Body Wise

This Recipe Can Help
Prevent Type 2 Diabetes

by Ann L. Rappoport, PhD

The increase in childhood obesity and diabetes might be old news, but dramatic new research indicates parents can play a strong role in preventing type 2 diabetes. For kids (and adults) at risk, certain improvements to lifestyle are even more effective interventions than medication.

You Have the Power
It’s a mistake to think of obesity as an uncontrollable epidemic or that type 2 diabetes is an inevitable result, says Terri Lipman, PhD, a pediatric nurse practitioner and professor at The Children’s Hospital of Philadelphia (CHOP). Dr. Lipman emphasizes that children and their families can prevent many risk factors as well as the disease itself by increasing daily activity and making healthy food choices.

“The recipe for disaster” is the combination of sedentary lifestyle with highly processed, hydrogenated food and high fructose corn syrup, according to Donald Bergman, MD, past president of the American College of Endocrinologists and creator of its Power of Prevention program. These “lethal” ingredients actually alter the body’s metabolism, and can contribute to the development of type 2 diabetes, he says. On the other hand, changing to a healthier lifestyle can be easier than many of us think. And, says Dr. Bergman, “It works.”

Did You Know?

One-third of elementary and middle school children in Philadelphia were at risk for type 2 diabetes in a limited study conducted through the University of Pennsylvania School of Nursing. The current average age when a child is diagnosed with type 2 diabetes is 12.

Did You Know?

One-third of elementary and middle school children in Philadelphia were at risk for type 2 diabetes in a limited study conducted through the University of Pennsylvania School of Nursing. The current average age when a child is diagnosed with type 2 diabetes is 12.

Recipe for Prevention
The ingredients that help prevent type 2 diabetes also can increase overall wellness and fitness across a child’s lifetime. One secret is to add them gradually, mixing them into a child’s daily routine in small amounts, to build up long-term wholesome habits. Experts recommend the following recipe for healthy lifestyle.

“Healthy living is a family affair,” says Lorraine Katz, MD, a pediatric endocrinologist at CHOP. It’s hard for a child to swallow lifestyle change if the family doesn’t walk and dine the talk. Prevention is a family commitment.

Add movement “snacks” throughout the day, suggests Dr. Bergman. Just as you might nibble on grapes or carrot sticks in between meals, also sprinkle little spurts of physical activity in between sitting times. Even 10-minute bursts of activity invigorate, build stamina and add muscle tone — important because muscles enhance the body’s use of glucose and the efficiency of insulin. It shouldn’t be hard to total 60 minutes of daily active fun.

Physical activity comes in many enjoyable flavors — dancing, skateboarding or walking pets, for example — so help children find activities they enjoy. Some video games, such as those on the Wii, now involve moving. These programs might es--pecially help the 20 percent of households in which children get no physical activity during the week and the 25 percent in which kids younger than age 6 have their own television set. There are also summer camp programs for children with diabetes and who need help with weight management.

Feel fuller with fiber. Foods with fiber include whole grains, nuts or seeds, raw fruits and vegetables. These foods take longer to digest than highly processed baked goods with white flour and many canned products, and that means the body absorbs the nutrients over a longer period of time, delaying the hunger sensation. They’re also better for your body.

Fruit beats juice. Many well-intentioned adults mistakenly encourage children to drink juice. But juice spikes blood sugar quickly without the helpful fiber that whole fruit provides. Calories from juice add up and can be an unnecessary excess for individuals fighting obesity. Kids are better off drinking water and milk for thirst and eating fresh salads and whole fruit for nutrients that parents might seek to provide in juice.

For More Info

American Diabetes Association, 800-DIABETES,

American Dietetic Association, 800-877-1600, ext. 4844,

Children’s Hospital of Philadelphia (CHOP),
215-590-1000; Diabetes Center, 215-590-3174,

National Diabetes Education
Program, National Institutes of Health,

National Institute of
Diabetes and Digestive and Kidney Diseases,

U.S. Dept. of Agriculture,

Teach kids to read labels. They help children to understand nutrition and make good choices. Be mindful of the size of a “portion.” During the past 20 years, the size of dinner plates has grown, distorting what we tend to think of as an appropriate serving.

Let children participate in food shopping, when possible. The child’s job could be to select a new vegetable, suggests Dr. Katz.

A buddy system can help children overcome embarassment about their weight or fitness goals. They should talk with friends and partner with them to adopt healthy habits together.

”Eating isn’t just about hunger,” says Loretta Newsom, RN, president of the Delaware School Nurse Association and school nurse at Alfred G. Waters Middle School in Middletown, DE. Many professionals – counselors, therapists, nurses, dietitians, trainers, psychologists, doctors and support groups – can help families and kids with eating and behavioral issues.

Presentation matters. Experts caution against using the word “exercise” for children, because that makes normal play and movement sound like a chore. For many reasons, including the fact that children are still growing, youngsters should not be “dieting.” Nutritional education is important to help them understand why certain food choices are healthier than others.

One of the most delicious outcomes of this prevention recipe is that benefits of behavioral changes go well beyond preventing type 2 diabetes. They help kids at risk for other conditions such as cardiovascular diseases, orthopedic problems and sleep apnea. And they build long-term healthy habits.

Ann L. Rappoport is a contributing writer to MetroKids.