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The Role of Diets in The Risk of Type 2 Diabetes

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Type 2 diabetes (T2D) is one of the main global public health issues and the prevalence of it is in an increasing trend year by year. It is predicted that the cases of T2D worldwide will rise to approximately 552 million by the year 2030 which almost doubles the number in 2011 (Whiting et al., 2011, p. 316). T2D is a disease that is attributed to the abnormal secretion of a hormone called insulin or insulin resistance which is a problem that cells cannot respond to the signal from insulin. Therefore, the digestion of carbohydrate, lipid, and protein will not be regulated properly. American Diabetes Association (2011) indicates that there are many serious syndromes resulted in T2D including cardiovascular disease (CVD), blindness, kidney failure, and lower limb amputation. There are many possible causes of T2D such as modern dietary patterns, lifestyle, and genetics. This essay will discuss the association between unbalanced diets and T2D and the Mediterranean diet as a measure to attenuate the risk of T2D. 

The Mediterranean diet refers to the one that consists of a large portion of vegetables, a medium portion of fish, chicken, wine, dairy products and a small portion of processed meat (Esposito et al., 2017, p. 27). First, different unhealthy diets as causes of T2D will be analysed, and then the benefits and drawbacks of the Mediterranean diet will be evaluated. Finally, this essay will conclude that although there are some limitations for the Mediterranean diet pattern, it could be a viable choice in the prevention of T2D. On account of the length constraint, this essay will only discuss the high-sugar consumption and high-meat consumption patterns. Excessive intake of sugar contributes to T2D. In the USA, 1.8 million cases of T2D is imputable to sugary drinks out of a whole of 20.9 million cases in 10 years which are one of the main sources of sugar intake; and 79000 out of 2.6 million is caused by it in the UK. It is also pointed out in the research of Imamura et al. (2015, p. 4) that one serving more fruit juice consumed a day will increase the incidence of T2D by 18% and the rate can be up to 18% for sugar-sweetened beverages and 25% for artificially sweetened beverages. Based on an epidemiological research, if women consume overmuch soft drink before pregnancy, their children will be exposed to a higher risk rate of T2D. 

A high consumption of different sugars such as fructose and sucrose causes T2D mainly derived from obesity called adiposity-based mechanism which brings about the disorder of metabolism system associated with T2D such as insulin resistance (Johnson et al., 2009, p. 99). Therefore, it can be proved that high-sugar consumption is a nutritional model that can cause T2D. Besides, excess meat intake can also stimulate the occurrence of T2D. It is illustrated in a trial involved in 6525 diabetics in a whole of 445323 examinees that the relative risk (ratio of prevalence rate between two different groups) of high meat-consumption group versus the low one is 1.17. The data demonstrates that the intake of meat is positively correlated with the morbidity rate of T2D. 

Another research conducted by Ericson et al. (2012, p. 1148) also agrees that the high consumption of different kinds of meat including processed, non-processed red meat and poultry is all relevant to T2D. There is an explanation for the mechanism behind it that a reaction would occur between nitrites in meat especially processed one and amino compounds in the human body to form a substance called nitrosamine. Nitrosamines can affect the normal expression of insulin receptors which is responsible for receiving the signal from insulin namely, insulin resistance is developed. Moreover, nitrosamine is harmful to b-cells (cells producing insulin). According to the discussion above, the high consumption of meat is one cause of T2D. The Mediterranean diet pattern is proved to be one effective measure to reduce the incidence of T2D. Many studies are showing this conclusion. For example, in a study called ATTICA, 191 cases who are followed up for 10 years were recorded. It is concluded that medium and high compliance of the Mediterranean diet have a lower risk of T2D by 49% and 62% than the low one. 

Another experiment known as PREDIMED produces a result that the incidence of T2D decreases by 30% due to the Mediterranean diet (Salas-Salvado et al., 2016, p. 920S). Salas-Salvado et al. (2015, p. 923S) also explain how this dietary pattern functions reducing the risk of T2D: a low-glycemic index meal rich in vegetables, fruit, wholegrain cereal, legumes with small amount of processed meat and sugar has a positive effect on many metabolic reactions associated with T2D. Besides, the antioxidant profile contained in it can help intervene insulin resistance and the malfunction of b-cell. Furthermore, other dietary patterns almost do not have the benefit of antioxidant profile. However, a limitation is existing for the Mediterranean diet as a measure to reduce the risk of T2D. It is found that most people cannot stick to the recommended diet due to their long-term eating habits which are hard to change but compared with other patterns such as low-energy and low-fat ones, the Mediterranean diet is much more valid and plausible with various types of food contained to meet different individuals’ needs. Also, it is recommended that the Mediterranean diet can be adapted based on dietary habits in particular regions.

In conclusion, this essay has discussed the dietary cause for T2D including high-sugar and high-meat diets and evaluated the Mediterranean diet for reducing the prevalence rate of T2D. Although changing dietary habits is difficult for patients, the Mediterranean diet pattern is comparatively a viable choice. Therefore, citizens at risk of T2D could be encouraged to try the Mediterranean diet and a decrease in the prevalence rate might be seen in the future.

Reference list 

  • Aune, D., Ursin, G. and Veierod, M.B. (2009) ‘Meat consumption and the risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies’, Diabetologia, 52, pp. 2277-2287. doi:10.1007/s00125-009-1481-x 
  • DeFronzo, R.A. et al. (2015) ‘Type 2 diabetes mellitus’, Nature Reviews Disease Primers, 1, pp. 1-22. doi:10. 1038/nrdp.2015. 19 
  • Eguaras, S. et al. (2017) ‘May the Mediterranean diet attenuate the risk of type 2 diabetes associated with obesity: the Seguimiento Universidad de Navarra (SUN) cohort’, British Journal of Nutrition, 117, pp. 1478-1485. doi:10.1017/S0007114517001404
  • Ericson, U. et al. (2012) ‘High intakes of protein and processed meat associate with increased incidence of type 2 diabetes’, British Journal of Nutrition, 109, pp. 1143-1153. doi:10.1017/S0007114512003017 
  • Esposito, K et al. (2016) ‘Mediterranean diet for type 2 diabetes: cardiometabolic benefits’, Endocrine, 56, pp. 27-32. doi:10.1007/s12020-016-1018-2 
  • Imamura, F. et al. (2015) ‘Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction’ British Medical Journal, 351(20 Jul 2015 – 26 Jul 2015), pp. 1-12. doi:10.1136/bmj.h3576 
  • Johnson, R.J. et al. (2009) ‘Hypothesis: Could Excessive Fructose Intake and Uric Acid Cause Type 2 Diabetes?’, Endocrine Reviews, 30(1), pp. 96–116. doi:10.1210/er.2008-0033 
  • Koloverou, E. et al. (2014) ‘The effect of Mediterranean diet on the development of type 2 diabetes mellitus: A meta-analysis of 10 prospective studies and 136,846 participants’, Metabolism Clinical and Experimental, 63, pp. 903–911. doi: org/10.1016/j.metabol.2014.04.010 
  • Koloverou, E. et al. (2015) ‘Adherence to Mediterranean diet and 10-year incidence (2002–2012) of diabetes: correlations with inflammatory and oxidative stress biomarkers in the ATTICA cohort study’, Diabetes/Metabolism Research and Reviews, 32, pp. 73-81. doi:10.1002/dmrr.2672 
  • Muhlhausler, B.S., Toop, C. and Gentili, S. (2020) ‘Nutritional Models of Type 2 Diabetes Mellitus’, in Stocker, C.J. (ed.) Type 2 Diabetes: Methods and Protocols, Methods in Molecular Biology. Buckingham, Buckinghamshire, UK: Hamana Press, pp. 43-69. 
  • Salas-Salvado, J. et al. (2016) ‘Protective Effects of the Mediterranean Diet on Type 2 Diabetes and Metabolic Syndrome’ The Journal of Nutrition, pp. 920S-927S. doi:10.3945/jn.115.218487 
  • Thanopoulou, A. et al. (2004) ‘Nutritional habits of subjects with Type 2 diabetes mellitus in the Mediterranean Basin: comparison with the non-diabetic population and the dietary recommendations. Multi-Centre Study of the Mediterranean Group for the Study of Diabetes (MGSD)’ Diabetologia, pp.367-376. doi:10.1007/s00125-003-1316-0 
  • Whiting, D.R. et al. (2011) ‘IDF Diabetes Atlas: Global estimates of the prevalence of diabetes for 2011 and 2030’ Diabetes Research and Clinical Practice, pp. 311-321. doi: 10.1016/j.diabres.2011.10.029 

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