Sugar, white rice, and bread – this medley of ingredients is the holy grail of Filipino cuisine. But while we owe our fluffy ensaymadas and creamy leche flans to them, satisfying our sweet tooth comes at the expense of our blood sugar levels.

4 million adults in the Philippines are diagnosed with diabetes and complications commonly associated with Type 2 diabetes (T2DM) like heart diseases. For instance, 32% of T2DM patients suffer cardiovascular complications, and more than 87% of them are either overweight or obese. Unsurprisingly, diabetes is the 4th most deadly disease in the country.

In 2019, 1 in every 5 Filipinos was diabetic or pre-diabetic, with the latter making up 14.2% of the population. Given that sedentary lifestyles became the new norm shortly after, one shudders to think what the updated numbers could be. Rather than remaining as sitting ducks, it’s only prudent to learn how to lower your risks of developing type 2 diabetes.

Type 2 Diabetes Risk Factors

Uncontrollable Factors Controllable Factors

- Genetic predisposition - having a direct family member (parent of sibling) diagnosed with diabetes

- Age – risks of getting diabetes increases with age. If you are 40 years old or older,you have a higher risk compared to someone who is 10 years younger

- Weight – having a BMI of 23.0kg/m2 or higher

- Leading a sedentary (inactive) lifestyle

- Smoking

- Excessive alcohol consumption

 

1) Maintain your right body weight

Whereas “ideal” body weight may differ across individuals, “healthy” body weight is ubiquitously measured by one’s Body Mass Index (BMI). According to Sun Life’s medical director Dr Raymond Tso, maintaining healthy body weight is one of the two most important ways of keeping T2DM at bay because people who are overweight are seven times more at risk.

How to calculate BMI

BMI = Weight (kg) / Height2 (in metres)

BMI (kg/m2) Category (Asian cut-off) Type 2 Diabetes Risks
>= 30.0 Obese High Risk
23.0 – 29.9 Overweight Medium Risk
18.5 – 22.9 Normal Low Risk (Healthy range)
< 18.5 Underweight Risk of nutritional deficiency diseases and osteoporosis

 

 

  • If your BMI is between 23.0 and 29.9, you are at moderate risk for Type 2 diabetes and should consider losing some body weight.
  • If your BMI is >= 30.0, you are at high risk and should see a doctor and start planning to lose body weight as soon as possible
  • If your BMI is between 18.8 – 22.9, you are at low risk. Continue to monitor your body weight.
  • If your BMI is below 18.5, you may not be in the high-risk group for Type 2 diabetes. However, you are at risk of developing nutritional deficiencies such as anaemia and osteoporosis (weak bones).
  • Aim for a healthy body weight with a BMI between 18.5 – 22.9.

If you’ve done the math and the result isn’t stellar, hold your horses before embarking on fad diets and the like. Weight loss should be gradual and sustainable, and a daily calorie deficit – where you consume less energy than is used – of about 500kcal is a good “day one” goal. With a proper diet and exercise regime in place, you could be well on your way to shedding between 0.5 to 1 kg a week. Start small or, better yet, have a doctor or dietician guide you along.

 

2) Eat a balanced diet

A diet that prevents diabetes is no different than the next healthy eating plan. Fresh fruit and vegetables provide antioxidants, strengthen immunity, and reduce risks of chronic diseases – diabetes included.

The following choices also add up:

a) Choose complex over processed carbohydrates, such as brown rice or wholemeal bread. They slow down the release of glucose into your bloodstream.

b) Swap red meat out for poultry, fish, or plant-based protein sources like kidney beans, chickpeas, tofu, lentils, edamame, and quinoa.

c) Switch to healthy fats and oils made from nuts, olives, avocados, canola, or fish. Even then, consume in moderation.

d) Picking water, coffee, and tea over sugar drinks and alcohol – however difficult that may seem in social situations.

With Pinggang Pinoy by the National Nutrition Council, a plate-based guideline which indicates the recommended portions for each food type, we have no excuse to forget what makes a balanced meal.

 

3) Get moving with regular exercise

Regular exercise not only reduces the risk of Type 2 Diabetes by improving your body’s sensitivity to insulin; it also burns excess calories and builds lean body mass. According to the Philippines' National Guidelines on physical activity, adults aged 21 to 45 should clock 30 to 60 minutes of physical activity every day.

In diabetes prevention, cardiovascular exercise is preferable. From moderate-intensity activities like brisk walking, hiking, cycling, and swimming, to vigorous workouts that make you pant and sweat, picking something you enjoy helps integrate exercise into your lifestyle. For some, that looks like breaking a sweat with friends over tennis, badminton, basketball, or soccer.

A word of caution if you haven’t exercised in a long time: Get clearance from your doctor if need be, take it easy at the start, and increase your pace and intensity over time.

 

4) Get enough sleep

Sleeping less than 5 hours per night and having one’s circadian rhythm disrupted by night shifts are risk factors for Type 2 diabetes, according to the Asian Diabetes Prevention Initiative, a joint research program by the University of Singapore and the Harvard School of Public Health. Sleep apnea, a condition where breathing repeatedly stops and starts in slumber, is yet another red flag.

For a restful night, avoid caffeine and electronic devices at night. Instead, wind down with a warm shower and keep your room dark and cool. Aim for 6 to 7 hours of sleep for a start, and sync up your internal clock by turning in and waking up at fixed times. That includes weekends, however strong the temptation to sleep in may be.

 

5) Be proactive with regular health checks

Health checks often take a backseat when there is no urgency. Ironically, when symptoms do show up, they can be much more challenging to remedy. According to the Philippine Practice Guidelines on the Diagnosis and Management of Diabetes Mellitus, diabetes screening should be an annual affair for those above 40 years old or at risk of developing diabetes. For high-risk individuals, including those with a family history of diabetes or who are overweight, these health checks should commence even before they turn 40.

Age aside, people with above-average blood sugar levels (pre-diabetes) ought to attend checkups every 3 months; then every 6 months after they’re stable.

Start diabetes prevention early

Knowing how to avoid diabetes is one thing; hitting the gym after a long day of work and piling on the greens at dinnertime is another. It takes discipline to wake up early on a Sunday and schedule health screenings proactively, but your sacrifices today could ensure your wellbeing tomorrow.

 

More tips on reducing the risk of diabetes through nutrition and exercise can be found at GoWell, a preventive wellness program under the life and health insurance plan SUN Fit and Well. This new generation wellness plan is suited for young people who want to keep healthy from prevention to recovery. Through GoWell, SUN Fit and Well clients are entitled to Gold membership which allows them to avail of special access and privileges to premium workouts and various wellness activities that will help them stay fit and healthy..

 

 

References:

  1. HK Health Bureau
  2. Nature.com
  3. Asian Diabetes Prevention Initiative - Harvard T.H. Chan
  4. Healthhub SG