don't instigate these measures soon.”
“While food industry self-regulation and reformulation has a role to play, the ultimate goal of these companies is to make a profit. It is imperative that the NZ government protects New Zealanders from the effects of harmful foods, much like the measures it puts in place to help protect the population from the harm caused by tobacco and alcohol. Preserving the future capacity of our health system depends on this,” says Professor Mann.
Another urgent initiative is to increase the number of dietitians being trained in Aotearoa New Zealand, says Professor Mann, and to increase funded places for dietitians in the health system.
“For New Zealanders already diagnosed with type 2 diabetes, or who are found to have prediabetes through screening programmes, it is essential to have appropriately trained health professionals to prescribe medical nutrition therapy. The current number of dietitians in NZ is totally inadequate for this purpose.”
Listen to Professor Jim Mann on RNZ
Scientists warn a type two diabetes pandemic is looming, RNZ Morning Report, 18 April 2023
For more information, please contact:
Dr Andrew Reynolds
Senior Research Fellow
University of Otago
Professor Jim Mann
Co-Director, Edgar Diabetes and Obesity Research Centre
Director, Healthier Lives–He Oranga Hauora National Science Challenge
University of Otago
Dr Cherie Stayner
Edgar Diabetes and Obesity Research Centre
& Healthier Lives–He Oranga Hauora National Science Challenge
University of Otago