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World Diabetes Day highlights need for further studies in African context

14/11/2022

With 1 in 9 adults living with diabetes, South Africa has the highest diabetes prevalence in Africa

 

Figures released in 2021 by the International Diabetes Federation (IDF) show that over 4 million adults in South Africa are affected by the condition, while just under half of the people living with diabetes are undiagnosed, and one in three adults in the country is at high risk of developing type 2 diabetes.

A total of 96 000 deaths were caused by diabetes in 2021, while the cost of diabetes-related health expenditure has risen to $1 700 per person (+/- R29 300), totaling an estimated $7.2 billion.

“Diabetes is a serious threat to global health that respects neither socioeconomic status nor national boundaries,” Professor Ayesha Motala said in a press release by the IDF. Professor Motala is the head of the Department of Diabetes and Endocrinology at the School of Clinical Medicine of the University of KwaZulu-Natal.

“The increasing prevalence of diabetes in South Africa confirms diabetes is a significant challenge to the health and well-being of individuals and families in the country.” 

In 2022, the World Diabetes Federation’s campaign focuses on the need for better access to quality diabetes education for healthcare professionals and people living with diabetes. 

It is fitting then that a new study, conducted for the first time on South African soil, aims to illumate the health co-benefits of adopting plant-rich diets as a climate mitigation strategy ahead of World Diabetes Day and COP27.

Results of South Africa’s first-ever whole food plant-based diabetes reversal challenge has drawn international attention and will be presented to world leaders during the 27th United Nations Climate Change Conference (COP27) in Sharm El-Sheikh, Egypt, this week.

The research, conducted by a research group affiliated with the North West University (NWU) and the Physicians Association for Nutrition (PAN) South Africa, is in the form of a case study on the pilot program created by the Ubuntu Wellness Institute (UWI).

Dr Nanine Wyma, Programmes Manager at ProVeg South Africa and Managing Director at the Physicians Association for Nutrition (PAN) South Africa, worked first-hand with the data derived from the challenge. Researchers at PAN South Africa gathered information from 10 diabetics and their physicians who followed a whole food plant-based challenge over 21 days. Wyma will be presenting the findings at COP27 during the only day solely dedicated to discussing the health co-benefits of plant-based food system transformation. 

“In our country, we have unique cultural and socioeconomic circumstances that should be taken into account when implementing whole-food plant-based interventions,” Wyma said.

“Using plant-based nutrition to manage chronic diseases has been shown to be effective in many countries around the world. But we cannot simply copy and paste interventions from the Global North. South Africa is incredibly unique and we must explore research on how these interventions can be applied within a local context. This is not only an opportunity for improved healthcare in South Africa but the rest of the continent as well.”

Officially, the 21-Day Ubuntu Diabetes Reversal Challenge has been in development by the Ubuntu Wellness Institute (UWI) since 2018 and began practically in 2020.

“Diabetes is a health issue and it’s also a food and hunger issue. When you see foods that are driving climate change being animal-based products, then also it’s a climate solution,” Macfarlane said. 

“It’s bringing the solution we desperately need to keep a habitable earth, to stay within the temperature ranges being determined by the scientists globally,” 

The 21-Day Ubuntu Diabetes Reversal Challenge included participants from across South Africa, including Cape Town, Nyanga, Imizama Yethu, Bonteheuwel, Sandton, Springs, Kempton Park, and Napier. Most notably, Western Cape Premier, Alan Winde, also partook in the study.

“My original diabetic journey was [to] take a whole lot of meds. Then getting to understand it through research [I realised] I had to change my diet and by changing my diet, losing some weight, exercising, get off the medicine, I could manage it through diet and exercise,” Winde said.

“When I started [the program] 21 days ago, I was on three different diabetic medicines and I have now gotten rid of all of them, so it is quite amazing.” 

Pearl Mpange, a massage therapist from Cape Town and another participant in the challenge also spoke highly of her experience during the challenge. After her diagnosis, the doctors at her local clinic wanted to see her twice a month as she had developed severe type 2 diabetes. 

“I started to feel weak and losing lots of weight. So I went to the clinic and that is where I got the diabetic [diagnosis],” Mpange explained.

“On the nineteenth day of my [diabetes reversal] program, the doctor said I could be completely off of my medication. I reserved my diabetes.”

Also part of the research team was Professor Andrew Robinson, Public Health Specialist at NWU.

“When I studied medicine, once you were labelled as a type 2 diabetic or [diagnosed with] hypertension, it was for life. Now there is sufficient evidence to show that is not the case and that if one addresses your nourishment to health you can reverse these illnesses.” 

 

To watch the live presentation of the study results, register here: https://bit.ly/pansouthafrica_food4climatepavilion-virtualevent_media

To watch a short video about the study, click here: https://ubuntuwellness.com/diabetes-reversal/

Quick whole-food plant-based diet facts:

  • Eating an exclusive whole-food plant-based diet could cut your individual carbon footprint in half.
  • Finding solutions to noncommunicable diseases is the target for Sustainable Development goal 3.4. Whole food plant-based diets are also known to prevent and manage NCDs, specifically type 2 diabetes, cardiovascular disease and some cancers. Research shows that whole food plant-based nutrition reduces the risk of type 2 diabetes and is associated with other positive health outcomes such as weight loss, psychological well-being and quality of life.

Quick diabetes facts:

  • World Diabetes Day became an official United Nations Day in 2006 with the passage of United Nations Resolution 61/225. It is marked every year on 14 November, the birthday of Sir Frederick Banting, who co-discovered insulin along with Charles Best in 1922
  • According to the World Diabetes Federation, 1 in 10 adults (or 537 million people) globally are now living with diabetes. This number is expected to rise to 643 million by 2030 and 783 million by 2045. The majority of undiagnosed adults have type 2 diabetes. More than 3 in 4 people with diabetes live in low and middle-income countries.

 

What is type 2 diabetes and how does it affect you?

In layman’s terms – when an individual eats food, their blood sugar spikes which trigger the release of insulin from the pancreas. Insulin opens cellular gates for glucose, drawing sugar out of the blood and into the cells. In the case of Type 1 diabetes, insulin cannot produce insulin. This is an autoimmune disease that cannot be reversed. However, the vast majority of diabetics have type 2 diabetes, where the cells do not respond to insulin and this causes insulin insensitivity. Because insulin insensitivity causes high blood sugar, most diabetics limit their sugar, or carbohydrate, intake. However, research suggests that overconsumption of fat may interfere with insulin sensitivity. This means that fat may be the cause, whereas sugar is only a symptoms. Type 2 diabetics that reduce their fat intake often become more sensitive to insulin and their blood sugar stabilizes. Unhealthy fats are found in fried foods and trans fats, but animal products are also very high in saturated fats. 

The Adventist health study demonstrates this concept very well. For religious reasons, 7th-day Adventists abstain from alcohol and meat consumption. When comparing their dietary lifestyles to their health risks, the research showed that every step taken to reduce animal product consumption reduced their weight and risk for type 2 diabetes, incrementally. 

 

Study disclaimer

Not all participants managed to reverse their diabetes. More research is needed over larger sample populations before the results can be generalizable to the entire South African population.

 

ENDS

 

Notes to Editors

For media inquiries, email Arleen Nel at [email protected]

For more information about PAN South Africa and the research mentioned, contact Dr Nanine Wyma at [email protected]

 

About ProVeg South Africa:

ProVeg South Africa is the local branch of ProVeg International. ProVeg is an international food awareness organisation working to transform the global food system by replacing conventional animal-based products with plant-based and cultured alternatives.

ProVeg works with international decision-making bodies, governments, food producers, investors, the media, and the general public to help the world transition to a society and economy that are less dependent on animal agriculture and more sustainable for humans, animals, and the planet.

ProVeg has permanent-observer status with the UNFCCC, is accredited for UNEA, and has received the United Nations’ Momentum for Change Award.

 

References:
1. Drew, K. 2017. Healthy & Climate-friendly eating patterns in New Zealand. Otago: University of Otago (Thesis – Hon).

  1. Hallström, E., Carlsson-Kanyama, A. Börjesson, P. 2015. Environmental Impact of dietary change: A systematic review. Journal of Cleaner Production, 91:1-11 doi:10.1016/j.jclepro.2014.12.008.
  2. Scarborough P, Appleby PN, Mizdrak A, Briggs AD, Travis RC, Bradbury KE, Key TJ. Dietary greenhouse gas emissions of meat-eaters, fish-eaters, vegetarians and vegans in the UK. Clim Change. 2014;125(2):179-192. doi: 10.1007/s10584-014-1169-1. Epub 2014 Jun 11. PMID: 25834298; PMCID: PMC4372775.
  3. Craig, W.J., Mangels, A.R., Fresan, U., Marsh, K., Miles, F.L., Saunders, A.V., … Orlich, M. 2021. The Safe and Effective Use of Plant-Based Diets with Guidelines for Health Professionals. Nutrients. https://doi.org/10.3390/nu13114144.
  4. Qian, F., Liu, G., Hu, F.B., Bhupathiraju, S.N., Sun, Q. 2019. Association Between Plant-Based Dietary Patterns and Risk of Type 2 Diabetes: A Systematic Review and Meta-Analysis. JAMA Internal Med, 179(10):1335-1344. doi: 10.1001/jamainternmed.2019.2195.
  5. Toumpanakis A, Turnbull T, Alba-Barba Effectiveness of plant-based diets in promoting well-being in the management of type 2 diabetes: a systematic review BMJ Open Diabetes Research and Care 2018;6:e000534. doi: 10.1136/bmjdrc-2018-000534
  6. International Diabetes Federation. 2021. Diabetes in Africa. https://diabetesatlas.org/idfawp/resource-files/2022/01/IDF-Atlas-Factsheet-2021_AFR.pdf Date of Access: 31 Oct. 2022.
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