Tag Archives: Diabetes Prevention Program

Fat Calories in common foods

Fat Culprits In Your Diet

Most people know the difference between good fats and bad fats but do they realize making even small changes in the amounts of the usual culprits high in fat calories can help them lose up to a pound a month with no pain?  Everyone thinks that eating a salad for lunch is going to move that scale needle southward.  But when you load that salad with nuts, olives, avocado, cheese and dressing, that healthy salad can deliver as many calories as a Big Mac with fries.

Fat Calories Add Up

Fat calories are twice as potent as calories from carbohydrates and protein.  There are 9 calories in a gram of fat versus only 4 calories in a gram of carbohydrate and protein.  The chart below lists some common foods that people eat regularly that are high in the heart healthy unsaturated fats but calorie dense because they are high in fat. fat calories in good fatsEaten without attention to portion sizes, these foods can pack a lot of calories.  A salad topped with 10 olives, half an avocado, 2 oz of chopped nuts, a few slices of cheese and some dressing can deliver over 1000 calories, or more than the 930 calories in a Big Mac with medium fries.  And you salad eaters are thinking, “that salad didn’t even contain one carbohydrate, so it’s got to help me lose weight, right?”  Nope.  fat calories in salad dressing

Salad dressing is the big calorie kicker depending on the choice.  Two Tbsp of Caesar salad dressing delivers 165 calories, and that’s if you are measuring.  If you are getting your salad from the grocery store and pouring the dressing from those large containers, how do you really know?  I know the prepackaged servings of dressings at the deli near me is a 1/4 cup serving or 4 Tbsp.  That can be at least 290 calories.

What if you are adding extra “healthy ingredients” like artichokes or some of the other vegetable like the ones in the Whole Food’s salad bar that are swimming in oil; that adds additional calories.

Count Your Fat Culprits

The CDC’s National Diabetes Prevention Program focused on the total grams of fat in the diet with fat gram goals geared around an individual’s weight.  CDC Fat Gram GoalI always thought it was strange that a diabetes program would focus on fat and not carbohydrates, but truthfully it is much simpler to track just fats than total calories.  Furthermore, you get more bang for your effort by reducing total grams of fat since they are high in calories.  With 3600 calories in a pound, cutting out 15 gms of daily fat will mean a one pound weight loss in about 27 days.  That doesn’t seem like much, but that’s 14 pounds in a year and it’s painless with just a little awareness and a few substitutions.  low fat substitutioinsHere’s how you can find cut those fat grams in just your lunch salad.  Reducing the avocado to  one quarter will save 7 gms of fat.  Cutting the portion of nuts in half will save you another 7 gms.  Using fat-free Feta cheese, which is sharp and still has the consistency of cheese, will save you another 10 gms.  Being mindful of salad dressing portion sizes, or better yet making your own by using a 2:1 ratio of vinegar to oil (I like adding lemon juice and herbs to mine) will save you another 7 gms.  With just these suggestions you would save 21 gms of fat, 190 calories and a pound in 19 days.  That doesn’t even include making other small changes like switching to light mayo, or using mustard or hummus in lieu of mayo on sandwiches, or using fat-free Greek yogurt instead of mayo or sour cream in dips.

Your Culprits Are Calorie Dense

Often times I hear people being frustrated that they are not losing weight despite their best intentions of eating a salad every day.  Making these small changes are painless and yield big results.  It doesn’t take a radical diet to lose weight.  It takes knowing what your culprits are, making small changes that don’t lead to feelings of deprivation, and being mindful of portion sizes.  Losing weight gradually is a much healthier and more sustainable way to lose weight and keep it off.  That’s the healthy way to a happy weigh!

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.

 

Type 1 Versus Type 2 Diabetes

There is a big difference between type 1 and type 2 diabetes.  They are two completely different disease processes that really should not share the same name.  Type 1 is actually an autoimmune disease with a small genetic link that usually occurs in youth and causes damage to the insulin producing cells of the pancreas.  If diagnosed early then some of the pancreatic function can be preserved.   However in most cases of recently diagnosed type 1 diabetes significant permanent damage occurs requiring the individual to administer multiple daily  insulin injections to control blood sugar levels. With frequent daily blood sugar checking, insulin administration and dietary planning a person with type 1 diabetes can lead a full healthy life.  If blood sugars are not kept in good control,  blindness, kidney disease, heart disease and amputation due to poor circulation and infection can occur. Since the pancreas is not producing any insulin, it’s always a challenge for an individual with type 1 diabetes to find the balance between managing their disease and not letting it overrun their life.

Type 2 diabetes is actually a stress state of the associated with a strong family history of diabetes in conjunction with an unhealthy lifestyle.  The typical individual diagnosed with type 2 diabetes has excessive abdominal fat, leads a sedentary lifestyle and consumes a diet high in refined carbohydrates, saturated fats and not enough legumes, whole grains, and fruits and vegetables.  They often feel tired due to high blood sugars and/or sleep apnea.  It can lead to increased inflammatory markers that contribute to atherosclerosis or hardening of the arteries, decreased insulin production and sensitivity, and stress on the overworked pancreas.  Medications can help to control the disease process but without lifestyle changes as well, eventually the pancreas fails and insulin through injection is required.  Type 2 diabetes is really a vascular problem that if not controlled leads to circulatory problems resulting in slow healing of cuts, loss of vision from retinopathy, erectile dysfunction, painful neuropathies of extremities due to nerve damage, and kidney damage from high blood sugars that damage the intricate filtering components, the nephrons, of the kidneys.

The National Institute of Health did a large study involving 27 medical centers across the country on preventing diabetes in those diagnosed with prediabetes.   Prediabetes is diagnosed with a blood test as having a fasting blood sugar greater than 100 or an A1c greater than 5.8.  The results of the study were published in the New England Journal of Medicine February 7, 2002.  Initially the study involved  four groups of randomly assigned people to either a lifestyle intervention group involving motivational counseling, one of two medication groups or a placebo group.  One of the medication intervention groups was discontinued after the drug was found to cause severe liver damage.  The lifestyle intervention group involved losing 7% of body weight and exercising 150 minutes at moderate intensity level a week.  The drug group was given the oral medication, Glucophage.  The study was stopped early because the results found that a 7% weight loss in conjunction with 150 minutes of exercise a week to be the most effective in preventing diabetes in those already diagnosed with prediabetes.

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In prediabetes the pancreas makes extra insulin in order to help glucose get into the cells where it is needed for energy. Over time insulin production decreases, and blood sugars increase, leading to the development of type 2 diabetes. Once type 2 diabetes has developed there is some permanent damage done to the pancreas.

Almost 26 million people in the United States  have type 2 diabetes.  That’s 8.3% of the population!   It takes a good understanding of disease management, planning, and good support both financially and emotionally to maintain good control.  Can you imagine the cost savings of preventing this disease if everyone diagnosed with prediabetes could just lose 7% of their weight and find 150 minutes out of the 10,080 minutes in the week to exercise?  And for those already diagnosed with type 2 diabetes, just being physically active for 30 minutes daily and reining in the fast food, chips, sweets, cheese and full fat dairy and eating more whole grains, fruits and vegetables, could make all the difference in the world between just living and living well.  In this time of rising health care costs and limited resources don’t we all have a responsibility to take our health seriously and give it the focus that we give to other parts of our lives?

Exercise- #3 of Ten Actions To Improve Health

lilybayjuly08011Exercise for Your Health

As we get older we lose about 8% of our muscle mass every decade after age 40.  Our metabolism is determined by our muscle mass.  So if we continue to eat the same way every year and do not exercise then weight creeps up as metabolic needs decrease.  That quarter pounder at lunch can lead to a gradual weekly quarter pound weight gain that becomes ten pounds by the end of the year.  Couple that with a family history of diabetes and you can see why more and more people are developing prediabetes and diabetes, not to mention feeling sluggish, tired and frustrated.  We need to exercise for health.

The Diabetes Prevention Program

The Diabetes Prevention Program, a study involving 27 health centers nationwide, compared 3 different groups of people to see what intervention was the most effective for preventing type 2 diabetes in participants with blood sugars in the prediabetes range.  The first group was a lifestyle group, the second was a group that was put on the drug Metformin and the last group was given a placebo.  There was a fourth group that was put on another drug but it was stopped after it was found to cause liver damage.  The results revealed that the lifestyle intervention group was the most effective for delaying and preventing the development of diabetes.  The lifestyle intervention goal was to lose 7% body weight and exercise 150 minutes a week at moderate intensity.

Exercise Is the Best Kind of Medicine

So why is exercise the magic pill?  Moving our bodies involves large muscle groups that helps our bodies be more sensitive to our own insulin, it helps reduce bad cholesterol (LDL) and raises the good cholesterol (HDL).  It maintains muscle mass preventing the slowing down of metabolism after age 40.  If strengthening exercises are done then this can increase muscle mass and raise metabolism even more, helping with weight loss.  Regular exercise improves sleep, mood, and energy level.  So why isn’t everyone doing it??

What Do You Do If You Hate to Exercise?

You do not have to start out like gangbusters.  I recommend my clients buy a pedometer – a good one that you can wear in your pocket and will be accurate will cost you about $30.  The Fit Bit is a good one that can also count your stair steps as well as walking steps.  It is recommended that people walk about 10,000 steps a day.  A sedentary person only walks between 1000-3000 steps daily.  Wearing a pedometer can be a motivator.  I had one client who near the end of the day was behind in her steps and ended up walking around her house several laps to meet her daily goal.  Another trick I tell my clients is to mute through the commercials (which also helps avoid the munchies ads) and do sit down leg marching through all the commercials.   This adds a little aerobic as well as some core strength as you lift your legs.  I also recommend that whenever you are on the phone to walk around.  The other key is to know yourself.   Would you do better in a class that is fun and structured or would you do better working with a trainer to make you accountable?  Know what the obstacles are and tackle those first.  Is weather an issue that could keep you from going out or making a class?  Then try a walking DVD by Leslie Sansone or personal equipment like a stationary bike, elliptical or Cybex.  Is time a problem? Set the alarm earlier to get exercise in first thing in the morning before you have time to talk yourself out of it.   Or consider exercising over your lunch break or in the evening after dinner.

Other Tricks

The hardest part about exercise is just forming the habit.  The more often you do it the more likely the habit will stick.  Exercising for 15 minutes every day will make it a habit sooner than exercising just 1-2 times a week.  The more you associate your exercise with other habits the more likely it will stick.    Free up time in the morning to give yourself more time to exercise by doing some of your chores the night before like making your lunch, laying out your clothes and feeding the pets.  The more you plan for your exercise and work other life demands around it, the more you will stay with it.

Start Gradually, Notice Improvement, and Encourage Yourself

I have many clients who tell me that exercise hurts their knees or back.  Keep in mind that it is our muscles that give our joints and spine support.  If you have been sedentary you may have lost this support which might initially cause some pain with movement.  I have witnessed many times how my clients who have stuck with the exercise regimen gain strength and support and their pain goes away.  The key is to start gradually and divide it up into 10 minute segments if this is all your body can tolerate.  Tell yourself that after a few weeks you will notice positive changes.  After a few weeks be aware of the positive changes you notice.  Take the time to notice and talk to yourself kindly and positively!

Other Safety Tips

Wear supportive shoes – your feet are your shock absorbers.  Treat yourself to some new sneakers and keep them just for exercise.   Replace them every 6 months when you develop a regular routine.  Hydrate ahead of time if you plan in being out in the heat.   And remember to stretch after you exercise.

Know Your Body, Know Your Workout

The ideal exercise routine should include some aerobic exercise, some stregthening exercise and some stretching.  Obviously if someone hates to exercise then the ideal might be to just start walking on a regular basis.  To expect more might mean complete derailment.  Often times after a few months of doing a routine and noticing the positive changes in how clothes fit, energy level and compliments from friends and coworkers, then willingness to try other kinds of exercise improves.  Success builds success.