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Diabetes and Anti-inflammatory Diets: Fact or Fallacy

Issue: January 2009

By: Tracy Taylor, R.D., D.C.E.

With almost 24 million people, or 8% of the U.S. population, having diabetes, the push to find ways to improve care and management is increasing. In one area that is gaining more attention, researchers are now exploring the possible connection between diet, inflammation and diabetes.

If you’ve been walking around the bookstore, reading popular magazines, or surfing the net, you’ve probably noticed a plethora of “anti-inflammatory” diets. Whether promising to erase crow’s feet, prevent heart disease or reverse the effects of aging, they generally recommend eating more minimally processed, high-fiber, plant-based foods and reducing sugar, saturated fat and nutrient depleted foods.

How may this relate to diabetes? We do know there is an association between chronic inflammation and heart disease and diabetes. What remains to be proven is how the association works, and how and what, if anything, can be done to control it. Some call inflammation a silent epidemic that triggers chronic diseases, including diabetes, over the years.

A number of studies suggest that the commonly eaten diet of, highly processed, calorie-dense, nutrient-depleted foods combined with a sedentary lifestyle leads to post-prandial spikes in blood glucose and lipids. This state, called post-prandial dysmetabolism, creates immediate oxidant stress after a meal. The transient increase in free radicals acutely triggers atherogenic changes including inflammation, endothelial dysfunction, hypercoagulability, and sympathetic hyperactivity.

Other studies have looked at whether some foods may protect against inflammation. For example, in vivo research has shown flavonoids suppressed free-radical formation. While this certainly doesn’t prove that anti-inflammatory diets work, findings will be used to improve future research to know whether the anti-inflammatory diet results in less inflammation and a better response by the immune system than the standard diabetes diet.

Even though this area of research currently has more questions than answers, the dietary recommendations are in line with much of the advice set forth by groups such as the American Diabetes Association and American Heart Association. Keep in mind that individual foods should not be the focus. Patients often believe that the newest anti-oxidant-rich exotic fruit juice is a magic bullet. Instead encourage them to pay attention to their overall eating pattern.

Anti-inflammatory diet guidelines include:

Select high-fiber carbohydrates such as vegetables, fruits, whole grains, and legumes.
Choose healthier protein such as lean meats, fatty fish and plant-based sources.
Eat approximately 1 handful of nuts daily.
Eat salad daily, consisting of leafy greens with dressing of vinegar and virgin olive oil. Eat a variety of colorful fruits and vegetables.
Avoid highly processed foods and beverages, particularly those containing sugar, high-fructose corn syrup, white flour, or trans fats.
Spice it up. Ginger, curry, and other spices can have an anti-inflammatory effect.
Limit portion sizes to modest quantities to help attain and maintain a healthy weight.

Also remember that reducing inflammation is not just about what we eat.

We also need to stress to our patients the importance of getting enough sleep and exercise, regularly practicing diabetes self-management skills and being supervised by a physician and healthcare team.

As healthcare providers we understand performance of self-care recommendations is a key to the successful treatment of diabetes. Many patients, however, have difficulty adhering to diabetes self-care recommendations.

We also recognize that successful diabetes management is a team effort with the patient being the most important member. Teaming up with a Certified Diabetes Educator- nurses, dietitians, pharmacists, doctors, exercise physiologists, podiatrists, and social workers, among others –will free more of your valuable time to medically treat your patients and to continue providing them with the quality of care that you strive for.

Tracy Taylor, R.D., C.D.E. is the Director of Diabetes Management and Outpatient Nutrition Programs Clinical Nutrition Supervisor at Doctors Medical Center in San Pablo. She may be reached at 510-970-5344.

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