Category Archives: Disease Physiology

bad carbs

Are Your Carbs Slowly Killing You?

Let’s go have a burger, but make the bun whole grain please! Ok, so fat is now in and carbs are out. It seems like there’s research to support any diet you choose to follow. Are we getting smarter or just making things so confusing people just throw their arms up in the air, say “screw that” and just eat whatever their heart desires.

But, if you desire your heart, you might want to read this to get some clarity on the controversy.

PURE research

The Prospective Urban Rural Epidemiology (PURE) study, reported in ScienceDaily.com, asked dietary questions to over 135,000 low, middle and high income people over a 10-year period from Africa, North America, South America, Asia and Europe.

There were three parts to the PURE study. One looked at the impact of dietary fats on clinical outcomes while another focused on the consumption of fruits, vegetables and legumes in relation to death, heart disease and strokes. The third component, reported in The Lancet Diabetes and Endocrinology, looked at the impact of dietary fats and carbohydrates on blood lipids and blood pressure.

A summary of the data released in August, revealed that a diet consisting of a moderate amount of fat, fruits, vegetables and legumes and avoidance of a high proportion of carbohydrate was associated with a lower risk of death.

The results were surprising and not in accordance with the current dietary guidelines of dietary fats making up 30% or less of total calories, carbohydrates making up 50% and fats making up the rest while keeping saturated fats to less than 10% of daily calories.

Making sense of the PURE data

Actually, the results do make sense. The lead researcher, Mahshid Dehghan, in an interview with Science Daily said:

“A decrease in fat intake automatically led to an increase in carbohydrate consumption and our findings may explain why certain populations such as South Asians, who do not consume much fat but consume a lot of carbohydrates, have higher mortality rates.”

Many of the participants were low income and ate a diet consisting heavily of white rice and lower on animal products and produce. White rice is a high glycemic food – making blood sugars skyrocket with each additional serving. Animal products are high in protein and produce is high in fiber which slows down digestion and the rise in blood sugar.

If you look at the graph of macronutrients below, you’ll notice that carbohydrates make the blood sugar spike with a steeper parabola than protein and fat. The larger the portion of a simple carbohydrate like white rice, and not combined with much protein or fat, the quicker and larger the blood sugar rise which puts stress on the pancreas to make more insulin to take care of the extra glucose in the blood stream. Eventually, this leads to damage of the arteries and an impaired pancreas, and an earlier death.

macronutrients and impact on blood sugar

Blood sugar and lipid connection

metabolic syndromeHow can high blood sugar affect the fats in your blood stream?

When you eat a lot of processed, white carbs – like white pasta, rice, bread, and crackers – your body quickly digests them and converts them to glucose. Your body can use some of this glucose for fuel, but any extra gets stored in the form of triglycerides.

Findings from the third study also found that a high carbohydrate diet, particularly one with refined grains, was associated with a lower good cholesterol – HDL – which is heart-protective.

A low HDL and high triglycerides are two of the five components of metabolic syndrome – one more of the 5 components and you’ve got heart disease and diabetes in your future.

Glycemic Index and your blood sugar

Glycemic IndexThere are “good” and “bad” carbs. Well, maybe there are some “bad” or unhealthy carbs that really taste good, darn it. I love you Holy Donut. But there are also some “good” carbs that also taste good.

Carbs that are lower in glycemic index are much healthier for you as explained below. Low glycemic foods include legumes like lentils, steel-cut oats, whole grain pasta, fruits and non-starchy veggies. Do you think donuts could taste as good if they were made with whole oat flour and baked instead of fried?

High glycemic foods are all your “white” foods including russet potatoes, pretzels, popcorn, rice cakes and melons and pineapple.

So, a plate of white pasta, which can be as much as four times the recommended serving, with tomato sauce (and most have added sugars), will shoot your blood sugar way up. A large bowl of Rice Chex with milk will do the same thing. Both meals are high in low glycemic carbohydrates and low in protein, fiber and fat.

The rise in blood sugar will cause your body to release extra insulin that will cause your blood sugar to plummet, as you can tell by the graph on the right. In fact, your blood sugar can drop down lower than normal, triggering an adaptive response by your body to get your blood sugar back up to normal. This adaptive response releases epinephrine leading to shakiness, irritability and even a headache. So, you go from food coma to nervous Nellie – that’s an emotional roller-coaster I wouldn’t want to be on.

What you can do

The findings from the PURE study are logical. The important message here is to:

  1. Pay attention to portion sizes of your carbohydrates – use the food label to become aware of a serving size.
  2. Make at least half of your carbs low-glycemic, moving away from the “whites”.
  3. Include a source of protein – low-fat Greek yogurt, low-fat cheese, poultry, fish or lean meat with your meals and snacks.

 

Can you eat a very low carb diet forever?

No more sugar, no more grains, no more processed foods and no more potatoes; yes, to full fat and food products with no processing, just real ingredients. Does this low carb diet sound good to you?

I recently was asked about my thoughts of dramatically reducing carbs and following the above recommendations. This way of eating is essentially the message delivered by Dr. Sarah Hallberg, DO, an obesity specialist with her own patient research to back it up.

No grains or potatoes means no more pasta or rice, or baked potatoes with that steak. It means anything made with flour from grains or sugar is out. Good bye to crackers and cheese, pie and ice cream, all cereal and bread, including pizza. And that means no more Holy Donut…. Hmmmm.

Reducing carbs, reduces insulin levels.

The theory behind this way of eating is very logical: the goal being to reduce insulin levels. Almost half of this country has a condition called insulin resistance where the body makes extra insulin due to compensate for decreased insulin sensitivity. This is partly due to genetics and partly due to eating a high carb diet consisting of too many processed foods.

Insulin is a fat storage hormone so the more insulin on board, the more weight people gain. High insulin levels also raise inflammatory proteins that raise the risk for type 2 diabetes, heart disease and cancer.

So, reducing carbs, reduces the need for that extra insulin. Less insulin means weight loss and decreased inflammation. Sounds perfect on paper, but how about execution? I’d say daunting.

Why do we eat too many carbs, sugar, potatoes and grains?

If you look at each insulin spike caused by eating too many carbs as the enemy, then this shifts the solution to understanding the motivation for eating too many carbs. It’s emotions that drive our behavior. If you want to make behavior change, you should understand the “why”.

Why are so many of us eating too many white, processed carbs?

  • Is it from a lack of understanding of the consequences of food choices?
  • Is it from cravings from too little sleep, too much stress, loneliness or boredom?
  • Is from not knowing how to cook?
  • Is it from unwillingness to change eating patterns due to entitlement, denial, or plain stubbornness?
  • Is it from bringing tempting foods in the house that make it hard to say “no”?
  • Is it from watching too much TV with all the food commercials that trigger binge eating?

The solution lies in addressing both the emotional component of eating as well as the structural component of how to eat. Moreover, the stronger the reason someone has for not wanting to reduce carbs, the smaller the changes in eating patterns must be. It’s like asking someone to suddenly reverse direction going 60 mph. First, they must brake slowly, then down shift and then turn the steering wheel before they can go 60 mph the other direction. Cutting out grains, sugar and potatoes for most people is like being asked to reverse direction mid race. Mindset needs to be shifted first, then change needs to happen gradually before someone can resume usual speed.

If someone is an emotional eater, then it starts with addressing the emotions first and then the plate second.

Damage control

I don’t believe in drastic dietary changes. I believe in making gradual changes that fit the person where they are in life. If someone grew up eating boxed, canned, and fast food, it’s pretty unlikely they’re going to have success in the long run cutting out sugar, grains or potatoes. That’s all I’m saying.

There is another way. It doesn’t have to be all or nothing. It’s called damage control.

What if someone reduced their insulin spikes by eating well some of the meals, and eased up a bit on one meal each day. That would be a 50-66% improvement. Not perfect, but much better.

What if someone ate a lower carb breakfast consisting of plain Greek yogurt with some fruit and nuts, or an omelet with lots of sautéed veggies and one piece of whole grain toast, and a lower carb lunch consisting of a couple of hard-boiled eggs with a piece of fruit, a salad with chicken, or some cottage cheese with fruit and then had a burger, chips and dessert for dinner. That would be much better than a donut or muffin for breakfast, McDonald’s for lunch and eating the same dinner.

Making two out of three meals lower carb is much better than eating poorly at all 3. Even making just one of your meals lower carb is still a 33% improvement.

Or what if someone followed a low carb diet 5 days out of the week, and the other two days they ate “their way”? This is similar to the intermittent fasting diet.

A good place to begin

People with insulin resistance tend to have the highest insulin resistance in the morning. Skipping cereal and making breakfast low carb with focus on healthy fats and lean protein is a perfect place to start. My experience shows that people who eat this way at breakfast tend to stay full until lunch and be less likely to binge the rest of the day.

Psychologically, when people start off the day on the right foot, they have more confidence to make healthier choices the rest of the day.

Success builds success

From my experience, I also find that when people have success for a few weeks, they have the confidence and desire to take further steps as long as these three things are also in place:

  1. They must like what they are doing.
  2. They must not feel deprived.
  3. They must feel it is sustainable.

I’ve worked with so many people who think making drastic changes will get them into the size 10 pants forever. Some achieve their goal but end up regaining it once a vacation, holiday or stressful event happens.

Making gradual changes allows enough time to strategize, explore and understand what’s behind unhealthy eating. It’s not that people can’t reverse direction in life, it’s that the mindset has to be reversed first.

Cutting out grains, potatoes and sugar makes complete sense for the body, but the head has to be on the same page.

Barbara will work work with you for 3 months free if you make a donation to the St Vincent De Paul Soup Kitchen 

 

 

addiction

Addiction Crossovers: The Striking Similarities of Food and Drug Addictions

This is a guest blog from Kevin Brenden in conjunction with Westwind Recovery, a sober living community offering support on the road to recovery

People unfamiliar with how substance addictions work falsely believe that people can only become addicted to drugs or alcohol. They fail to realize that food, especially sugary and carbohydrate-laden fare, can be a sort of gateway to drug and alcohol dependency.

As such, binge eaters often experience the same range of emotions, thought processes, and behaviors as people who are dependent on drugs and alcohol. Learn how food can be a crossover to alcoholism and drug addiction and what factors behind binge eating mimic those found with substance abuse problems.

Reward

People who binge on foods like ice cream, cake, doughnuts, chips, and other treats often experience intense feelings of satisfaction and reward. In fact, studies have shown that indulging in foods laden with sugars and carbohydrates trigger the same chemical reactions in the part of the brain responsible for reward and happiness found when someone snorts a line of coke, takes a hit of heroin, or uses a similar substance.

With that, binge eaters continue to stuff themselves with these kinds of foods to get the same sort of high and feelings of satisfaction. However, as with drug users and alcoholics, they eventually plateau and become tolerant to the amount they are eating. They must increase their sugar and carbohydrate intake to feel the same sense of satisfaction and reward, much like how drug users and alcoholics must increase the amount that they use to achieve the same level of high.

Cravings

People who are addicted to food also experience cravings that are as intense and distressing as those experienced by drug addicts and alcoholics. They are desperate for another scoop of ice cream, another bite of pastry, or another plateful of sugar and carb-filled foods. Some binge eaters will even become so desperate that they will resort to stealing or lying to get what they want.

Their desperation and sneaky behaviors are not unlike those that drug addicts and alcoholics will use to score more drugs or alcohol. Cravings are not reserved just for people who are dependent on drinking or using illicit or prescription drugs. They also are found with people who cannot stop binge eating.

Shame

Finally, people who are addicted to food will often feel ashamed of themselves, putting them in the same category of many drug addicts and alcoholics. Just as people who are dependent on alcohol or drugs feel ashamed of themselves, so do binge eaters. They realize that their behavior is abnormal and not acceptable in society. Even so, they cannot help themselves from binge eating.

Like drug addicts and alcoholics, binge eaters stand the best chance of recovering from their addictions by undergoing professional treatment at a dependency recovery center. They can learn coping mechanisms and benefit from professional care as they overcome their cravings for foods that are full of sugar and carbohydrates.

 

stats on cancer

Derail cancer, get this tested

What if there were one blood test that could tell you early on that your health was heading down the wrong path? Like a railway crossing signal, there are early warning signs that our body is in danger. The danger doesn’t happen quickly, but like the rails of a train, once it has started it has a predictable path towards an unwanted health destination. The warning sign is insulin resistance; the test is an insulin fasting blood test or Immunoreactive Insulin. People may know about the connection between insulin resistance and diabetes, but how many know about the connection to cancer?

Insulin Resistance and Cancer

Insulin is a hormone that helps glucose get into the cells for energy. Insulin resistance is a pathological condition where the muscles, liver and fat cells don’t respond to the insulin. The diminished response forces the pancreas to make extra amounts and increases circulating insulin. Society for Endocrinology’s review sheds light on the connection between insulin resistance and cancer. On a cellular level, insulin along with related insulin-like peptide receptor sites play a role in immune deregulation. These specific peptides impact normal cell proliferation, differentiation, metabolism and destruction and set up an environment more inviting for cancer development.

Insulin resistance is a harbinger not only for diabetes, but for cancer as well

Insulin Resistance in Children

Insulin resistance isn’t just for adults. In a retrospective study published December 2014 in the Jornal de Pediatria, 33% of 220 obese children between the ages 5-14 were found to have insulin resistance. These children had the hallmark of metabolic syndrome: high BMI, abdominal obesity, LDL and triglycerides, and low heart protective HDL. Not only are these children on their way to type 2 diabetes, but they are at much greater risk of getting cancer.

Take The Test

Insulin resistance can happen before high blood sugars or hyperglycemia develops. Anyone who is obese, has a family history of diabetes or is from one of these ethnic groups: African-American, Mexican, American Indian, Native Hawaiian, Pacific Islander or Asian American, should have their fasting insulin level assessed. Your insurance may or may not cover it, but it is very affordable if you want to have it checked.

Cancer

I don’t think there is anything more scary than getting the diagnosis of cancer. The National Cancer Institute reports that US cancer death rates have declined since 1990, primarily due to a decline in smoking, but it is projected to rise with an aging population and a rise in obesity.

Obesity, a risk factor for cancer, is also increasing.

Insulin resistance is reversible. If you knew that you had it, and now know that it’s link to cancer, would it give you extra motivation to change your diet and move a little more? Habits are hard to change, but if you knew you were on the path for derailment, wouldn’t you want to jump off that train now?

Barbara is a certified diabetes educator, nurse and health coach. She has a passion for health education and inspiring a healthy lifestyle. If you like what she writes about, please like and share her posts on her facebook page.

Most Mainers at risk for, or has diabetes

Does 48% scare you? Those are some pretty good bettin’ odds. That’s better than the overall odds at winning in Blackjack. The 2014 CDC data found 37% of Maine residents have prediabetes. Over 11% or 137,413 have diabetes and 36,000 of those people don’t even know they have it. Now that is really scary. How can people live with the common symptoms of uncontrolled blood sugars like yeast infections, extreme fatigue, erectile dysfunction, thirst and peeing all the time without going to their medical provider and complaining? Do people with these symptoms really think that life can’t get any better than that?

Metabolic Syndrome or Prediabetes- Reversible

metabolic syndromePrediabetes goes by several different names:  Metabolic syndrome, Syndrome X, and impaired fasting glucose are all names used for prediabetes. If you have central obesity, high blood pressure and unhealthy cholesterol, there’s a good chance you are on the road to diabetes. More specifically, if you have 3 of the 5 conditions to the left, you have prediabetes. Those odds of developing Type 2 diabetes are even greater if you have a family history of diabetes, had gestational diabetes, are older or are African-American, Hispanic, Asian, Alaska native, or Native American. You can see why the odds go up with each factor.  And just to clarify, type 1 and type 2 diabetes are really two different diseases with different causes. Type 1 diabetes is an autoimmune disease associated with sudden changes in insulin production whose cause is not associated with lifestyle changes. Type 2 diabetes is a preventable disease. You can learn about your odds here and talk to your healthcare provider.

A Prediabetes Diagnosis Should Imply A Sense of Urgency

Once prediabetes becomes diabetes, the insulin producing beta cells of the pancreas quit working – some say as much as 50%. When the pancreas can’t meet the needs of the body not only do blood sugars rise, but other metabolic changes occur, particularly with fat metabolism. The higher blood sugars and lipid levels damage the blood vessels of the body. That’s why diabetes is really heart disease with a sugar problem. Complications of poorly managed diabetes are a result of nerve and vascular damage leading to blindness, stroke, heart disease, kidney failure, and amputation. These severe complications happen over time with earlier patient reported symptoms of depression, nerve pain in the extremities, frequent infections, sexual difficulty and a change in quality of life.

Let’s Stop Diabetes

Diabetes costs Mainers $1.6 billion every year. The costs are for treatment of severe complications like hospitalizations for heart disease and stroke, amputations and prosthetics, surgery to prevent blindness and dialysis. Wouldn’t it be wonderful if we could shift that money from end-of-life treatment to early detection, education and support?

Our healthcare system is changing. Where fee-for-service was the standard of care, outcome-based results is now the gold standard. Our health care system is now a team of medical providers, nurse practitioners, physician assistants, population health nurses and medical assistants all with the aid of health informatics and data analysis. Healthcare is doing a much better job with managing chronic disease but is still weak on prevention. There is not a financial incentive yet to focus on that. The days of our medical provider being the sole conductor of our healthcare are over.  The new reality is that we need to play a proactive role in our own health.  Blood sugar levels often get overlooked. There were many times in my previous job when patients saw me for health education, unaware that they had prediabetes or diabetes. Things do get missed.

What You Must Do

Prediabetes develops over time. Blood sugar levels rise over many years and don’t suddenly hit the 100 mg/dl threshold. When I first became a certified diabetes educator the level was at 110 mg/dl, but lowering it provided earlier intervention.  Everyone should have a fasting blood glucose level done annually, especially if they have a family history of diabetes, are sedentary or overweight. And once it is done, get the results and know the significance of those results. There is support if you need it!

Barbara is a certified diabetes educator and health coach. She would love to help with any health questions and can be reached through her facebook page.

The Truth About Losing Weight

Our bodies want to stay the same.  You can trick them into losing weight for a short time, but they will make adjustments to help that weight come back on.  Oh boy, now that’s motivation to take the diet plunge…!

A May, 2016 New York Times interview with metabolism expert, Dr Kevin Hall from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the NIH, examines the weight regain of the Biggest Losers over a six-year period.  Dr Hall has found that with weight loss, not only does resting metabolism decline, but it slows down for years after weight loss making it even more difficult to keep the weight off.  After following the contestants all but one regained their lost weight, but what surprised the researchers the most was how much their body’s metabolism had slowed down, even years after they had regained the weight.  One contestant in particular, Danny Cahill, had one of the worst declines in metabolism.  Just in order to maintain his weight of 295, he had to consume 800 calories fewer than other men of his stature.

Stress And Losing Weight

A NIH review of different obesity models discussed the psycho-biological impact of stress on eating habits in terms of the “wanting” and “liking” versus hunger and fullness.  Stated simply, you can like a food but not want to eat it, and you like be full and still want something you like.  If we lived 1000 years ago, we would have pretty slim pickings to choose from.  But given the wide variety of crunchy, creamy, chocolaty and sweet choices we have today we are constantly negotiating needs and wants, fullness and hunger.  Later in the article it discusses the different brain pathways between liking and wanting a food and how they are altered in times of stress.   Research indicated:  “Post-prandial (after eating) food choice and food intake in the absence of hunger are exaggerated under stress, especially in overweight individuals with visceral adiposity (excess weight around the waist).”  In other words, stressed induced post-prandial eating was linked to not only more “wanting”, but to reduced – “liking”.  Hence, the after dinner kitchen raid during times of stress.  And for those with extra inches around the waist, the message is even louder.

Losing Weight:  A Complex Solution

Obesity is clearly not just a matter of eating too much.  There are physiological barriers to weight loss:  the body’s relentless physiological hold on body weight, perhaps thinking it is preparing for famine.  Add stress to the picture and no wonder fruits and vegetables just don’t make the cut.  We know through the National Weight Control Registry that people can lose and keep weight it off, but it is clear that to do so, it has to stay front and center of one’s life.  It means constant coping with hunger, nutritional vigilance, getting regular exercise and management of stress.  Next few blogs will show you how to make it easier.

Barbara writes a biweekly blog to help inform and empower people to live healthy lives.  Please “share” her articles and “like” her facebook page to help spread the word

Breaking The Weight Barrier: Set Point

Set PointHave you lost weight in the past only to regain all of it and perhaps a bit more?  You are not alone, most dieters regain their weight.  Our body has a genetically determined set point for weight it wants to maintain.  The Set Point for weight is an internal physiological system.  It involves hormones that work on the brain to regulate hunger and satiation.

The Physiological Feedback Loop

Leptin is a protein made by fat cells that signals the brain that the body is full.  Along with insulin, another hormone released when we eat, our body has a physiological mechanism for maintaining weight homeostasis or set point.  According to ObesityAction.org, we have a body fat thermostat that influences our appetite.  When weight goes up, more insulin and leptin are released, reducing appetite.  When weight goes down, insulin and leptin levels decrease, increasing appetite.  A gradual weight gain over time can raise the set point making it difficult to lose weight, especially when one feels constantly hungry.

In a WebMD interview with Robert Lustig, MD, a member of the Endocrine Society’s Obesity Task Force, he states that “Leptin is the way your fat cells tell your brain that your energy thermostat is set right”.   He goes on to say that with obesity, despite the high levels of leptin, the brain does not get the message to slow down eating.  He talks about the brain thinking it is in a “starvation mode” because it is not getting the leptin message:

 “The leptin is being made by the fat cells, the fat cells are trying to tell the brain, ‘Hey, I don’t need to eat so much,’ but the brain can’t get the signal. You feel hungrier and the reward doesn’t get extinguished. It only gets fostered, and so you eat more and you keep going and it becomes a vicious cycle. If your brain can’t see the leptin signal, you’re going to get obese.”

Lustig calls this “leptin resistance” and believes that it is caused by insulin resistance:  impaired ability for the body to recognize insulin.  He believes the best way to address insulin resistance is to not let insulin levels get high in the first place, by reducing sugar intake.

Resetting The Set Point

Dr George Blackburn, Associate Director of the Division of Nutrition at Harvard Medical School, discusses in his book, Breaking Through The Set Point:  How To Finally Lose The Weight You Want And Keep It Off, how to lower one’s set point.  Based on Set Point theory developed by Bennett and Gurin, Blackburn recommends a combination of physical activity and dietary changes.  He believes that people should lose weight gradually and maintain it for at least six months in order to reset their set point.  He has observed that rapid weight loss results in rapid weight gain.  He also observes that after someone has lost 10% of their weight, the body starts to conserve calories.  He has found that if someone can maintain the weight loss for six months, the set point will be reset and more weight can be lost if desired.

Looking At What Works

The National Weight Control Registry, a registry that tracks individuals who have lost 30 pounds or more and have kept it off for a year, lists common behavior patterns.  94% of these individuals increased their physical activity with 90% of them exercising for an hour on average a day.  98% have changed their eating habits eating a lower calorie, lower fat diet and 78% eat breakfast daily.  You can read more individual success stories here.

Making Sustainable Lifestyle Changes

Although dieting can get someone into that bikini quickly, I believe finding a broader purpose for losing weight is going to give more lasting motivation and sustainable results.  Excess weight tends to creep on over many years, so it should come off gradually – no more than a half pound or pound a week.  I believe the focus should be on getting healthy, not losing weight which connotes something negative about the process.  Personally, I believe in finding a daily exercise plan that can work throughout the seasons whether it’s walking outside, having personal equipment or videos, or going to the gym.  I believe in eating a diet high in fruits, vegetables, lean protein and no refined grains or processed food.  I believe it requires looking at habits and finding good substitutes for unhealthy habits.  I believe it’s making small permanent changes at a pace that seems natural and interesting.  I believe it starts with an attitude of curiosity and adventure, that ends with better health and satisfaction.

Barbara writes a biweekly blog to help inform and empower people to live healthy lives.  Please “share” her articles and “like” her facebook page to help spread the word

Free Help, Are You Ready?

I’m ready, are you ready?  This is your gift to yourself or to someone you care about.  I am ready to “pay it forward” and help 10 people individually who are interested in losing weight, especially if they have prediabetes or a family history of Type 2 diabetes.  I am a registered nurse, certified as a diabetes educator and also a health coach with extensive knowledge of prediabetes and diabetes and helping people make lasting lifestyle changes.  I know it is not easy but sometimes eliminating the burden of price while offering support in developing new habits is all it takes to get over the inertia of making lifestyle changes.

It’s Free

I have a passion for preventing diabetes.  Prediabetes is such a huge opportunity.  Address prediabetes and that person avoids developing permanent cardiovascular damage.  See, diabetes is really heart disease with a sugar problem.  Research shows that a 7% weight loss in conjunction with 150 minutes of moderate intensity exercise a week dramatically reduces the chance of prediabetes becoming diabetes.  I will give you the tools to learn how to eat to avoid the insulin spike.  I will support you and work with you on finding an exercise routine that will work for you.  I will help you get to that 7% weight loss.

How I Will Help

I will Skype with you or meet in person for 6 hourly sessions and review your food log on myfitnesspal for free.  I will also give you useful handouts to help you understand how to fuel and move your body.  Why am I doing this?  Because I can and because I have a passion for preventing diabetes.  I think I’m good at what I do and I also have learned that people don’t know what they don’t know about health and about taking care of their bodies.  Small changes can make a huge difference.  I have the time right now, and I love what I do.  That’s it, that’s all.

What’s The Catch?

I was recommended to add this because some people might not take this offer seriously because they don’t think there never really anything free.  So, if you want, I ask that you refer me to 3 of your friends or family.  You don’t have to, but at the end of our sessions, if you are happy with what you learned, I would love the opportunity to help others.

How To Contact Me

The best way to reach me is to email me at barbarahgroth@gmail.com.  We can connect and see if this opportunity would work for you.  There is nothing to lose and only everything to gain. This opportunity will end October 31, 2015.  Now is the time to reach out for yourself or for someone you love.  I’d love to help and now is the time.  Pass it on so I can pay it forward.

 

refined carbs

Prediabetes, A Cry For Help

Diabetes doesn’t just come knocking at the door one morning when you wake up.  Diabetes is foreshadowed if you understand its disguise.  If you can catch prediabetes before it becomes diabetes you can prevent some the permanent damage to your cardiovascular system and pancreas, the insulin-producing organ.

The Significance of Prediabetes

There are over 86 million people in the US that have prediabetes and 9 out of 10 of those people do not even know they have it.  Once someone is diagnosed with prediabetes they will most likely develop diabetes within ten years if they do not make lasting lifestyle changes.  Being diagnosed with prediabetes is a gift or warning to make changes now before permanent damage occurs.

How Would You Know If You Have Prediabetes?

Prediabetes doesn’t have any signs or symptoms.  That is the scary thing.  Your body doesn’t give any warning until diabetes has shown its ugly face.  However, your healthcare provider may have checked a basic or complete metabolic panel that includes a blood glucose test.  In our busy healthcare system, having an elevated blood sugar at the prediabetes level often gets missed by busy providers.  Ask for your results and if your glucose level was done after you had been fasting and was greater than 100, then you should have this repeated with one of the tests below.  If you have symptoms of excessive thirst, increased urination, blurry vision or frequent fatigue, then this could indicate that you have diabetes.

What Is Prediabetes?

Prediabetes is a problem with processing sugar or glucose, mostly from the foods we eat, leading to higher than normal blood glucose levels but not high enough to be diabetes.   This is partially due to the body not utilizing insulin in the normal way.  Over time this problem with insulin progresses, leading to higher blood sugars and diabetes.  There are three tests for diagnosing prediabetes and diabetes:

  • Glycated Hemoglobin (A1c) which indicates an average blood sugar over 2-3 months time.   An A1c between 5.7-6.4 indicates prediabetes.  An A1c over 6.4 over two different occasions indicates diabetes.
  • Fasting Blood Sugar is done by taking a blood sample after 8 hours of fasting (usually done overnight).  Under 100 is considered normal.  Having a result between 100-125 indicates prediabetes.  Having a result 126 or greater on two different occasions indicates the individual may have prediabetes.
  • Oral Glucose Tolerance Test is a slightly more involved test but probably the most accurate since it directly assesses how the body manages a glucose challenge.  This test is done fasting as well but the individual is given a sugary drink and blood sugar levels are checked before and several times afterwards.  A normal reading is under 140.  Having a reading between 140-199 is considered prediabetes; greater than 199 is considered diabetes.

Who Should Be On Alert For Prediabetes?

The exact cause of prediabetes isn’t well understood but there is a genetic link and it is associated with leading an inactive lifestyle and having abdominal fat.  The following are indications for getting checked for prediabetes:

  • Have/had a parent with type 2 diabetes
  • Having a waist circumference > than 35 for women, > 40 for men
  • Are overweight
  • Are inactive
  • Are of Asian, African, Pacific Island, Hispanic or American Indian descent
  • Are over 45
  • Had gestational diabetes or a baby weighing over 9 pounds
  • Had PCOS- polycystic ovary syndrome
  • Have sleep apnea
  • Have high triglycerides, low HDL or have high blood pressure

Prediabetes Is A Chance For A Do-Over!

The Diabetes Prevention Program, a multi-center clinical research study, showed that a 7% weight loss along with 150 minutes of moderate intensity exercise a week greatly reduced the risk of developing diabetes in those who had prediabetes.  For a 200 pound individual that’s only 14 pounds!  That’s not a huge amount of weight.  Couple that with a walk after dinner most nights and that’s a pretty doable plan.

Let Me Help You

This is my passion.  I understand the nuances to making lifestyle changes.  I will help you find your steps towards prevention of diabetes.

good carbs

Make Your Carbs Count

Some of us are carnivores, people who crave steaks, ribs and other bloody meat, and some of us are carbivores, my definition of people who crave chips, cookies and candy.  But too many carbs, especially the processed ones, do us more harm than the few minutes of pleasure we get from eating them.  It’s not about abstention from them; it is about making informed choices.

Carbohydrate Sources

Carbohydrates (carbs) are those foods that contain sugar, starch and/or fiber.  Some grow naturally in the environment while others are manufactured.  Naturally occurring carbs inherently contain more fiber, vitamins and minerals than manufactured carbs.  Manufactured carbohydrates are often times more manipulated to enhance shelf life, taste, advertising appeal and texture.  These are the kinds of manufactured carbohydrates I’m referring to in this article.  It’s the degree and intent to which these “man-made” carbs are manufactured that is the issue when it comes to health.

Naturally Occurring Carbs

Naturally occurring carbs include fruits and starchy veggies, legumes and whole grains, and some dairy.  The amount of carbohydrates found in fruits can vary depending on the kind and the ripeness.  A cup of grapes has 28 grams of carbs, while a cup of raspberries has 15 grams.  Less ripe fruits have more resistant starches in them that are not digestible while riper fruits have more of their starch converted to easily digested sugar, raising their carb load and their impact on blood sugars.  Starchy veggies include all potatoes, corn, peas and winter squashes.  Think of veggies that are denser and sweeter.   Lower carb veggies are less sweet and have a higher water content like celery, zucchini and broccoli.

And like those resistant starches converted in riper fruit, the same thing happens when grains are cooked longer.  Soft pasta has a higher carb load than the less boiled al dente pasta.

Milk has the natural occurring sugar, lactose, which adds about 12 grams of carbs per cup.  Cheese and plain unsweetened yogurts, especially plain Greek, have less lactose, therefore fewer carbs.

Manufactured Carbs

Manufactured carbs include things like certain breads and pasta, candy and baked goods, chips and crackers, and ice cream and fruit-filled yogurt.  In particular I want to focus on the manufactured carbs that strip the good, naturally occurring benefits out of the product and then try to add other ingredients to artificially enhance a product.

Manufactured goodness pasta labelFor example, Barilla Plus pasta tries to appeal to the health conscious consumer by advertising on their food label “multigrain”, “protein, fiber and ALA Omega-3”.  When you look at the complicated food label you can see that what they’ve done is take wheat flour (only part of the wheat berry) and blended it with flour from lentils, chick peas, flaxseed(tha t’s how it gets to promote the ALA omega 3), oats and barley, and enhanced the fiber artificially by adding oat fiber, enhanced the protein by adding egg whites, and enhanced the nutrients by adding vitamins and iron.  There are 16 ingredients in this product.  Now compare that to Luigi Vitelli organic pasta which contains only one ingredient – whole wheat durum semolina flour grown organically – and you can see what I am talking about.  Not only is the Luigi pasta higher in naturally occurring fiber but there is no food manipulation going on.  A food shouldn’t brag on the front of the box when there are 16 ingredients in it when only one truly good ingredient is needed.  You don’t need to mess around with mother nature to try to enhance a product.

Another example is oatmeal.  Oatmeal comes as quick cooked, old-fashioned, steel-cut and in its pure form, the “grout”.  You can find quick cooked that has added fiber to make consumers think they are getting a really good thing but they really aren’t in this case. Quaker Oats High Fiber Instant Cinnamon Swirl Oatmeal is made from precooked and dried oatmeal, a created fiber called maltodextrin, sugar and sugar substitute, caramel coloring and vitamins and minerals to make it sound really healthy.  Keep in mind that maltodextrine is a type of  manipulated fiber that doesn’t provide the same health benefits of naturally occurring fiber.  This cereal gets high ratings for taste but in a man-made, less healthy way.  The less processed the oatmeal grain – which starts with the grout, the more naturally occurring fiber, vitamins and minerals you will get.  You’re better off eating steel-cut oats flavored with a teaspoon of honey and cinnamon than a quick cooked sweetened oatmeal if you are really trying to take care of your health.

In general, look at the number of ingredients in a label when you are comparing similar foods.  The fewer the ingredients, the less man has manipulated it, and the more nature leaves its imprint.

Good Carbs, Bad Carbs

I think of carbs as the body’s gas pedal.  When you eat a lot of manufactured carbs, especially ones made with white flour and lots of sugar, the body’s rpm’s go really high.  This causes blood sugars to go really high and the pancreas to have to work really hard to take care of the extra blood sugar.  Getting back to the car metaphor, carbs are the gas pedal and the brake pads are the pancreas.  Eating foods that are highly processed, laden with sugar and stripped of the bran and germ of the grain is like pressing down hard and fast on the gas pedal and the pancreas, like the brake pads of your car, gets worn out.

Not "whole" foods

Not “whole” foods

These kind of carbs in the picture at left, are what cause the insulin spike and when consumed frequently, keep blood insulin levels high creating the cascade of events mentioned in the previous post.

Getting back to the gas pedal metaphor, choosing mostly intact carbs with little processing like whole grains, fruits and beans it’s like gently putting your foot on the pedal to  accelerate.  When you choose these kinds of carbs you get a more gradual blood sugar rise and put less stress on the pancreas.  And because they are high in fiber you stay fuller longer – which is like getting more mileage for the same amount of gas.  Furthermore, the best payback that I hear from my clients is that they have more energy.  With fewer blood sugar swings there are also fewer times during the course of the day where they have trouble focusing and feel sleepy.

How Many Carbs Should You Have?

Last post I talked about reducing carbs to the lower end of the Institute of Medicine acceptable range of around 45% of total daily calories.  How many grams of carbohydrates does that amount to for a day?  First you need to calculate your recommended daily caloric needs that considers your age, sex, height and activity level.  The Mayo Clinic has a nice interactive calculator you can use here.

For me to maintain my current weight considering my activity level, I would need 2100 calories daily.  To determine my daily carbohydrate needs Based on the points made in my last post, I will multiply the 2100 calories by the 45% and then divide it by 4 since there are 4 calories per gram of carbohydrate.

                                                                     2100 X .45 = 945                                                                                                                                              945/4 = 236 grams

If I divide the 236 grams over my three meals it works out to about 80 grams per meal.  If I were to have a snack containing carbohydrates I would reduce the carbs in the meals accordingly.  You can look at the food label under total carbohydrate to see how many grams a serving has.  For those foods that do not have a food label The Calorie King Calorie and Carbohydrate Counter Book is a nice resource.  Keep in mind that many prepared food items contain more than one serving.  The Stouffer’s Macaroni and Cheese in the above picture actually contains 5 servings in the box.  Many people would either eat the whole box or split it with someone.

How To Begin

  • Cut out or reduce your soda intake.   A 12 oz. coke has 55 grams of sugary carbs.  Try seltzer water with natural flavoring or tea.
  • Reduce the amount of chips you ea.   A serving of Stacy’s pita chips has 19 grams of carbs.  Measure your portion and put it on a plate, do not eat out of the bag.  And don’t think that just because pretzels have little fat and are low in calories are a good choice.  Most pretzels are make with white flour.  Eating a few servings of those is just like putting the pedal to the metal.
  • Switch to black coffee or coffee with whole milk with less sugar or use Truvia.  A vanilla Frappuccino at Starbucks has 68 grams of carbs.
  • Eat your fruit instead of drinking it so you get the fiber.  Juice glasses use to be 4 ounces, now they are 8 oz – that’s 30 grams of quickly digested sugary carbs.
  • Cut out the donuts and muffins (unless it’s my high fiber, high protein recipe) and eat a breakfast with more protein and fiber from whole grains and fewer carbs- like my frittata with 2 pieces of whole grain bread.  Or something more simple might be a cup of plain Greek lowfat yogurt, with 1/2 cup of thawed frozen berries and some chopped nuts.
  • If you are a candy lover switch to one small piece of dark chocolate which is lower in carbs (4 gms) and has heart healthy flavonoids.  A candy bar like 3 Musketeers can have 42 grams of sugary carbs.

Most of us love our carbs whether they are sweet, salty or crunchie.  Everything in moderation has to be defined.  It can’t be permission to indulge without discretion.  Next post I’ll discuss tips to make this process easier.