Gaining or losing weight quickly can advance an undiagnosed pre-diabetic to frank-diabetes, writes Geeta Padmanabhan

A casual disclosure added great significance to World Diabetes Day (November 14) this year. Weeks before, actor Tom Hanks had walked into the Late Show with David Letterman, ahead of the release of Captain Phillips, and when complimented on his slim and trim hard-working-ship-captain looks, said, “I went to the doctor and he said, ‘You know the high blood-sugar numbers you’ve been dealing with since you were 36? Well, you’ve graduated. You’ve got Type-II diabetes, young man’.” Hanks said he was advised to lose weight to control his chronic condition.

Monitoring weight

Hanks was also told that if he could bring his weight down to what it was in high school, he would be completely healthy. He had replied, “I have to live with diabetes; there’s no way I can weigh as much as I did in high school.” He was a skinny 96 pounds then. Now, roles demanding weight-gain were out, he said. Later, at a Captain Phillips press conference, he stated: “Gaining and losing weight may have had something to do with this because you eat so much bad food and you don’t get any exercise when you’re heavy.”

That comment sparked a health(y) debate. Is a yo-yo weight programme a risk factor for Type-II diabetes? The two-time Oscar winner had to gain for A League of Their Own (1992)and lose drasticallyforPhiladelphia (1993) and Cast Away (2000). He said pizza was a key ingredient when he bulked up for roles. “Pizza is the most delightful thing ever invented and it’s — for me — diabolically dangerous.”

“People who lose or gain weight quickly for reasons like acting can put their body’s metabolism through a period of severe stress,” said diabetologist Dr. Muthukumaran Jayapaul. “Gaining weight quickly can advance an undiagnosed pre-diabetic to frank-diabetes with very high glucose levels.” Weight gain/loss programmes should be planned and graduated slowly, he said. An experienced physician/nutritionist should prescribe and monitor it. “Hanks had said, ‘I think I was genetically inclined to get it... it goes back to a lifestyle I’ve been leading since I was seven.’ Overall, heredity, diet and physical activity play roles in the onset of Type-II diabetes.” If a sudden increase in total energy intake and weight-gain unmasks diabetes in people who are at risk, a huge drop plays havoc with metabolism and the hormonal system. We moved from a feast-and-famine lifestyle to one of round-the-year feasting. “Diabetes is an end-result.”

Healthy diet

To gain weight, increase calorie intake with protein content, and exercise regularly, he said. Gain gradually with increased muscle mass; don’t pile fat around the belly by eating carbohydrate-loaded food like pizzas and carbonated drinks. Equally, low-calorie diets (less than 1,000 calories/day) without proper advice would cause severe migraine, tiredness — may even halt periods in women. Weight loss through only-high-protein diets can cause kidney damage or put the body into a catabolic state. Weight-loss should correspond to one’s energy expenditure. To maintain weight, have healthy meals of complex carbohydrates (60-70 per cent), such as whole wheat, unpolished rice, protein from pulses and soya (accounting for 20-25 per cent) and fat around 10 per cent. Avoid saturated/trans-fatty acids.

Women tolerate weight gain better than men, said Dr. Muthukamaran. However, once both sexes become overweight or fat, the ill-effects are the same. Extra weight around the waist is bad for both. Once diabetes is confirmed women do worse with glucose control, and suffer more complications. To the raft of troubles from diabetes, from intense thirst/hunger to Alzheimer’s disease and pancreatic cancer, why add the trouble of sudden weight-loss and gain?

Type-II can be controlled, even reversed, as this story in U.S. News shows. After being diagnosed with it, Keith Jones, 58 “got to a much healthier point in his life,” by purging many “lifelong negative habits”. His unhealthy diet choices — the major reason for the lifestyle disorder — had included trans-fatty french fries, ice-cream sodas, alcohol, glazed doughnuts, fried chicken — what his son calls Foods of Mass Destruction. Mom put him on medication and a diet of brown rice and veggies. Keith also went vegan. After a few months of meat-free menus and exercise, his HbA1c — lab-test for blood-sugar level — dropped from 9 per cent to 5 per cent, and he was declared diabetes-free. Keith has stopped his medication and has taken up vegetable farming. His son runs a health/fitness/wellness website Fit Fathers (@FitFathers).