Increasing Access and Affordability of Produce Improves Perceived Consumption of Vegetables in Low-Income Seniors

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Increasing Access and Affordability of Produce Improves Perceived Consumption of Vegetables in Low-Income Seniors.

 

Pre-Diabetes and Doctor Questions

 Here is a question that I received from: www.foodpicker.org

  Q) I was recently diagnosed with pre-diabetes.  Could you tell me what questions I should be asking my doctor in order for me to be successful in the prevention of type 2 diabetes?

  Answer: The most important thing to discuss with your doctor would be about diet and lifestyle changes you will be making to prevent type 2 diabetes.

  Some questions to ask would be :

 1. If you have a weight issue getting on a diet plan would be beneficial. Ask your doctor about refering you to a dietitian or a diabetes educator.

 Watching your carbohydrate intake and understanding portion sizes for every meal is very essential something that a dietitian would be able to help you with.

  2. Talk about cooking habits, do you enjoy cooking or do you eat outside? Get information about various cook books for diabetes and options for eating outside.

  3. Along with diet comes exercise, plan on a good exercise regimen with your doctor. If you have any other health issues that prevent you from exercising, talk to your doctor about them.

  4. Talk to your doctor about your lifestyle, are you extremely busy, or at home and how you can gradually make changes.

5. Discuss how often will you be checking your blood glucose, if you need any medications and how often will you be following with your health care providers.

  6. Find information about various community programs and support groups you can join for additional guidance.

6. Discuss about payments and insurance options.

  It is not easy to accept that you can be at a risk of developing diabetes and family support becomes very important during this time. I would advice you to take a family member or a friend along. Doesn’t hurt to have an extra pair of listening ears for all the instructions.

Exercise Ideas?

Here is a question I received from: www.foodpicker.org

 Q) I have pre-diabetes and have been doing a pretty good job of exercising outdoors during the spring and summer months.  Now that the weather is starting to cool down, I am trying to determine what I can do for physical activity in the colder months.  Suggestions?

 Answer: Since the weather will be restricting your outdoor activities, unless you are a peron who can once in a while brave the cold and go out for a walk. You can always experiment with something you have never tried before for physical activity:

• Walking on the trade mill or using the exercise bike
• If you enjoy dancing and music really gets you excited then you can always try taking a dance class or something like aerobics or zumba
• If you enjoy relaxed activities you can try joining a yoga class
• You can take up some light sports like swimming or badminton
• If you enjoy window shopping you can go for a walk inside the mall. Use stairs whenever possible instead of an elevator or escalator

While it is challenging to stay active in winter, it is important to remember that any light activity within the house can also contribute towards being physically active for example:

• Increase standing activity by cleaning the house, ironing, cooking, getting up to take the remote or switching off the television

Hope these help you keep going!!

Diabetes & Healthy Tailgating?

Here is a question I received from: www.foodpicker.org

Q) My husband has diabetes and this time of year we attend a lot of football games.  Before the game we often will meet up with friends for tailgating parties.  Can you give me some healthy ideas of what we can eat during the tailgate?

 Here are some ideas for healthy tailgating:

v    As tailgate parties involve a lot of grilling, choose lean meat like chicken without the skin, turkey, meatless burger which are usually made of soybeans or veggie burgers.

v    Go for whole wheat buns instead of regular buns.

v    Use mustard or horseradish sauce (if you like that zing!!).

v    Add a couple tomato slices, cucumber and some shredded lettuce, to make it tasty. You can also grill the vegetables before adding them on the burger.

v    If you have the option of chipping in a few food items than you can get- whole grain chips, pita chips, a bean dip instead of fattening dips. You can also carry a tray of fruit or vegetable kebabs.

v    If you are just attending it fill up your plate ones and savor the food by eating it slowly.

v    Invest more time talking to friends.

v    Stay away from the serving table.

v    Drink water, squeeze in a lemon for taste. Stay away from soft drinks and colas as much as possible.

 

Type 2 Diabetes Symptoms

Here is a response to the question that I received from: www.foodpicker.org

 Q) Diabetes runs in my family and I think this puts me at risk.  Could you tell me what are the symptoms of type 2 diabetes?

 Type 2 diabetes is a condition marked with high blood sugar in the blood. In type 2 diabetes the body does not respond well to insulin, so the blood sugar does not enter the cell to be stored as energy causing hyperglycemia (excess blood sugar). As a result the pancreas produces more and more insulin but it is not enough to keep up with the body’s demand.

• Hyperglycemia is first observed in postprandial blood glucose level due to insulin resistance followed by elevation in the fasting blood glucose level.
• Risk factors for type 2 diabetes include:
  • Family history of diabetes (parents or siblings)
  • Obesity particularly intra-abdominal obesity
  • Are overweight with a body mass index (BMI) >25 kg/m²
  • Physical inactivity
  • Intake of excessive calories
  • Hypertension (blood pressure > 140/90 mm Hg)
  • Have a low High Density Lipoprotein (HDL) ≤ 35mg/dl and triglyceride > 250 mg/dl
  •  Had impaired glucose tolerance or impaired fasting glucose (pre-diabetes)
• Symptoms can vary from person to person and include:
  • Hyperglycemia
  • Excessive thirst
  • Excessive urination
  • Unexplained weight loss     
• Proper lifestyle changes include:

The goal is to manage the blood glucose level to normal.

• Regular exercise of moderate intensity for 30 min for days of the week
• Making the right food choices- include whole grains, fruits and vegetables, low fat food choices
• Losing weight ~ 1-2 lbs /week, can help maintain blood sugar levels
• Reducing total calorie intake

 Below is a table to refer to the recommended blood glucose goals for diabetes by the American Diabetes Association (ADA) and the American Association of Clinical Endrocrinologists (AACE): 

Goal	ADA	AACE
Pre-prandial (before eating)	90-130 mg/dl	110 mg/dl
Post-prandial (1-2 hours after beginning to eat)	< 180 mg/dl	140 mg/dl

 

Healthy eating for the entire household?

Here is a question that I received from: www.foodpicker.org

 Q) I have pre-diabetes and am struggling to eat healthy.  My brother and his family live with me and there are tons of junk food temptations in my kitchen.  I want the entire household to start eating healthy with me, they can all benefit, but they are resistant.  Any suggestions?

 ANSWER: I congratulate your desire to make a change for the entire family. It is challenging to expect someone to change their eating behavior.

Here are a few tips to help you:

1)    Whenever you buy junk food always portion them out into small servings. Never sit with an entire bag.

2)    If possible hide the bags so that they are out of sight and out of mind.

3)    Keep healthy snacks like fruits, vegetables, whole grain snacks easily available.

4)    Gradually substitute junk food with healthy snack, such as instead of chips gets whole grain pita chips to try with humus or guacamole.

5)    Make cooking a family event. Make an old grandma recipe together.

6)    Shop at a local farmers market to get introduce to new fruits and vegetables. Many times locals farmers have a “taste and take event” where you can try out a new vegetable or a recipe.

7)    Use lots of flavors, spices, vinegar while cooking to make the dish tasty.

 Here is recipe for you to try:

2 cups of cooked black-eyed peas

1 c cut yellow, green, red pepper

11/2 tbsp Italian dressing or you can add olive oil and vinegar (3:1)

1 tsp black pepper

1 tsp basil

½ tsp finely chopped jalapeño pepper

Soak the black-eyed peas in hot water for 30 minutes. Boil water add black-eyed peas. Boil till until they become tender to soft. Drain completely.  Mix all the other ingredients add black-eyed peas. Mix well and refrigerate. Serve cold with whole grain wheat bread and boiled corn, it is a perfect snack item.  

If you are using canned beans drain them well, wash it under running water and put it in the strainer to drain the excess water.

Salad Bar Suggestions

Here is a question I received from: www.foodpicker.org

Q: We have a large salad bar at the work cafeteria that I would like to take advantage of for lunch (especially during the summer).  I’m trying to lose weight and control blood sugar.  Could you give me some tips on what to choose and what to steer clear on at the salad bar?

 A: Taking advantage of the salad bar is a great idea! Here are a few tips for you:

• Go for plenty of vegetables and fruits such as, carrots, broccoli, mushrooms, lettuce, shard, spinach, peaches, berries, etc.
• You can sprinkle ½ tsp of unsalted nuts and seeds like soybeans, pine nuts, walnuts for taste.
• You can add low fat or fat free salad dressing or just add flavored vinegar (1 tbsp). If you have issues with the taste of the fat free dressings it is better to drizzle a little bit of original salad dressing then at least you will not add too much of the fat free version. 
• Watch your side filler like crouton, biscuits, fries, bread they might quickly add on your calories.
• Also you might want to limit high fat pasta salad or potato or macaroni salad and coleslaw.
•  If you are taking a soup go for broth based soup rather than creamy soups.
• Go easy on the bacon strips, fried tofu, cheese instead have edamame, beans or peas, chicken or turkey slices for proteins.
• Take a small plate to start and fill it as much as you can this way you will avoid over filling it as well as over eating.
• You can always have a second helping but before going back give a thought if you really need a second !
• With fruits you can have yogurt or 1 tbsp of low fat cottage cheese.

 Hope this is helpful enjoy your salad!!

Fruit and Pre-Diabetes

 Here is a question that I received from: www.foodpicker.org

 Q) I was diagnosed as having pre-diabetes earlier this year.  Since then I have completely changed my eating habits and become a vegetarian.  I’ve lost weight but want to lose more.  Can you tell me which fruits have a high sugar content?  I am wondering about apples, raisins, bananas, and strawberries.  I already know I need to avoid orange juice. Thanks for your help!

 Answer: Great! You are definitely putting in a lot of effort to make a healthier you.  Weight loss and maintaining the weight is a life long commitment. However, you have already started taking steps in the right direction. A good weight loss would be 1-2 lbs/ week, which would mean eating 500 calories less. Restricting yourself too much is not a good idea because those restrictions are bound to cause a failure. Instead eat in controlled amounts (portion control). Vegetarian is good you can still get all your proteins from beans, peas, tofu and nuts. You can also eat an egg and low fat milk. Occasionally if you wish to have meat, choose lean meat, fish, turkey or chicken.  Include more mono and polyunsaturated fatty acid sources like canola oil or olive oil and sunflower oil and minimize on solid fat and trans fat like butter, margarine and shortenings.

Fruits are an important component of the healthy diet as they are good source of vitamins, minerals and fiber necessary to maintain good health. Apples, raisins, bananas, and strawberries are all great choices to have as they are loaded with beneficial nutrients. However, fruits are carbohydrates and can raise blood sugar; 1 serving of fruit (½ c canned fruit or fresh fruit or unsweetened juice, 1 small fresh fruit or ¼ c dried fruit) has 15 gm of carbohydrates. Hence, it is important to learn to monitor the carbohydrate intake at every meal. You do not have to avoid orange juice completely. You can have ½ c of orange juice ones a day; you can dilute it to reduce on calories. You can also add orange juice to various food preparations for extra flavor.

 Hope this is helpful. Good luck with your efforts.

Pre-Diabetes and Diabetes

 

Here is a question that I received from: www.foodpicker.org

 Q: What is the difference between Pre-Diabetes and Type 2 Diabetes?  Could you tell me the diagnostic criteria for both as well as the treatment?

 Pre-diabetes is a condition wherein the fasting blood glucose level is higher than the normal (100 -125mg/dl) but not high enough to be diagnosed as diabetes (>126mg/dl). Pre-diabetes is sometimes also referred as impaired glucose tolerance (IGT) or impaired fasting glucose (IFG).

Patients with pre-diabetes condition can reduce their risk of getting type 2 diabetes by- 5-7% of weight loss, regular moderate/vigorous intensity physical activity for at least 30 minutes most days of the weeks and by improving eating habits like, portion control, reducing intake of fat and total calories, eating more fruits and vegetables and more whole grains.

 Type 2 diabetes is a condition marked with high blood sugar. In type 2 diabetes the body does not respond well to insulin, so sugar does not enter the cell to be stored as energy causing a condition known as  hyperglycemia. As a result the pancreas produces more and more insulin but it is not enough to keep up with the body’s demand. Hyperglycemia is first observed in postprandial blood glucose level due to insulin resistance followed by elevation in the fasting blood glucose level.

Risk factors for type 2 diabetes include:

Family history of diabetes

Obesity particularly intra-abdominal obesity

Physical inactivity

Intake of excessive calories

Lifestyle changes like regular exercise of moderate intensity for 30 min for days of the week, making the right food choices, losing weight ~ 1-2 lbs /week, oral medications can help maintain blood sugar levels as close to normal. With type 2 diabetes insulin may be needed depending on your blood sugar goals and medical condition.

 The goal for both pre-diabetes and diabetes is normalizing the blood sugar.  It is important to talk to your healthcare provider about your blood sugar goals. There are 2 different guideline for diagnosis of diabetes, talk to your doctor about them as well. Your physician might follow one of the following blood sugar guidelines for diagnosis.

American Diabetes Association acknowledges these as normal blood sugar for healthy people who do not have diabetes:

Fasting/before eating < 100 mg/dl

Bedtime 120 mg/dl

A1c blood sugar test (3 month blood sugar indicator) <6%

Diagnostic criteria according to the American Diabetes Association

	Pre-prandial	Post-prandial	A1C
Pre-diabetes	90-130mg/dl	<180mg/dl	<7%

 

 

 

Diagnostic criteria according to the American Association of Clinical Endocrinology

	Pre-prandial	Post-prandial	A1C
Pre-diabetes	110mg/dl	140mg/dl	<6.5%

Pre-Diabetes Weight Loss?

Here is a question I recently received from: www.foodpicker.org

Q: I was recently diagnosed with pre-diabetes and was prescribed medication. I have been following a diet to lose weight but unfortunately in the past few weeks, I have actually gained a few pounds. When I was eating whatever I wanted without the medication, I stayed the same weight. In the past, I have exercised at least 3 days a week but after a year of doing this I only lost about 10 pounds. Do you have any suggestions?

Answer: Good to know that you are taking active steps towards becoming healthy. Losing weight and maintaining the weight loss is the most difficult balancing act! And definitely needs a lifelong commitment. Maintaining a healthy body weight not only reduces the risk of diabetes but also many other chronic diseases, so all the efforts are for a good cause and do not give up!

Losing 1-2lbs/week (i.e. eating 500 kcal less from your daily diet) is an ideal weight loss goal to adapt to as it is more sustainable. When you try to lose weight too aggressively you are over restricting your intake and in the process developing an unsustainable system.

Certain diabetes medication can also affect weight loss. Talk to your doctor about your medication and make sure there is no other underlying health issue. Meanwhile here are a few tips to follow:

1) Since you exercise 3 days a week –make sure your intensity is moderate to vigorous for at least 30 min or you can also do three 10 minutes bout in a day. The intensity of physical activity should be high enough to increase your heart beat, like brisk walk, jogging or lap swimming. Other examples of moderate/vigorous physical activity are available at: http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html

2) Research indicates that staying active throughout the day apart from exercise is important and hence if your daily routine is sedentary make sure you move around and sit less.

3) Eating a low calorie, low fat especially low in saturated fat meal is beneficial. Incorporate variety of fruits and vegetables they are low in calories. Consume more whole grain cereals as they not only provide vitamins and minerals but are good source of fiber. Choose low/fat free diary products. USe more herbs and spices to garnish the food.

4) Read labels to follow serving sizes and other nutritional information. A lot of time a single serving pack has two serving worth of portions.

5) Maintain a diary to record what you eat along with information about- time, place, mood and with whom did you eat. Research shows that this approach helps in keeping track of ones progress and easily identify downfall. Also one does not have to rely on memory in the doctors’ office.

6) Talk to your family members or friends about your weight loss goals. Support from the loved ones help in sticking with the commitment.