Good nutrition has received a great deal of attention lately as an intervention for various disorders, such as reducing type 2 diabetes. What role can a dietitian play in this? We ask it on World Diabetes Day (November 14) from Connie Hoek, dietician and involved with Keerdiabetesom.nl.
Is it really possible to reverse type 2 diabetes?
Hoek: "This does not apply to all patients. But a large proportion can indeed be used with less insulin with the help of a different diet and possibly different lifestyle adjustments. Some may even no longer use medication at all."
How is that possible? What is type 2 diabetes anyway?
"What goes wrong with type 2 diabetes is the action of the hormone insulin. Normally our body makes insulin to transport the glucose in the blood to the tissues, including the muscles, where glucose serves as food."
"Diabetes 2 patients make insulin, but the body's cells respond less and less to it. As a result, the glucose cannot leave the bloodstream and the level of glucose in the blood becomes too high."
Diabetes 2 patients make insulin, but the body cells respond less and less well. When medicines no longer work, patients must inject insulin. (Photo: Thinkstock)
And that is harmful?
"Yes, too high a glucose level causes the body to restore balance. That does not work through the normal way. This results in a series of reactions that damage the body at all levels. In the long term, diabetes increases risk of old age diseases such as cardiovascular disease, cancer, strokes, eye and kidney problems and dementia. "
Why should you go to the dietician with type 2 diabetes? There are medicines for it, right?
"That's right. First, the doctor prescribes pills to make the body more sensitive to insulin. Then come other pills that stimulate the body to make some more insulin. If they no longer work, many diabetic patients must inject insulin."
"That often works well, but in the long run more and more insulin has to be added. In addition, high insulin levels have many side effects. They raise blood pressure. You come from it. And there are indications that they promote the growth of cancer cells."
"In the long term, diabetes increases the risk of age-related diseases, such as cardiovascular disease, cancer and dementia." Connie Hoek, dietician
So you fall from the rain in the drip?
"Medications do not address the core of the problem. You lower blood sugar by increasing insulin, but it does nothing about the underlying cause: the body's insensitivity to insulin. Proper nutrition can lower sugar levels. Among other things by reducing belly fat. The only problem is that losing weight is extremely difficult for people with type 2 diabetes. "
How is that possible?
"That's because of the high insulin level. Every time you eat something, the level rises. Indirectly, this causes your body to crave more food. It makes you hungry and tired."
How can you break that vicious circle?
"By avoiding processed carbohydrates. That comes down to limited slow carbohydrates, such as in vegetables, beans, fruit and nuts, sufficient protein and more healthy fats. With this, your body switches from burning sugar to burning fat."
Avoid processed carbohydrates, but eat fruits, nuts and healthy fats. (Photo: Getty Images)
Fat? Isn't that bad for cholesterol?
"For years it was indeed thought that fat is bad for us. It would make us fat. But that appears to be obsolete. In fact, good fats from olive oil and nuts protect us against all kinds of diseases. Because they have the content of the so-called 'good "raising cholesterol increases the balance between 'bad' and 'good' cholesterol."
What do you think is the role of dietitian?
"Listen carefully to the patient and think along with him or her. Everyone can improve the lifestyle, but most of the time this is not only about nutrition and exercise. Often a lot can be gained through stress management or better sleep. Those things also play a role. "
"I always find it extremely valuable to see how people grow psychologically and emotionally when they get the feeling that they are in control of their illness. It is very nice for many people to not only feel like they are patients, but also being able to do something for your health yourself. "
Connie Hoek is a dietician involved with Keer Diabetes Om, lifestyle program of Stichting Voeding Leeft.