Why is World Diabetes Day Important?

November 14th was World Diabetes Day. To acknowledge this, it is important to understand why there is a day dedicated to diabetes awareness. The burden of diabetes has quadrupled over the past decades; the World Health Organization estimates there are 422 million adults who currently have diabetes worldwide. That is 1 in 11 adults. Data from the National Diabetes Statistics Report found that in 2017, there were 30.3 million people who had diabetes, of which 23.1 million people are diagnosed and 7.2 million people remain undiagnosed.

The burden of diabetes is not just in the numbers affected but also in health costs, and, most importantly, quality of life. Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputations. WHO projects that diabetes will be the seventh leading cause of death in 2030. Currently, it is estimated that 1.6 million deaths were directly caused by diabetes and another 2.2 million deaths were attributable to high blood glucose in 2015 and 2012, respectively.

The above numbers are why we must focus on awareness, prevention and treatment of diabetes.

What are the symptoms of diabetes?

Diabetes can be treated. Dietary and lifestyles factors have been proven to make the largest impact on decreasing, preventing and treating the complications from diabetes. As with most progressive illnesses, diabetes onset typically goes unrecognized by the patient for a number of years, with the exception of type 1 diabetes, which is typically a sudden onset of symptoms. So what are the warning signs of high blood sugars and possibly undiagnosed diabetes?

Symptoms of hyperglycemia to look for:

  • Frequent urination
  • Frequent thirst and hunger, even right after eating
  • Extreme fatigue
  • Changes in vision
  • Sores that won’t heal
  • Gum disease, gums pulling away from teeth, red, swollen gums or changes in the way your dentures fit
  • Weight loss
  • Tingling, pain or numbness in hands or feet

How does a diabetes diagnosis happen?

When should someone consider getting screened for diabetes?

  • Are overweight (BMI >25)
  • Are 45 years or older
  • Have a parent or sibling with type 2 diabetes
  • Have ever had gestational diabetes or given birth to a baby who weighed more than 9 pounds
  • Are African American, Hispanic/Latino American, American Indian, or Alaska Native (Some Pacific Islanders and Asian Americans are also at higher risk.)

What tests will my providers/doctors order, and what will they mean?

Result A1c
Normal less than 5.7%
Prediabetes 5.7% to 6.4%
Diabetes 6.5% or higher

 

Result Fasting Plasma Glucose (FPG)
Normal less than 100 mg/dl
Prediabetes 100 mg/dl to 125 mg/dl
Diabetes 126 mg/dl or higher

 

Result Oral Glucose Tolerance Test (OGTT)
Normal  less than 140 mg/dl
Prediabetes  140 mg/dl to 199 mg/dl
Diabetes  200 mg/dl or higher

 

Your doctor will typically use two methods to confirm a diagnosis of prediabetes or diabetes.

What comes after a diabetes diagnosis?

In either case of prediabetes or diabetes, the treatment includes a healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco. It is important to incorporate these with any medication regimen your doctor may prescribe. In fact, diet and lifestyle changes have been shown to decrease your hemoglobin A1c by one to two percent!

When you are thinking of beginning a new dietary plan, you must incorporate schedule, food behaviors, and even your favorite foods. For example, if you grew up on meat and potatoes, I would not say you could never eat those foods again. Instead, it is important to discuss healthier cuts of meat or poultry or healthier types, portions and ways to prepare potatoes. Many people think a diet is depriving yourself of food—instead think of adding new foods to portion-controlled foods you enjoy. A good guideline is the USDA’s Plate Method.

Using this method, you can incorporate a controlled amount of carbohydrate sources, while increasing your non-starchy vegetable intake. The most challenging part for most individuals is making half of your plate non-starchy vegetables. It helps to get creative with your vegetables—explore zucchini noodles, spaghetti squash pasta or even eggplant pizzas! Or, try this cauliflower rice recipe:

Cauliflower “Rice” Salad

Salad

  • 12 ounces of cauliflower florets or pre-made cauliflower “rice”
  • 1 cup cucumber, diced
  • 1 cup grape tomatoes, cut in half
  • 2 green onions, sliced
  • 3 tablespoons sliced Kalamata olives

Dressing

  • 1/4 cup red wine vinegar
  • 2 tablespoons olive oil
  • 1/2 tablespoon Dijon mustard

Instructions

  1. Make your own cauliflower rice by placing cauliflower florets in a food processor and processing them to rice-like consistency. (Be careful not to over-process.)
  2. In a salad bowl, combine all salad ingredients.
  3. In a small bowl, whisk together the dressing ingredients.
  4. Pour dressing over salad and serve with reduced-fat feta cheese, if desired.

Try cauliflower rice in other traditional rice dishes—you might be surprised!

From http://www.diabetes.org/mfa-recipes/recipes/2016-07-cauliflower-rice-salad.html.

Are you ready for “Ask a Dietitian: Holiday Hibernation” next week?

Ready or not…the last “Doctor is In” seminar is on Nov. 1. In this presentation, registered dietitians Amanda Figge and Megan Klemm will talk eating right throughout the holidays—and getting through winter without packing on the pounds!

Attendees of “Doctor is In” next week will be given three recipes to try at home that show how to balance a plate with carbs, proteins, dairy and veggies. Here’s a sneak peek!

House Salad

Salad ingredients:

  • 1 head red-leaf lettuce, chopped into bite-sized pieces
  • 1 head romaine lettuce, chopped into bite-sized pieces
  • Half of a small red onion, peeled and thinly sliced
  • 2 (14 ounce) jars quartered artichoke hearts, drained and roughly chopped
  • 1 (12 ounce) jar roasted red peppers, drained and diced
  • 1/2 cup toasted pine nuts

Zesty red wine vinaigrette ingredients:

  • 1/2 cup grated Parmesan cheese
  • 1/3 cup extra-virgin olive oil
  • 1/4 cup red wine vinegar
  • 1 teaspoon Italian seasoning, store-bought or homemade
  • 1/2 teaspoon kosher salt
  • 1/2 teaspoon freshly-ground cracked black pepper
  • 1/4 teaspoon garlic powder

Instructions

  1. Whisk the ingredients for the zesty red wine vinaigrette together until combined or add them together in a mason jar and shake until combined.
  2. Add all the ingredients for the salad together in a large bowl, and then toss until evenly combined.
  3. Serve immediately.

From: Gimme Some Oven

Enjoy Halloween Treats—Avoid Sugary Tricks

From vampire bats to Kit Kats®, Halloween is a long-standing tradition celebrated with tricks and treats. In fact, it’s one of my favorite holidays. I have always found humor in dressing up in non-traditional Halloween costumes, even at an early age. Luckily, I have great friends and family that are willing to partake in my couple/group Halloween costume extravaganzas. 

 Routine consumption of “sugary tricks” can lead to high blood sugars, hypertension, insulin resistance, metabolic syndrome, gut problems—and the list goes on and on.

There is no “healthy” candy

As a dietitian, the most common question I get this time of year is, “What is the best/healthiest candy to eat”? Unfortunately, there isn’t an answer. But don’t worry! This is not going to be your typical “don’t eat candy” Halloween post.  In my eyes, it’s perfectly fine to eat your heart out in candy for a night (or two). Why? Because we are a product of what we routinely do, not what we occasionally do. This applies to all aspects of life, but especially to our health.  

Everything in Moderation

What I mean by this concept is that it is perfectly fine to enjoy some less-nutritious foods, such as pizza, donuts and candy, occasionally. The problem is that most people enjoy these foods far too often than what their metabolisms are capable of processing. I am more concerned with the “daily candy” our youth and adults consume. Routine consumption of these foods can lead to high blood sugars, hypertension, insulin resistance, metabolic syndrome, gut problems—and the list goes on and on.

Breakfast Candy

Cereals, Pop-Tarts® and pastries are some of the best ways to start off your day…. If you want a sugar and insulin surge. These habits lead to fluctuations in blood sugar and insulin control throughout the day, disrupt concentration and can suck the energy right out of you. Lower sugar options include eggs, lean breakfast meats, nuts, peanut butter, cottage cheese and small servings of fruit.

Liquid Candy

Juice, soda, sweet tea and sports drinks are simply sugar in a liquid form. Perceived benefits of caffeine, vitamins and electrolytes are far outweighed by the consequences of the rapid absorption of sugar into the bloodstream. Not only does this sugar tidal wave spike insulin levels, it also increases preferences towards high-sugar foods, so the cycle unfortunately continues.

Fake Candy

Often, people gravitate towards items that are “sugar-free,” such as diet soda or sugar-free snacks, with the assumption that these products are healthier. I firmly stand my ground that low-calorie, chemical versions of sugar are no healthier for you than real and processed sugars. They may have a reduced nutrient density, but research shows that sugar substitutes greatly damage our gut lining. This can lead to leaky gut syndrome, propelling a host of other disease conditions.

Fruit Candy

Fruit roll-ups, fruit snacks and fruit-fillings are not fruit. They are pastes and mixtures created to taste like fruit. While these foods may appear to be healthier choices than other snack foods, nutritionally, they are no different than Skittles®.

Dairy Candy

Milk and yogurt contain both natural and added sugars. Calcium intake is important but not at the price of 20 grams of sugar, which is what you may find in a standard serving of yogurt (even Greek) and especially flavored milk varieties. Opt for low-sugar calcium sources such as unsweetened milk substitutes, broccoli, spinach, cheese, cottage cheese or whey/casein-based protein powders.

Don’t Stress about PCOS: 5 Habits for Better Weight Management

Baseball, food and dancing are three of my favorite things. On a typical fall Monday night, you will find me cooking dinner while flipping back and forth between the Cubs game and Dancing with the Stars. Recently, one of the new celebrity dancers spoke out regarding her struggles with weight gain from polycystic ovary syndrome (PCOS).

PCOS is the culprit of many of my female patients’ stress, fatigue and struggles with weight management. Luckily, there are some methods that work better for weight loss over others.

What is polycystic ovary syndrome?

For those that are unfamiliar with polycystic ovary syndrome (PCOS), it is more common than you might think. PCOS is the culprit of many of my female patients’ stress, fatigue and struggles with weight management. Women with PCOS experience irregularities in hormone levels and insulin resistance, struggle with fertility and commonly have great difficulties losing weight. Luckily, there are some methods that work better for weight loss over others.

1. Practice good meal pattern habits.

It is incredibly important to control metabolic hormones through proper eating habits. Skipping meals can cause wide fluctuations in insulin levels, which can make weight loss near impossible. Eating a meal or snack at least every 4 hours has shown to control insulin levels and help women avoid blood sugar crashes. If you are not a snacker, consider eating five to six small meals spaced evenly throughout the day.

2. Choose high-protein foods.

Protein naturally lowers insulin and blood sugar levels. That is why this is the most important food group for women with PCOS. Remember to start each day with a high-protein breakfast, whether it’s from eggs, lean meats or a power-packed protein shake.

3.Be consistent.

One of the most important things to help with hormone control is to establish a routine for your body. The lifestyle factors that can influence hormone levels include how often you eat, what you eat and when you exercise. It is important to eat frequently and not skip meals. Ideally, all your meals and snacks should be balanced and not high in carbs and sugar. If you work out, try to exercise at the same time each day. The more your body follows the same daily routine, the easier it is to control metabolic and sex hormone levels.

4. Limit carbs & sugar.

Since carbohydrate-rich foods and those with added sugars raise blood sugar and insulin levels, it is good practice to cut down on these menu items. You don’t have to cut out bread, pasta and potatoes all together, but it’s a good rule of thumb to make sure these are the smallest portions of food on your plate. Load up on lean proteins and veggies to create satisfying and balanced meals.

5. Do regular strength training.

Every form of exercise has its benefits, but strength and interval training cause greater metabolic improvements.  Strength training can help both retain and build lean muscle tissue while simultaneously burning fat. Reducing body fat is one of the best ways to speed up metabolism and control hormone levels.

What do you know about your sugar?

I recently attended the American Association of Diabetes Educators conference in Indianapolis. How great and refreshing it was to be with 3,000 other diabetes educators from across the U.S. At this conference, there was a great display from the Abbott Freestyle “Know Your Sugar Tour” bus, which is a cross-country expedition to raise awareness about the ill effects of sugar on the body. This tour, featuring one-of-a-kind sugar sculptures made by world-renowned Irish sculptors Brendan Jamison and Mark Revels, promotes the importance of understanding sugar’s effects on the body.

When there is extra sugar, it can be stored in muscles and liver for later use, but it also can be stored as fat.

We Need Sugar—to an Extent

Our body is fueled by carbohydrates, fats and proteins. Sugar is a type of carbohydrate that occurs naturally in foods, but can also be added during food processing. Sugar is consumed in many different forms, but our bodies digest almost all of the sugar we eat into glucose. Glucose is the primary sugar our bodies use to create energy.

Our bodies do need a minimum amount of sugar every day to function properly. The reason for this is that glucose is the only source of energy for the brain and red blood cells. The human bloodstream normally contains only about 5 grams of glucose at any one time, which is the equivalent of just one teaspoon of sugar.

But Too Much Sugar Can Risk your Health

Sugar is not the enemy, as it is our fuel source, but too much sugar can be. So when we eat, this is what happens…

When there is extra sugar, it can be stored in muscles and liver for later use, but it also can be stored as fat. Additionally, if there is too much sugar, adverse effects start to occur within our bodies. Too much glucose in the bloodstream is the third highest risk factor for premature death worldwide, preceded only by tobacco use and high blood pressure. Additionally, consistent high blood glucose can lead to serious diseases affecting the heart and blood vessels, eyes, kidneys and nerves.

Steps for Managing your Sugar

Now, I’m not trying to alarm you! Insulin resistance, an effect of too much sugar in our bodies commonly known as type 2 diabetes, can be managed with healthy eating, increased physical activity and education and awareness. Complications in diabetes can also be better managed with:
• early diagnosis
• health professional support
• controlling glucose levels, blood pressure and cholesterol levels
• access to insulin, oral medications and monitoring devices.

You can get started on eating less sugar right away by making the following food choices:
• non-starchy vegetables
• whole-grain foods
• fish 2-3 times a week (fried fish doesn’t count)
• lean cuts of beef and pork
• removing the skin from chicken and turkey
• non-fat or low-fat dairy products
• water, unsweetened tea, coffee and calorie-free ‘diet’ drinks instead of drinks with sugar
• liquid oils for cooking instead of solid fats (limit quantities)

In addition to changing what you eat, you can change how you eat. Consider making the following changes to your eating habits for better health and balance:
• eat a variety of foods
• eat small portions several times a day
• match how much you eat with your activity level
• eat few foods high in calories, cholesterol, saturated fat, trans fat and sodium.

I know this sounds like a lot, so to simplify:

Try to not go more than 3-4 hours without eating, get a portioned amount of carbohydrates and protein together and follow My Plate guidelines with portioning all types of foods. Strive to get some movement in daily. This could be going to a gym, walking, “chair walking,” water therapy, exercise classes—anything you want, really, as long as you’re moving! Don’t hesitate to also set up an appointment with one of the dietitians at Springfield Clinic, too.

How to Read the FDA’s New Food Label

If you are a label reader, you may have noticed some changes to food labels recently. In 2016, the FDA announced the food label would get a makeover­­—with the hopes that this new label will make it easier for consumers to make better informed food choices. The current nutrition label is more than 20 years old. The changes that will be made, according to the FDA, are based on updated scientific information, new nutrition and public health research, more recent dietary recommendations from expert groups and input from the public.

The current nutrition label is more than 20 years old—but its makeover will help consumers make better-informed food choices.

The changes you will see include:

  • increase in type size for “Calories,” “servings per container” and “serving size”
  • bolding the number of calories and serving size
  • including “added sugars” in grams and as percent Daily Value
  • updating the list of nutrients permitted or required


US Food and Drug Administration

What do these changes mean?

Let’s take a closer look at why these changes are happening and how they will affect the way we read food labels.

Serving Size

Serving sizes are based on amounts of foods and beverages people are eating, not what they should be eating. The previous serving size requirements were published in 1993, and how much we eat and drink now has changed. For example, the reference amount used for a serving of ice cream was previously 1/2 cup but is changing to 2/3 cup because that’s more likely the amount someone will eat at one time.

Packaging Size

Package size also affects what people eat. So for packages that are between one and two servings, such as a 20-ounce soda or a 15-ounce can of soup, the FDA now requires that calories and other nutrients be labeled as one serving because people typically consume it in one sitting.

For certain products that are larger than a single serving but that could be consumed either in one sitting or over time, manufacturers will have to provide “dual-column labels” to indicate the amount of calories and nutrients both per serving and per package. Examples would be a 24-ounce bottle of soda or a pint of ice cream. The hope is with dual-column labels available, people will be able to more easily understand how many calories and nutrients they are getting if they eat or drink the entire package at one time.

US Food and Drug Administration

Added Sugars

You will also see “Added sugars” in grams and as percent Daily Value. Scientific data shows that it is difficult to meet nutrient needs while staying within calorie limits if you consume more than 10 percent of your total daily calories from added sugar. The FDA will continue to require “Total Fat,” “Saturated Fat” and “Trans Fat” on the label but will remove “Calories from Fat” because research shows the type of fat is more important than the amount.

Nutrients

The FDA is updating the list of nutrients that are required or permitted to be declared. Vitamin D and potassium will be required on the label. Calcium and iron will continue to be required. Vitamins A and C will no longer be required but can be included on a voluntary basis. Vitamin D, calcium, iron and potassium are required to be shown in actual amount and percent Daily Value. Other vitamins and minerals can be shown as well in gram amount. The footnote is also changed to better explain what percent Daily Value means. It will read: “*The % Daily Value tells you how much a nutrient in a serving of food contributes to a daily diet. 2,000 calories a day is used for general nutrition advice.”

US Food and Drug Administration

Questions?

When will you see all packages with this new food label? The FDA set a compliance date for July 2018 with an additional year to comply for smaller manufacturers. So be on the lookout.

For more information you can go to the FDA’s website.