People who tend to put on weight around the abdomen are at higher risk of developing a number of lifestyle-related diseases including type 2 diabetes, particularly if they are genetically predisposed. Dr Adri Kok, a physician practising at Netcare Union Hospital, explains why ‘tummy fat’ is a particularly concerning factor for one’s health.
“Being overweight, especially for people who carry more fat around their middle, is a sign of a high risk for heart disease and type 2 diabetes, as well as cancer. This is called visceral fat, which is fat that accumulates and surrounds organs in the abdominal cavity,” Dr Kok explains.
At least 2.2 million South Africans live with diabetes, although it is believed that this figure would be significantly higher if it included undiagnosed diabetics. Many more people are prediabetic, which means that they are at risk of developing type 2 diabetes.
Type 2 diabetes is a health condition where a person’s body does not produce adequate amounts of insulin or cannot use insulin effectively due to insulin resistance. Insulin, which is produced by the pancreas, is a hormone that converts sugars from food into energy needed to conduct our daily activities.
What is visceral fat?
“Visceral fat is metabolically active, which means it releases various secretions that affect normal body functions such as blood pressure and how our bodies metabolise sugars. The hormones in our bodies regulate a number of functions including how our bodies respond to glucose from the food we eat,” she explains.
According to Dr Kok, individuals with a family history of diabetes have a significantly increased risk – up to a one-in-four chance – of developing type 2 diabetes.
“It is advisable therefore that people, especially those who have a predisposition to diabetes, take precautions to reduce their risk as far as possible. The best measure one can take is to reduce visceral fat in an attempt to restore the healthy balance of metabolic hormones through exercise and diet,” Dr Kok adds.
People who do not realise that they are living with diabetes and are therefore not receiving appropriate treatment may develop a number of severe complications, including kidney damage and visual impairment. This is why people, particularly those who have risk factors such as a genetic predisposition, abdominal fat and who are over the age of 35, should have their blood sugar levels tested as part of an annual physical check up.
Can adult onset diabetes be prevented?
A study conducted by the Diabetes Prevention Programme of the US National Institute of Diabetes and Digestive and Kidney Diseases, found that weight loss through dietary changes and exercise, supported with motivational counselling to assist behaviour modification, reduced the participants’ risk of developing diabetes by 58%.
Dr Kok says that while this research is cause for hope, it is important to note that it only reflects a positive result for the duration of the study, rather than over the long-term. “This study must be considered in context, however it does suggest that healthy lifestyle changes and weight loss can help to at least delay the onset of diabetes in those who are particularly at risk. In combination with medicine, the outlook for certain patients may be further improved.”
Can diabetes be ‘cured’?
Dr Kok says that there is no known ‘cure’ for diabetes, however the condition can effectively be managed. “We would never say diabetes is ‘cured’, the term ‘sugar controlled’ is more accurate although even this cannot be stated on the basis of symptoms alone. One can only establish effective control by monitoring of glucose levels and the HbA1c blood test,” she notes.
“The only patients one might consider to be in remission are some of those who have undergone bariatric surgery, but again this is according to the results of blood tests rather than the absence of symptoms. Unfortunately, some of these patients were later found to have had a recurrence of the condition and the remission may not have been permanent.”
Current evidence suggests that initial insulin therapy under strict supervision may reverse the glucose toxicity and restore pancreatic function. Medication that tackles insulin resistance seems to help control glucose levels, which in turn help to prevent complications in the long run. “Newer agents, which protect the pancreas as well as medications that work independent of the pancreas, may again be effective in avoiding progression of complications by controlling glucose levels effectively. We know that early effective control results in a legacy effect, good control initially prevents complications in the long run.
Tips for reducing your diabetes risk
Lifestyle interventions can help make the body’s metabolism more efficient by reducing visceral fat and improving insulin sensitivity.
“Exercise improves the efficiency of insulin action, as it opens more receptors in the muscles. This is why it is very important to get regular exercise, especially if you are diabetic or prediabetic. The exercise must be aerobic, which means it must raise your heart rate sufficiently to burn calories. At least four or five sessions per week are advisable, and this must be maintained to be effective,” Dr Kok advises.
“Diet is also extremely helpful in controlling blood sugar levels, and it remains one of the key pillars for treatment. The emphasis is on reducing the amount of simple carbohydrates, including cane sugar and starches, as well as fat in the diet. Restricted carbohydrates greatly assist weight loss, including the proportion of particularly unhealthy visceral fat in your body. Carbonated drinks, even those labelled as ‘diet’ drinks should be avoided,” Dr Kok concluded.
Issued by: MNA on behalf of Netcare Union Hospital
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville, Pieter Rossouw or Alison Sharp
Telephone: (011) 469 3016
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