Fall into New, Healthy Habits!
By: Jessica Cook MS RD LD CDE (Director of Education)
Fall is upon us and we at Palm Beach Diabetes & Endocrine Specialists cannot think of a better time to focus on trying to create new, healthy habits for you that will last a lifetime.
Here are some helpful tips to get you back on track with healthy habits:
- Place positive cues around your home. Instead of having chips, cookies and ice cream at home try loading your fridge or pantry with fresh fruit, vegetables, nuts and low fat dairy products such as yogurt or non fat cottage cheese. This way the next time you reach for a snack you have a healthy choice available.
- Find an exercise buddy! Having a buddy to help you stay on track with exercise goals is not only motivating, but creates a support system to aid you through the challenges of behavior change. Try starting a walking group in your neighborhood or grab a friend to hit the gym with you at least 3x/ week. Remember exercise is truly the best medicine.
- Swap out poor food choices with better choices. Eating healthy foods doesn’t mean you have to give up everything you enjoy! Try purchasing reduced fat cheeses versus regular varieties, choose 100 calorie mini bags of popcorn versus movie theater style bags or go for low calorie ice cream bars versus the gallon tub of ice cream to help create portion control.
- Don’t beat yourself up! Creating new habits is difficult for everyone. If you mess up on your meal plan or fitness routine one day try to look at the next day as a new opportunity to start over and focus on your goals. Remember no one is perfect, so the best reward you can give yourself is to not give up and try again!
Please enjoy this issue of Living Well with Diabetes including articles from our physicians and education staff to help you start this fall with a bang!
Understanding the Epidemic of Type 2 Diabetes in Children and Teens in the U.S.
By: Gary Pepper, M.D. and Andrew Levine Pre-Med UCF
If you ask the average person to define diabetes, a typical response might be “it’s when you have unhealthy eating habits and an overabundance of sugar in your blood.” Although that is not far from the truth, a more accurate definition is that diabetes is a disorder in the way the body uses insulin to process digested food for energy and storage. A good part of what we eat is broken down into glucose, the principle form of sugar in the blood. Diabetes occurs when there is not enough insulin to push the glucose into our cells. This deprives the body of the energy it needs because glucose is the fuel used by all the organs in the body. Therefore in diabetes despite an elevated amount of sugar in the blood, the cells are actually starving for energy. We sometimes conceive of glucose in the blood as the enemy , but without it we would die.
Adults are usually diagnosed with the form of diabetes known as “type 2” which is associated with being overweight and is treatable with oral medication. Children, on the other hand, are usually diagnosed with “type 1” diabetes which is not associated with being overweight and, in most cases, is treated with insulin. Common complications of poorly controlled diabetes include difficulties with vision, heart disease, and nerve and kidney damage. Just over a decade ago, only 9% of adolescents aged 12-19 years tested positive for either type 2 diabetes or pre-diabetes. Pre-diabetes occurs when blood glucose levels are higher than normal but not high enough to be formally diagnosed as diabetes. A follow-up study of diabetes in adolescents in 2007-2008 reported that 23% of teens tested positive for these conditions.
What could be the possible reasons for the percentage of teens with diabetes and pre-diabetes tripling in only one decade? One answer is a decrease in physical activity due to pervasive use of technology by teens. Children are becoming less active spending more time indoors on electronic devices which leads to poor muscle growth and weight gain. Another answer could be the rapid increase in the minority population in this country, which may be more prone to develop type 2 diabetes due to genetic susceptibility in addition to lifestyle considerations.
Recent studies also show that children taking antipsychotic medications are at increased risk for developing type 2 diabetes. A recent study from Vanderbilt University showed that children taking certain psychiatric drugs tripled their risk of developing diabetes. Drugs in this group include Abilify, Seroquel, Risperdal and Zyprexa. These medications are prescribed to children with bipolar and affective disorders, as well as for behavioral issues. Diabetes is more prevalent in cases where the medication is taken for longer periods of time and at higher dosages. A troubling finding is that diabetic risk for these children were seen rising after one year of use but, after the medication was stopped for a year, the risk factor for diabetes did not significantly decrease.
Finally, and perhaps most importantly, poor eating habits contribute to the rise of type 2 diabetes and pre-diabetes in children and adolescents. One of the major nutritional culprits is the high consumption of soda. The amount of sugar in soda is astounding. According to The American Heart Association, sugar intake should be limited to six teaspoons per day for women (equivalent to about 100 calories), nine teaspoons per day for men (about 150 calories) and three teaspoons for children (about 60 calories) . There are numerous drinks available on the market containing as much as 14.6 teaspoons, or 73 grams, of sugar in a 20 oz bottle. A single 20 oz bottle therefore has almost 5 times the recommended daily sugar allowance for a child, 2-1/2 times the recommended allowance for women and 1-1/2 times the recommended allowance of sugar for men .
Data from the National Health and Nutrition Survey shows that due to unhealthy eating habits the average teenager consumes 119 g or about 28.3 tsp., of added sugar per day. This sugar intake equals 476 calories, or about 22% of an average teenager’s total caloric intake.
In a later installment of this newsletter we will provide advice to patients of Palm Beach Diabetes and Endocrine Specialists, in ways to help protect our children or teens from developing type 2 diabetes or pre-diabetes.
When It Comes to Nutritional Supplements, Look for the USP Verified Mark
By: Monika Lambertson, MS RD LD CDE
More than half of adult Americans take at least one over-the-counter nutritional supplement. A dietary supplement is defined as any product taken by mouth that contains a “dietary ingredient” intended to supplement the diet and may include substances such as vitamins, minerals, herbs, and amino acids. Unlike prescription drugs which have undergone years of testing and are strictly regulated by the Food and Drug Administration (FDA), over-the-counter nutritional supplements are not analyzed by the FDA. Instead, it is the manufacturer who is responsible for ensuring that the supplement label and ingredient list are accurate, the dietary ingredients are safe, and the content matches the amount declared on the label. So whether you take a daily multivitamin, vitamin D, calcium, iron, or other nutritional supplement, you want to be sure you are getting what the label says. That’s why you should look for the “USP Verified” mark. It indicates that the supplement manufacturer has voluntarily asked the United States Pharmacopeia (USP), a trusted nonprofit, private standards-setting authority, to verify the quality, purity, and potency of its products.
Seeing the USP Verified Mark on a label indicates that the dietary supplement:
- Contains the ingredients listed on the label, in the declared potency and amounts
Tests have shown that contents of some supplements don’t match the label and some contain significantly less or more than the claimed amount of key ingredients. USP Dietary Supplement Verification helps assure customers that they are getting the value they expect from a product they are purchasing.
- Does not contain harmful levels of specified contaminants
Some supplements have been shown to contain harmful levels of certain heavy metals (e.g., lead and mercury), pesticides, bacteria, molds, toxins, or other contaminants. At specific levels these contaminants can pose serious risks to one’s health.
- Will break down and release into the body within a specified amount of time
If a supplement does not break down properly to allow its ingredients to be available for absorption in the body, the consumer will not get the full benefit of its contents. USP Dietary Supplement Verification tests products against federally-recognized dissolution standards.
- Has been made according to FDA current Good Manufacturing Practices using sanitary and well-controlled procedures
- Has undergone random, off-the-shelf testing to confirm that the supplement continues to meet USP’s strict standards
If the supplement you are taking does not bear the USP verified mark, it does not necessarily mean that it is an inferior product. However, you can be confident that a product that boasts the USP mark has been independently verified for quality. Remember to use caution when taking a supplement and make sure to discuss its use with your physician.
For a list of USP verified products, or for more information about the verification process, please visit the USP website at www.usp.org.
Having difficulty losing weight?
Here at Palm Beach Diabetes & Endocrine Specialists we are currently offering the Living Well with Diabetes 1, 2, 3 Program, which focuses on weight loss, healthy eating and good blood sugar control. Many patients that have participated in the Living Well with Diabetes 1, 2, 3 Program have been able to reduce their A1c levels as well as meet their weight loss goals by working with registered dietitians and certified diabetes educators in a group class or one on one setting.
Several principles we focus on during the Living Well with Diabetes 1, 2, 3 Program include:
- Healthy dining out
- Low carbohydrate, low calorie meal preparation at home
- Mindful eating
- Exercise tips
- Good blood sugar control
If you have tried losing weight on your own without success why not try our Living Well with Diabetes 1, 2, 3 Program to help you get back on track with your weight loss goals. If interested attending the Living Well with Diabetes 1, 2, 3 Program please contact our scheduling department at (561) 513-5100 today!
At Healthy Living with Diabetes we want to ensure that you are satisfied with all services received. We also would like your input on educational workshops that you would like us to offer, information you would like to read about in Healthy Living with Diabetes Monthly or feedback on any workshop that you may have attended.
You can contact the director of education personally by email jcook@PBDES.COM or leave a message at (561) 513-5100. We would love to hear from you!