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.

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.

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.

 

Back-to-School Lunches: Tips & Tricks

As a follow-up to my school breakfast post, I want to share my strategies for healthy school lunches. As I said, we are not morning people. There is not much time to get everything ready and everyone out of the house. My philosophy: Prepping and planning are key. If it is not there, we can’t eat it, so make sure it is there. 

I want to emphasize that I don’t make these packed lunches fancy! I am about simple, quick and easy—all made possible by planning and prepping.

Prepping

My goal is to go to the grocery store every week or even two times a week, but honestly, that is not always possible. To get the most bang out of my time and wallet, I make a list on my phone. If I make the list on a piece of paper, it never fails that that piece of paper is sitting on my counter when it is time to shop. I make my list from staples needed and from my meal planning.

Planning

I strive to plan all three meals each day.  Ugh, you may be saying—yeah, its work, I’m not going to deny that. If I don’t plan, then we don’t eat or we don’t eat well. I also plan for two kid’s breakfast, a child lunch and family dinner. For myself, I make a shake daily for breakfast and leftovers for lunch—so it’s not as horrendous as you may think.

To plan the lunches, first we go through the monthly school menu and pick out what days my son wants to eat school lunch. Yes, I let him eat school lunch—even on hot dog day.  Most days he takes his lunch, I know what healthy foods he is eating at home, so to me it balances out.  I ask him what foods he would like in his lunch; I’ll listen, but typically veto many options. When kids think they have input they are more apt to eat it 🙂

I like to keep the #plategoals ( ½ of the plate is non-starchy vegetables, ¼ is whole grains/fruits/starchy vegetables and ¼ is lean protein) in mind when packing lunches. Offer variety and keep portion sizes small. Remember there is no “parent fail” if you don’t get a veggie in their lunch, however, encourage them to snack on some after school and to include them at dinner. I try to include at least two colors of plant-based foods at lunch. Not only does this boost the nutritional quality, but it also makes the meal more colorful and fun! Examples: orange carrots and frozen pineapple tidbits, plum tomatoes and green grapes, black bean dip and frozen mango chunks.

On those rare days when I have an extra minute, I try to label a container or two with little post it notes, like “magnificent mango” or “tasty hummus”—it may help the lunchbox come home empty.

Packing 

I plan, make my list, grocery shop, have it at home, prep it and send it. What do I send it in? I like containers, like these, that have the three compartments. They make it easy to have multiple items in the lunch box without colliding and smashing.  I am not a fan of the character lunch boxes; nothing against the characters, but they are just not big enough for the containers. We got a lunchbox this year that fits the containers, lays flat, and the handle on top to hold the containers flat.  If the handle is on the side, making the container on its side, it always leaks.

If your child’s school doesn’t have a refrigerator for cold lunches, then you need to make sure there is also room for an ice pack to help keep the lunch cool. If the lunch doesn’t stay cool then bacteria grows and the not so good happens—you get the idea.

Unpacking

When the lunchbox comes home, wipe it down and wash the container to use again.  Those lunchboxes can come home nasty at times and fill with lots of bacteria. Don’t forget about the box and wiping down the ice pack.

Here are some quick, simple healthy foods my kids will eat.

  • Sandwiches with
    • Bread, tortilla, flat bread, English muffin, bagel, day old Jimmy John bread and pita pockets.
    • To help mix it up I try to add fun shapes to the sandwich by using sandwich cutters or cookie cutter and sandwich kabobs.
  • Leftovers
  • Entrees
    • Bagels with cream cheese, quesadilla, nachos, ravioli and pasta.
  • Fruit
    • Applesauce, fresh fruit (apple slices, grapes, orange slices, cutie or pear), or canned fruit, canned in light syrup.
  • Vegetables
    • Salad with salad dressing in a small cup to drizzle on, raw veggies with ranch dressing or hummus to dip in, or cold roasted vegetables.
  • Grains
    • Whole-wheat crackers, pretzels, goldfish crackers, or baked chips.
  • Treats
    • One cookie, rice Krispy treat, Oreo, or tootsie roll.

I want to emphasize that I don’t make these packed lunches fancy! I am about simple, quick and easy—all made possible by planning and prepping. There is no foolproof way to make sure your kids will eat their lunch while at school, but you can at least know you are doing your part for their health. Happy Back to School!

Help Your Kids Eat Right

August is Kids Eat Right Month—what a great time to help kids learn about nutrition and better food choices! As a dietitian mom, you would think my kids are poster children. They definitely are not, especially my middle child. Goodness, do my children love their sweets, snack foods and treats; it can be a challenge to get them to eat right. I have discovered the best way to get them eating healthy is getting them in the kitchen to help and learn.

Having a 16-month, 3 year old and 6 year old it is limiting on what they can and can’t do in the kitchen. Often times it ends up being a much BIGGER disaster when they help, but it makes for good teaching and fun memories. Our two older children have their own apron with their name on it along with their own cooking utensils that I feel are safe and age appropriate to use. This helps to entice them into the kitchen. I try to get their input on what we should cook/make for the snack or meal we are working on.

To help things go smoother, I try to stock better-for-you choices in my pantry/snack drawer (yes we have a snack drawer), and then the kids have the choice to take it upon themselves to experiment.

That is what cooking – and creating – is all about: the discovery and the delicious result.

CLICK HERE to print off the Kid-Friendly Kitchen Tasks for Every Age PDF!

Here are a few of the things we like to make together in the kitchen.

 

 

 

1. Trail Mix

Whatever we have in the cabinet, pantry and snack drawer (within reason) the kids can grab and mix. Some ingredients they like are pretzels, raisins, dried cranberries, chocolate chips, cereal, whole-grain goldfish crackers, almonds and mini marshmallows.

2. Smoothie

We start with a base of water and ice, and add from there— fresh or frozen fruit of any kind, Greek yogurt, Sugar Free/Fat Free pudding powder. I also have a shake product we use from a former weight management program I worked with and we like to add that as well.

3. Wraps

We lay out whole wheat tortilla and then the kids use their age appropriate knife to spread peanut butter on the wrap. They sprinkle a few chocolate chips and lay a banana in the center. The kids with assistance from me roll up the tortilla. Either they eat like this or I will cut in to pinwheel size for them to eat.

4. Watermelon and Blueberry Salad

I slice the watermelon into thick slices and the kids use cookie cutters to cut shapes out of the watermelon. We then throw in any berries we have—blueberry, raspberry, blackberry and even grapes.

5. Chocolate Chips Banana Bread

This may not be the healthiest of recipes, but it is a huge hit in our house, and we only make it a few times a year.

What You Need:

  • ½ cup butter, melted
  • 1 cup sugar
  • 2 eggs
  • 1 tsp vanilla extract
  • 1 ½ cups flour
  • ½ tsp salt
  • ½ cup low fat sour cream
  • ¾ cup mini chocolate chips
  • 2 medium bananas

Directions:

  1. Preheat oven to 350 degrees, grease loaf pan.
  2. Mix together melted butter and sugar, and add in eggs and vanilla.
  3. Combine flour, baking soda and salt, then add to butter mixture
  4. Add in sour cream, bananas, and chocolate chips. Spread in loaf pan.
  5. Bake for 50-60 minutes, until baked through.
  6. Cool on wire rack in pan, and remove from pan to finish cooling.