Chewing food helps to lower blood sugar in diabetics

Diabetics who have lost teeth and cannot chew properly have significantly higher blood sugar levels than diabetics who can chew their food well (PloS ONE, April 14, 2023;18(4):e0284319). Correcting dental problems so a person can chew food adequately can help to lower high blood sugar levels. The treatment for both diabetes and general weight control should include:
• eating lots of fiber-rich plants
• chewing food properly
• correcting dental problems that may prevent people from chewing food properly or eating healthful foods

Inability to chew food is associated with increased risk for obesity, often because people with problems chewing will choose soft foods that don’t need much chewing but are also the most fattening, such as bread, spaghetti, macaroni, most dry breakfast cereals, candies, desserts and packaged and fast foods. Obesity markedly increases diabetes risk. People who have trouble chewing also tend to avoid bulky foods such as fresh vegetables — foods that are full of soluble fiber that helps to prevent and treat high blood sugar levels. In your colon, soluble fiber is converted to short chain fatty acids (SCFAs) that lower high blood sugar, high insulin levels, high cholesterol and harmful inflammation that increases risk for diabetes and its horrible complications.

Study of Chewing Problems and Diabetes
This study demonstrates, for the first time, an association between difficulty chewing and high blood sugar levels in people with type II diabetes. The study compared diabetics who could not chew well because they were missing teeth with diabetics who had normal chewing capacity. Ninety-four subjects, average age 55, were divided into subjects who had 1 to 3 areas where the teeth did not meet properly and those who had no difficulty chewing. Those who had missing teeth had a hemoglobin A1c (HbA1c) averaging 9.42, while those with normal teeth had HbA1c levels of 7.48. Then those who had difficulty chewing because their teeth did not meet properly were treated with a fixed implant-supported restoration and their HbA1c was reduced from 9.1 to 6.2, a very large improvement in diabetes control. Their diabetes control improved significantly, even though their blood sugar after meals was a little higher.

HbA1c measures the amount of hemoglobin with sugar attached to it; something that occurs when blood sugar is high. This value is commonly interpreted as a measure of cell damage throughout the body as a result of high blood sugar. Since red blood cells last about 2-3 months in the body, the HbA1c value is a good estimate of the average blood sugar levels during that time period. In this study, the difference between the two groups was very large and shows that the people with missing and damaged teeth were at much higher risk for the complications of diabetes: heart attacks, strokes, nerve damage, kidney, heart and liver damage, loss of vision and hearing, dementia and sleep apnea.

Why Chewing Your Food is Important for Your Health
Prolonged chewing of food with increased saliva production increases blood sugar levels after a meal in prediabetics (Food Funct, 2023 Feb 21;14(4):2260-2269), but chewing helps to control blood sugar the rest of the time (PloS ONE, April 14, 2023;18(4):e0284319). Participants who engaged in more vigorous chewing experienced fewer sugar spikes throughout the day.
• People who are unable to chew their food adequately often suffer from inadequate intake of fiber, magnesium, or calcium (J Am Dent Assoc. 2002;133:1369-79), which can increase diabetes risk (Am J Clin Nutr, 2009;89:1059-67).
• People who have lost all their teeth are at increased risk for becoming diabetic (Front Endocrinol (Lausanne), 2022;13:934274).
• Chewing helps to control diabetes by decreasing hunger and increasing the satiety gut peptide YY and glucagon-like peptide 1 (GLP-1) in the intestinal tissue (Endocr J, 2013;60:311-9).

My Recommendations
More than 70 percent of North Americans will become diabetic or pre-diabetic. Everyone should try to reduce their chances of becoming diabetic by maintaining a healthy weight, participating in regular physical activity, eating a healthful diet, not smoking, and controlling high cholesterol and blood pressure. Fixing damaged teeth will help to make it possible for you to chew your food well, which can encourage you to eat more high-fiber foods that can be harder to chew. If this is an issue for you, check with your dentist.

Dr. Gabe Mirkin is a Villager. Learn more at www.drmirkin.com