- Blood sugar (glucose) and/or fasting insulin should be used to select the right diet, particularly for people with pre-diabetes and diabetes.
- The specific diets that will work for people with diabetes or pre-diabetes differ based on whether a patient has normal blood sugar.
- A fiber-rich diet without calorie restriction will be very effective for pre-diabetics.
- For people with type 2 diabetes, a diet rich in healthy, plant-based fats (such as from olive oil, nuts and avocados) will be effective to achieve weight loss.
Blood glucose levels and fasting insulin were repeatedly proven as predictors of weight loss and maintenance success in people with pre-diabetes and diabetes.
Evaluated across six major interventional diet studies utilizing a variety of nutrition strategies, these biomarkers were repeatedly proven as predictors of weight loss and maintenance success.
‘For successful weight loss, fasting blood sugar and fasting insulin should be used to select an approach; be it a high fiber diet or a low calorie that is proven to work.’
"Remarkably, for many patients, use of these biomarkers can lead to a six- to seven-fold greater weight loss," commented Arne Astrup, Professor, Head of the Department of Nutrition, Exercise and Sports at the University of Copenhagen, Denmark.
Prevalence of Diabetes & Pre-diabetes
According to the American Diabetes Association, 29.1 million people in the U.S. had diabetes in 2012. Each year, 1.4 million more people in the U.S. are diagnosed with diabetes. At that same point in time, approximately 86 million Americans over the age of 20 had pre-diabetes, up from 79 million in 2010.
Individuals with pre-diabetes have higher than normal blood glucose but not yet high enough to be diagnosed as diabetes. Approximately 30 percent of people with pre-diabetes will develop type 2 diabetes over a three-year period.
Studies have found that lifestyle changes and weight loss in the range of 5 percent to 10 percent can prevent or delay the development of type 2 diabetes among high-risk adults.
Weight Loss May Reduce Risk Of Diabetes in Pre-diabetics
The studies demonstrate that, for successful weight loss, fasting blood sugar and fasting insulin should be used to select an approach that is proven to work based on those biomarkers.
For most people with pre-diabetes, a fiber-rich diet without calorie restriction will be very effective and has been shown to improve diabetes markers. In this population, carbohydrates or fats should be adjusted based on fasting insulin levels.
For people with type 2 diabetes, a diet rich in healthy, plant-based fats (such as from olive oil, nuts and avocados) will be effective to achieve weight loss. The researchers acknowledge that no one solution will work for every patient, but for many in the US and EU these strategies are likely to be more effective than a generic, 'one size fits all' approach.
Weight loss strategies should be customized based on an individual's biomarkers, which is a big step forward in using personalized nutrition to help people achieve greater weight loss success.
"These findings are particularly important as they allow us to provide those with pre-diabetes a custom strategy to help them lose weight, which can ultimately prevent or delay the development of type 2 diabetes."
The University of Copenhagen will continue to participate in and support research to explore additional biomarkers such as gut microbiota and genomics approaches, which may offer more insights and help to better predict success with specific diets.
- Arne Astrup et al., Fasting plasma glucose and insulin are determinants of dietary weight loss success, American Journal of Clinical Nutrition (2017).