Diet, movement and weight management work together to lower diabetes risk

Diabetes remains a major public health concern in Jamaica, where more than 235,000 adults are estimated to be living with the condition, with almost one in four cases going undiagnosed. The disease can cause serious damage to the heart, blood vessels, kidneys, eyes and nerves, placing a significant burden on individuals, families and healthcare systems.

The International Diabetes Federation’s 2025 Diabetes Atlas estimates that 235,600 Jamaican adults age 20 to 79 were living with diabetes in 2024. This represents an estimated prevalence of 11.6 per cent, while the age-standardised prevalence was 12.5 per cent. The federation further estimates that 24.3 per cent of people with diabetes in Jamaica are unaware that they have the condition. Diabetes was also associated with an estimated 3,622 deaths among adults in this age group during 2024.

The figures reflect a wider regional and global challenge. An estimated 589 million adults worldwide are living with diabetes, including approximately 56.2 million across North America and the Caribbean. In the region, an estimated 29.1 per cent of adults with diabetes remain undiagnosed.

While age and family history can influence a person’s risk, everyday lifestyle choices also play an important role in prevention. A balanced diet, regular physical activity and maintaining a healthy weight can work together to improve blood glucose control, support heart health, and reduce the likelihood of developing type 2 diabetes.

Dr Sanjeev Kumar Gulati, FACC, executive deputy director of Baptist Health Heart & Vascular Care and system chief of cardiovascular medicine, says understanding the relationship between diabetes and cardiovascular disease is essential to recognising the importance of prevention.

“Type 2 diabetes develops when the body becomes resistant to insulin or does not produce enough to regulate blood glucose effectively. Over time, elevated blood sugar can damage blood vessels and increase the risk of coronary artery disease, heart attack, stroke and heart failure, while also affecting the kidneys, eyes and nerves,” he said.

The close relationship between diabetes and cardiovascular disease makes prevention and early intervention particularly important. The World Health Organization’s 2023 estimates for Jamaica identify diabetes mellitus as the country’s third-leading cause of death overall, with an estimated 78.8 deaths per 100,000 people.

practical adjustments

Dr Gulati points to findings from the PREDIMED-Plus clinical trial as further evidence of how lifestyle changes can help reduce the risk of developing type 2 diabetes.

The study followed 4,746 adults age 55 to 75 who were overweight or obesity and had metabolic syndrome. Participants who followed a calorie-reduced Mediterranean eating pattern, combined with physical activity, lowered their risk of developing type 2 diabetes by 31 per cent, compared with those following a traditional Mediterranean diet alone.

“Lifestyle habits can play an important role in reducing risk and supporting long-term health. The findings reinforce the benefits of combining dietary changes with physical activity, rather than relying on one lifestyle adjustment alone,” Dr Gulati said.

The Mediterranean diet, which formed part of the study’s intervention, emphasises vegetables, fruits, whole grains, beans, legumes, nuts, seeds, olive oil, fish and seafood. Poultry, eggs and dairy products can also be included in moderate amounts. This eating pattern provides fibre, healthy fats and essential nutrients that support blood glucose management, weight control and cardiovascular health.

Choosing minimally processed foods while limiting excess sodium, added sugars and saturated fats can further help maintain healthy blood pressure, cholesterol levels and blood vessels.

Dr Gulati explains that adopting this approach does not require following a strict or restrictive diet. Instead, the Mediterranean diet offers an eating pattern that can be maintained over the long term and adapted to local preferences.

“The Mediterranean diet is not intended to be a short-term diet. Its principles can be incorporated into everyday meals by including more plant-based foods, whole grains, healthy fats and lean sources of protein,” he said.

As it relates to Jamaicans, this means making practical adjustments to familiar meals, including eating more vegetables and legumes, choosing whole grains more often, and being mindful of cooking methods and portion sizes. Healthy eating is most effective when it becomes a consistent part of everyday life.

Portion control is another important consideration. In PREDIMED-Plus, participants in the intervention group followed a Mediterranean diet with a moderate reduction in daily calorie intake. After six years, they lost an average of 3.3 kilograms and reduced their waist circumference by 3.6 centimetres.

shared risk factors

“Portion awareness and control can help people manage their energy intake while maintaining a varied diet. However, individual calorie needs differ according to age, activity level, health status and personal goals,” he said.

Physical activity was also a central part of the intervention. Participants received guidance on moderate exercise, including brisk walking and strength training. The combination of dietary changes and physical activity produced greater benefits than the Mediterranean eating pattern alone.

“The study paired dietary changes with guidance on moderate physical activity, including brisk walking and strength training. Regular movement also supports heart health, blood pressure, weight management and insulin sensitivity,” he said.

Walking, cycling, swimming and resistance exercises can all contribute to an active routine. The important consideration is finding activities that can be maintained consistently and safely.

Nutrition and physical activity reinforce each other. Together, they can improve several cardiovascular and metabolic risk factors while helping individuals maintain a healthier weight.

Recognising personal risk is equally important. Age, excess weight, family history, physical inactivity and certain metabolic conditions can increase the likelihood of developing type 2 diabetes. Because diabetes and cardiovascular disease share many risk factors, regular medical visits provide an opportunity to assess blood glucose, blood pressure, cholesterol, kidney function, and other indicators of metabolic and cardiovascular health.

“The risk factors for diabetes and cardiovascular disease often overlap, so regular medical check-ups are important. These visits provide an opportunity to review blood glucose, blood pressure, cholesterol and kidney function, and to identify concerns that may require further attention,” Dr Gulati said.

The high proportion of undiagnosed cases in Jamaica makes screening particularly important. People may have elevated blood glucose without experiencing obvious symptoms, meaning routine checks can help identify the condition earlier and reduce the likelihood of complications.

Individuals who already have prediabetes or other risk factors can work with their healthcare teams to develop eating and activity plans suited to their needs. Those living with heart disease, experiencing heart failure symptoms or managing multiple cardiovascular risk factors may require a more personalised approach and closer medical follow-up.

“People with prediabetes or additional risk factors should work with their healthcare team to develop a plan that meets their individual needs. Those with existing heart disease or multiple cardiovascular risk factors may need closer medical supervision. Lifestyle changes should complement, rather than replace, prescribed medication and professional medical advice,” he said.

Reducing diabetes risk involves more than changing what is on the plate. Combining nutritious eating, regular physical activity and weight management can help protect the heart, improve metabolic health and reduce the likelihood of developing type 2 diabetes. Alongside routine monitoring of blood glucose, blood pressure and cholesterol, these habits can make a lasting contribution to better health throughout adulthood.

keisha.hill@gleanerjm.com