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Millet-based meals can lower risk of diabetes—study

Scientists say eating millets can reduce the risk of developing type two diabetes

Consumers of thobwa (fermented sweet beer) drinkers have all the reasons to smile that they have been doing the right thing all along because the traditional beverage, infused with millet, has more benefits than the drinkers ever imagined.

Researchers have found that a millet-based diet can lower the risk of type two diabetes and help manage blood glucose levels in people diagnosed with diabetes.

The finding offers an option to nutritionists to design appropriate meals for diabetic and pre-diabetic people, as well as for non-diabetic people as a preventive approach.

The study published on July 28 in Frontiers in Nutrition says diabetic people who consumed millets as part of their daily diet saw their blood glucose levels drop between 12 and 15 percent, fasting and post-meal.  In fact, their blood glucose levels went from diabetic to pre-diabetic levels.

The blood glucose bound to hemoglobin (HbA1c) levels lowered by 17 percent on average for pre-diabetic individuals, taking the levels from pre-diabetic to normal status, says the study.

In an interview, Anitha Seetha, the study lead researcher and senior scientist for nutrition at International Crops Research Institute for the Semi-arid Tropics (Icrisat), says the findings affirm that eating millets can lead to a better glycemic response.

 “Consumption of millet-based diets helps to reduce blood glucose level, insulin resistance, glycated hemoglobin [HAb1c] level and in turn helps in managing type two diabetes,” Seetha says.

“For the same reasons, it also reduces the risk of onset in pre-diabetic individuals.”

She says millets are able to have these effects because they are low glycemic index foods.

Millet index

The researchers used a systematic review and meta-analysis to analyse data across all the existing studies to identify the significance of the impact of consuming millets on blood glucose levels and diabetes.

This included 65 global studies undertaken on humans with data on commonly monitored clinical parameters used in diabetes management.

Five of the studies came from Africa with two from Nigeria and one each from Tanzania, Ethiopia and Sudan. Other studies came from Asia, Canada, the United States and the United Kingdom.

The study found that millets have a low average glycemic index (GI) of 52.7, which is about 30 percent lower than what it is for milled rice and refined wheat. The glycemic index of millets is about 14-37 points lower than what it is for maize.

All 11 types of millets studied either had low (less than 55) or medium GIs (55-69). Glycemic index is an indicator of how much and how soon a food item increases the blood sugar level.

Pearl millet, finger millet, fonio and teff as well as sorghum (included in the study) are the most produced millet family crops in Africa.

“Their GI is lower than the major staples that are commonly refined and consumed even after accounting for different cooking methods. Including millets in diets reduces the dietary GI.  This shows that diversifying staples with millets can have a significant positive impact in management of diabetes and mitigation of its onset risk,” Seetha explains.

Joanna Kane-Potaka, executive director at Smart Food and co-author of the study says besides diabetes management, millets offer benefits in other ways as they are rich in micronutrients.

“Finger millet has extremely high calcium (three times more calcium than milk) and is good for growing children. All the millets, especially pearl millet and teff, are high in iron and zinc, which are in the top three micronutrient deficiencies globally. The millets also have good levels of protein,” she says.

Diabetes as a public health issue

The study was initiated in 2017 and is the first in a series of surveys on the impact of millets consumption. The others in the series include studies on millets and lipid profile, obesity, its impact on calcium deficiency and anemia which are set to be published later in the year.

The researchers were motivated to conduct the study because type two diabetes is a non-communicable disease and its onset risk is increased by poor dietary and lifestyle habits.

“It is a global public health issue as the world is witnessing increased incidence,” Seetha says. “Diets across Africa and Asia are dominated by rice, wheat and maize, which make up almost 70 percent of the plate and provide a lot of starch with high GI and minimal nutrients.  Therefore, it is important to focus on this major portion of a meal if we are to be able to make favorable impacts for health and nutrition,” she adds.

According to the International Diabetes Federation, about 19 million people aged betweem 20 and 79 were diabetic in sub-Saharan Africa in 2019.

Some of the top countries across Africa with most number of diabetic people are South Africa, Nigeria, the Democratic Republic of Congo, Ethiopia and Tanzania, according to Rosemary Botha, who was at the International Food Policy Research Institute in Malawi at the time of the study. 

“The numbers could be higher as three  in five people with diabetes are undiagnosed. About 75 percent of the deaths due to diabetes were in people aged under 60,” says Botha, who is now a monitoring and evaluation lead at the One Acre Fund.

Botha says it is estimated that by 2045, Africa will have 47 million people with diabetes, a 143 percent increase over the 2019 number. The diabetes-related health expenditure is also expected to go up from $9.4 billion to $17.4 billion during the same time.

“Diabetes exacts a huge toll that will only get bigger if we don’t do something about it in ways that matter the most,” Botha tells SciDev.Net.

Dietary options

Alexander Kalimbira, Associate Professor of Human Nutrition at the Lilongwe University and Natural Resources, says the systematic review and meta-analysis by Seetha and others adds a layer of evidence that there are dietary options that can be adopted to reduce the risk of elevated blood glucose levels by using foods that grow well in sub-Saharan Africa.

“Firstly, dietitians and nutritionists have a reason to pay attention to the study because they have primary understanding and responsibility to promote healthful foods that have proven efficacy and effectiveness in preventing surges in blood sugar levels,” he says.

Kalimbira says nutritionits would use this kind of evidence to promote culturally acceptable foods that can be added to diets for control of blood sugar.

“Food scientists would be critical in developing recipes and processing methods that preserve critical dietary components yet diversifying the type of foods that can be prepared and enjoyed by many people in sub-Saharan Africa,” he adds.

Kalimbira contends that the agriculture sector (comprising experts in seeds, agronomy, breeding and others) should pay attention to this study because without quality seed, knowledge on effective agronomic practices, breeding programmes and research on neglected crops such as millet, the inherent benefits of such foods will not be realised by the majority population.

For his part, Kane-Potaka urges governments to formulate policies that can support this forgotten crop.

“It is also time for the masses to think about what they are consuming. Unless consumers become aware of the nutrition in their food and demand nutritious foods, the food production systems cannot change,” she says. n

This article was produced with support from SciDev.Net.

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