Use these checklists to see if you are developing diabetes

Are You Developing Diabetes?

This post was written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, but you can read the original post here.

USE THESE CHECKLISTS TO SEE IF YOU ARE DEVELOPING DIABETES

One of the biggest threats of gaining 20 pounds is the increased risk of developing diabetes. Twenty pounds is all it takes to go from a healthy body mass index (BMI) of 21 to an unhealthy one of 25. That is the point on the BMI chart when you are considered overweight.

Being overweight is a risk factor for developing type 2 diabetes in both children and adults.

Why the Disconnect Between Overweight and Diabetes?

When I was in private practice, many of my new clients who had gained 20 pounds came in saying they didn’t like the way they looked or how their clothes fit — as if that was all that was at stake. When I was writing The Wedding Dress Diet, many of the brides-to-be I talked to admitted they would probably gain 20 pounds after they got married — as if it didn’t matter.

Obviously, the connection between being overweight and diabetes had not hit home because whenever I asked anyone how they felt about getting diabetes, they shuddered. Being a little pudgy was one thing, having diabetes was quite another.

Sadly, the message still has not sunk in. Nearly 26 million Americans now have diabetes and three times that many are pre-diabetic – people with elevated blood glucose levels that are not quite high enough to be diagnosed as diabetes. That’s 75 million people who almost have diabetes!

If you or someone you know is concerned about developing diabetes, use the checklists below recognize the risks and warning signs, then get the help you need to prevent or treat it.

Who is At Risk of Developing Diabetes?

  • Overweight or obese with a BMI of 25 or higher
  • Waist circumference greater than 35 inches in men and 32 inches in women
  • Woman who had gestational diabetes or gave birth to a baby weighting more than 9 pounds
  • Low HLD cholesterol of 35 mg/dL or less
  • High triglyceride level of 250 mg/dL or more
  • High blood pressure of 140/90 mmHg or greater
  • Family history of diabetes in parents or siblings
  • Low physical activity level of exercising less than 3 times a week

Early Warning Signs of Diabetes

  • Blurry, clouded vision – once blood sugar is lowered, vision returns to normal
  • Increased thirst and hunger – not satisfied after drinking or eating
  • Frequent urination – 20 or more times a day
  • Always tired, weak, fatigued – even after sleeping since cells can’t get the energy they need
  • Sudden, unexplained weight loss –the body is breaking down muscle and fat for energy

Tests Used to Diagnose Diabetes

  • Fasting blood glucose: 126 mg/dL or greater on 2 separate tests. Blood sample is taken after not eating or drinking anything for at least 8 hours, but not more than 16 hours
  • Casual blood glucose: 200 mg/dL or greater. Blood sample used is taken at any time regardless of last meal
  • Glucose tolerance test: 200 mg/dL at the 2-hour reading. Blood glucose is tested after fasting, then a sweet liquid containing a known amount of sugar is consumed and blood glucose is tested periodically for up to two hours.
  • Glycated hemoglobin (A1C): 6.5% or greater. Used to tell blood glucose control over the previous 2-3 months.

Goals for Treating Diabetes

  • Maintain blood glucose levels as close to normal as possible with changes in diet and exercise and, if needed, medication
  • Lose at least 10% of body weight to improve symptoms, maintain a BMI of 25 or less to eliminate diabetes

Dietary Objectives for Diabetes

  • Eat meals and snack at the same times every day
  • Distribute total calories evenly among meals, don’t skip meals or eat just one or two big meals
  • Increase soluble fiber content in meals from oatmeal, oat bran, beans, lentils, barley, flax seed, nuts, apples, pears, oranges celery, and carrots.
  • Control the type of carbohydrates eaten by choosing “whole grain” breads and cereals over refined grains, raw and cooked vegetables and whole fruits instead of juice.
  • Limit the amount of carbohydrate to 45-60 grams per meal, including carbohydrates from added sugars
  • Pay attention to all of the ingredients in “sugar free” foods and those made with sugar substitutes
  • Use healthier fats and oils, such as olive and canola oil, and limit saturated fat and trans fat to reduce heart disease risk

See these related stories on diabetes.

  • Fast Eaters Have Greater Risk of Diabetes Than Slow Eaters
  • A Secret Weapon to Help Control Diabetes: Barley
  • Tired All the Time? 11 Reasons Why (Besides Lack of Sleep)
Older people have an added danger of dehydration when symptoms are misdiagnosed

Hidden Danger of Dehydration for the Elderly

OLDER PEOPLE HAVE AN ADDED DANGER OF DEHYDRATION WHEN SYMPTOMS ARE MISDIAGNOSED

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. This site was deactivated on July 1, 2013, but you can read the post here.

Staying properly hydrated in hot weather is important for everyone, but the danger of dehydration in the elderly is of special concern. Not only do older adults become dehydrated more easily than younger people, the warning signs are often mistaken for something more serious.

Anyone who lives alone and has limited mobility is at risk of dehydration. The use of multiple medications increases the risk. Now add all those people being cared for by others who cannot communicate clearly and the count gets higher.

Why? They simply don’t drink enough. The primary causes of dehydration for the general population are vomiting, diarrhea, heavy sweating, uncontrolled or undiagnosed diabetes, infections, high fevers, and burns. But for those who can’t, won’t or don’t drink all that they should, dehydration is a dark secret.

Why Some Seniors Don’t Drink Enough

  • Fear of incontinence, especially if taking diuretics
  • Unable to get up out of a chair or bed alone
  • Too difficult or exhausting to walk to the bathroom
  • Difficulty toileting alone – undressing, sitting on commode, cleaning themself, redressing
  • Inability to get food or beverages for themselves or get enough
  • Don’t feel thirsty, especially if inactive
  • Trouble holding a glass or cup to drink for themself
  • Unable or unwilling to ask for help
  • Depression

The danger of dehydration for the elderly is heightened when the symptoms are not addressed because they are so similar to age-related dementia or senility and Alzheimer’s disease. Instead of getting the fluids and assistance with using the bathroom that they need, they may be viewed as incompetent. That is why it is important to monitor fluid intake and excretion in someone with the symptoms below before taking other steps.

Mental Signs of Dehydration

  • Headache
  • Dizziness, especially upon standing
  • Light-headedness
  • Confusion
  • Disorientation
  • Irritability
  • Forgetfulness

Physical Signs of Dehydration

  • Dry or sticky mouth
  • Thick saliva
  • Dry, inelastic skin – doesn’t relax if pinched
  • Rapid breathing
  • Increased heart rate
  • Low tear production
  • Low sweat production
  • Unexplained weight loss

Functional Signs of Dehydration

  • Muscle weakness or cramps
  • Fatigue or lethargy
  • Tired or sleepy
  • Nauseas
  • Constipated
  • Infrequent urination
  • Dark-colored urine

Both foods and beverages can provide the fluids our bodies need each day. Fruits and vegetables are very high in moisture and may be easier for some people to consume than another glass of water, juice or tea. You can also rely on flavored gelatin, pudding, yogurt, ice pops, sherbet, and soup for added fluids.

Catch up on more news about aging and hydration with these other posts:

It’s not just what you eat on the Mediterranean Diet plan, but how you eat it

The Mediterranean Diet Plan is About More Than the Food

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, but you can read the original blog here.

IT’S NOT JUST WHAT YOU EAT ON THE MEDITERRANEAN DIET PLAN BUT HOW YOU EAT IT

What makes the Mediterranean diet plan so special? The cuisines of Spain, France, Italy, Egypt, Morocco, Syria, Malta, Tunisia, Turkey, Algeria, Albania, Greece, Israel, Croatia, Libya and Lebanon – all countries that have a border on the Mediterranean – certainly are not all the same. Some use rice as a staple, others rely on wheat. Some feature pork, while for others it’s forbidden. Some drink wine every day, yet some abstain completely.

Could the health benefits be due to something other than the food?

What Foods Make the Mediterranean Diet Special?

In the 1960s researchers first reported longer lifespans and less chronic disease among people in Spain, southern Italy, and Greece compared to the US, Japan and several European countries. The scientists attributed the health and longevity of the people living along the Mediterranean to their diet.

After 50 years of continuing study into what they were eating, a Mediterranean Diet Pyramid was published in 1995 (we had Food Pyramids before we got My Plate), then updated in 2008.

The current version includes foods recommended for every meal in the first tier: fruits, vegetables, grains (mostly whole), nuts, legumes, seeds, olives, olive oil, herbs and spices. The next level adds fish and seafood, to be eaten at least twice a week. The third tier introduces moderate amounts of poultry, eggs, cheese and yogurt, either daily or weekly. Then the top and final space is for sweets and meats, both to be eaten sparingly. Water and wine are the only beverages called for.

The major distinctions from the Dietary Guidelines for Americans are the emphasis on foods from plant sources at every meal, using olive oil as the primary fat, choosing minimally processed food, and eating very little red meat. But that’s not all that’s different.

What Else Makes the Mediterranean Diet Special?

As it turns out, the way people eat is as important as what they eat. For folks living the good life along the Mediterranean, mealtimes are social occasions enjoyed in the company of family and friends. That does not mean they eat off their best china at every meal, but rather, they spend time at the table savoring their food without the distractions of their jobs or beeping electronic gadgets.

And that just might be the best way to begin your journey towards a more Mediterranean diet. Yes, the whole wheat couscous, Kalamata olives and fresh fish are important, but who knows what else might happen if you come to the table ready to sit down, log off, and tune in to one another?

How are you going to celebrate National Mediterranean Diet Month this May?

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If you take dietary supplements, follow these guidelines for best results.

Dietary Supplements Use Increases as We Age

FOLLOW THESE GUIDELINES IF TAKING DIETARY SUPPLEMENTS

More than one half of American adults take dietary supplements. Women are bigger users than men and the use of dietary supplements is steadily rising among those over age 60. If you are among the crowd that takes a daily multivitamin or any self-selected nutrient, herb or related product, there are some important guidelines you should follow.

First, you must remember that no matter how compelling the advertising for dietary supplements may be, the U.S. Food and Drug Administration does not require that the manufacturers prove the safety and effectiveness of their products before they are brought to market. That is left up to the consumer to decide. Do you have money to waste on products that don’t work or can do you harm?

The best way to know if you even need to take supplements is get a thorough dietary assessment from a registered dietitian to find out if there are nutrients missing from your usual diet. A dietitian can then help you decide whether they can be obtained by changes in what or how much you eat or if a supplement is recommended. Why take pills you don’t need?

If you are advised to take a supplement or are doing so on your own, follow these guidelines.

Guidelines for Dietary Supplement Users

  • Bring a current list with you to every doctor’s appointment naming all of the nutritional supplements you take, including the brand, how much of each and how often you take them. Bring it to each of the specialists who treat you as well as to visits with your primary care physician. You may not see a connection between your supplements and your skin condition, but your dermatologist might.
  • Provide a current list to your pharmacist of all of the supplements, over-the-counter drugs and prescription medications you take every time you get a new prescription filled. Ask for advice about potential interactions, side effects or contra-indications for their use.
  • Make a copy of the label for any multivitamin-mineral supplement or other combinations containing herbal and botanical products so the exact amounts of each item in it can be viewed, and offer it to your healthcare professionals. Copies can often be printed from the website for the brand.
  • Don’t assume more is better. Once you are consuming nutrients, herbs or botanicals in amounts that would not be possible if getting them by eating foods, they can be toxic.
  • Beware of the compounding effect that can occur when taking individual vitamin or mineral supplements, plus multivitamins, plus highly fortified foods, like some breakfast cereals, or meal replacement shakes and bars.
  • Don’t take all of your supplements and medications at one time and assume they can sort themselves out in your stomach. You may be canceling out the effectiveness of some and increasing the chance for complications with others.
  • Read the literature that comes with each medication and dietary supplement you take to learn when is the best time to take each, what to take with them and what not to take with them. Make a chart to help keep track of that information.

Would you like to cut down on the numbers of pills you take each day?

It is never too late to adopt a healthy diet in retirement

A Healthy Diet in Retirement, Does it Matter?

FOLLOW THESE GOALS FOR A HEALTHY DIET IN RETIREMENT

Hypertension, heart disease and diabetes – three preventable diseases that are the result of modern lifestyles. No matter which one you are diagnosed with, medications are immediately prescribed and dietary modifications are recommended. Unfortunately, few people make the needed changes in their diets while it might still do them some good. Instead, they take the pills and hope for the best.

Then by the time they’re ready to retire, there is little that a change in diet can do to reverse the damage from eating too much saturated fat, sodium and sugar. The most they can hope for is the ability to juggle all the overlapping conditions and restrictions.

So what are the dietary goals for those in retirement?

Aging results in changes in normal digestion and absorption, which impact your nutrient requirements, along with the effects of multiple medications and long-standing diseases. That is why most nutrition research does not typically include subjects older than 55 – there aren’t enough “healthy” people in that age group to study.

Consequently, there is no simple diet plan for the over 60 crowd. But there are three important areas to focus on until you can get a thorough nutritional assessment and individualized dietary plan from a registered dietitian.

Nutrient Density

While there is no one diet that fits all, we do know that a more nutrient dense one is important. That means your diet should be made up foods that provide more nutrients in fewer calories because calorie needs go down with age while nutrient requirements increase. Nutrient dense foods include:

  • Colorful fruits and vegetables, including fresh, frozen, canned, dried and juice
  • Lean cuts of meat, skinless poultry, fish, eggs, beans
  • Low fat and fat free milk, yogurt and cheese
  • Whole grains and cereals and the products made from them, like whole wheat bread and pasta

Expand Variety

Meals can easily become repetitious and monotonous, and that’s not a good. Variety is important both within each food group and throughout the year to be sure all of the nutrients you need are available from the foods in which they are naturally found.

It can be as simple as adding something new to your menu each week. Try a different type of apple or a frozen vegetable medley containing edamame (they’re soybeans!). Have cornmeal polenta as a side dish or black beans in your salad.

Ease Up on Extras

There are many things people enjoy eating and drinking that add little nutritional value to their diets, but do add calories. These extras include cake, cookies and candy and the butter, cream cheese and other spreads added to foods. While it is not necessary to give them up entirely, it is important to eat them less often and in smaller portions or to use lower calorie substitutes for them when available.

For example, a slice of peach pie can be replaced with a dish of sliced peaches (fresh, frozen or canned in unsweetened juice) topped with 2 crushed ginger snaps as a way how to have your pie and eat it, too!

Are you ready to change your eating habits for the better?

Numbers matter for weight control, healthy diet and physical fitness

Weight Control, Healthy Diet and Fitness are All a Numbers Game

MAKING SURE ALL THE NUMBERS ADD UP RIGHT ARE IMPORTANT FOR WEIGHT CONTROL, A HEALTHY DIET AND PHYSICAL FITNESS

I’ve written about some of the important numbers involved in weight control and balanced diets before. Things like the difference between serving sizes and portion sizes and the grams of protein you need each day. But there are more numbers you need to know for good nutrition and physical fitness. Many more.

Unfortunately, self-control and mindful eating are not enough. If you want to lose, gain or maintain your weight or strive for a healthier diet and fitter body, you’ve got to watch the numbers. Here are some that matter most.

Calorie level? This is based on your age, height, and weight and activity level – all important numbers to know. If you do, you can figure out your daily calorie requirement here.

Number of Food Groups? 5 + 1 + “extra calories” are what we get in the latest USDA eating guide, ChoseMyPlate.

Number of servings per day from each group? Varies based on calorie level. The ranges for adults are:

5 – 8 ounce equivalents of Grains, with at least ½ as whole grains

2 – 3 cups of Vegetables, with specific amounts per week for the 4 subgroups

1 ½ – 2 cups Fruit

3 cups Dairy

5 – 6 ½ ounce equivalents Protein Foods

5 – 7 teaspoons oils

120 – 265 Empty Calories

Serving size? Varies with each food and each food group, but includes numbers of ounces, cups, tablespoons, teaspoons and counted pieces, like 3 pancakes or 16 seedless grapes.

Amount of aerobic activity? 2 hours + 30 minutes per week at a moderate level or 1 hour + 15 minutes at a vigorous level based on the latest guidelines from the Centers for Disease Control.

Steps or Miles per day? 10,000 steps a day counted on a pedometer, which is equivalent to approximately 5 miles, can be an alternative way to get your aerobic activity according to Shape Up America!

Amount of strength conditioning? 2 days a week working all the major muscle groups (legs, hips, back, chest, abdomen, shoulders and arms), with 8-12 repetitions per activity that counts as one set.

As you can see, there are many numbers involved in reaching all the goals for a healthy diet and fit body. Fortunately, if you make a habit of eating right and staying active you won’t need a calculator to get through your day!

Check these related articles to help you get your numbers to add up right.

Protein in the Diet – How Much is Enough?

Getting Enough Protein from the Foods You Eat

Serving Size, Portion Size and Body Size Are All Connected

): Investing in childhood nutrition saves money in healthcare costs

Good Pediatric Care Offers Solution to Healthcare Crisis

Cost of healthcare can be reduced if children learn to eat right

While the nation continues to search for a way to resolve the healthcare crisis, I am convinced the answer lies in making sure every child in the country has good pediatric care. Other than selecting your own grandparents for their longevity genes, getting goo healthcare in the first two decades of life is the best way to improve your odds of beating your actuarial table.

Let me explain.

The growth and development of a healthy child require fresh air and water, a balanced diet, time to play, plenty of sleep and a safe environment. Adequate immunization and education seal the deal.

Accidents are the only leading cause of death in the U.S. (at number 5) that are not completely preventable, but virtually all of the others are.

Diet plays a major role in each of the top three causes of death while smoking controls the fourth:

  1. Heart disease
  2. Cancer
  3. Stroke (cerebrovascular diseases)
  4. Chronic lower respiratory diseases

So as I see it, the single best way to topple this country’s runaway healthcare costs is to make sure every child has an adequate diet throughout their childhood and adolescence. Establishing healthy eating habits at an early age is the best way to insure those habits will continue for the rest of one’s life and continue to protect one’s health. Trying to change poor eating habits in adulthood is far more difficult.

Pediatric healthcare providers have a distinct advantage when it comes to promoting good nutrition to their patients because the nutritional needs of children are remarkably the same around the world. They need foods of the right consistency, variety and quantity to thrive, yet no single food other than breast milk is universally found in the diets of children. Their undeveloped palates leave them open to experience and enjoy many new tastes and textures if regularly introduced, so there is no need to create special foods and menus just for kids.

To prevent overeating children should not receive external pressures to consume more than they want. Instead be allowed to respond to their internal cues of hunger and satiety. The same is true about eating for other external reasons, such as when food is used as a reward or to meet emotional needs. When these inappropriate relationships with food are not encouraged, children learn to eat for the right reasons and avoid the “food issues” that lead so many people to overeat today.

It almost sounds too simple to be true, but “you are what you eat.” The sooner in life we get that right, the better off we’ll all be.

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