Obesity, Diabetes and Finding the Best Diet

Friday 11 May 2007

Obesity, Diabetes and Finding the Best Diet

Obesity is the most important modifiable risk factor in the development of Type 2 diabetes. A team from the University of Otago, Wellington, led by Endocrinologist Dr Jeremy Krebs, is launching a $1.4 million Health Research Council funded study into what exactly is the best diet to reduce weight in people with type 2 diabetes, and to keep it off long term.

Diabetes is running at epidemic proportions in New Zealand and getting worse. Some 200,000 people, or 5% of the adult population, are now estimated to have Type 2, or adult onset diabetes; with many still undiagnosed.

The researchers from the Wellington School of Medicine and Health Sciences say the problem is acute, and will put huge cost pressures on the health system in future, with 40% of those on dialysis having a history of diabetes. Diabetes is particularly high amongst Maori and Pacific Islanders.

Dr Krebs says that so far public health strategies regarding weight loss and diabetes have not worked. The extensive range of popular diet books and reality-TV programmes about ‘fighting fat’ tend to focus on short-term quick-fix strategies.

However, keeping weight down long-term is critical in managing diabetes. The challenge is to find a diet which is easy to maintain and is effective long-term says Krebs.

“The big problem is that people don’t stick to their diet. Most people find that maintaining a diet long-term is too difficult. Our study aims to find a better way to get people with Type 2 diabetes to lose weight, and keep it off.”

“Over two decades the health system has pushed a low-fat/high carb diet. However this is often sabotaged by increases in refined carbohydrate rather than a focus on reducing fat and increasing fibre. Short term studies have indicated that diets higher in protein with lower levels of carbohydrate may be easier. This means eating more things such as lean meat or legumes, and less white bread, white rice or refined snacks, but focussing on low glycaemic foods. The vital factor is still reducing total energy intake.”

Dr Krebs says this is one of the reasons why so-called “low carb” diets, such as the ‘Dr Atkins Diet’ and ‘The Zone Diet’ have been popular, although there is no evidence that they actually work long-term.
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The University of Otago researchers are funded by the Health Research Council to carry out a randomised controlled trial comparing these two diets (low fat/high carb v’s high protein/lower carb) over a period of two years to determine which works the best with Type 2 diabetes.

This has never been done before and could have major implications in controlling obesity and escalating diabetes in this country.

The study needs 450 overweight people with Type 2 Diabetes, in Auckland Wellington and Christchurch, to take part in this important health research. It will involve assistance through a group-based diet programme, as well as individual dietitian support.

Weight loss, along with diabetes control, cardiovascular disease, adverse effects and cost-effectiveness will be assessed over a long time span of two years. Participants will learn a great deal more about their condition, and improve their health.

Dr Krebs is keen for any overweight adult between 30 and 75 with Type 2 diabetes, living in the Wellington, Auckland and Christchurch areas to contact the research team at Wellington 04 3855 999 ext 4703 or cecilia.ross[at]ccdhb.org.nz, Auckland cathrinep[at]adhb.govt.nz mobile 021 667 564, Christchurch florence.logan[at]cdhb.govt.nz

ENDS

www.wnmeds.ac.nz

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