America's top endocrinologist offers solutions to diabesity

( - January 24, 2016 - 7:15pm

While many people know an obesity epidemic is sweeping the world, little is known about an associated disease called “diabesity”, more commonly known as Type 2 diabetes. In essence, this is a lifestyle disease arising from poor diet and lack of exercise. It happens when the body becomes resistant to insulin, the hormone that helps the body use blood sugar.

"Diabesity" is a term created recently to show the strong connection between this form of diabetes and obesity. Given this, you might think it mainly concerns people who are extremely overweight, maybe feasting on humungous hamburgers and guzzling gallons of sugary drinks. But even people who appear relatively slim can suffer from diabetes, particularly those with very little muscle and a high proportion of fat.

Diabesity develops over a two to 10-year period after high levels of blood sugar are noted. Studies done at multiple centers for diabetes in the United States and funded by the National Institutes of Health showed that 58 percent of new cases of this disease over a period of five years in individuals with high blood sugar could be prevented with a simple program of diet and exercise. Similar studies conducted in Finland have confirmed the results of these earlier researches in the U.S.

Diabesity is especially common among Asians. In fact, a 2013 study titled "Global obesity: trends, risk factors and policy implications" reported that 60 percent of the world's diabetic population come from Asia. Perhaps, this reflects a genetic tendency to have lesser muscles and the accumulation of abdominal fat when exposed to lifestyle factors such as reduced exercise, cooking with unhealthy fats like palm oil, rising adoption of Western-style fast food, and eating white rice or other refined grains that deliver "empty calories" with little nutritional value other than energy.

Worldwide, the prevalence of diabesity is predicted to increase by 54 percent between 2010 and 2030. By this time, it is predicted that one adult in 10 will have diabetes, according to Nature Reviews and the International Diabetes Federation. Asia is at the epicenter of this epidemic, reflected by a prediction that cases of diabesity in Malaysia could soar up to 164 percent by 2030. Countries such as the US are also experiencing a strain on healthcare support as a result of diabesity, which is costing the nation $130 billion in healthcare spending annually according to the World Health Organization.

Science shows mother knows best

Thankfully, however, the fact that lifestyle plays a vital role in diabesity also means that it can be prevented, and early symptoms can be reversed.

Exercise is also vital, but it doesn't mean exerting yourself as if you will be suddenly training for the Olympics. Just 30 minutes of physical activity each day, like brisk walking on our way home, can provide significant benefits to your overall well-being in the long run.

I am also keenly aware through my research that diet can play a major role in combating diabesity. Ideally, a healthy diet should consist of protein (providing 30 percent of daily calories), healthy fats (30 percent), carbohydrates (40 percent) and fiber (25 grams per day). Here, "healthy fats" refer to less omega-6 fats (from processed food and vegetable oils other than olive oil) and more Omega-3 fatty acids. Maybe your mother often advised to eat more fruits and vegetables when you were younger, which is certainly true. Whole grains, fish, spices and nuts are other excellent components of a wholesome diet.

If you have read anything about dieting recently, you would surely have learned of the notion that avoiding carbohydrates is a good way to lose weight. This has been popularized by the low-carb/no-carb Atkins diet that makes carbohydrates seem like the villains in making people fat. But this is a myth. It is true that excess sugar and fats both contribute to the rising epidemic of obesity around the world but neither of these are poisons. 

Cutting down carbohydrates means reducing calories, leading to weight loss. Not all carbohydrates are unhealthy, and eliminating them would also cut out healthy food such as antioxidant-rich fruits and vegetables.

health concerns and perceptions of filipinos infographic

Sugar rush bad, slow sugar rise good

But what makes carbohydrates good or bad? One thing to consider is to what extent they arrive as "empty calories", or in nutrient-rich food. Then, there is the Glycemic Index (GI), which serves as a measure of carbohydrate-containing food in terms of their impact on your blood sugar levels.

The index ranks food with carbohydrates on a scale from 0 to 100, depending on how quickly they raise blood sugar after you eat them. High GI food rank at least 70 on the scale, and cause rapid spikes in blood sugar—which in turn stimulate rapid insulin production, with blood sugar levels perhaps then falling quickly. Over time, it appears such spikes in blood sugar and insulin can lead to Diabesity.

Some food are now labeled according to their GI, and you can find information on the internet to help you four medium GI (56-69) and low GI (0-55 food). With the latter, blood sugar levels rise and decline only slowly, which is evidently beneficial for insulin efficiency. This information is being increasingly used by people seeking to control their blood sugar levels, and can have wider health implications.

Research has shown that a low GI diet can deliver benefits such as lower insulin secretion, stable blood glucose levels, and lower risk of cardiovascular diseases. It may also lower the levels of low-density lipoprotein (LDL) cholesterol - also known as "bad" cholesterol, and boost levels of HDL, "good" cholesterol.

While it may seem troublesome to check the GI for each food item, one rule of thumb for eating healthier carbohydrates ranked lower on the index is to choose less refined food—such as having brown rather than white rice, avoid over-cooking, and minimize food with excessive added sugars and refined corn syrup. Meal replacement shakes such as Herbalife Formula1 provide another low GI option, and can be used in place of one or two meals a day.

These simple lifestyle changes—exercising more, and choosing the right food—can have great benefits. You can significantly reduce your chances of suffering from Diabesity and its multiple impacts, as well as improve your health in other ways. Plus you will look better and feel more energized, so you can really enjoy life to the fullest.


Dr. David Heber is a specialist in obesity treatment and nutrition and the Chairman of the Nutrition Institute and Nutrition Advisory Board of Herbalife. He has been in the faculty of the UCLA School of Medicine since 1978. He is currently professor emeritus of medicine and public health as well as founding chief of the division of clinical nutrition in the department of medicine. Dr. Heber is included in the Thomson Reuters “The World’s Most Influential Scientific Minds: 2014” list. Dr. Heber recently visited the Philippines as the main speaker in Herbalife’s Asia Pacific Wellness Tour.


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