Sunday, March 23, 2014

Growth & Renewal

I started a new job this week.  I’m working with Type 1 diabetes, Type 2 diabetes, Type 1.5 diabetes (yes, there’s such a thing), Gestational Diabetes, and people with Prediabetes.  Diabetes has always been an area of interest to me because it’s a disease that you can manage.  After a person is diagnosed with diabetes, they often feel overwhelmed and frightened.  But I let them know the good news, they CAN manage their diabetes.  ¡Si se puede controlar la diabetes!  That’s where my job as a dietitian comes in to allow them to know how foods affect their blood sugar level as well as how much food they can eat at once.  As I was sitting in on a few sessions this week with the nurse, I was able to observe.  Sometimes as an educator I go into the mode of teaching and want to provide the patient with all the information they need to be successful, when it’s always better to let the patient tell you what they need. So with this 1st week, as I’m entering into a new job, I observed a few education sessions to get me started on the right foot and then began to start a few sessions on my own.   Here are a few observations and that I made:

Our bodies are amazing! – No, I didn’t just realize that this week J  But if you really sit back and take the time to process all that our bodies do day in and day out – our heart alone beats 100,000 times per day, pumping five or six quarts of blood each minute, or about 2,000 gallons per day - we should really treat our bodies better than we do!  People that have been diagnosed with diabetes are in a situation where they’re forced to or else their health will be compromised.  But what if we were all faced with this possible diagnosis?  Would we try and prevent it or just think that in due time we’re bound to get some disease?  From the moment a bite of food enters the mouth, each morsel of nutrition within starts to be broken down for use by the body.  You’ve heard the whole adage, “You are what you eat.”  Well it seems there’s an updated version surfacing on social media, “You are what you eat – so don’t be fast, cheap, easy, or fake.”  Our bodies are remarkably adept at making do with whatever type of food is available.  And so begins the process of metabolism, the series of chemical reactions that transform food into components that can be used for the body’s basic processes.  Give your body the nourishment it needs to be able to perform at an optimal level – don’t be fast, cheap, easy, OR fake.
We should all be as conscientious as a diabetic has to be – Diabetes Mellitus means high levels of sugar (glucose) in the bloodstream (circulation) and in the urine.  Our body needs a certain amount of glucose to help us think clearly and function, as well as give our bodies the energy that we need now and for later.  In order for our bodies to use glucose for energy, they rely on insulin.  Insulin is a hormone that is produced by the beta cells in the pancreas.  If the pancreas is not able to produce enough insulin (insulin deficiency) or if the body cannot use the insulin it produces (insulin resistance), glucose builds up in the bloodstream (hyperglycemia) and diabetes develops.  The goal in diabetes treatment is to keep blood glucose and blood pressure as close to normal as possible.  How does one do this?  Diabetes can be controlled by food, exercise, and medicine.  (Otherwise, with chronically high blood glucose levels it can damage many parts of the body, including the eyes, kidneys, nerves, and cardiovascular system.)  I teach the patient what foods contain carbohydrates, the body’s main energy source, and how fat and protein play a role as well. 

I use this picture frequently when educating the patients.  It’s a good visual to show them how quickly a fruit can be broken down, but when combined with a protein and fat source, i.e. nuts, how the two mixed together will make for a more balanced blood glucose level.  This is the key to diabetes – balancing what the person eats and not eating too much of any one food.  I then go on to explain to the patients that this is the way ALL people should eat.  The diabetics always look at me as if they don’t believe me, but it’s true.  We should ALL be as conscientious as a diabetic has to be – the problem is we aren’t.  What if we had to not only count how many carbohydrates that we were having at each meal but also limit how many carbohydrates we had?  I think many of us would be surprised at how much “extra” they’re eating. And with all this “extra” food that makes our bodies work that much harder.  Over time this excess consumption is what makes us sick. For some it will surface sooner than for others and for some maybe it will never surface.  I guess as I was sitting and observing this week I was in my nutrition dream world and began to hope that people would see this as clearly as I was and maybe begin to start to change and make healthier habits one at a time.
Just because you talk loud doesn’t mean the patient will hear – How many times have you done this – you have a person in front of you that speaks a different language.  They understand English but it is their second language, so it takes them longer to process/understand.  While you’re having a conversation with them your voice begins to rise.  All of a sudden you feel like you’re yelling at them, but for some reason you think you’re getting through to them.  We’ve all done it.  This week we had help from a son translating for his mom.  She only spoke Italian so I was grateful he was there to help translate.  As the session went on I realized he wasn’t helping.  And not only that but by the end of the session I had a headache from all the yelling that went on (and yes maybe part of it is cultural to talk loud) but let me explain.  I began by showing the foods that contain carbohydrates, I showed how much of each she could have at each meal, and then allowed her to help me create meals to show me her understanding.  All along the son was translating this and I’d wait for him to translate back what the mother was saying.  All of a sudden the son began to tell me that the mother was hard headed and I needed to be firm with her and not allow her to have gelato.  The only time I had mentioned the word gelato was in the explanation to her that it does affect her blood sugar level, but I know I never mentioned she could have a limitless amount.  The son began to tell me I needed to tell her she could never have it.  The mother kept repeating the word gelato.  And that’s when some louder talking began and the translation stopped.  Lots of other things were going on needless to say, but I am happy to say that by the end of the session a few things were discussed and addressed.  What the son had on his agenda was completely different from what the mother needed from the session.  There I was watching what I knew wouldn’t work and trying to help the son understand what the mother was going through.  It’s a great reminder that just because we want someone to hear what we have to say it might not be what they’re ready to hear. 
Spring is always described as a time of growth and renewal.  It’s fitting that during this 1st week at my new job it was also the 1st day of spring.  I have a lot to learn and am excited for where this journey is going to take me.  I’ve always been passionate about helping people live a healthier lifestyle.  But with this new start it has only made me more passionate (so watch out!)  I’m at a place where not only do people need to know what they have to eat in order to be healthy but also where people want to know.           

Sunday, March 9, 2014


What is mindfulness?

Being mindful means paying close attention, being aware or careful, to what’s happening in the moment.  Simply put, mindfulness is about being present.  It means noticing what’s happening inside your mind and in your body (Your stomach hurts from the thought of having to do your taxes.)  And it means being aware of what’s happening around you (Flowers are blooming on your route to work.)  When you’re being mindful, the key is not to label or judge what’s happening.  Feelings aren’t “good” or “bad”.  They just are. 

The opposite of mindfulness is being on autopilot – doing things without any thought or consideration.  An example of being on autopilot is backing out of your driveway and heading to work on a Saturday when you meant to go to the grocery store. 

Here’s how to be mindful when you have a few minutes to yourself (not when you’re driving):

·       Pause and focus on your body.  Notice what you see and hear.  Also, check what you smell, taste, and feel.  You acknowledge the sensations, but then let them go.

·       Then narrow your focus.  What do you feel in your body?  Notice those subtle sensations, like an itch or tingling.  Give each part of your body a moment of your full attention.  Start with your head and move down to your toes.

·       Next, be more intent on your breath.  Where in your body do you feel it most?  Rest your attention there. 

·       Ask yourself, “How am I in this moment?”  Recognize your thoughts and emotions and spend a few moments with them.

·       When your mind wanders (oh, and it will), simply return your focus to your breath.

Being mindful helps you notice  when you’re on autopilot.  It allows you to change what you’re doing in the moment, versus getting upset about it later.  We’ve all done it.  We sit in front of the TV with a bag of chips.  We’re in a trance watching the show and continue to eat.   We reach for some more chips and there are no more to grab.  Being mindful can help you break free from that autopilot trance and take a moment to make a different choice.  You can take out a set amount of chips (versus the whole bag), or you could decide to skip TV and take a walk around the block instead. 

Practicing being in the present moment can help one take a step back and better manage stress or even cope with a serious illness.  Mindfulness can even help ease anxiety and depression.  Those who practice it say they’re able to relax more easily, they have a greater enthusiasm for life, and even feel more self-confident. 

Mindfulness can even help you be more fully engaged in activities – which can help you connect more deeply with others (put the cell phones down!)

So how can we be mindful when we eat?  Remember being mindful simply means to give full attention to your environment, thoughts, behaviors, and experiences.  So here a few tips to help you eat mindfully:

·       Inhale and exhale.  Slow, deep, even breathing tells the brain stem to put the entire brain into a state of calm.  Take five deep in-and-out breaths after you sit down at the table and before you lift your fork.

·       Do a gut check to see if you’re really hungry before you eat.  We’ve all done it – eating when we’re bored, eating when we’re stressed, or just ordering what we normally order when what we might need is only a snack! 

·       Focus on each bite, savoring its flavor and texture.  Americans usually eat fast, spending just 8 to 11 minutes on each meal.  Yet your body needs 20 minutes to register that it’s full.  Instead of gulping, take one bite, put your fork down, and chew slowly.  Savor every morsel.  By taking your time it will make it much easier to tell when you’re full.

·       Notice if what you’re saying to yourself is helpful.  Remove “good” and “bad” from your food vocabulary.  You can’t completely enjoy a piece of cake if you’re telling yourself that it’s bad for you.  (I can’t tell you how many times I hear this being said!)  There is NO such thing as a bad or wrong food.  We need to get rid of the judgmental language around food.  When you make your food decisions, try replacing “I should” or “I shouldn’t” with “I choose to.”

·       Do another gut check to see how full you are.  That way you can stop eating when you feel full instead of mindlessly cleaning your plate and feeling stuffed!

·       Enjoy what’s on your plate.  Never eat anything you don’t enjoy, and truly enjoy everything you eat.  Savor the flavors and textures so that you can begin to understand what mindful eating feels like.

Want to be more present in your daily life?  All you need to do is put your mind to it J