How Much Weight Do I Need to Lose to Prevent Diabetes?

Q. How can a blood test determine if I have prediabetes? How much weight do I need to lose to bring my numbers down?

A. Doctors typically perform one of three blood tests to diagnose prediabetes, a condition marked by blood sugar (glucose) levels that are higher than normal but not high enough to qualify as diabetes. While prediabetes often leads to full-fledged Type 2 diabetes, many people can hold the condition in check if they lose a relatively small amount of weight and increase their physical activity, said Dr. Rhonda Bentley-Lewis, an assistant professor of medicine at Harvard Medical School. “I stress to my patients that we’re not talking about a huge amount of weight,” she said, “just 5 to 7 percent of one’s body weight” — or 10 to 14 pounds for someone who weighs 200 pounds.

Two of the tests require fasting, which helps prevent results being distorted by a prior meal and provides “an even baseline,” Dr. Bentley-Lewis said. One, the fasting plasma glucose test, checks blood glucose levels after an 8 to 10 hour fast; results of 100 to 125 milligrams per deciliter indicate prediabetes. The other, the oral glucose tolerance test, is the most sensitive. It checks blood glucose levels after fasting and then two hours after you consume a sweetened drink; levels of 140 to 199 after the drink indicate prediabetes.

A third test, the A1C test, may be the most convenient because it doesn’t require fasting. It measures your average blood glucose levels over the past two to three months; results of 5.7 percent to 6.4 percent, which indicate the percentage of red blood cells that have glucose attached to them, indicate prediabetes.

Though doctors often repeat a test to confirm a diabetes diagnosis, they do not always do so for a prediabetes diagnosis, Dr. Bentley-Lewis said.

Doctors can treat prediabetes with medication, but many patients prefer to try weight loss and exercise first, Dr. Bentley-Lewis said. Among thousands of people with prediabetes who participated in a national study called the Diabetes Prevention Program, those who received counseling about lifestyle changes, like losing a modest amount of weight, stepping up physical activity and reducing the amount of fat and calories in their diets, were able to reduce their risk of developing diabetes by 58 percent.

What Your Sugar Cravings Might Really Mean

For many people, the battle with sugar can be particularly ferocious. It can arise during an afternoon slump at work, first thing in the morning, after every meal, in the middle of a workout — or, worst, in the middle of the night. In a sugar-laden world, it becomes too easy to reach for a quick fix.

Cravings tend to crop up when there’s a sense of depletion. However, if you can pinpoint what you lack, it’s easier to make healthier choices instead of going for something sugar-coated.

Here are a few possibilities for what may be driving those sweet cravings:

MAGNESIUM DEFICIENCY

For many people, a sugar craving in the form of chocolate could signal a lack of magnesium, a common deficiency according to researcher Susan Yanovski from the National Institute of Diabetes and Digestive and Kidney Diseases.

Yanovski says that around 80% of people in the U.S. may be deficient in the mineral, which can be tied to irritability, insomnia and high blood pressure. If you feel stressed, chocolate may seem like the answer, but it could be your body yearning for magnesium instead.

While the cacao in chocolate is a rich source of magnesium, the sugar in chocolate could turn frequent consumption into a potential problem since it causes insulin spikes and other issues. Instead of chocolate, reach for non-sugar magnesium sources like nuts, seeds, beans and dark leafy greens.

IMBALANCED GUT BACTERIA

“If we are to prescribe a diet to improve someone’s health, it’s important that we understand what microbes help control those beneficial effects,” says Jeffrey Gordon biologist and professor at Washington University in St. Louis.

Sugar cravings can sometimes be the result of an imbalance in your gut health, which means that all those good bacteria in your digestive system aren’t working as happily as they could be. Compounding the problem is that eating sugary junk food makes the problem worse.

In his research, Gordon found consumption of sugary food can cause gut bacteria to become dependent on it, and cause rejection when healthier foods are introduced. That’s right: Your gut can actively sabotage your attempts to eat better. But the good news is that it can be retrained, according to Gordon.

By bringing in foods that promote healthier bacteria — particularly options with high amounts of probiotics like low-sugar yogurt and other fermented foods — the good bacteria can replace the saboteurs.

NOT ENOUGH REST

Although sleep might be part of resting, consider adding more non-snoozing time into your day instead of seeing bedtime as your only opportunity to get some stress relief.

Alex Soojung-Kim Pang, author of “Rest: Why You Get More Done When You Work Less,” notes that lack of adequate rest can make your body feel depleted in many ways, including nutritionally. This can kick off a need for a “boost” that might come in the form of sugar. While that may provide a temporary surge, it’s very short-lived and can quickly become a habit.

He suggests integrating short rest periods into every day, especially at times when sugar cravings are strong. For instance, instead of that afternoon pick-me-up of sugary snacks, try going for a 15-minute walk outside. Walking is a conscious form of rest, Pang says, because it offers a break from everyday stressors.

Sometimes, sugar cravings can be particularly strong when you have a combination of these factors. For example, you might feel overwhelmed at work, which leads to less-than-ideal food choices that quickly turn into depletion and fatigue.

That kind of chain reaction sets up a condition for cravings. But fortunately, you can easily create healthier habits by taking a moment when the sugar monster appears to consider what you really want instead.

4 Favorite Anti-Inflammatory Foods

More and more evidence is accumulating that suggests chronic inflammation is the root cause of many serious diseases in the developed world, including heart disease, Alzheimer’s and many cancers. Research also makes it clear that certain foods can ramp up the body’s inflammatory response, while others can dampen or “cool” it. For optimal health, foods in the latter category should be prominent in the diet.

But there is more to eating than just maximizing health advantages. The best foods are those that offer disease-preventive benefits such as anti-inflammatory effects and delectable flavor. When one eat such foods, one feels as though they've hit a grand-slam homerun – the sensory pleasure is heightened by the fact that each bite contributes to your overall well-being.

Many foods promote anti-inflammatory action. Some are not only potent in this regard, but also taste absolutely wonderful, particularly when harvested at peak quality and prepared with focus and skill. Here are four that, in my view, meet those criteria admirably:

Berries: We can’t be more specific here, because we love the tastes of all kinds of berries, and all have anti-inflammatory effects – in fact, they are among the most healthful foods one can eat. One exciting research development: a study at Ohio State University found that black raspberries reduce the incidence of certain cancers in animals by 50 percent. An exotic choice, new on the U.S. market, is the juice (not the oil) of sea buckthorn berries. Known by its Italian name, olivello juice, this is one of the most concentrated natural sources of vitamin C ever discovered.

Black cod: Also known as butterfish or sablefish, black cod has even more omega-3 fatty acids than does salmon. As one of its names suggests, it also has a buttery taste that makes it simply the finest fish we have ever eaten. Once rare in the U.S. markets, it is becoming much easier to find; any well-stocked fish market should have it.

Bok choy: Cruciferous vegetables have potent anti-inflammatory and anti-cancer effects, and bok choy has a higher concentration of beta-carotene and vitamin A than any other variety of cabbage. Toss it into soups, stews and stir-frys.

Ginger: Not just a potent anti-inflammatory, this spicy root is also an extraordinary carminative (which means a substance that helps reduce the formation of intestinal gas) and anti-nausea agent. Add freshly grated ginger root to stir-frys, and try ginger lemonade made with grated ginger, lemon juice, honey and water.