Other Nutritional Factors

There are no firm epidemiological data with regard to the role of dietary protein in the etiology of type 2 diabetes. Although vegetarians present with lower rates of type 2 diabetes compared with persons who eat meat, it is impossible to disentangle the association of animal protein with the risk of type 2 diabetes from other dietary factors, such as saturated fat and fiber intake (11). The relationship between alcohol and other dietary variables similarly complicates attempts to evaluate a potential role for alcohol in the etiology of type 2 diabetes. In the Rancho Bernardo Study, increasing intakes of alcohol in obese men were associated with an increased risk of type 2 diabetes (33). On the other hand, moderate alcohol intake has been shown to be associated with enhanced insulin sensitivity (34,35).

So far, no epidemiological studies have provided convincing support for the role of micronutrients in the etiology of type 2 diabetes. The suggestion that low-birth weight infants, especially those who show rapid catch-up growth, are at increased risk of developing IGT and type 2 diabetes later in life is fairly consistent, but the possible relation of this phenomenon to maternal malnutrition needs further research.

Recent knowledge regarding the potential of nutritional factors in the prevention of type 2 diabetes can be summarized as follows:

■ Structured programs on lifestyle modification that emphasize a reduction in total energy and saturated fat intake, and encourage an increase in fiber consumption, together with increased physical activity and regular contact with the healthcare team, are the most promising approaches to reducing the risk of developing type 2 diabetes.

■ Avoiding being overweight, treating overweight and obesity as well as prevention of weight regain once weight loss has been achieved are particularly important for those with a familial predisposition for type 2 diabetes.

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