November is Diabetes Awareness Month®

Diabetes Awareness Month®

November is American Diabetes Month®.  The vision of the American Diabetes Association is a “life free of diabetes and all of its burdens.  Raising awareness of this ever-growing disease is one of the main efforts behind the mission of the Association.”  

Here are a few of the most recent statistics:

• Nearly 30 million children and adults in the United States have diabetes.  
• Another 86 million Americans have pre-diabetes and are at risk of developing Type 2 diabetes.
• The American Diabetes Association estimates that the total national cost of diagnosed diabetes in United States is $245 billion.

Nearly one in 10 Americans has diabetes.  There are many myths that still remain.  I hear them when I do presentations ALL the time!  I was just at a health fair for seniors a couple weeks back and that was the premise to my tabling.  I had “Fact vs Fiction” to draw the seniors to my table and help right the wrong information that circulates among people.  Because let’s face it, if your Aunt Sally told your mom and your mom told you, well then it must be true.  Am I right??  Unfortunately, this is how we get a lot of our information and/or from searching the internet.   Just remember not everything you read is true and/or reliable online (use a reliable source when it comes to your health - that's why you're here reading my blog).  So here we go, let’s set a few common myths to rest and get the facts. And p.s. - all the pictures featured will be foods that people with diabetes can eat.  It's food everyone should be eating - healthy, balanced, and in moderation, because all foods fit.  I hope you find them inspiring.  They're all my creations.  Now on to the myths!

Tomato Salad w/Homemade Ricotta

Myth:  Everyone who is overweight develops diabetes.

Fact:  Type 2 diabetes (which accounts for 90-95% of the cases) is much more common in people who are overweight.  Excess weight IS the strongest known risk factor.   Being overweight increases the chances of developing type 2 diabetes seven-fold.  Losing 7 to 10 percent 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.  However, keep in mind that other factors play a role as well: genetics, inactivity, age, and ethnicity.  The key is to know your numbers and know your risk – prevention is key! (With type 1 diabetes, the body’s immune system attacks part of its own pancreas. Scientists are not sure why – more on Type 1 in a separate blog post).  So while people who are overweight DO have an increased risk for developing diabetes, not ALL people who are overweight develop diabetes. 

Overnight Oats w/no added sugar.  Fruit compote - frozen berries & beets, just natural sugar

Myth:  If your fasting blood sugar is 100 to 125 (called pre-diabetes), you will develop type 2 diabetes.

Fact:  Having pre-diabetes does not mean that you will develop diabetes immediately.  The risk is there, and the key is to make lifestyle changes in order to prevent and delay it from progressing to diabetes.  The scary fact is that many people (when I used to counsel patients 1:1) would come into my office with pre-diabetes and not even know they had pre-diabetes. There are three reasons this could be the case.  The first I call the “Charlie Brown” syndrome – it’s possible their doctor did tell them and all they heard was, “wah waaah wah wah”.  The second reason is that their doctor told them they have pre-diabetes and they’re in denial and last but not least is the patient was never told by their doctor.  86 million people have pre-diabetes.  This CAN be prevented and/or delayed from progressing to diabetes.  Know your numbers.

Turning "fried" rice into vegetable "fried" rice, just look at all that kale.  It was more like sauteed rice vs fried rice btw.

Myth:  People with diabetes need to eat special food.

Fact:  The irony is that everyone should eat healthy food.  It’s no different than what I recommend to anyone, a person with diabetes or not.  As people are faced with a diagnosis of diabetes they’re simply more pressed to make immediate changes.    Healthy eating means having variety, balance, and moderation.  I teach people to limit their intake of sodium, saturated (and trans) fat, added sugars and refined grains.  I also teach people to place an emphasis on nutrient-dense foods, to increase their fiber intake, and begin to look at more whole foods and less processed (chemical enhanced) foods.  The key is to implement ONE change at a time and then move on to the next.  Healthy eating is a way of life, it’s not just a quick fix for a short period of time.

Lentils are a carbohydrate, so they do effect blood sugar.  But they have TONS of fiber which is super beneficial for blood sugar control.  Definitely a food to include.

Myth:  Eating sweets is off-limits for people with diabetes.

Fact:  Variety, balance, and moderation.  EVERYONE should limit their intake of sweets, not just people with diabetes.  Indulging in too many sweets makes it more difficult for anyone to keep off unwanted pounds and leaves less room for the nutrient-rich foods the body needs.  This is what I used to tell my patients:  you know yourself, are you the kind of person who can have a piece of chocolate or are you the type of person that will have the whole chocolate bar?  Having sweets lying around the house can only set you up to overeat if you’re the type to eat the whole chocolate bar.  The key is to allow for some of those moments with sweets and desserts, otherwise you’ll go overboard when you do see the desserts.  In people with diabetes I always try and explain that it’s important to have good blood sugar control.  Including these sugar-containing treats is possible with portion control and knowing their blood sugar levels – it’s called managing your diabetes.  I teach them that desserts are a part of life (especially as the holidays are approaching), however, desserts are not the fuel source your body needs to operate at full-strength capacity.  Always aim for the best fuel and keep the desserts in check.

Dessert - high in sugar & fat typically DO effect blood sugar.  There are ways to include desserts and still maintain good blood sugar control.  All foods can fit.  The key is definitely moderation AND frequency - and that's not just for people with diabetes.

Myth:  Fruit is a healthy food.  Therefore, it is okay to eat as much of it as you wish.

Fact:  Yes, fruit is a healthy food, but NO you cannot each as much of it as you wish (you can eat as much as you want, just keep in mind when it comes to blood sugar levels it does play a role).  Fruit does contain fiber and lots of vitamins and minerals.  However, fruit contains carbohydrates and therefore needs to be included as part of your meal plan, in a controlled amount.  After working at the Diabetes Research Institute, this is one change I’ve made – I’ve decreased the amount of total fruit I eat and started to increase the amount of non-starchy vegetables I’m consuming.  Tough?  Yes.  Healthier for me? Absolutely!  (p.s. Juicing, smoothie, and smoothie bowls as a trend needs to stop – the fiber is there but not functional and it tends to be a load of carbohydrates – EAT and CHEW your food.)  This is and has always been my motto – if you’re overeating fruit odds are you should try to pair it with another food group to help satiate you.  AND keep in mind that food is functional, so in the summer when you’re working outside and parched, watermelon is easy to overeat if you’re thirsty.  It is watermelon after all and helps hydrate – simply make sure to drink water and be able to identify that it is thirst that your body is trying to quench.  

Every food effects people differently.  Mango tends to be a fruit that raises blood sugar more than others.  Test, know the effect.  And of course pay attention to portion size, because mango is easy to overeat.  For everyone.

I’m always telling my patients to “know their numbers” Here’s a chart to help explain your numbers:

If you have your fasting blood sugar checked routinely for your doctor visits, the fasting blood sugar should be less than 100 mg/dL.  If it is above 100 mg/dL this will be an indicator to have your A1c checked.  The A1c is a blood test that runs an average over the last three months of your blood sugar level – so while your fasting blood sugar could’ve been high it doesn’t necessarily indicate your overall control.  The A1c is the best test for verification.  An A1c between 5.7-6.4% indicates pre-diabetes and an A1c at 6.5% and over is diabetes.  This November, have your A1c tested so you can know your numbers.  Knowing is the first part of prevention.  Here are a few other tips to help reduce your risk:

Sheet-pan dinners - easy to prepare & easy clean-up

Exercise moderately.  Aim for 150 minutes of exercise/week.  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.  Long hours of hot, sweaty exercise aren’t necessary to reap this benefit.  Walking briskly for a half hour every day reduces the risk of developing type 2 diabetes by 30 percent.  Limit the time you spend sitting at work, at home, or in between – that’s why my tracker is always buzzing trying to remind to get up and get moving every hour.

Make veggies fun & tasty so you'll want to eat them.  And please, whatever you do, do not call this a cauliflower "steak".

Tune Up Your Diet:  Making a few dietary changes can have a BIG impact on the risk of type 2 diabetes.       

• Choose whole grains and whole grain products over highly refined 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.  And don’t forget that whole grains have FIBER!  Fiber may be best known to help regulate bowel movements, but keep in mind within blood sugar control you don’t digest fiber.  The overall effect is that the fiber too helps slow down the blood sugar response – win win!
• 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 easy to take in a large amount so easily.  Think your drink – even if a certain coffee company is coming out with their gingerbread lattes.
• Include heart-healthy plant-based fats.                                                                            
• The types of fats in your diet can also affect the development of diabetes.  Healthy fats, such as the polyunsaturated fats found in liquid vegetable oils, nuts, and seeds can help ward off type 2 diabetes.  Trans fats do just the opposite.  These unhealthy fats are found in many margarines, packaged baked goods, fried foods in fast-food restaurants, and any product that lists “partially hydrogenated vegetable oil” on the label.  Luckily as of June 18^th, 2018 companies are no longer able to create a product that includes trans fat (and those already established with trans fat have until January 2020 to remove it completely!)  This is why so much emphasis has recently been placed on plant-based diets – the key message here is to eat more foods that come from a plant and less animal based protein (it is how the plate is distributed…we just tend to eat disproportionately, whether it’s too many carbs or too much protein)

Vary your grains and try NEW ones.  Black rice aka forbidden rice.

If You Smoke, Try to Quit                                                                                                        Smokers are roughly 50 percent more likely to develop diabetes than nonsmokers, and heavy smokers have an even higher risk.

Another whole grain, farro, to try and include in your repertoire.

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.

Tofu, Zucchini, Tomato Salad - all foods that don't effect blood sugar.  It's important to include foods that are filling yet don't effect blood sugar.  You'll want to eat this salad.  Promise.

The bottom line to prevent type 2 diabetes:  Keep your weight – and especially your waist – under control and spend more time on your feet than on your seat.  I’m not trying to make this sound simplistic, because it’s not.  I’ve always said that I’ll keep things real here on this blog.  And true life shows that this is tough for many people.  These are lifestyle changes that we need to make.  Whether you grew up in a family that didn’t eat vegetables – hello all my Cuban families out there – or whether you just don’t like/enjoy exercise like people say you should, diabetes is a real health concern when you look at the numbers.  Keep in mind Rome wasn’t built in a day and this so-called journey towards health IS going to take time.  That’s why I always say, change ONE thing at a time and keep moving towards improvement.  You’ll be more successful long-term with your changes, which is what we’re aiming for.  If you’re looking to join a lifestyle program to help prevent pre-diabetes, leave me a message and I’ll get back to you with the information – we have two groups, one in Dade and one in Broward starting in January 2019 -and believe me, it will be life-changing. 

More veggie inspo - cucumber & avocado salad.  Eat more veggies!