Field Notes

Poor Access to Nutritious Food May Harm Health of People With Diabetes

Preparing a healthy meal loaded with fresh vegetables seems like an easy thing to do. But some people living with diabetes have poor access to nutritious food, which may have a detrimental effect on their health and well-being, according to a new study led by Ryerson University and published in Diabetes Care.

“Diabetes is a chronic condition that requires a healthy diet to manage the disease,” says Enza Gucciardi, PhD, an assistant professor in Ryerson’s School of Nutrition. “Being food insecure and having diabetes appears to make this population extremely vulnerable to poor mental and physical health.”

Household food insecurity (HFI) refers to the inability of people to access safe and nutritious foods, which can pose serious health challenges for some people with diabetes. Some possible causes may be limited income, poor access to fresh fruits and vegetables for people living in remote communities, or a lack of ethnic foods consumed by individuals from diverse backgrounds in their daily diets.

Using data from a 2005 Canadian Community Health Survey of more than 132,000 people, the researchers looked at the prevalence of HFI in Canadians with diabetes compared with those who did not have the health condition. For example, participants were asked whether their financial situation was a barrier to purchasing healthy foods. The researchers also examined the relationship between HFI and access to diabetes management services and health status.

The study found that Canadians with diabetes had more difficulty accessing nutritious foods than those without the health condition. According to the authors, this is associated with unhealthy food choices such as eating fewer fruits and vegetables. The researchers also found that people with diabetes exhibited other unhealthy behaviors such as being less physically active and smoking.

Moreover, the odds of experiencing HFI were greater for two groups of people diagnosed with diabetes: adults under the age of 40 and women between the ages of 12 and 45.

But despite being food insecure, people did not encounter any barriers when it came to accessing diabetes management services, such as having their blood sugars checked and receiving eye exam referrals by their physician. This is not surprising, says Gucciardi, given Canadians’ universal access to healthcare services.

Gucciardi says for people living with diabetes, managing their health condition comes down to basic necessities. “If you don’t have enough money to purchase food for your household, this is a stressor that will impact not only your illness management but your overall well-being adversely,” she says.

— Source: Ryerson University


Regular Coffee and Tea Consumption Associated With Reduced Risk for Diabetes

Individuals who drink more coffee (regular or decaffeinated) or tea appear to have a lower risk of developing type 2 diabetes, according to an analysis of previous studies reported in the Archives of Internal Medicine.

By the year 2025, approximately 380 million individuals worldwide will be affected by type 2 diabetes, according to the article. “Despite considerable research attention, the role of specific dietary and lifestyle factors remains uncertain, although obesity and physical inactivity have consistently been reported to raise the risk of diabetes mellitus,” the authors wrote. A previously published meta-analysis suggested drinking more coffee may be linked with a reduced risk, but the amount of available information has more than doubled since.

Rachel Huxley, DPhil, of the George Institute for International Health at the University of Sydney in Australia, and colleagues identified 18 studies published between 1966 and 2009 involving 457,922 participants and assessing the association between coffee consumption and diabetes risk. Six studies involving 225,516 individuals also included information about decaffeinated coffee, whereas seven studies with 286,701 participants reported on tea consumption.

When the authors combined and analyzed the data, they found that each additional cup of coffee consumed in a day was associated with a 7% reduction in the risk of diabetes. Individuals who drank three to four cups per day had an approximately 25% lower risk than those who drank between zero and two cups per day.

In addition, in the studies that assessed decaffeinated coffee consumption, those who drank more than three to four cups per day had about a one third lower risk of diabetes than those who drank none. Those who drank more than three to four cups of tea had a one fifth lower risk than those who drank no tea.

“That the apparent protective effect of tea and coffee consumption appears to be independent of a number of potential confounding variables raises the possibility of direct biological effects,” the authors wrote. Because of the association between decaffeinated coffee and diabetes risk, the association is unlikely to be solely related to caffeine. Other compounds in coffee and tea—including magnesium, antioxidants known as lignans, or chlorogenic acids—may be involved, the authors noted.

“If such beneficial effects were observed in interventional trials to be real, the implications for the millions of individuals who have diabetes mellitus, or who are at future risk of developing it, would be substantial,” they concluded. “For example, the identification of the active components of these beverages would open up new therapeutic pathways for the primary prevention of diabetes mellitus. It could also be envisaged that we will advise our patients most at risk for diabetes mellitus to increase their consumption of tea and coffee in addition to increasing their levels of physical activity and weight loss.”

— Source: American Medical Association