Preventing Type 2 Diabetes requires more than diet alone

Published on
November 10, 2008

The occurrence of Type 2 Diabetes (adult-onset diabetes) can be effectively postponed or even prevented entirely. However, long-term and large-scale research has shown that a healthy lifestyle is required for this. The best therapy is a healthy and varied eating pattern, combined with more exercise, but only if this regime is continued permanently. A weight-loss diet does not always have good consequences, because a strict diet can also be harmful. Moreover, a small amount of weight loss combined with a healthy lifestyle is sufficient. “Many people want to return to size 36, but this is often impossible and is also unnecessary”, said Prof. Edith Feskens during her inaugural address as Professor (personal chair) of Nutrition and Metabolic Syndrome at Wageningen University.

The connection between a high risk of Type 2 Diabetes and lifestyle has been convincingly proven, stated Prof. Feskens in her inaugural address: "De gezondheid van Obelix?– Over Feestmalen en Toverdrankjes" (The health of Obelix? –  On feasting and magic potions). Every day, 200 Dutch citizens are diagnosed with diabetes; this is more than 70,000 per year. Every day, 116 people in our country die of cardiovascular disease.

The teaching and research remit of Edith Feskens – the metabolic syndrome – concerns the precursor stage of Type 2 Diabetes and cardiovascular disease. At this stage, people do not have these diseases, but they do have the risk factors for acquiring them. This are: a relatively big waist circumference, high blood pressure, and high concentrations of glucose, fats and cholesterol in the blood. One-fourth of people between 30 and 60 years of age are in this precursor stage of cardiovascular disease and diabetes. For people older than 60, this percentage is significantly higher.


According to Prof. Feskens, people today days tend to assume that a "magic potion" or pill will provide effective therapy for the metabolic syndrome. Or we go on a diet. She notes that the word diet originates from the Greek word diata, which means lifestyle, so this involves more than simply limiting food.

Weight loss has a downside, states Feskens. Successful therapy to treat metabolic syndrome depends on a number of factors. The most important is consistency: permanently maintaining a healthy lifestyle. It is also important whether someone has made previous attempts to lose weight; it is striking that people who have dieted the most tend to lose the least amount of weight. Feskens believes this could be a harmful effect of extreme diets, where a yo-yo effect occurs because the body adapts itself to a low energy intake. Recent figures from the TNO research institute have shown that girls between 13 and 18 years of age tend to lose weight in an unhealthy fashion, which actually results in a greater risk of overweight. In contrast, Feskens states that a 5 to 10% weight loss can be achieved by means of a change in lifestyle, and even this small amount of weight loss has a beneficial effect on the metabolic syndrome. Feskens: “almost everyone wants to lose more weight than this and would ideally like to return to size 36. It is good to understand that this is often unfeasible and is also unnecessary.”


According to Feskens, an interesting phenomenon is that one-fourth of overweight people do not have any other risk factors and are therefore ‘metabolically healthy’. In her inaugural address, she used the metaphor of obese characters from the Asterix comic book: the tribal chief Heroïx, who has health problems, and Obelix, who does not. Perhaps the mother of Obelix gave him the genes for obesity, but not the ones for high blood pressure or diabetes. It is still unclear which factors play a role in genetic predisposition, and Feskens believes this requires far-reaching research. However, she asserts that genetic predisposition does not mean that the metabolic syndrome is irreversible, and that even for these people a healthy lifestyle can postpone or even prevent diabetes.