Indonesia is synonymous with its rice paddies, and one would expect nothing less from the planet’s third-largest rice-consuming nation. Why, then, did the country make headlines in 2019 for ditching its beloved staple for no-rice diets? The answer: Diabetes

In that same year, 6.2% of their population, which works out to approximately 10.7 million people, were diabetic. As if this number were not already one of the highest across the globe, it is projected to hit 30 million by 2030. The fact that diabetes is Indonesia’s third most deadly disease, after stroke and heart disease, compounds the urgency of diabetes prevention.

Surely rice alone is not responsible for Indonesia’s diabetes crisis, and diet is just one of many ways to prevent diabetes. By discerning between risk factors that are within and outside of our control, you can lower your risks of type 2 diabetes with these simple but effective lifestyle adjustments.

Type 2 Diabetes Risk Factors

Uncontrollable Factors

Controllable Factors

- Genetic predisposition - having a direct family member (parent of sibling) diagnosed with diabetes

- Age – risks of getting diabetes increases with age. If you are 40 years old or older, you have a higher risk compared to someone who is 10 years younger

- Weight – having a BMI of 23.0kg/m2 or higher
- Leading a sedentary (inactive) lifestyle
- Smoking

 

1. Maintain a healthy body weight

Whereas “ideal” body weight may differ across individuals, “healthy” body weight is ubiquitously measured by one’s Body Mass Index (BMI). According to Sun Life’s medical director Dr Raymond Tso, maintaining healthy body weight is one of the two most important ways of keeping T2DM at bay because people who are overweight are seven times more at risk.

How to calculate BMI

BMI = Weight (kg) / Height2 (in metres)

BMI (kg/m2)

Category (Asian cut-off)

Type 2 Diabetes Risks

>= 30.0

Obese

High Risk

23.0 – 29.9

Overweight

Medium Risk

18.5 – 22.9

Normal

Low Risk (Healthy range)

< 18.5

Underweight

Risk of nutritional deficiency diseases and osteoporosis

  • If your BMI is between 23.0 and 29.9, you are at moderate risk for Type 2 diabetes and should consider losing some body weight.
  • If your BMI is >= 30.0, you are at high risk and should see a doctor and start planning to lose body weight as soon as possible
  • If your BMI is between 18.8 – 22.9, you are at low risk. Continue to monitor your body weight.
  • If your BMI is below 18.5, you may not be in the high-risk group for Type 2 diabetes. However, you are at risk of developing nutritional deficiencies such as anaemia and osteoporosis (weak bones).
  • Aim for a healthy body weight with a BMI between 18.5 – 22.9.

If you’ve done the math and the result isn’t stellar, hold your horses before embarking on fad diets and the like. Weight loss should be gradual and sustainable, and a daily calorie deficit – where you consume less energy than is used – of about 500kcal is a good “day one” goal. With a proper diet and exercise regime in place, you could be well on your way to shedding between 0.5 to 1 kg a week. Start small or, better yet, have a doctor or dietician guide you along. 

 

2. Eat a balanced diet

A diet that prevents diabetes is no different than the next healthy eating plan. Fresh fruit and vegetables provide antioxidants, strengthen immunity, and reduce risks of chronic diseases – diabetes included.

The following choices also add up:

a) Choose complex over processed carbohydrates, such as brown rice or wholemeal bread. They slow down the release of glucose into your bloodstream.

b) Swap red meat out for poultry, fish, or plant-based protein sources like kidney beans, chickpeas, tofu, lentils, edamame, and quinoa.

c) Switch to healthy fats and oils made from nuts, olives, avocados, canola, or fish. Even then, consume in moderation.

d) Picking water, coffee, and tea over sugar drinks – however difficult that may seem in social situations.

While you’re at that, why not use Piring Makanku, a dietary guideline by Indonesia’s Ministry of Health, as a reference? It illustrates the recommended portions of food groups to be consumed in each meal, and the importance of pre and post-meal hydration and hygiene.

 

3. Get moving with regular exercise

Regular exercise not only reduces the risk of Type 2 Diabetes by improving your body’s sensitivity to insulin; it also burns excess calories and builds lean body mass. According to the World Health Organisation (WHO), exercise should be cardiovascular in nature.

Their magic number for adults? At least 75 minutes of vigorous exercise makes you pant and sweat, or 150 minutes of moderate-intensity activities like brisk walking, running, hiking, cycling, or swimming every week. Importantly, pick something you enjoy so exercise becomes less of a chore. For some, that looks like breaking a sweat with friends over tennis, badminton, basketball, or soccer.

A word of caution if you haven’t exercised in a long time: Get clearance from your doctor if need be, take it easy at the start, and increase your pace and intensity over time.

 

4. Get enough sleep

Listen up, night owls. Sleeping less than 5 hours per night and having one’s circadian rhythm disrupted by night shifts are risk factors for Type 2 diabetes, according to the Asian Diabetes Prevention Initiative, a joint research program by the University of Singapore and the Harvard School of Public Health. Sleep apnea, a condition where breathing repeatedly stops and starts in slumber, is yet another red flag.

For a restful night, avoid caffeine and electronic devices at night. Instead, wind down with a warm shower and keep your room dark and cool. Aim for 6 to 7 hours of sleep for a start, and sync up your internal clock by turning in and waking up at fixed times. That includes weekends, however strong the temptation to sleep in may be.

 

5. Be proactive with regular health checks

Health checks often take a backseat when there is no urgency. Ironically, when symptoms do show up, they can be much more challenging to remedy. According to The American Diabetes Association, individuals above 45 years old should be screened for pre-diabetes and Type 2 Diabetes every 3 years. Age aside, people with above-average blood sugar levels (pre-diabetes) ought to attend checkups every 3 months; then every 6 months after they’re stable.

 

Start diabetes prevention early

Knowing how to prevent diabetes is half the equation; putting theory into practice is another. It’s easy to neglect exercise, diet, and sleep when work gets hectic, and health screening becomes the least of our priorities. In these times, it pays to remember that diabetes prevention is a long game best started early.