Tuesday, November 25, 2014



grate ful
feeling or showing an appreciation of kindness; thankful
I haven't had a laptop for the last few months.  My screen cracked and while I've been contemplating buying a new laptop I've also been pondering if I should just get it fixed.  Decisions, decisions.  Without my laptop I haven't been able to write down my thoughts for my blog and there have been minimal blogs for that reason in the last little bit.  Don't get me wrong, there have been plenty of topics running through my mind!  Whether part of it has been laziness on my part or part of it has been the inconvenience of not being able to write when I want to, today I had a patient remind me again of why I said I'd write a blog (and she reminded me of my gratitude jar):  to spread the word about what I'm passionate about, nutrition and educating people about nutrition.  At times people have told me that I can be too passionate, but what's wrong with a little passion?!  Food can be medicinal if we use it that way.  I try and teach people how to eat healthy, how to combine foods with the proper nutrients, and the ultimate goal:  balance, variety and moderation.  
We're days away from Thanksgiving and it's always at this time of year that we're reminded of what we're grateful for.  I started a gratitude jar last year and have been adding things throughout the year.  If you haven't ever done one, I highly recommend doing it.  While it's time consuming in the moment, reading all the notes at the end of the year is SO worth it.  Today alone I have a few that I can add and here's why:
My patient thanked me over and over again today.  But what I'm not sure if I communicated well enough to her was this:  I was GRATEFUL to her!!  Grateful for her asking so many questions, grateful for her wanting to soak up all my information, and grateful that she wanted to learn how to be healthy with food.  I'm reminded daily of the fact that I'm doing what I love.  While there are moments of crazy busyness and moments where I don't get a break all day, I know that I'm able to do what I love.  And that's just ONE of the reasons why I'm grateful this year.  Doing what I love and loving what I do, yeah, I'm grateful.  (it may sound cheesy, but when you spend as many hours a day as we do working it better be something that we love). 
Here are a few ideas that I discussed with my patient today that maybe you too can implement in your daily life:
  1. One day a week, go meatless.  I post a picture each Monday on my Instagram and Facebook as a reminder to go Meatless, but also as a way to show you how delish it can be!  And while I know being vegetarian ALL the time isn't for everyone, I do challenge my patients to try going meatless for at least one day a week (the health benefits are hard to deny!)  The key is to balance your carbohydrates with your protein to make sure you're adequately getting the nutrients that you need (and yes, you can get a sufficient amount of protein from plants). 
  2. Get moving!  Yes, I know this one is obvious, but we all need a friendly reminder every now and then.  I watched my mom's dog a while back and believe me, dogs are Nature's perfect personal trainers - loyal, hardworking, energetic, and enthusiastic.  If ever there was a day that I wanted to skip her walk, forget about it.  And while I'm not watching the dog anymore, I have this constant reminder of "get up and get moving".  I too have been trying to add in more movement, whether it's me being more consistent with my yoga practice or if it's that I'm going for a walk after lunch.  The key is that I'm being more consistent with my activity level and we can all benefit from that.  
  3.  The Holidays are here - yep, the holidays.  The time of year when desserts are aplenty and waist lines grow.  I recently had the chance to contribute to a few articles, one in a dietetics' journal and one for our local paper about how to survive the holidays.  The articles were geared towards those with diabetes, but guess what?  We ALL should eat in this manner, not just those with diabetes.  Check out the links if you haven't already for some helpful tips to help survive the holidays:

I also shared with my patient a couple of websites that I've been getting some really good recipes from.  I always tell people that I don't love to cook but I do love to eat good food.  A lot of times we get in a rut and cook the same thing over and over.  My mom on the other hand rarely uses a recipe twice (yeah, I'm grateful for all the yummy food she makes).  These two websites have been my go to places for finding new recipes recently.  I'm grateful for stumbling upon them and grateful for being able to find amazing concoctions of flavors in their recipes:

So while Thursday is Thanksgiving, today I was reminded every day is Thanksgiving.  I have a lot to be grateful for this year.  



Sunday, November 9, 2014

National Diabetes Awareness Month

November is National Diabetes Awareness Month.  25.8 million Americans have diabetes - 8.3% of the U.S. population.  Of these, 7 million do not know they have the disease.  If current trends continue, according to a report from the Centers for Disease Control and Prevention, 1 in 3 people will have Type 2 diabetes by 2050.  Is there any good news about an epidemic that's out of control?  Many health professionals believe that diabetes is an almost totally avoidable disease (type 2).  It's estimated that 92 percent of the cases could be avoided by diet and lifestyle.  

What's Your Risk?
Many people who have pre-diabetes - and many others who have diabetes - don't even know it.  (I wrote a whole blog about how pre-diabetes doesn't even trigger a fuss at the doctor's office when it should).  The only way to find out is to get your blood sugar tested (at least every three years starting at age 45).  Your risk is higher if you:

  • Are age 45 or older
  • Are overweight
  • Are African-American, Asian-American, Hispanic/Latino-American, Pacific Islander, or American Indian.
  • Have a parent, brother, or sister with diabetes.
  • Have high blood pressure (above 140 over 90)
  • Have low HDL ("good") cholesterol (less than 40 for men; less than 50 for women)
  • Have high triglycerides (250 or more)
  • Had diabetes when pregnant or gave birth to a large baby (over 9 pounds)
  • Are active fewer than three times a week
Here's a link from the American Diabetes Association to find out your risk:

If you have your blood work and are wondering what your numbers mean, pay attention to the blood glucose level.  Here's what the numbers indicate:

The cutoffs for pre-diabetes and diabetes depend on whether your blood is tested after an eight-hour fast or without fasting.  If your blood glucose if after an eight-hour fast, and your glucose is between 100-125mg/dL that is considered pre-diabetes.  If your blood glucose after the eight-hour fast is 126mg/dL or higher, that is considered diabetes.  

If you do have a family history of diabetes your doctor may also take test your Hemoglobin A1C.  The Hemoglobin A1C is an average over the last three months of what your blood sugar is doing.  If the Hemoglobin A1C is 5.7-6.4% this is considered to be pre-diabetes.  If the Hemoglobin A1C is 6.5% or higher, that is considered diabetes.  

Want to avoid diabetes?  Keep your weight - and especially your waist - under control, and spend more time on your feet than on your seat.  Making a few lifestyle changes can dramatically lower the chances of developing type 2 diabetes.

  1. Control Your Weight - The best way to dodge diabetes is to lose weight (or not gain) extra pounds.  Losing 7-10% of your current weight can cut your chances of developing type 2 diabetes in half. Losing any excess weight - and keeping it off - is the best defense against diabetes.
  2. Get Moving - and Turn off the Television -  Inactivity promotes type 2 diabetes. Working your muscles more often and making them work harder improves their ability to use insulin and absorb glucose.  This puts less stress on your insulin-making cells. Do at least 30 minutes of brisk walking or other aerobic exercise every day.  Include strength training two or three times a week as well.  Limit the time you spend sitting at work, at home, or in between.  
  3. Tune Up Your Diet - Dietary changes can have a big impact on the risk of type 2 diabetes:                                                                                                                         Choose whole grains and whole grain products over highly processed carbohydrates.  Whole grains don't have a magical nutrient that fights diabetes and improves health.  It's the entire package - elements intact and working together - that's important.  The bran and fiber in whole grains make it more difficult for digestive enzymes to break down the starches into glucose.  This leads to lower, slower increases in blood sugar and insulin, and a lower glycemic index.  As a result, they stress the body's insulin-making machinery less, and may help prevent type 2 diabetes.  Whole grains are also rich in essential vitamins, minerals, and phytochemicals that may help reduce the risk of diabetes.                                            Skip the sugary drinks and choose water.  When it comes to diabetes, sweet beverages seem to be a double-whammy.  Their high-fructose corn syrup and other sugars increase the demand for insulin and have a high glycemic load.  The sugar you sip may add flab more than the sugar you chew.  Liquid calories don't seem to lead to satiety and the reduction in subsequent food intake that you might have with solid calories.  It's east to take in a large amount so easily.  Think your drink.                     Replace saturated fat and trans fat with unsaturated fat - The types of fats in your diet can also affect the development of diabetes.  The unsaturated fats found in liquid vegetable oils, nuts, and seeds can help ward off type 2 diabetes.  Trans fats do just the opposite. Trans fats are found in many margarines, packaged baked good, fried foods in fast-food restaurants, and any product that lists "partially hydrogenated vegetable oil" on the label.             
  4. If you smoke, Try to quit.  Smokers are roughly 50% more likely to develop diabetes than nonsmokers, and heavy smokers have an even higher risk.
  5. Alcohol Now and Then May Help - A growing body of evidence links moderate alcohol consumption with reduced risk of heart disease.  The same may be true for type 2 diabetes.  Moderate amounts of alcohol - up to a drink a day for women, up to two drinks a day for men - increases the efficiency of insulin at getting glucose inside cells.  If you already drink alcohol, the key is to keep your consumption in the moderate range, as higher amounts of alcohol could increase diabetes risk.  If you don't drink alcohol, there's no need to start - you can get the same benefits by losing weight, exercising, and changing your eating patterns.
The bottom line and the good news about diabetes:  it's not inevitable.  Keep your weight - and especially your waist - under control, and spend more time on your feet than on your seat!