Type 2 Diabetes: Are You At Risk?

November is American Diabetes Month, which is a time when the American Diabetes Association (ADA) and other organizations raise awareness of diabetes and communicate the seriousness of the disease.

What is Type 2 Diabetes?

About 95% of those diagnosed with diabetes are classified as Type 2.  Type 2 diabetes is a chronic condition that affects the way your body metabolizes sugar (glucose), your body’s main source of fuel.  With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn’t produce enough insulin to maintain a normal glucose level. If left untreated, type 2 diabetes can be life-threatening.

Prevalence

26 million Americans have diabetes with 2 million new cases diagnosed each year.  An overwhelming 79 million Americans have higher than normal blood glucose levels but are not yet classified as diabetic and it’s expected that about 1 in 3 Americans will have diabetes in 2050 at the current rate of incidence.

Impact

Diabetes is costly financially as well as to your health and wellbeing.  Fiscally, diabetes costs the U.S. alone $174 billion each year.  This figure represents a 32% increase since 2007.  Let’s put this into prospective, about one out of every 10 healthcare dollars are spent in direct diabetes care.  The health impact is just as staggering with a risk for stroke and death from heart disease at 2-4 times higher among people with the disease.  Diabetes is also the number one cause of kidney failure, lower limb amputations and new cases of blindness among adults.

What You Can Do

You can do a lot to prevent or delay Type 2 Diabetes.

1.) Watch Your Weight

If you are over ideal weight, there are a number of studies that indicate that losing only 5-7% of your current body weight will lower your risk of type 2 diabetes.  For instance, if you weigh 200 lbs, a weight loss of only 10-14 lbs will lower your risk significantly.

2.) Controlling your Blood Pressure & Cholesterol

Get your blood pressure and cholesterol levels checked regularly and talk with your doctor about higher than normal readings.

3.) Eat Healthier

Consume plenty of fresh fruits, vegetables and whole grains.  Minimize the amount of take out and processed meals which typically have much higher levels of fat, calories and sodium and contribute to high cholesterol, blood pressure, and weight gain.

4.) Stay Active

Aim for a minimum of 25-30 minutes of cardiovascular exercise most days of the week.  And remember, exercise doesn’t only happen at a gym.  Staying active means taking advantage of opportunities to move more in our daily life.  Examples may be walking for short errands like mailing a letter or going to the store, gardening, taking the stairs instead of the elevator, walking the dog, etc.

5.) Quit Smoking

Those who smoke are at higher risk for type 2 diabetes.  So if you’re thinking about quitting, now is the time.

For more information on diabetes and prevention visit the American Diabetes Association.

About the author:

Gina M. Crome, M.S., M.P.H., R.D., is a Registered Dietitian and ACE Certified Personal Trainer based in Southern California.  She is the owner of Lifestyle Management Solutions, a company that provides customized nutrition and fitness programs designed to fit an individual’s lifestyle.  Become a fan of Gina on Facebook, follow her on Twitter, and visit her website Lifestyle Management Solutions.

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Healthy Holiday Meals: It’s All In The Planning

Most holidays revolve around eating.  Let’s face it, food seems to be the “main event” that brings us together.  A healthy holiday menu for family and friends can be simple with a bit of planning.

Think Ahead

There are bounties of resources for creating beautiful holiday meals and treats for your guests that are lighter in calories and fat than traditional faire without sacrificing flavor.  You can control how many calories you eat by simply thinking ahead about the dishes your family normally enjoys and determining how you can prepare them 1.)  Light (less fat),   2.)  Bright (more veggies), and 3.) Early in the Night.  An early evening meal will give your guests the opportunity to be more active as they digest their food.  Of course, planning winter activities can also help deal with this challenging time.  Look for ways that the entire family can get involved such as an early evening walk, interactive electronic games, or even a sport of choice in the backyard.  If weather is a factor, make use of indoor facilities such as local community centers that often have available sporting venues such as basketball courts, table tennis, etc.  Family excursions can present unique opportunities for exercise-based activities and enjoyment for everyone.

Choose Wisely

When faced with the foods we love, it’s often difficult to maintain any sense of control around the holidays.  To this I say, “eat what you love and love what you eat…. in moderation that is.”  Many times we approach the holidays with anxieties; worried about the foods we know are bad for us. We then tell ourselves that we are going to avoid those foods altogether in order to maintain our weight loss efforts.  Unfortunately, self-denial usually leads to an opposite phenomenon, self-indulgence.  Avoiding the foods we really enjoy usually causes us to eat more of the foods that we don’t enjoy as much.  Therefore, it’s best to approach the holiday season realistically knowing that you’ll be exposed to foods you really love and will likely consume them.  The difference is that this season you can plan to eat only the foods you absolutely love while minimizing those you don’t care so much about.  In other words, save room for the good stuff (in moderation) so that you won’t feel deprived.

Work With What You Have

While dining with family or friends, we don’t always have control of the foods being served around holiday events.  It’s during these times that we must plan to work with what we have.  Take an active role in simply minimizing foods a little higher in fat while at the same time focusing on items that will help satisfy you at a smaller caloric price (salads/veggies, broth-based soups, etc.).  These foods add volume to a meal so that you can still enjoy the higher fat items in moderation while being full and satisfied. 

Let’s plan to reduce our anxiety over holiday food weight gain by choosing the types and amounts wisely, and above all- enjoy the season!

Back to School and Back to You: Recommit to Taking Care of Yourself

It’s that time of year again.  The kids are back in school, the holidays are right around the corner and it’s time to recommit to taking care of yourself.  The difficult part always begs the question, where do I begin? 

One of the first things that I ask my clients seeking weight management is why it’s important for them to manage their weight and what does it mean to them personally.  At first glance, this seems like a simple question but actually the answers are very unique for everyone.  We each have personal reasons for wanting to make lifestyle changes.  Some may be based on health issues, others on physical appearance and confidence.  Whatever the reason, it’s important to have a clear picture as to what motivates you and if possible to get those thoughts down on paper.  

One place to start would be with creating a simple “Top 10 List” that highlights a few of the most important reasons why you would like to lose weight.  This is your personal list and doesn’t need to be shared with anyone so it’s best to be specific and candid.  It’s amazing how different we view our thoughts and feelings when they come out of our head and put onto paper.  This simple process not only legitimizes our efforts, but also helps us sort through our priorities. You’ll know that you’ve created a meaningful list if upon re-glancing at it in the future, it takes you back to the feelings you had the day you created it.

Another strategy I use to help clients begin their journey is through a simple tool that I created called the Commitment Worksheet.  This worksheet acts as a self-contract by outlining your short term goals, exploring potential roadblocks and setting a plan for rewarding your accomplishments.  

These items are not just an exercise in listing your thoughts and goals, but tools used to help keep you on track when your motivation begins to wane.  Everyone, and I mean everyone, goes through cycles of highs and lows in their motivation.  Much of the variance is related to your individual stress level and pressures of daily living.  Simple everyday distractions always seem to threaten our best efforts to stay on track.  Take control of your life by ensuring your goals are personally meaningful and visibly available; especially when you need a little extra help committing to taking better care of yourself.

Proper Hydration: For Summertime and Beyond

Getting the proper amount of hydration is not only important in the summer months, but throughout the year as well.  Water is one of the single most important elements in our body.  It regulates our body temperature, helps our digestion and even provides a cushiony barrier around our organs.  Those who participate in regular exercise know how vital it is to be properly hydrated for performance purposes as well.   At the microscopic level, water helps get nutrients in and out of our cells and after just several days without it, we would cease to survive.Therefore it’s important to understand the correct amount of water to have onboard, the signs of dehydration, and a few strategies to ensure you are properly hydrated in any weather.

How Much?

Hydration can come from the beverages we drink (80%) as well as the food we eat (20%).  It is recommended in total that women consume 2.7 liters (91oz) of fluid through a combination of beverages and food and men 3.7 liters (125 oz) in the same manner.  If you are exercising, especially in hot weather, your needs are even greater.  In just an hour of exercise, you could potentially lose around a quart of water!  At that rate, it’s easy to understand how dehydration can creep in.  Here are some exercise hydration tips:  

  • Drink 17 to 20 ounces of water two hours before the start of exercise.
  • Drink 7 to 10 ounces of fluid every 10 to 20 minutes during exercise.
  • Drink 16 to 24 ounces of fluid for every pound of body weight lost after exercise

Of course, these are just recommendations. Other factors influence your fluid loss during exercise such as higher temperatures or workout intensity. Additionally, men sweat more than women and larger people sweat more than those who are smaller.  Also, would you believe that the well-trained athlete sweats more than the average person? It’s because the body of an athlete is very efficient at cooling itself down and sweats more as a result.

Swimming in the summertime can be great way to cool down.  However, a common misconception is that swimmers are kept cool by the water and as a result don’t require as much hydration.  The truth is that swimmers as well as children splashing around in the pool sweat more and are also in danger of dehydration.  So ensure you keep drinking water even if you are cooling off in the water.

Signs of Dehydration

How do you know if you or someone else is in danger of dehydration? In the beginning there is simple thirst.  Most of the time we could easily ignore this sign which eventually turns into flushed skin, higher body temperatures, exhaustion, and increased difficulty to perform simple exercises.  If you don’t get water soon after these symptoms, you will experience increased weakness, dizziness, heavy breathing and finally pass out. 

Your Best Strategy

It’s easy to avoid the threat of dehydration by simply sipping water throughout the day.  Remember that our hydration comes from the foods we eat as well so choosing foods with higher water content such as melons, soups, leafy greens, and even tomatoes is a great idea.

Flavored waters and other beverages such as sports drinks can contribute needed fluids but if weight loss is your goal, beware of the hidden calories some of these contain.  Also, if you are drinking beverages that contain caffeine and/or alcohol, know that these are both diuretics meaning that they cause the body to lose more fluids which can undermine your hydration efforts.

Being aware of your fluid intake will not only keep you well hydrated, but may also give you a sense of fullness which will certainly help your weight loss efforts.

Weight Loss is a Journey, Not a Destination

Over 70 million people in the United States attempt to lose weight each year and spend more than $30 billion in the process.  Many will be successful at losing the initial weight; however sadly most will be unable to keep it off for very long.   Why is this the case?

I believe part of the problem lies within the fact that most people who set out to lose weight do so without anticipating (or perhaps wanting to anticipate) that their weight issues will continue beyond the point of their initial weight loss phase.  We have a sort of euphoric belief that somehow anything and everything will be better once we lose weight- and the issues and/or behaviors throughout our life that brought us to our heaviest weight will kindly go away.  Sounds great doesn’t it? Then sooner or later, the nasty truth begins to emerge, “You mean I have to watch what I eat for the rest of my life if I want to keep it off?”

If you are beginning to grapple with this harsh reality, congratulations!  You are among the minority of people who have discovered that weight management is a journey, not a destination.  People who are successful at losing and keeping off the weight forgo the so-called crash diets mostly because they realize that the faster they lose it, the faster they gain it back.  A healthy rate of weight loss is about 1-2 pounds per week.  If you are losing more than that, chances are you are losing more than fat-you’re probably losing muscle as well.  This drop in muscle mass is what contributes in part to the rapid regaining of weight during the maintenance phase, and it’s your muscle mass that is largely responsible for increasing your metabolic rate. 

But the real benefit to losing weight at a slower, healthier rate is something entirely different which has more to do with taking in the sights along the way.  You’ll discover your likes, dislikes, behaviors and habits, that may have contributed in some way to your weight gain in the first place and have an opportunity to address each in a way you wouldn’t normally had you plowed through the weight loss phase of your journey at 100 miles per hour. 

We all want to lose weight quickly.  But if you want this time to be the last time, you have to take the time.  Remember, it’s not about the speed of losing the weight, but about the journey.

To Snack or Not To Snack…That Isn’t The Question

The great snack debate is one that has embattled many of so-called “dieters” for decades.  It’s roots were planted at a time when doctors offered advice to their patients who wanted to shed a few pounds that sounded something like this, “If you want to lose weight, you need to cut out all your snacks in-between meals.”  This may have worked well at a time where most people sat down to three regular meals each day, possibly around a family table (think Ozzie and Harriet) to consume their food.  However, by today’s standard, it’s a rarity when a family has a single meal together, let alone three!  Family members always seem to be going in different directions with their schedules, and most tend to grab food on the run.  And often times what we grab isn’t what we would consider a meal, but rather a snack to hold us over until our next meal.   

New research released last week from the 2011 Institute of Food Technologists Annual Meeting indicated that what we consider as snacks (including what we drink between meals), comprises more than 25 percent of our total calorie intake every day.  On average, this equals about 580 extra and usually unaccounted for calories each day.

Most people would probably say at this point, “So what?  500 or so extra calories isn’t that much and besides if I’m really concerned about it, I’ll just do a few more minutes on the treadmill and burn it off in no time.”  To test this theory, let’s apply a little math:

500 extra calories a day (above what you use) = 3,500 extra calories a week

Based on metabolic equations- 3,500 extra calories a week = 1 pound of weight gain/week or 52 pounds of potential weight gain each year!

Now you’re convinced that the extra few minutes on the treadmill everyday will take care of those pesky calories.  The average 150 pound person would have to be on that treadmill 1 full hour extra each day to burn off approximately 450 calories-not even reaching the target of 500.  Most already have difficulties finding a few minutes to sit down to a healthy meal- who realistically will make the commitment to an extra hour or more of exercise?

It’s All About Choice

Asking people to stop eating snacks and begin sitting down to 3 meals a day at home is unrealistic.  The issue isn’t whether or not to partake in snacking, but rather look at making some smart choices that will work to stretch your calorie budget over the course of the day.  Moral of the story…choose wisely.  If you are among the many that find yourself eating on the run, opt for getting the most nutritional bang for your buck.  Choose grilled over fried, fresh over processed, and if weight control is one of your goals-make every effort to include low calorie/high fiber options like fruits, veggies, and whole grain products like oatmeal, popcorn, or whole wheat crackers.  The extra fiber will help keep you fuller longer thus making it less likely you’ll be tempted to grab another snack before your next meal.  Plus, it may also help prevent you from becoming overly hungry which can prove disastrous on a weight loss plan.

Beverage Calories

Make every attempt to avoid drinking your calories.  The calories we get from beverages can really pack a 1-2 punch.  They not only add up and contribute to our overall intake each day, but sweet beverages can spike blood sugar levels and often leave us hungrier in the end as those levels quickly take a dive in an attempt to return to normal.

Size Does Matter

Lastly and probably the most important, portion control.  Our best defense to guard against unwanted weight gain is to keep our portions in check.  A couple weeks ago, I covered information about the new USDA MyPlate educational materials.  One of the major objectives of this program is to help people understand appropriate portion sizes.  Because at the end of the day, all calories not used by the body regardless of whether they come from carbohydrates, protein or fat, will result in potential weight gain.

Is Your Fitness Routine Lapse More Like a Collapse?

Maintaining motivation to exercise is one of those topics that so many have written on because it’s a problem that affects everyone.  Motivation is not like a switch that we can readily be turned off and on.  Rather I see it more like a thermostat with degrees of motivation running along a constant slide.  Once at a predetermined temperature, your internal call to action kicks in and you find yourself willing to get out there and exercise. When we are super motivated, we don’t dread the thought of exercise.  We look at it as an opportunity to get healthier every day.  On the other hand, when we lack motivation, exercise can be the chore that manages quite nicely to get put onto the back burner.  It’s amazing how many things we’ll find to do to avoid exercise; clean the garage, wash the dog, organizing the junk drawer, pay bills, slop the hogs, etc.  And those things we don’t find to do, we’ll just make them up.  

We can joke about this because we’ve all been there.  The truth is motivation comes and goes.  You may find yourself on a roll for a little while then slowly the temperature drops in your thermostat and your exercise bouts begin to get fewer and farther between.  Here’s the key… recognition.  Recognize when your motivation is beginning to wane and guess what- stick it out baby.  Continue your fitness routine any way you can because eventually what goes down must come up.  I guarantee your motivation will pick back up eventually but those who let their exercise lapse turn into a collapse will not be around when the motivation thermostat starts to rise again.  Likewise, those who stuck it out and just continued along business as usual will be that much further down the path towards their goals.  

It’s easy to say, just stick it out and I certainly understand firsthand how difficult it is to actually put that into practice.  My motivation came and went a million times as I was losing my 172 pounds.  When my motivation was hovering somewhere between the dumps and the abyss, I used a number of things to get it going again like trying a different exercise activity, downloading some new music, etc.  I’ve even bought new workout outfits all in the name of motivation of course.  

Lastly, remember to cut yourself some slack.  We are all a “work in progress” and far from perfect.  If you don’t make it out there today, look at some of the motivation tactics and try again tomorrow.  By only concentrating on the things that we are not doing right, chances are we’ll miss the things we are doing right.