How Does the Gut Microbiome Relate to Diabetes?

Diabetes is becoming a worldwide public health issue. The International Diabetes Federation just published its ninth edition of its Diabetes Atlas depicting the global burden of diabetes. Globally, there are now an estimated 463 million adults aged 20–79 with diabetes. Based on the 2019 estimates, by 2030 a projected 578.4 million, and by 2045, 700.2 million adults aged 20–79 years, will be living with diabetes.

Within our own community, the Overlake Diabetes Education and Outpatient Nutrition teams have taken many opportunities to raise awareness of diabetes by providing education on how to manage the disease. The topic of nutrition as it relates to diabetes garners much interest. Fortunately, there is a plethora of research about how to eat to manage diabetes and more and more in recent years about the topic of gut health and its relationship to diabetes.

Research has shown a strong relationship between diabetes and the health of our gut or digestive tract. Specifically, scientists believe that diabetes is related to a disruption in the microbiome. The Human Microbiome Project, a National Institutes of Health research initiative, has helped improve our understanding of how the microbial flora is involved in human health and disease.

What is the microbiome?

Your digestive tract, primarily your large intestine, is full of microbes. Microbes consist of bacteria, viruses, fungi, and protozoa that significantly outnumber our human cells. Collectively, these microbes make up what is called the “microbiome.” These microbes are, for the most part, the good guys. They help strengthen our immune system, help promote good digestion and metabolism, help secrete gut hormones that influence our appetite, and they are a major contributor to our moods, sleep cycles and mental status. In short, a healthy microbiome is imperative to preventing and managing chronic diseases such as diabetes.  

What dietary interventions increase the health of our gut or microbiome?

A diet high in plant-based foods such as fruits, vegetables, legumes, whole grains, and nuts and seeds are good sources of fiber and prebiotics that promote gut health. Aim for 35–50 grams of fiber distributed throughout the day. Increase your fiber intake gradually and be sure to drink plenty of water.

Try these high fiber sources of plant-based foods:

  • Whole grains:
    • Aim for 2–3 servings a day.
    • Serving size: 1 ounce or 1/3 cup cooked.
    • Try millet, barley, bulgur, buckwheat, brown rice, quinoa or oats.
  • Legumes:
    • Aim for at least 3 servings per week.
    • Serving size: ½ cup cooked.
    • Try beans, peas, lentils, soy, tofu, tempeh.
  • Vegetables:
    • Aim for 3–5 vegetables daily.
    • Serving size: 1 cup raw, 2 cups green leafy, ½ cup cooked.
    • Try garlic, onions, leeks, asparagus, artichokes, sauerkraut, kimchi. 
  • Fruit:
    • Aim for 2–4 servings a day.
    • Serving size: 1 small piece (~4 ounces), ½ cup chopped, ¾–1 cup berries.
    • Try raspberries, blueberries, strawberries, apples.
  • Seeds and nuts:
    • At least 3 per week.
    • Serving size: 1 ounce or ¼ cup.
    • Try walnuts, peanuts, almonds, pistachios, flaxseeds, chia seeds.

Additional dietary interventions to improve gut health that are evidence based include limiting processed foods and added sugars, and avoiding soda and sugar substitutes.

Healthy eating can go a long way toward protecting the health of your gut. Try to incorporate a healthy dietary intervention every day to boost not only your health, reduce your risk of chronic diseases such as diabetes and obesity, but also to improve the quality of your sleep and your mental health. 

Always consult your healthcare provider before making any major changes to your diet or lifestyle, especially if you have a chronic disease.

Stacy Trogdon, RDN, CDE, is a registered dietitian nutritionist and certified diabetes educator with the Overlake Diabetes Education and Outpatient Nutrition clinics.

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