The processed food diet of the Western world has contributed greatly to the type 2 diabetes epidemic in the United States. The rate of type 2 diabetes has increased since processed foods flooded our food supply. Other populations that adopt a Western diet also have high rates of type 2 diabetes. All minorities living in the United States for which data exist have a higher prevalence of diabetes than do residents of their countries of origin. (“Diabetes Disparities”, 2001, Reducing Disparities section). It is predicted that by 2010, 221 million people, and by 2025, 324 million will be diabetic in the U.S. (Cheng, 2005). The food quality and diet of the westerner is abundant in refined grains, altered fats and oils, and foods and beverages that contain high fructose corn syrup. Some research leads many individuals to believe that there is a genetic or hereditary component to this disease, but other research shows that nutrition plays a major role in who will develop type 2 diabetes. Our genes have not changed in the past decades but food quality and diet have (“Because the Light”, 2002, Premise section).
THE HISTORY OF FOOD PROCESSING
Food processing has slowly changed since before the 1900’s, as family farms began to disappear and the agriculture industry was emerging. Sugar, once considered a luxury item, began being processed at a low cost. Early into the 1900’s, a new process capable of deriving sugar from corn as corn syrup was added to foods. This new form of sugar, now added to soft drinks and other food items, became extremely popular in the Western world.
New methods of food storage and preservation, as well as improved transportation, made the refined products and sugar laden agricultural products available to many Americans. Rapid growth of these food sources made from refined wheat flour and sugar began to gain major acceptance from the public because they were abundant, inexpensive, and could be stored for longer periods.
After World War II, processed foods such as refined breads, sweet rolls, cakes, doughnuts, and various other sugary foods grew into a profitable business for the Western world. When grains are milled (processed or refined), the fiber (germ and bran) are removed. Approximately 80 % of the vital nutrients found in the bran and germ are also removed during this process. These nutrients include magnesium, chromium, iron, vitamin E, zinc, and B vitamins. The removal of this fiber causes the food to digest rapidly, and this greatly affects the blood sugar and insulin levels in the body. Along with refined flours and sugary products, another food source that contributes greatly to type 2 diabetes is the new sources of edible oils and fats available today called hydrogenated and partially hydrogenated oils. These healthy oils such as olive, flax, and coconut were slowly being replaced with these new hydrogenated vegetable oils. The hydrogenation process altered the chemical composition of the vegetable oils, so they did not become rancid in storage and gave the product a long shelf life. Unfortunately, this process removes the essential omega 3 fatty acids. These healthy fatty acids are removed because they do not produce a long shelf life. Udo Erasmus (1993) states, “The oils you buy in a supermarket today are very different from those that people consumed 100 years ago” (p. 83). Butter, has now been replaced by margarine spreads. These margarine spreads are made using the hydrogenation process and contain trans fatty acids. These vital nutrients such as fiber, essential fatty acids, vitamins, and minerals are important and necessary components in the prevention of type 2 diabetes. The nutrients that are now missing from our food supply are required for proper balancing of blood sugar and insulin levels.
WHAT IS TYPE 2 DIABETES?
There are two types of diabetes, type 1 and type 2. Type 1 diabetes, is an autoimmune disease that is believed to be caused by a virus that attacks and damages the beta cells of the pancreas and decreases its ability to control blood glucose (Becker, 2003). The person with type 1 diabetes produces little or no insulin and needs to take insulin for the rest of their lives. Five to ten percent of all diabetics are type 1 (Murray, 2003). There does not appear to be any nutritional connection to type 1 diabetes, but rather an environmental cause.
Type 2 diabetes is a condition that affects the way your body metabolizes glucose. Type 2 diabetes, is the most common form of diabetes, and it accounts for more than 90% of all cases of diabetes (Delahanty & Nathan, 2005). There are different stages in the development of type 2 diabetes. In the early stages of type 2 diabetes, a person may be told they have pre-diabetes, and there blood sugar levels may be increasing slowly but are not in the range for any type of diagnosis. Next, a person can develop insulin resistance or hyperinsulinemia (high insulin levels). At this stage of the disease, the tissues of the body can become less sensitive to the effects of insulin, and blood sugar does not enter the cells as easily as it should. An estimated 40 million people in the United States have insulin resistance (Delahanty & Nathan, 2005). Genetics may determine whether you become insulin resistant quickly or slowly, but diet is the principal controllable factor influencing this disorder (Burton, Challem, & Smith, 2000, p. 22). Proper nutrition at this time can greatly influence whether a person may develop type 2 diabetes. The final stage of the disease that can occur is when the blood sugar control system begins to breakdown further. At this time, the body either resists the effects of insulin or does not produce enough of it to maintain normal glucose levels in the body. At this stage, a person may be diagnosed by a medical professional with type 2 diabetes. Orthodox medicine recommends medications to correct these insulin issues without any recommendations for dietary changes. Most cases of type 2 diabetes are considered to have a nutritional cause (Ottoboni & Ottoboni, 2002).
RISK FACTORS FOR TYPE 2 DIABETES:
Processed Food Diet- When foods are processed it can affect the glycemic index of the foods. The more processed a food is, the higher the glycemic response it will produce (Ross, Brand, Thorburn & Trussel, 1987, p. 635). Most foods eaten today in the Western world are prepared using factory processing methods. These methods are used to maintain a long shelf life for such foods as, breads, cakes, pastries, and snack foods. These methods such as extrusion cooking, explosion puffing and instantization use extremely high temperatures and pressure or repeated wetting and drying. This process can affect the digestibility of starch in these products, giving them a high glycemic index. These foods, eaten continuously over time can affect how the blood sugar control system of the body works. During these processing methods, the fiber content is altered from its natural state, and essential fatty acids are removed to increase shelf life. Fiber has been shown in many studies to help maintain a proper blood sugar balance in the body. In addition to removing essential fiber and altering fats and oil, a highly processed high fructose corn syrup is then added to these foods. The components in processed foods that cause the most concern with the current standard American diet are as follows:
Fiber-less food - Fiber is an important element in our food supply that is lost when food is processed (Smith, 2000, p. 94). Fiber is an important component to a healthy diet for many reasons, but it is most important job is to helps keep blood sugar and insulin levels balanced in the body. Compared with refined grain products, whole-grain products are generally digested and absorbed slowly because of their physical form and high content of viscous fiber, and they elicit smaller postprandial glucose responses, thus exerting less insulin demand on the cells of the pancreas (Liu et al. 2000). The best sources of fiber can be found in whole foods such as vegetables, fruits, legumes, whole grains, nuts and seeds. Approximately 85% of the grains consumed in the current U.S. diet are highly processed (Cordain et al. 2005). Methods that are used in food processing to refine grain products are grinding, pressing, and rolling, all can affect the glycemic index of a food and effect blood sugar levels in the body. These food-processing methods can damage the outer layers of grains and the chemical composition of starches, thereby affecting the GI of these foods (Draznin, 2003).
High Fructose Corn Syrup - High fructose corn syrup became popular in the 1970’s. Fructose being much sweeter than sucrose (table sugar),allowed food manufacturers the opportunity to use less ingredients to sweeten any processed food and gave them the ability to increase their profits. The average American eats 83 pounds of corn syrup a year (Cordain, 2002). HFCS does not appear to cause an immediate elevation in blood glucose after a meal, but long-term use is a major concern. High fructose corn syrup is metabolized by the liver and is stored as fat, this is how it contributes to obesity and insulin resistance, which is strongly linked to type 2 diabetes. High fructose corn syrup powerfully promotes insulin resistance (Cordain, 2002, p. 35).
Trans Fatty Acids -Trans fatty acids are processed fats that are a product of technology not nature. Trans fatty acids are found in all sorts of processed foods such as margarines, oils, salad dressings, potato chips, bakery goods, candies, crackers and other snack foods. These fats are made from a process call hydrogenation or partial hydrogenation. The fat first starts out as an unsaturated fat that is heated to a high temperature. Next, a nickel catalyst is added to the heated fat and then hydrogen gas is pumped into the mixture. This process removes all healthy essential fatty acids and gives the fat a much longer shelf life. Trans fatty acids have been shown to affect a person with type 2 diabetes by decreasing the response of the cell to insulin. They do this by hampering proper function of the insulin receptor by changing the fluidity of the lipid bilayer and other cellular membranes (Eades & Eades, 2000, p. 76). Our cells are made up of healthy essential fatty acids, when we replace these fats with trans fatty acids the body will use this wrong type of fat to repair and maintain the cells.
OTHER RISK FACTORS:
Obesity- Obesity is been defined as a body mass index (BMI) of 30 or greater (CDC, 2009). A processed foods diet and a sedentary lifestyle have contributed to the obesity epidemic that is plaguing Americans as well as many other populations. The rise of obesity closely parallels dramatic changes in our environment and to the rise in type 2 diabetes that is linked to the systematic corruption of the food supply (Smith, 2000, p. 64).When a person is experiencing chronic high levels of insulin, the extra glucose that is produced by the insulin gets stored in fat cells. This is how insulin resistance and type 2 diabetes may contribute to obesity. Approximately 90 % of individuals with type 2 diabetes are obese (Murray, 2003, p.18). Eating a healthy whole foods diet and removing processed and refined foods from the diet along with daily exercise can keep blood sugar and insulin levels balanced in the body and this can help with the prevention of obesity as well as diabetes.
Sedentary Lifestyle -Physical inactivity makes the muscles of the body less sensitive to the effects of insulin. Physical activity almost immediately improves your muscle sensitivity to insulin, making it easier to store sugar in your muscles rather that have it rise in your circulation (Delahanty & Nathan, 2005). Becoming more physically active and, implementing a daily exercise program is important in maintaining a healthy body, and can be helpful in preventing problems with insulin and blood sugar levels within the body.
Race/Ethnicity – Many people of different race such as Pima Indians, Australian Aborigines, and Pacific Islanders seem to be more susceptible to the development of type 2 diabetes than other races. During this century, the urbanization of many indigenous populations has been associated with a dramatic rise in the prevalence of noninsulin-dependent diabetes mellitus (NIDDM) (Thorburn, Brand, & Truswell, 1987). Pima Indians have the highest rate of noninsulin dependent diabetes mellitus in the world (Lillioja, et al. 1991). Until the 19th century, the Pima Indians had their own way of life and lived traditionally. The white settlers diverted their water supply, disrupting their irrigation and agriculture. This forced the Pima’s to survive on processed foods such as lard, white sugar, and flour, supplied by the United States government. Pima Indians of Arizona are largely sedentary and follow the dietary practices of typical Americans (Murray, 2003, p. 67). Changing from their traditional diet and way of life may have more to do with their prevalence to type 2 diabetes than their race or even genetic background.
Genetic Predisposition/Family History– Type 2 diabetes is a multifactorial disease, and is believed to have a genetic predisposition and an environmental component. There are many different genes involved in the blood sugar control system of the body. DNA variants have been discovered and are involved in areas such as the regulation of insulin sensitivity and protection against type 2 diabetes, increased susceptibility to insulin resistance and type 2 diabetes, glucose-stimulated insulin secretion in pancreatic cells and reduced insulin in the cells of the pancreas. Many different genes are thought to be involved in type 2 diabetes, but they are poorly defined (Dean & McEntyre, 2004). Family history has long been associated with type 2 diabetes as a strong risk factor. Whether it is because of genetics or there are learned behaviors such as poor dietary habits and lack of exercise passed down from generation to generation is still unknown. Family history could have effects on glycemic control via genetic or behavioral mechanisms (Gong, Kao, Brancati, Batts-Turner, & Gary, 2008).
COMPLICATIONS OF TYPE 2 DIABETES:
Heart Disease, Stroke, and Peripheral Vascular Disease - Studies have shown that poor blood glucose control can increases the risk of many different cardiovascular problems in diabetics such as coronary artery disease, heart attack, stroke, atherosclerosis and high blood pressure. Fifty-five percent of deaths in diabetics are caused by cardiovascular disease (Murray, 2003). Type 2 diabetes can contribute to other vascular problems such as peripheral vascular disease, which is caused from poor circulation problems in the blood vessels of the legs and feet. People with diabetes can have problems with wound healing, and in some cases can develop gangrene, a condition which can lead to amputations of the extremities.
Neuropathy – Diabetic Neuropathy is the loss of peripheral nerve function. This condition can cause numbness, tingling sensations, and even loss of function of the extremities. High blood glucose levels in the body can negatively affect the walls of the small blood vessels (capillaries) that nourish the nerves. Approximately 60% of all people with diabetes will eventually develop neuropathy, (Murray, 2003, p. 232). The nerves that are affected branch from the brain and spinal cord to the rest of the body, especially affecting the legs and feet. Diabetic neuropathy also affects the nerves of the autonomic nervous system, which can cause impotence and contribute to problems with the digestive tract and bladder.
Nephropathy - The kidneys job is to filter toxins and wastes through urination, as well as reserve proper nutrients. Studies have shown high blood glucose levels can damage the small blood vessel in the filtering units of the kidneys. Diabetes is the leading cause of end-stage renal disease, accounting for 44% of new cases (Chace, & Keane, 2007, p. 54)
Periodontal Disease – High blood glucose levels affect the blood vessels that deliver oxygen and nourish the tissues of the mouth. When the gums do not receive proper oxygen this can slow the flow of nutrients and affect the removal of bacteria, this can be a contributing factor to inflammation and as well as a gum infection. Another way diabetics can be affected by periodontal disease is through their salvia. When blood sugar levels are elevated in the blood, they are also elevated in the saliva (Chace, & Keane, 2007). This elevated glucose in the mouth can contribute to an overgrowth of bacteria and increase the risk of gum disease.
Retinopathy and Other Eye Diseases- Studies show that high blood glucose levels can negatively affect the blood vessels of the eye. Over time, this can contribute to vision problems and conditions such as glaucoma, cataracts and diabetic retinopathy. Diabetic retinopathy can occur when one of the arteries that supplies blood to the retina becomes blocked. Diabetic retinopathy is the leading cause of blindness in the United Sates, and 20 percent of type 2 diabetics have significant retinopathy (Murray, 2003).
CAN DIETARY CHANGES PREVENT OR ELIMINATE TYPE 2 DIABETES?
The purpose of this article is to educate people to look at the possibility that a diet high in processed foods may have a strong connection as to whether someone will develop type 2 diabetes and its many devastating complications. Obesity has long been associated with type 2 diabetes, and the medical community recommends weight loss as the solution. The Shultze, Fung, Manson, Willet, & Hu (2006) study, explored whether certain dietary patterns caused weight changes in women over a 9-year period. The study found participants who adhered to a “Western” dietary pattern of processed foods had the largest weight gain, and the participants that followed a “Prudent” dietary pattern that consisted of whole foods, had less weight gain and were able to maintain a healthy weight. Losing weight is a step in the right direction, but recommending weight loss, without properly educating someone on how certain foods can affect blood sugar and insulin levels in the body, may not lead to successful permanent weight loss, or even the prevention or elimination of metabolic diseases.
Changing the type of foods you consume, and adhering to an exercise plan, can greatly affect your blood sugar and insulin levels in the body. If you have a medical condition, it is important to check with your medical doctor before implementing any changes with diet or exercise.
