Most people at risk for diabetes cannot prevent it with diet and exercise
While exercise and diet can prevent diabetes on the individual level, it doesn’t work at the societal level. Yes, the relative risk for lifestyle interventions in preventing diabetes is 0.61—that means, if you can carry out those interventions, your risk for diabetes goes down 39 percent. Sounds good, right? If you’re one of the people for whom it works, then fantastic. But the relative risk is not the important factor. The the number of people who have to go on a diet and lose weight to prevent one case of diabetes—is twenty-five. That’s right, twenty-five people have to diet and exercise rigorously to prevent one of them from progressing on to developing diabetes.
No doubt you’ve also watched some TV-doctor show where the guest dropped weight, their diabetes got better, their insulin went down, and they got a makeover. Cue studio applause. But it’s actually the other way around. Their insulin didn’t go down because their weight went down—their weight went down because their insulin went down. Weight gain occurs after metabolic syndrome. Dr. Robert H. Lustig and colleuges got children’s insulins to go down without losing any weight, simply by getting them off dietary sugar. What they lost as a result was liver fat, which then made them insulin sensitive. Again, modern medicine tends to target the pathology of an illness rather than preventing it.
References
- Lustig, Robert. (2021). Metabolical Chapter 2. “Modern Medicine” Treats Symptoms, Not Disease (p. 42). New York, NY: HarperCollins Publishers.