Diabetes Risk Factors

Today, 40 percent of Americans between the ages of 40 and 70 are prediabetic. The prevalence of prediabetes has tripled over the past several decades, and today most patients in coronary care units are prediabetic or diabetic.

The cause of these burgeoning problems goes back to our fat-storage survival mechanism, which, rather than being lifesaving, has become harmful in modern times. As it turns out, it's the accumulation of visceral fat that leads to insulin resistance, the condition in which the body produces enough insulin but the cells can't use it properly (the cells are in fact resistant to the action of insulin). Insulin resistance causes the exaggerated swings in blood sugar that in turn cause hunger. Without periods of food scarcity, this hunger leads to further fat accumulation. And the more fat you store around your midsection, the bigger your belly-fat cells become. The problem is that insulin does not communicate effectively with swollen fat cells after a meal. As a result, the pancreas has to keep producing extra insulin to overcome the insulin resistance of these larger cells and move sugar and fat from the bloodstream into the tissues. Eventually the pancreas becomes exhausted and cannot produce adequate insulin. When this happens, blood sugar remains elevated after meals, and type 2 diabetes is diagnosed.

Clearly, what helped man survive in the past is killing us today. Luckily, we now understand why, as a nation, we have gotten so fat and hyper-inflamed. And luckily, we now know what to do about it.

Don't worry — I'm not suggesting that we all starve ourselves or try to imitate those times of food scarcity or famine. But in some ways, we all do need to eat more like our ancestors. This means consuming more fruits, vegetables, whole grains, healthy fats, and lean protein. These are the basic tenets of the South Beach Diet, and following them will reverse our accumulation of belly fat and its detrimental health consequences.

The other thing we must do is move more, the way our ancestors did. This means regularly doing aerobic (cardio) conditioning and functional core exercises. In fact, studies show that exercise is one of the most effective ways to get rid of visceral fat. In a 2005 study conducted at Duke University, 175 overweight men and women with mild to moderately bad blood fats (cholesterol and trigylcerides) were randomly assigned to participate for 8 months in one of three exercise groups. The participants were instructed not to change their eating habits. One group exercised at a moderate intensity (40 to 55 percent of aerobic capacity) for approximately 3 hours per week. A second group exercised at a high intensity (65 to 80 percent of aerobic capacity) for 2 hours a week. The third group exercised at the same high intensity but for 3 hours per week. Both the 2-hour high-intensity group and the 3-hour moderate-intensity group showed no further accumulation of visceral fat. But the best news was that the high-intensity group that worked for 3 hours per week actually showed a significant decrease in visceral fat. And the bad news for couch potatoes; A control group that didn't exercise showed a significant increase in visceral fat, which means that if you do nothing to stop it, visceral fat just keeps on growing.

Another study, published in 2006 in the International Journal of Obesity, found that a combination of diet and exercise — not diet alone — reduced the size of abdominal fat cells. This is an extremely important finding because swollen fat cells are the ones that become insulin resistant. Shrinking abdominal fat cells can help restore a normal insulin response, which will help prevent prediabetes.