Gary’s notes and some key takeaways from this year’s ADA Scientific Sessions 2024 conference in Orlando, FL
by IDS Director of Lifestyle and Nutrition, Jenny Smith
Gary Scheiner had a great time attending many sessions at this year’s ADA Scientific Sessions 2024 conference in Orlando, FL!
Of great interest, was information related to insulin resistance. He attended several very informative sessions in particular; the following are his notes as well as some of my thoughts on integrating this into life with diabetes.
Oral BPA (bisphenol A) is an industrial coating found in cans, containers, and utensils – think anything with a plastic-y type of internal coating or anything plastic (many organic canned food brands now note “non-BPA lining”).
This substance leaks into the food -not only by being stored in it, but also by cooking in plastics that are not BPA free, or by storing warm/hot foods in plastic containers and allowing the condensation to form and then drip back onto the foods.
The important thing found in this just from a standpoint of the impact on diabetes and BG management is that chronic use of these products leads to increased glucose levels. Why? Because it causes a 92% decrease in insulin sensitivity over 4 days of high-dose administration.
Sucralose is a well-known alternative sweetener for sugar. It’s been a long time in use and is commonly known as Splenda.
Many foods contain this to lower the overall carb content. Studies have found that an intake of 270mgd/day of sucralose (the equivalent of 5 cans of diet soda with sucralose as the sweetener) caused a significant decrease in insulin sensitivity directly in the muscle cells.
Plant-based nutrition has many references to overall health and longevity, because when done right, it takes out most of the processed foods that wiggle their way into day-to-day life including taking down the level of AGEs that come with the food.
What are AGEs? : Advanced glycation end products -Essentially the end result of sugar reacting with fats and proteins in the bloodstream along with cooking methods (frying/grilling) which leads to inflammation and stress – both which impact insulin sensitivity. Strategies to assist with reducing AGEs and insulin resistance include moving toward an increase in plant based foods as well as paying attention to cooking methods.
(Comparison of Very Low Fat Vegan Diet to Traditional Diet on Insulin Resistance)
Many with diabetes shy away from a vegan or more plant-based diet because they feel that it increases carb intake which can have a direct impact on BG management and insulin use. It seems counterintuitive to increase carbohydrate intake to reduce insulin resistance but research on adopting a plant-heavy diet has over and over suggested significant benefits.
This presentation provided good insight on the relationship between animal protein consumption/cooking methods and processed carbohydrates to the development of diabetes and diabetes complications. Evaluation of a traditional diet to that of a low-fat vegan diet showed considerable differences in insulin resistance. On a low-fat vegan diet – with no more than 32g fat/day, low GI foods, and an overall higher carb intake than the traditional diet (modest carb and modest fat – even more conservative than the very typical westernized intake of high fat/high processed carb) the low-fat vegan diet won hands down. Total daily insulin was decreased by 28%, insulin sensitivity increased by 127% and there was modest weight loss of 5lb. Overall a decrease of 24% in comparing insulin dose decrease to weight loss (kg).
What can we take away from this information?
As the IDS Director of Lifestyle and Nutrition, I have long term tried to encourage more real food intake. Aiming for an 80/20 type of plan with 80% being the majority of our intake which should include REAL food.
80% is essentially 17 meals out of a week with 21 meals (3 meals/day x 7 days = 21 meals).
This food should be whole, real, lean, low glycemic, and not from a package/box. As a favorite author of mine puts it, “Eat food, not too much, mostly plants” (Michael Pollan). The other 20% should come in when it needs to for the ability to enjoy social settings – I like to think of it like food for the soul. While you can certainly continue your healthy habits in social settings, you need to prepare and plan for this, so allowing for 20% of your intake to be off the normal healthy path can be a good way to start.
When the items in these presentations are put together, we can see that making some changes to food choices can impact our insulin sensitivity and glucose management.
- Start by looking at the content of what you are eating – ingredients matter. Avoid low-carb, processed foods with sucralose, and drink some water. I often recommend looking for food with less than 5 ingredients if it is in a package, and make sure you can read all the ingredients. Are they real food?
- Look at what your food is packaged in, and how you store it and cook it – aim to get rid of as much BPA/plastic as possible.
- Take out as much processed food as possible, aim for lower GI carbs, and start by adding in some plant-based meals a few times per week. Pay attention to how your glucose looks compared to other meals, and how well does the insulin work in conjunction with the food. Do you end up taking more insulin later for a high-fat, processed food meal compared to a lean, whole-food meal?
We can be thankful for all the information available in today’s world for living well with diabetes, but it is ultimately up to each of us to put that information into action in our own lives.
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