RESUMEN
Patients with impaired glucose tolerance (IGT) are now considered as being pre-diabetic, which indicates their relatively high risk for developing diabetes mellitus associated with abnormal metabolic syndrome and cardiovascular diseases. However, dietary modification and physical exercise may play a critical role in this respect. To determine the influence of dietary modification and physical exercise in subjects with impaired glucose tolerance in Bangladesh, thirty three newly detected otherwise healthy subjects with IGT, aged 30-63 years, were randomly selected to participate in a 12 weeks diet and exercise program. Substantial improvement in glucose tolerance was observed at the end of 12 weeks particularly in middle aged subjects (41-50 years). Mean fasting blood glucose and 2 hr post load glucose value were reduced significantly. Glucose tolerance was reverted to normal in 66.7% of the participants, remained unchanged in 26.7% and deteriorated to diabetes in 6.7%. Significant reduction in serum total cholesterol, LDL cholesterol along with mild deterioration in HDL cholesterol and increase in triglyceride values were observed. It was found that the principles of 'prudent diet' in combination with physical exercise are highly effective in improving glucose tolerance, lowering total cholesterol and LDL cholesterol in IGT subjects.
RESUMEN
Globalization has made calorie rich, cheap, convenient marketed foods the main menu for the common man. Indians are particularly susceptible to the adverse outcomes of this dietary change because of ethnic, epigenetic reasons and sarcopenic adiposity (less muscle more fat for the same body weight). Children have smaller body frame making them more susceptible to adverse effects of hyperglycaemia leading to stress on beta cells and their damage. This has resulted in escalation of lifestyle diseases by three-fold, that too at our younger age group at lower body mass indices. Preventive measures are necessary in early life to protect the beta cells, to achieve a metabolically healthy society. This will help in sustaining optimal beta cell function throughout a person’s life. Modification in dietary habits by educating the society, proper food labelling and legal regulation, restricting calorie, sugar, saturated fat, trans-fat and salt intake has proved its benefits in the developed world. Changes in the quality of food is as important as restricting calorie intake. This includes facilitation of increased consumption of dietary fiber, complex carbohydrates, nuts, fruits and vegetables. Restrictions are needed to reduce trans-fats, saturated fats and cooking habits such as deep frying which oxidizes cholesterol and lipids. Foods with long shelf-life shorten the life line because of their salt, sugar or trans-fat content. Individual meals need to be targeted in the general dietary guidelines, to minimize the post-prandial metabolic insult. In general, we need healthy start to early life particularly the first twenty years of life so that the habits cultured during childhood are sustained for the rest of productive years.