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.

Fruit: Is there really a good and bad choice?

fruit_woman_iStock_000019680537XXXLargeWhen it comes to fruit, numerous patients have asked me if there is such a thing as good and bad fruit. Many will read on the internet that bananas are bad for you and grapes are too high in sugar. Messages like this can be quite confusing because after all, isn’t fruit supposed to be good for you?  The perk of eating fruit is that it is low in calories and contains a bundle of vitamins and minerals. The downfall of fruit is that it also contains natural sugars and like we know, too much sugar (even natural) is not a good thing.

I don’t really like to say that there are good fruits and bad fruits, but I do try encouraging some fruits over others based on their glycemic index. Glycemic index is a value assigned to foods that indicates what type of affect that food may have on one’s blood sugar and insulin level. A low glycemic food such as broccoli will have a minimal effect on blood sugar and insulin whereas a high glycemic food like a white potato will make both levels skyrocket. This information is especially important for someone who is diabetic or even pre-diabetic. In fact, a recent meta-analysis in the American Journal for Clinical Nutrition suggests that high intakes of foods with a high glycemic index can greatly increase one’s risk for developing diabetes. Elevated levels of insulin can also increase LDL (the bad cholesterol) as well as promote fat storage. It is understood that elevated insulin levels can make it more difficult for the body to burn stored fat; therefore, choosing foods with a lower glycemic index can help reduce insulin levels and thus, may help the body burn more fat and promote weight loss. Other consequences of chronically elevated insulin levels can include increased sugar cravings, elevated triglyceride levels and hypertension.

The glycemic index is a scale of 0-100. Foods with a score of 70 or higher are considered high glycemic foods and are encouraged to be limited. Foods with a medium score of 50-70 are considered moderate glycemic foods and should be eaten in moderation while foods with a score of less than 50 are lower on the glycemic index and should make up the bulk of one’s dietary choices. Below is a list of common fruits and their GI values.

Where does your favorite fruit fall on the list?

Fruit GI Value
Cherries 22
Grapefruit 25
Prunes 29
Apricot, dried 30
Apple 38
Pear, fresh 38
Peach, canned in juice 38
Plum 39
Orange 40
Peach, fresh 42
Grapes 46
Mango 51
Banana 52
Fruit Cocktail 55
Papaya 56
Raisins 56
Apricots, fresh 57
Kiwi 58
Figs, dried 61
Cantaloupe 65
Pineapple 66
Watermelon 72
Dates 103

Remember, just because a fruit has a high glycemic index doesn’t mean that you have to cut it completely out of your diet. It’s perfectly fine to enjoy some of these fruits from time to time guilt-free but at least try to mix up your choices with a variety of GI values.

5 Myths About Diabetes

Česky: Aplikace "rychlého" inzulínu ...1. Diabetics have to give up all sweets and desserts.

Having a diagnosis of diabetes certainly does not mean that one has to forever give up their favorite desserts or sweet treats. However, these are foods that should be enjoyed less often and in smaller portion sizes since high-sugar desserts can cause blood sugars to become more elevated. A serving size of a brownie is a 2 inch x 2 inch square and the proper portion of ice cream is one scoop or ½ cup. Cakes and pies tend to be richer in carbohydrates and should only be enjoyed on special occasions.

2. You can eat as much as you want if it says “sugar-free.”  

Sugar-free does not mean carbohydrate-free. Controlling carbohydrate intake is one of the most essential dietary modifications for diabetics to make. In efforts to reduce carbohydrate intake, many linger towards sugar-free products. These products may contain fewer carbohydrates than their regular counterparts, but they still do contain carbohydrates and portion sizes need to be  monitored. One staple of my childhood summers was Schwann’s ice cream. Schwan’s no sugar added, fat-free vanilla ice cream sounds like a perfect healthy option, right? However, a ½ cup serving contains 19 grams of carbohydrates. One serving of the regular vanilla ice cream contains 15 grams of carbohydrates. For this particular example, the no sugar added variety actually contains more carbs than the regular version. This highlights the importance to always read food labels and to compare like-products when deciding on a brand/variety to purchase.

3. You will have to start taking insulin

When someone has diabetes, it means that their body; is not producing enough insulin or not efficiently using the insulin available in their body causing abnormal blood sugar levels. Sometimes diabetic medications are needed to help the body properly use the insulin that is currently available and better control one’s blood sugars. For some people, this is not enough and these individuals require insulin shots. However, many individuals can control their blood sugars simply by eating healthier, losing weight and increasing their physical activity levels.

4. I’m not obese; I won’t get diabetes.

Diabetes comes in all shapes and sizes. It’s important to have a yearly physical with your doctor to make sure you are not experiencing any early signs of diabetes. These can include:

  • Urinating often
  • Feeling extra thirsty or extra hungry
  • Extreme fatigue
  • Blurry vision
  • Cuts/bruises that are healing poorly
  • Tingling, pain, numbness in hands or feet

Gummy candy5. Diabetes is caused from eating too much candy.

Type 2 diabetes has a strong family link but it can also be triggered by environmental factors such as obesity, eating habits, meal patterns and exercise habits. Being overweight is often caused from excessive calorie intake. Sugar-packed foods and beverages such as candy and soda are a common source of extra, unnecessary calories in the diet. Following a healthy diet that is rich in vegetables, fruits, lean proteins, low-fat dairy products, whole grains, beans, nuts/seeds and low in added fats and sugar can help reduce one’s risk for developing diabetes.

Hidden Price You Pay

Dollar Sign

I’ll admit it; I am a huge sucker for deals and saving money. Sometimes I take advantage of spectacular sale prices of items I need and other times, the sheer sale itself provokes me to go shopping. For example, I recently went on a shopping trip to Kohl’s. Did I need anything? Not necessarily, but I had a 30% off coupon and $10 worth of Kohl’s cash that I knew could be put to good use! Sales and deals like this can not only entice us to spend money on clothes, household products and electronics, it can also influence one’s eating habits and food selections.

One deal that always grabs people’s attention is the word FREE. When something is free, we almost feel compelled to give in to the deal as if we would be wasting it if we didn’t take advantage of it. Baker’s Square is now featuring their free pie special. Every Wednesday, customers may enjoy a free piece of pie with an approved menu item purchase. While this deal may be great on one’s wallet, it may not be so nice on the waistline.  According to their website,  one slice of their French silk pie ranks in at 650 calories. This is more calories than what most people need for an entire meal. The lemon meringue slice may seem like a lighter fare coming in at 430 calories; however it contains nearly 72 grams of carbohydrates. For diabetics, this slice of pie would most likely cause their post-meal blood sugars to rise higher than normal.

Other restaurant deals that frequently occur are the “endless” or “unlimited” promotions such as the unlimited stack of pancakes, never-ending pasta bowls and bottomless amount of fries.


Just like when people dine out at a buffet, the whole “I need to get my money’s worth of food” phenomena kicks in. Ask yourself, “Do I really need 2 bowls of pasta or 10 pancakes?” Unfortunately, most of these items are very carb-rich foods. For individuals with diabetes or even pre-diabetes, controlling one’s carbohydrate intake is of high importance for healthier eating habits and better blood sugar control. A stack of 3 pancakes with 2 Tbsp. of syrup at IHOP contains 96 grams of carbohydrates. For some women, this is the amount equivalent to 2-3 meals’ worth of carbohydrates.

We are powerfully influenced by our environment, especially when it comes to how much food we eat. For example, eating with more people has shown to increase the amount of calories one consumes at their meal. When eating alone, we typically stop eating when we are full and get up from the table. However, when eating with a crowd, one often sits and lingers after they are finished eating. The longer one sits around the food, the more likely they are to continue to nibble and drink. Earlier this year, the family had gone out to eat for my mother-in-law’s birthday. It was a delicious meal and I was full at the end of it. Because it was her birthday, she was eligible for a free dessert, which happened to be an ice cream cake. When the waitress brought out the cake with 6 serving spoons, I threw my internal cues of hunger out the window and dug in with everyone else. And sadly, I became yet another victim to overeating.

christmas dinnerRestaurant promotions on free food or large portions may seem appetizing, especially on the wallet; but, consider the hidden price you may be paying in calories and unwelcome extra pounds from these “deals”. This holiday season can bring on extra stress in our lives, but don’t let an increased waistline be one of those stressors!


Are You Eating Your Stress?

cookieWork, errands, cooking meals, soccer practice, gymnastics meets, taking grandma to the doctor, finding time to workout…do you feel like your to-do list is never-ending? If you’re like me, there are days where you wish you could settle everything with “bubble gum bubble gum in a dish…”

Stress is a constant in our lives. Stress can be a physical, emotional or chemical factor that causes bodily or mental tension. It can cloud our decision-making skills, affect our moods and induce specific food cravings; but, it can also help us perform better, work harder and faster. You may not always be able to control the amount of stress in your life but what you do have is the power to control the way you react to it.

cortexWhen our bodies perceive stress, two things occur: 1) Activation of the flight or fight hormones. There is no other time that I have ever felt more like a real ninja leaping through the air than the moment you realize you’ve slept through your alarm (fight/flight hormones). 2) Activation of the HPA axis. To respond to a physical/emotional stress, the hypothalamus (H) produces the hormone CRF (corticotrophin-releasing factor). This hormone binds to specific receptors on the pituitary gland (P) which stimulates the production of adrenocorticotropic hormone (ACTH). ACTH is transported to the adrenal glands (A) which stimulates the production of cortisol…and that is where our problem begins.

vendingmachineChronic stress and high levels of circulating cortisol can affect our bodies in many different ways. Acne, stomach ulcers, muscle tension, headaches, hypertension…all problems in the different systems in our bodies, all can be exacerbated by stress. A study in the 2010 International Journal of Obesity concluded that “high cortisol levels resulted in altered food choices”. Stress can also induce more frequent non-hunger food cravings which can contribute to abdominal fat storage. Stressful individuals tend to consume quick, convenient food items, which often include processed, high-sodium, high-calorie choices.

Planning ahead is the one of the best defenses you can have to combat stress. Snacks, for example, can be pre-cut, pre-portioned and stored conveniently in your fridge, purse, car, gym bag.

Dr. Cassandra Claman, dermatologist at Springfield Clinic, comments on eating healthy with a very busy workday, “At work, I have had to hone my eating to brief breaks between patients and foods I can eat while working on charts. I have a huge drawer filled with food, my little fridge is filled and I carry food in my purse, my tote and my car. Some of the foods I have on hand to eat throughout the day are various flavors of almonds, all sorts of fresh fruits and veggies, dried fruits and trail mix, hard boiled eggs, skim milk cheese sticks, pretzels and a couple liters of  water. As I leave the office for the day, I almost always have an apple in my hand so I am not ravenous the minute I walk into the door at home.”

Eating well-balanced meals and having high-nutrient snacks on hand can also help prevent spikes and dips in our blood sugars. Drastic changes in our blood sugar levels can cause crankiness, anxiety and irritability. Remember to listen to your internal cues of physical hunger. Stress can induce emotional hunger. Physical hunger strikes below the neck (stomach growls) and emotional hunger occurs above the neck (ice cream sounds like a good idea). Don’t forget about the power of exercise as a stress reliever. We turn our backs on exercise most often when we need it most.

I had an extremely long day last Tuesday. I was at the news station at 6:15am to appear as a guest on the Sunrise News. From there, I went to work and was bottled down until 6:30 pm. I had a headache and every ounce of me wanted to just drive past the gym, go home and crawl in bed. But I didn’t; I went to the gym, worked out and felt amazing. My headache disappeared and I was left with nothing but positive feelings about myself and all that I had accomplished during my day. Again, never underestimate the power of exercise.


“Incredible change happens in your life when you decide to take control.”