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Revolutionizing diabetes management: the Cook2DIAbeat project






Non-Communicable Diseases (NCD)

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About the Authors

Leticia Goñi

Leticia Goñi is a postdoc at the Department of Preventive Medicine and Public Health of the University of Navarra and an investigator of the Physiopathology of Obesity and Nutrition Networking Biomedical Research Centre (CIBEROBN). She is a dietitian-nutritionist with a Master’s Degree in Nutrition and Metabolism. Her research is now focused on the prevention of chronic diseases in childhood and adulthood with healthy lifestyle habits, mainly dietary. She is a researcher on the Cook2DIAbeat project funded by Erasmus+.

Postdoc researcher - Universidad de Navarra

Professor and Chair - Universidad de Navarra

Miguel Ruiz-Canela is Professor and Chair of the Preventive Medicine and Public Health Department at the University of Navarra and investigator of the Physiopathology of Obesity and Nutrition Networking Biomedical Research Centre (CIBEROBN). He completed his Ph.D. at the University of Navarra and his Master’s in Public Health at the London School of Hygiene and Tropical Medicine. He also has the title of chef de partie by the ESAH (Estudios Superiores Abiertos de Hosteleria). His research focuses on the relationship between diet and healthy cooking, and chronic diseases. He is the coordinator of the Cook2DIAbeat project.

Miguel Ruiz-Canela

In recent years, the prevalence of type 2 diabetes has reached alarming levels, posing significant health and economic challenges globally. As diabetes continues to be a prevalent condition, it is crucial to explore innovative ways to manage it effectively. How we eat and cook goes beyond just what is on our plate. It affects digestion, nutrient absorption, social connections, and cultural appreciation. By eating mindfully and making smart choices in the kitchen, we contribute to a healthy and balanced lifestyle. In this article, we will introduce an initiative which aims to reshape the experience of individuals living with type 2 diabetes: the Cook2DIAbeat project.

The alarming increase of type 2 diabetes 

Type 2 diabetes has emerged as a major public health concern, impacting millions of lives around the world. Current evidence indicates a rising global prevalence, largely attributed to increasing obesity rates influenced by multiple factors. In 2021, the global population of people living with diabetes was 529 million, with a worldwide age-standardized total diabetes prevalence of 6.1%, of which type 2 diabetes accounted for the majority of cases. Projections for 2050 estimate that over 1.31 billion people will be living with diabetes, and 89 (43.6%) of 204 countries and territories are anticipated to have age-standardized rates greater than 10% (1).

For people with type 2 diabetes, heart problems tend to show up about 14.6 years earlier and can be more severe than in those without diabetes. These individuals are twice as likely to develop heart issues, even when considering factors like age, smoking, weight, and blood pressure. Diabetes also doubles the risk of vascular-related deaths, especially in women, erasing the usual lower risk of heart problems seen in younger women. In addition, about 10% of deaths in people with type 2 diabetes are linked to kidney failure, although ethnic differences in genetics, lifestyle, and awareness of complications may contribute to these variations in kidney disease among diabetes patients.

A healthy lifestyle: a path to prevention

Type 2 diabetes is often preventable and potentially reversible through early identification and management. However, addressing and controlling type 2 diabetes poses ongoing challenges, emphasising the need to comprehend variations in risk factor profiles and diabetes burden across populations. Strategies for effective diabetes control must consider the intricate interplay of multiple drivers and disparities in risk factors.

Studies consistently highlight the positive impact of healthy lifestyles in reducing the risk of developing type 2 diabetes. This includes keeping a healthy weight, eating well, staying active, not smoking, and drinking alcohol in moderation (2). Important studies have shown that adopting healthier habits can reduce the chances of getting diabetes by 58%, which is better than using medications (3). By emphasising the importance of lifestyle modifications, individuals can be empowered to take charge of their health and well-being.

The relevance of how we eat what we eat

Diet is a crucial aspect of the prevention of type 2 diabetes. A study assessing risk across 184 countries found that in 2018, 14.1 million new type 2 diabetes cases (representing 70.3% of global cases) were linked to suboptimal dietary habits (4). The major contributors were insufficient whole-grain intake, excessive refined rice and wheat consumption, and too much processed meat. In addition, men, urban residents, and higher-educated individuals generally had larger proportions of diet-related type 2 diabetes. These findings emphasise the need for improved dietary habits to reduce type 2 diabetes globally, particularly in the segments mentioned above.

Despite the increasing evidence showing how eating healthily can help prevent diseases like type 2 diabetes, many people are moving away from healthy eating habits. People are eating fewer fruits, vegetables, and fibre, which are essential for good health. Experts recommend improving nutrition education by including practical cooking skills. Home cooking, defined as preparing food at home by combining, mixing, and heating ingredients, is seen as a valuable skill, and teaching people to cook at home can be a new and effective strategy to encourage healthier eating, reducing the risk of type 2 diabetes and its metabolic effects (5).

One important factor to support the relevance of cooking is that it affects how many nutrients stay in our food. Some nutrients can get lost during cooking, but it can also make some nutrients easier for the human body to use. Also, how fast we eat and enjoy our food affects how much we eat. Taking time and enjoying each bite helps control how much we eat, which helps manage our weight and keeps us healthy. Chewing well and eating slowly helps our bodies digest food properly. The way we eat can also affect our blood sugar levels. Eating balanced meals and avoiding fast-eating of sugary foods helps keep our blood sugar in check, reducing the risk of spikes. It is also important to highlight that cooking lets us try different foods and flavours. Exploring diverse foods and cooking at home can give our bodies a mix of important nutrients, keeping us healthy. Finally, eating is not just about food; it is a chance to connect with others. Sharing meals with family and friends builds bonds and makes us feel part of a community, as well as celebrating cultural traditions (2).

The Cook2DIAbeat project

Culinary medicine presents a distinctive approach to diabetes management, seamlessly blending nutrition with the art of cooking. Through the Cook2DIAbeat project, titled "Healthier Eating for Type 2 Diabetes Self-Management: Co-creating a Novel Nutrition Education Program with Culinary Medicine" (6), a groundbreaking effort is underway to transform the landscape of type 2 diabetes care by focusing on education and empowerment. The project's vision is ambitious yet achievable: the development of an interactive training curriculum tailored to the specific needs of individuals and families dealing with type 2 diabetes.

Addressing the crucial intersection of nutrition education and culinary medicine, Cook2DIAbeat tackles key obstacles to healthy eating and self-management. Eight co-creation sessions have been conducted across four European regions, engaging patients with type 2 diabetes, their families, as well as healthcare providers. By actively involving individuals diagnosed with type 2 diabetes and collaborating with healthcare providers, the project aims to build a supportive environment that acknowledges the unique challenges and preferences of those living with diabetes.

Figure 1. Co-creation session with type 2 diabetic patients and family members in Spain, 11/05/2023.

The sessions highlighted the importance of addressing the psychosocial aspects of the disease and emphasised the need for social support and empathy. Acknowledging the impact of emotional associations with food, the training will aim to approach information positively rather than focusing on forbidden foods.

Key findings from co-creation sessions were reinforced by an online survey involving over 200 people living with type 2 diabetes across Belgium, Cyprus, Greece, and Spain. The survey indicated that stress-induced unhealthy eating was prevalent, aligning with the outcomes of the co-creation sessions. The results supported the conclusion that Cook2DIAbeat's proposed training resonates with patients across these regions, recognising the pivotal role of healthy nutrition in type 2 diabetes treatment.

Through collaboration with partners in Spain (the University of Navarra, the Basque Culinary Center and the Foundation for Health Novo Nordisk), Greece (the Prolepsis Institute), Cyprus (Center for Social Innovation), and Belgium (the European Food Information Council), Cook2DIAbeat extends its impact and reach and emerges as a catalyst for change in diabetes management. As the project gains momentum, it underscores the potential to revolutionise diabetes care by equipping individuals with knowledge, skills, and support. For those seeking to take control of their health journey, the project exemplifies the transformative capacities of education and empowerment in navigating the complexities of diabetes.

Disclaimer: Project funded by the European Union. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the European Education and Culture Executive Agency (EACEA). Neither the European Union nor EACEA can be held responsible for them.

Parents understand that the maintenance of their child’s health and wellness is their responsibility; however, many parents face various challenges when trying to do so. FMCG Gurus findings highlight that sugar is the ingredient that parents are most conscious about in food and drink products, with 74% of consumers concerned by sugar content in products. As children are typically drawn to sugary indulgences, parents are concerned by the link between obesity and diabetes and the hidden sugars in products.

Many parents believe that the complex labeling used by brands disguises ingredients. As a result, brands should ensure that nutritional labeling is made clear and simple for parents so that they are able to unpick the nutritional profile of products within seconds.