LET HEALTH BECOME YOUR NEW YEAR’S RESOLUTION!
By: Director of Education – Jessica Cook MS, RD, LD, CDE
We are starting a new year which may bring new opportunities, new challenges and new ways to improve your health! Here at Palm Beach Diabetes & Endocrine Specialists we offer many opportunities to get back on track with your health, help you feel better, manage blood glucose levels and gain energy. Currently, we are offering healthy meal planning workshops, free diabetes support groups, pump therapy workshops and our ADA recognized education Living Well with Diabetes 1-2-3 Program. All of these education workshops are designed to help you achieve a better A1c, maintain a healthy weight and learn optimal ways to control blood glucose levels.
If you would like an individualized appointment, we always have available appointments with a registered dietitian or certified diabetes educator to help you track blood glucose trends, learn about your diabetes medications, lower your A1c, lose weight and develop a personalized meal plan to better control blood glucose levels.
Our education team has helped countless patients lose weight, reduce blood glucose levels, reduce medication use and feel better. If you want to schedule an appointment for any one of our educational workshops please call (561) 513-5100.
Thank you for taking time to read our Living Well with Diabetes January 2016 Newsletter and Happy New Year.
AN OUNCE OF PREVENTION
By: Paul Aoun, D.O., Ph.D.
You might have heard the terms or been told you have pre-diabetes, impaired fasting glucose, and/or impaired glucose tolerance. Although they are not interchangeable, they all share the common feature of higher than normal blood sugars but not high enough for you to be granted a diagnosis of diabetes. Despite increasing your risk of developing diabetes, the good news is that acquiring one or more of these conditions does not commit you to an inevitable path towards diabetes. There are various strategies that you can adopt to prevent or delay your progression to overt diabetes, and in the process feel better and live a healthier life.
Before elaborating further, let us look at the diagnostic criteria for each one:
- Impaired Fasting Glucose (IFG): Fasting venous blood sugar 100-125 mg/dL
- Impaired Glucose tolerance (IGT): Venous blood glucose 140-199 mg/dl, 2 hours after drinking a glucose-containing solution
- Prediabetes: Hemoglobin A1C (HbA1C) 5.7-6.4%
- Diabetes: HbA1C at or above 6.5% or fasting blood glucose at or above 126 mg/dl
Why worry? The number of those who have prediabetes (and many do not know it) is about three times that of diabetes. Without any form of intervention to address pre-diabetes, IFG, or IGT, you will likely evolve to developing type-2 diabetes in the subsequent few years. Also, the long-term damages one could develop from having diabetes, known as diabetic complications, might be brewing already, especially in your heart, brain, and large vessels supplying your organs.
Are they genetic? There is enough evidence to support an underlying genetic component to blood sugar abnormalities that lead to diabetes, but this should never make someone feel helpless. While genes set the stage, the behavior tells the tale. What you do (or don’t do) can certainly shape the trajectory of your metabolic path.
What can you do? To prevent the progression to diabetes and to improve your overall health, it is important that your plan of action targets different fronts:
Healthier eating habits: I do not advise my patients to just “go on a diet” simply because many later go back “off that diet” or “fall off the wagon” due to difficulty sustaining the required restrictions. I recommend, instead, that they focus on developing long-lasting healthy eating habits. To do so, keep in mind the following:
Quantity: Practice portion control. Excess calories that you do not burn will be stored as fat. Use smaller plates. A couple of bites or scoops less per meal can go a long way over the subsequent few months to years to help you shed off the pounds and help you reach your weight loss goals.
Quality: Consume lesser quantities while making better quality choices. Restrict deep fried, refined (white) carbohydrates, and processed foods with added simple sugars or hydrogenated oils. Pay attention to caloric vs. nutrients densities as described below.
Density: Density refers to the number of calories relative to nutritional content in one serving size. Simply put, calorie-dense foods contain high calories and minimal nutrients; whereas, for the same serving size, nutrients-dense foods have fewer calories and greater nutritional value. Foods and drinks with added sugars such as cakes, cookies, donuts, sodas, and juices are considered calorie dense. For the same serving size, fresh fruits and vegetables have more nutrients and lesser calories. Dark green vegetables (i.e. Kale), berries, sweet potatoes, and tomatoes fall under this category. Many whole grains, including quinoa, barley, and oats are also nutrients-dense. This being said, if you take blood thinners (i.e., Warfarin; Coumadin) discuss with your physician before modifying your vegetable intake.
Focus: Pay attention to how you eat. Eat slowly and most importantly mindfully. Avoid “mindless bites,” snagging a piece of candy or sampling a meal when you are not hungry as the calories could easily add up. Counter stress through a walk or a fun activity rather than stress-eating.
- Physical activity: Physical activity, especially if you are overweight or obese, is an essential adjunct to healthier eating habits to help reduce your risk of progressing to type-2 diabetes. While some feel they will be more disciplined if they adopt a structured activity program, do not underestimate the positive impacts of steps you take around the house, garden, park, or work. Energy expenditure could range from only 30 calories watching TV in the evening to up to 600 calories should you elect instead in favor of more energetic pursuits such as gardening or home repairs. Don’t let “lack of time” be an issue. Think of exercise as a matter of priority, not time. There is always room to squeeze in some form of activities. Break the monotony, vary your activity types, and keep an open mind for unplanned activities should they arise.
- Medications: Should your medical condition prohibit you from being physically active and/or if your efforts have not yielded the desired outcomes, your physician may prescribe medications to complement your healthy lifestyle habits. Bearing no contraindications, Metformin is one drug that is sometimes used. Pharmaceutical companies continue to also develop novel agents for weight loss. While some people may lose weight using these drugs, many regain it back if they do not adopt long-lasting lifestyle changes. Also, one must weigh the promised benefits against the risks associated with the use of these meds, especially, that the long-term safety for most of them remains to be established.
In summary, do not give in to a diagnosis of prediabetes, IFG, or IGT or feel you are doomed to develop diabetes. Think of the recommendations outlined herein not as sets of rigid rules but as investments in your own health. Allow for sporadic dietary indiscretions if they make you feel good, but avoid over-doing them. Even if you have been diagnosed already with type-2 diabetes, incorporating these strategies could certainly help reduce the number of medications you take to treat this condition.
While the earlier you implement these steps, the better, it is never too late to turn the tide around and introduce positive changes. Palm Beach Diabetes and Endocrine Specialists (PBDES) is proud to offer office-based programs to guide you along the way. Our team of endocrinologists, dietician, nutritionists, and diabetes educators, work together to develop individualized strategies to help you reach your goals.
EATING AND LIVING LIKE THE WORLD’S HEALTHIEST PEOPLE: THE BLUE ZONE SOLUTION
By: Chelsey Steinarsson RD, LD/N, CDE
Blue Zones are 5 hot spots of longevity around the world: Ikaria, Greece, has one of the world’s lowest rates of middle-age mortality and the lowest rate of dementia; Okinawa, Japan, home to the world’s longest lived woman; Sardinia, Italy, home to the world’s highest concentration of centenarian men; Loma Linda, CA, community of Seventh-day Adventists where residents live 10 more years than average Americans; and Nicoya Peninsula, Costa Rica, has the world’s lowest rate of middle-age death and the second highest concentration of males 100 years old or more.
Diet includes lots of vegetable (mostly self-grown) and olive oil, whole grains and fruit, smaller amounts of dairy and meat, and moderate amounts of wine. Typically eat meat 1-2 times per week, and sweets perhaps 2 times per week, not including the local honey used to sweeten their herbal teas. They eat slowly with friends and family, take regular naps, and maintain a healthy sex life.
The traditional Okinawan diet was about 80% carbohydrates (most coming from the imo, or Okinawan sweet potato). They consumed fish 3 times per week, seven servings of vegetables, 1-2 servings of grains and 2 servings of tofu daily. They didn’t eat much fruit and only a few eggs a week.
65% of calories came from carbohydrates (bread, pasta, potatoes, beans). Fat accounted to 20% of the diet (sheep or goat milk, cheese and olive oil) and 15% from protein, most of which came from plants (beans). Sardinians consumed around 2,700 calories but their physical activity warranted this high caloric intake. Most people were gently walking up and down hills all day long.
Loma Linda, California
Home to a large population of Seventh-day Adventist who followed the diet that God prescribed from the Garden of Eden (Genesis 1:29.) A diet rich in nuts, whole grains, beans, soy, small amounts of meat, dairy, eggs, and discourages coffee and alcohol. Seventh-day Adventist have been found to live up to a decade longer than the rest of us.
Nicoya Peninsula, Costa Rica
68% of the diet comes from carbohydrates (maize, rice, beans), 20% fat and only 10% protein. Their diet is rich in beans, homemade corn tortillas, squash and fruit. There they soak their corn in lime juice and water which infuses calcium and unlocks certain amino acids.
Blue Zone Food Guidelines:
- 95% of your food comes from plants – beans, vegetables, potatoes, fruits, nuts, seeds, and grains
- Reduce meat to no more than 2 times per week
- Eat up to 3 oz of fish daily
- Minimize intake of cow’s milk and dairy products; choose goat or sheep products
- No more than 3 eggs per week
- Eat at least ½ cup of cooked beans daily
- Restrict added sugar to less than 7 teaspoons per day
- Eat two handfuls of nuts per day
- Choose sourdough or 100% whole wheat bread
- Choose more whole foods, foods that are recognizable for what they are versus processed foods
Longevity Superfoods from the 5 Blue Zones:
- Fennel, Kombu (seaweed), Wakame (seaweed), Potatoes, Shiitake mushrooms, Squash, Sweet Potatoes, Wild Greens, Yams
- Avocado, Bananas, Bitter Melon, Lemons, Papayas, Pejivalles (peach palms), Plantains, Tomatoes
- Black, Black-eyed peas, Chickpeas, Fava beans, and other cooked beans
- Barley, Whole-grain bread, brown rice, Maize nixtamal, Oatmeal
Nuts and seeds
- Almonds and other nuts
- Salmon, Soy milk, Tofu
- Feta cheese (goat), Pecorino cheese
- Coffee, Green tea, Red wine (9-12 oz/day), Water
Sweeteners and Seasonings
- Garlic, Honey, Mediterranean herbs, Milk thistle, Tumeric
LOOKING FOR NEW INFORMATION IN DIABETES CARE? THEN COME JOIN OUR FREE DIABETES SUPPORT GROUP!
WEDNESDAY FEBRUARY 3RD
5:30 -7:00 P.M.
Flagler Waterview Building
1515 N. Flagler Drive, Suite 430
West Palm Beach, FL 33401
Will provide Healthy Snacks!
Certified Diabetes Educator Chelsey Steinarsson will discuss:
- Blood Sugar Monitoring/ Management
- Hyperglycemia Management
- Hypoglycemia Management
- Medications that Cause Hypoglycemia
- Diabetes Complication Prevention
- Questions & Answers Session
**May bring one guest free of charge!
If interested attending this 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, the 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!