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What's Race Got to Do With Diabetes?

If you're in a group with an elevated risk, here are 5 tips on how to lower it


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En español | You’ve likely heard the warning: If you don’t watch your diet and exercise regularly, you’re raising your risk for type 2 diabetes as well as prediabetes. What you may not know is that ethnicity also plays a major role. That’s right. African Americans, Hispanics, American Indians, and some Pacific Islanders and Asian Americans are all at higher risk for type 2 diabetes than Caucasians, according to the American Diabetes Association (ADA). Blacks are disproportionately affected; they’re almost twice as likely as whites to develop type 2 diabetes by middle age. And those who get it are significantly more likely to suffer complications such as blindness, kidney disease and amputations than their white counterparts.

Until recently, researchers couldn’t make sense of it. They believed that genes were to blame — meaning people of certain races were simply destined to develop diabetes — but a study published in 2017, in the Journal of the American Medical Association (JAMA), suggests that’s not the case. Blacks and whites actually have the same biological risk of developing type 2 diabetes. The reason for the disparity has to do with a single culprit: obesity.

“Far and away, the leading factor for type 2 diabetes appears to be obesity,” says study coauthor Mercedes Carnethon, professor and vice chair of the Department of Preventive Medicine at Northwestern University’s Feinberg School of Medicine. “Factors we collectively refer to as the social determinants of health — our financial resources, access to health care, level of education and the neighborhoods we live in — all of these contribute to the development of obesity and common complications of being overweight, such as diabetes.”

Consider the consequences of living in a community that doesn’t have easy access to health care, nutritious foods or spaces that lend themselves to physical activity. “These things lead people to make choices that result in a higher risk of obesity,” says Carnethon. “That’s really what drives the disparities in the development of diabetes among ethnic groups.”

Now for the encouraging part. There’s plenty you can do, no matter your race, to reduce your risk of developing diabetes. Read on to see how.

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1. Keep your weight down

Why is obesity arguably the greatest risk factor for type 2 diabetes? The more fatty tissue you have, especially when it’s concentrated around your abdomen, the more resistant your cells become to insulin, a hallmark of diabetes. To lose weight, make lifestyle tweaks you can stick with. Pick an activity you enjoy and schedule it as you would any other must-do event. And instead of overhauling your diet all at once, start by practicing portion control. Fill half your plate with non-starchy vegetables, one-quarter of it with lean protein, and the final quarter with carbs, such as brown rice or whole-grain pasta.

2. Follow a healthy eating plan

A study published in a 2018 issue of JAMA suggests that a so-called Southern diet (meaning high in sugar, sodium and fat) may be the reason that black people are more prone to high blood pressure (a risk factor for both heart disease and diabetes) than white people. You don’t have to give up all your favorite foods, but you should look for ways to make healthy swaps. So choose grilled skinless chicken, instead of the fried variety; brown rice, instead of white; and pizza topped with veggies, not pepperoni. At the grocery store, pick foods that say “low sodium” and “no trans fat” on the labels.

3. Break a sweat

Aim to log 30 minutes of moderate-to-vigorous aerobic activity (brisk walking, swimming, cycling on a flat surface, even vacuuming) at least five days a week. Regular exercise helps keep your weight in check, but that’s not all: It also helps reduce your risk for heart disease, strengthens your bones and lowers stress levels. Just starting out? Try this strategy to avoid injury: Start with five or 10 minutes of physical activity a day, three days a week, and increase the time by 10 percent each week until you reach 150 minutes.

4. If you smoke, quit

Studies show that cigarette smokers are around 30 to 40 percent more likely to develop diabetes than nonsmokers; heavy smokers have an even higher risk. If you’re having trouble kicking the habit, ask your doctor about available tools. A combination of behavioral support — whether it’s face-to-face, by phone or online — and cessation aids (like nicotine patches, lozenges and gum, or prescription drugs) can be effective, according to a study published in the Archives of Internal Medicine.

5. Get tested

In addition to obesity, age is a risk factor for diabetes. If you’re overweight and 45 or older, the ADA recommends getting the blood test, which is the only way to know for sure if you have diabetes. A blood test can also tell you if you have prediabetes, a common precursor. While more than 1 in 3 American adults have this condition — which means their blood glucose is higher than it should be but not high enough to meet the threshold for diabetes — 90 percent of them don’t know it. To find out your likelihood, try this prediabetes risk test developed and powered by the American Diabetes Association.


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