Type 2 diabetes risk factors

As with most things in life, there are some things you can change, others you cannot.

Factors like your age (type 2 diabetes risk increases as you get older), family history or ethnic background contribute to your risk of diabetes but are out of your control.

Your lifestyle is something you can change and is the thing experts want you to pay close attention to. Being overweight, smoking, lack of physical exercise, eating an unhealthy diet, and having high blood pressure are all risk factors you can do something about. Even small changes will reduce your risk of getting type 2 diabetes or improve your control of your blood sugar if you have diabetes.

What can you do?

Moving your body for 30 minutes every day will significantly reduce your risk of developing type 2 diabetes. A brisk walk, an online exercise class or playing sport are all simple and effective types of cardio exercise. Doing weights once or twice a week is also helpful as increasing your muscle mass improves your blood sugar levels.

Eat a healthy diet. Concentrate more on vegetables, fruit and wholegrains, lean protein like fish, lean meat, nuts, tofu and diary options like milk, yoghurt, or calcium-rich plant-based options.

Avoid highly processed food and try to reduce your saturated fat intake.

What are digestive enzymes?

“Digestive enzymes are proteins your body produces and uses to break down food into energy and nutrients,” says US registered dietitian and nutrition writer, Christy Brissette.

Once you start eating, your body releases many digestive enzymes. Some are made in the mouth, others in the stomach and small intestine, but most come from your pancreas.

Some enzymes you may have heard of include amylase, which breaks down starches, protease, which breaks down protein, and lipase which helps break down fat. Lactase is another, which breaks down lactose, the sugar in milk and diary foods.

Once broken down into small molecules, these nutrients are absorbed through the wall of the small intestine and into your bloodstream.

When you do not have enough enzymes

Sometimes the body does not make enough digestive enzymes, meaning it cannot break down certain foods and absorb nutrients. People with conditions affecting the pancreas, such as pancreatitis and cystic fibrosis, often need to take prescription digestive enzymes which help the body digest food and absorb nutrients better.

Some people with diabetes, inflammatory bowel disease, uncontrolled coeliac disease, or following weight loss surgery may also need digestive enzymes.

“When your body does not produce enough of certain digestive enzymes, undigested compounds can make their way into your large intestine and cause unpleasant symptoms,” says Brissette.

These include gas, belly pain or cramps, bloating, oily stools and unexplained weight loss. If you have any of these symptoms, do not assume it is due to a lack of enzymes. Talk to your doctor as they could be signs of gut irritation or a more serious condition.

Should I take them “just in case’?

“Unless you have a digestive enzyme production issue, you do not need to take digestive enzyme supplements,” says Canadian registered dietitian Abby Langer.

“Taking more digestive enzymes via supplementation does not help you break down or absorb your food better if your enzyme levels from your own body are not low.

“That being said, there are two more common digestive enzyme supplements that are more routinely used,” says Langer.

“Lactase for lactase deficiency which results in lactose intolerance, and alpha-galactosidase, which nobody’s body makes, but is the main ingredient in the product ‘Beano’. This enzyme can potentially help break down fermentable carbohydrates in foods like beans and vegetables,” she says.

“Both of these supplements may help with Irritable Bowel Syndrome in certain cases.”

Digestive enzymes may be natural, but they are not risk free. Some reported side effects include allergic reactions, interactions with medications, and abdominal pain. It is best to avoid digestive enzymes unless they have been recommended by a health professional.

Here are a few ways Dr Chatterjee suggests getting your morning light fix:

• Have your morning tea or coffee in your garden, balcony, or next to a window.
• If you work from home, take a walk around the block or do a short workout outside before you start work.
• If you need to drive in the morning, leave your car a 10-minute walk from your destination. The same can apply if you get the bus or train.
• Walk your dog first thing in the morning (or offer to walk someone else’s).
• Talk a morning break and spend it outside.

How to strengthen your pelvic floor

Pelvic floor exercises are not just for women. Men can also benefit from learning to contract and relax their pelvic floor muscles.

• Imagine you are trying to avoid passing wind or stop the flow of urine. Tighten those muscles at the same time for one second then release.
• Repeat that 10 times, aiming for three sets altogether. If you are finding it difficult to locate your pelvic floor muscles, a pelvic floor physiotherapist is a great next step.

“My advice is that if you notice a change in your continence that is impacting your quality of life, please seek help sooner rather than later,” says Dr Kariappa.

“Highly processed breakfast cereals often have fibre and protein added to increase their health rating,” says accredited practising dietitian and Choice food expert Shadia Djakovic.

“Rolled oats have a high rating due to their naturally-occurring fibre content. But they have only one ingredient – oats – which means they have a higher rating without the need for any added nutrients to make them healthier.

“Look at the shape and colour, does it look like a natural product?” says Djakovic. “If it is far from natural-looking, chances are it is highly processed and needs things like salt and sugar to make it taste good.”

Salads

Watch out for salads, warns accredited practising dietitian Melissa Meier in body&soul. We think of them as a healthy option but they are not always the best thing on the menu, she says.

Salads contain vegetables, but may come loaded with refined carbohydrates and processed meats, says Meier. And store-bought dressings often contain way too much sodium (which may increase blood pressure), with some also high in added sugar and saturated fat.

The best bet is to make your own dressing, says Meier, with good quality oil such as extra virgin olive oil, a splash of vinegar or citrus juice, and some flavour in the form of mustard, pepper and dried herbs and spices.

Protein bars

Protein bars are promoted as a healthy snack to fill the protein gap in our diets and help build muscle.

But most people do not need extra protein as they get enough through their diet, says Dietitians Australia. For those who do need more, foods naturally high in protein like eggs, fish, yoghurt, nuts, tofu and beans are good choices as they also add nutrients.

Protein bars vary significantly in quality, so it pays to read labels. Many are full of sugar, salt, artificial sweeteners and colours, and oils and thickeners that add kilojoules without making you healthier.

Heart health

Octopus is a good, affordable source of omega-3 fatty acids, commonly known as ‘good fats’. These fats can reduce blood pressure and lessen the buildup of cholesterol plaques in blood vessels. This in turn can lower your risk of stroke and heart attack.

Octopus also contains an amino acid called taurine which reduces blood pressure and cholesterol.

Anti-oxidants

Taurine is also an antioxidant. It protects cells from damage often associated with inflammation and cancer. Octopus contains other antioxidants such as selenium, vitamin B12 and folate.

Brain health

Octopus contains magnesium which can help support healthy brain function. The omega-3 fatty acids found in octopus may lower the risk of developing depression.

Note: While for many people octopus is a healthy choice, some people need to avoid or approach with caution.

• If you have a shellfish allergy, you need to avoid octopus as well.
• Octopus has a higher salt content than some other lean protein sources. Factor this in if you are watching your sodium intake.

How can exercise change your brain?

Neuroplasticity is a term that describes your brain’s ability to change itself in response to various experiences or exposures. A review article published in Neural Plasticity in 2021 draws on many smaller studies to describe how exercise releases various chemicals that change the number and function of nerve cells (neurons) and their neighbouring support cells (astrocytes). It found exercise also improves blood flow to nerve cells in the brain and increases the connections between nerve cells.

Other studies using brain scans in people have shown that those who exercise have an increased size of the parts of their brain that control thinking and memory.

These findings support the growing understanding that exercise leads to structural and functional changes in the brain.

Scientific Reports published a study in 2023 that included data from more than 350,000 people. It showed that physical exercise leads to better memory, better thinking skills and lowers the risk of developing dementia.

What counts as exercise and how much do you need to do?

The research describes physical exercise as being different to just ‘activity’. To get the benefits of exercise for your brain, you need to aim for 30 minutes, five days a week of moderate exercise (for example a brisk walk, light jog) or 15 minutes fives days a week of more intense exercise. It takes six months before you start to see the benefits, so it is important to develop a habit and stick with it.

How does exercise help my brain overall?

As well as the changes the scientists saw in the structure and function of the brain, physical exercise is also known to help reduce stress and anxiety, improve your mood and often helps you get a better night’s sleep. This all contributes to better brain function.

Getting started

As tempting as it may be to strap on your running shoes and race out for brain health, if you are a novice exerciser, it is a good idea to start slow and build up. Aim for 10 minutes a day and build up to half an hour. Find something you enjoy whether that be a walking group, solo runs or a dance class. You want to start something you can stick to.

Finding your fit

1. Aerobic exercise. Studies show it is never too late to start. Get your blood pumping to boost blood flow to your brain.

2. Weight training. Research shows the benefit of weight training for both memory and other thinking skills. When you practice unfamiliar movements, you activate the nerve pathways in your brain.

3. Yoga. A 2016 University of California study showed that yoga can help your visual-spatial skills and some aspects of memory.

4. Tai Chi. Tai Chi combines both mental focus and movement. It often has a community aspect to it which is also helpful for making your brain feel good.

5. Dancing. A landmark 2003 study published in the New England Journal of Medicine showed regular dancing reduced the risk of dementia by 76 per cent.

Geriatrician Dr Tabitha Hartwell reminds us ‘Exercise, preferably a mixture of aerobic, strength and stability, is the single most important factor in maintaining physical, mental and emotional health across your lifetime’.

What all these different experiences have in common is that they are often the quiet moments in your day that get missed when you are worried or rushing.

Author and mental health expert, Robyn Haney Dafoe, writes in Psychology Today, ‘Cultivating joy is a (re)learning how to foster a feeling of ease and a sense of hope, even when things might still be uncertain.’

This reminds us that bringing joy into our life is not about creating big moments, it is about finding joy where it already is. Becoming joy detectives.

Focusing on joy does not mean you deny things that are hard in your world. But it opens you up to see that both can exist at the same time, that there is room for joy in your life. Over time, your brain will more naturally tune into joyous moments, allowing you to experience happiness and hope more often across more of your day.

Another reason joy feels so good is that it brings energy and connection. Oxford University philosopher and leading joy researcher Matthew Johnson wrote in the Journal of Positive Psychology, ‘joy… is energising, joy is motivating’. He also describes joy as ‘a gathering emotion’. Harnessing that shared positive energy can help you keep going, even when things feel hard.

So perhaps rather than waiting for a grand expensive holiday, start now. Start small, start simple, look for the moments that bring an exhale, a drop of your shoulders, the ‘eye sparkle’ smile, the warm lift to your heart. Find the joy that is already there, waiting for you!

Finding joy

Try these tips to add more joy to your daily routine.

1. Get curious and creative.

It may be a while since you have thought about what makes you feel joyous. Instead of feeling daunted, get curious and creative! Try listening to different types of music, going for a walk, do a taste test of different foods to see what brings that smile to your face. Focus on the fun in the small things.

2. Do more of what feels good

Once you know what brings you joy, do more of it and give yourself time to savour the experience.

3. Think gratitude

Yale-Professor Laurie Santos teaches that joy is connected to appreciating particular things. Remembering to ‘count your blessings’ helps focus on the good things in your life that brings joy.

4. Be mindful

Slow down, connect to the moment, and adjust your expectations around what joy is. If you are only looking for grand moments, you will miss all those beautiful tiny daily bits of joy life gives you.

There is a certain pleasure in biting into a crisp apple, juice spraying. It is a childhood memory for many of us.

We now know the skin and those juices contain antioxidants and fibre that fight many diseases of the modern world.

Apples contain antioxidants called polyphenols, along with pectin which is a fibre and a prebiotic.

What do these things do?

Heart health

The polyphenols in apples are thought to reduce both total and LDL (or ‘bad’) cholesterol. They improve blood vessel health, which may reduce high blood pressure and lower the risk of stroke and heart disease.

Appetite

It was previously thought that the high water and fibre content helped us feel satiated after eating an apple. It is now thought that polyphenols also play a role in appetite suppression.

Gut microbiome

Recent research has shown the importance of the gut microbiome in overall health. Pectin is a prebiotic; it fosters growth of ‘good’ gut bacteria. A healthy microbiome is associated with a lower cancer risk, reduced risk of some inflammatory diseases and improved mental wellbeing.

Get those benefits!

Leave the skin on! Half the fibre and nearly all the polyphenols are contained in the skin. Eat the skin to get the most out of your snack.