The statistics are shocking-23% of Americans age 60 and up now have diabetes, a deadly disease that can lead to heart disease, stroke, blindness, amputation, kidney failure and coma. Yet the Nurses Health Study (NHS), which tracked 84,941 women for 16 years, suggests that about 90% of cases could be prevented.

With type 2 diabetes (the most common form), either the pancreas does not produce enough insulin (a hormone needed to convert glucose into energy) or the body's cells ignore insulin. Certain risk factors cannot be helped a family history of diabetes...a personal history of polycystic ovary syndrome or diabetes during pregnancy...delivering a baby with a birth weight of nine pounds or more...or being non-Caucasian. However, the majority of risk factors are within your control.

  • Avoid "diabesity." Researchers coined this term to emphasize the interconnection between obesity and diabetes. In the NHS, obese women were 10 times more likely to get diabetes than women of normal weight.

Theory: Fat cells—particularly those deep inside the belly-produce hormones and chemical messengers that trigger inflammation so that cells become resistant to insulin. Even modest weight loss can cut diabetes risk in half.

  • Stand, don't sit. Just getting off the couch can help. NHS participants had a 14% increased risk for diabetes for every two hours per day spent watching TV-and a 12% decreased risk for every two hours per day spent standing or walking around at home.

Even better: A brisk one-hour walk daily can reduce diabetes risk by 34%

  • Skip soda and fruit punch. Sugar-sweetened soft drinks are the largest single source of calories in the US diet. Daily soda drinkers tend to take in more calories, gain more weight and develop diabetes more often than others.

Wise: Drink water or unsweetened beverages.

  • Choose the right fats. Polyunsaturated fats—found in corn oil, soybean oil, nuts and fish-may affect cell membranes in a way that improves insulin use. Trans fats, found in some packaged and fast foods, and stick margarines, may have the opposite effect.
  • Limit red meat. In the NHS, a one-serving-daily increase in red meat (beef, pork, lamb) or processed meat (cold cuts, hot dogs) increased diabetes risk by 26% and 38%, respectively.

Theory: Higher iron and preservative levels in meat products may damage the pancreas.

  • Go for whole grains. Compared with refined grains (white flour, white rice), whole grains minimize blood sugar fluctuations, easing demands on the pancreas and provide more magnesium, which makes insulin more effective.
  • Consider coffee. In studies involving about 200,000 people, drinking four to six cups of coffee daily was associated with a 28% reduction in diabetes risk compared with drinking two or fewer cups daily. Chlorogenic acid, an antioxidant in regular and decaf coffee, may make cells more responsive to insulin.

When Fat Hips Are Good

Abdominal fat increases a person's risk for type 2 diabetes.

But: Fat just beneath the skin on hips and thighs actually may improve insulin sensitivity the ability of the body's cells to recognize and properly respond to insulin).

Theory: Subcutaneous fat produces adipokines, hormones that have beneficial effects on glucose metabolism.

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