November is National Awareness Diabetes Month. No, I am not going “crazy!” I know it’s August---not November. So, why am I discussing Diabetes Awareness in August? Because, I just can’t wait three more months, and neither can you if you have this disease, or if you are at increased risk for diabetes due to an unhealthy lifestyle!
You see, a recent survey conducted by the American Association of Clinical Endocrinologists and the American College of Endocrinologist, painted a very bleak picture of how two out of every three Americans with Type 2 diabetes do not have there disease under control. In fact, Dr. Jaime Davidson, a diabetes expert at Texas Southwestern Medical School, in Dallas, recently told a news conference that diabetes management has actually worsened in the past 10 years. That’s amazing to me, considering how much we know and how many resources are available to control diabetes.
Type 2 diabetes can be prevented and treated with diet and exercise, and/or with medication, but too many people are not heeding the warnings, or they are not aware of the seriousness of the situation. Even if you do not have diabetes, you really should be aware of this disease, because you may have a predisposition for diabetes, whether it be due to genetics and/or lifestyle. And if you have a family member with this disease, there is no doubt that your life is also affected by diabetes.
As you know, I offer a section every quarter in this newsletter, called “The Diabetes Corner,” but this month I am devoting the entire newsletter to the subject of diabetes. The “Wellness Topic” section of this newsletter, speaks more to males who have diabetes, but it will become clear after reading it that “spouses” or “significant others” of those with diabetes can also significantly be affected by diabetes, without even having the disease. In “The Diabetes Corner” section of this newsletter, I will make you aware of two new drugs that have recently come on the market to treat diabetes, and as always, every “Meal Plan” and “Food Focus” section is always appropriate for people with diabetes. Just know, however, that the calorie level or carbohydrate distribution of the meal plan may NOT be appropriate for all people with diabetes, and for that reason, an individual nutritional consultation is strongly encouraged.
Please know that there is so much that can be done to help one prevent or treat this potentially devastating disease, and live a happy and productive life. Please contact me if I can help you or a loved one in the management of diabetes, and remember to forward this newsletter onto your family and friends and ask that they sign up for this valuable monthly newsletter.
In Health,
Cheryl
P.S. I recently had the opportunity to record a brief radio spot (audio file; MP3 - may take a minute to download) for a very good cause. If you are in the Dallas/Fort Worth area, tune in to KRLD News Radio 1080 for more information on how you can help too, or see the links and announcement below.
Make your reservations!
KRLD Restaurant Week is Aug. 15-21, so plan now to treat yourself while helping others.
Select from any of the over 100 restaurants and enjoy a fabulous three- course dinner for just $30 per person, excluding beverage, tax and gratuity. For each prix fixe dinner purchased, participating restaurants will make a $6 donation to the North Texas Food Bank in Dallas and the Lena Pope Home in Fort Worth to benefit families in need .
Because of Restaurant Week's popularity, we encourage you to call your restaurants now to make reservations.
Go to KRLD.com to see the list of participating restaurants. And thank you for supporting the North Texas Food Bank and Lena Pope Home!
I. Wellness Topic of the Month: Take Charge. Talk T.
Nationwide, an estimated 13 million men age 45 and older suffer from Low T. Just what is Low T? Low T is Low Testosterone. The American Association of Diabetes Educators, in which I am a member of, has just launched a new campaign, called “Take Charge. Talk T.” The reason for the campaign is that there is new research suggesting that men with diabetes are more than twice as likely to have low testosterone (Low T), compared to other men. Plus, overweight men are also more than twice as likely as other men to have Low T. It is estimated that fewer than 10 percent of men with the condition are currently receiving treatment. Unlike “women’s menopause,” this condition is not a natural course of a man’s life cycle.
Low T can also be affected by other medical conditions, not just diabetes. High blood pressure, asthma, and COPD can also affect testosterone levels and increase one’s risk for Low T. Symptoms of Low T can include a low sex drive, erectile dysfunction, depression and fatigue. In addition, however, low levels of this male hormone can also contribute to higher body fat, reduced muscle mass, and decreased bone mineral density, therefore this condition is not just isolated to libido, but instead impacts many aspects of one’s health. Low T can be easily diagnosed with a simple blood test, and treatment involves testosterone supplementation. However, the risk of enlarged prostate exists with testosterone supplementation, and therefore treatment must be carefully monitored to prevent negative effects to the prostate. Men with prostate cancer cannot be given testosterone supplementation.
This new information and astonishing prevalence rate of Low T among men with diabetes (and overweight men), is just one more reason why the management of diabetes (and “w” management) is so crucial. Managing blood glucose levels can, at first, seem like a daunting task, but its benefits will be reaped in so many different aspects of one’s health. Medical Nutrition Therapy and “w” management are the cornerstones for controlling diabetes. If you have diabetes, it is crucial that you learn how to manage it with proper nutrition and a meal plan, as well as with activity, and daily blood glucose monitoring with a glucometer. If you are overweight and have not been tested for diabetes, be sure to see your physician to be screened for this disease. (See April 2005 Newsletter archives for more information about self-glucose monitoring and how you can get a “complimentary” glucose meter and sample daily log to keep track of your results.)
For a complimentary electronic brochure produced by the American Association of Diabetes Educators on the causes, symptoms and treatment options for Low T, contact me, and I will be happy to email it to you. TAKE CHARGE!
HealthSteps Rx can help you improve your nutritional and fitness lifestyle, and help you sort through any health or medical conditions. There are many services available at www.HealthStepsRx.com, with various price options to fit your budget. Medicare benefits accepted for some conditions and some medical plans are accepted.
II. Food Focus
III. Recipe Rescue
- Recipe Rescue Feature: Sour Cream Substitute
Thanks to Renee of Double Oak, Texas who had two of her friends sign up to receive the “Step-Power Weigh.” In return, Renee is able to receive a “complimentary” recipe modification. Renee reported that she loves having baked potatoes with cheese and sour cream for lunch, but knows that both can be quite high in calories and fat. She does not like the store bought sour cream substitutes, and wondered if I had a recipe for a sour cream substitute. And, actually, I have two! One is actually not a recipe, however, but, it does the trick!
First of all, however, let me say that Renee is correct in being concerned about the calories and the fat content in sour cream. As delicious as it is, it is not “heart healthy.” Two tablespoons (1 serving of regular sour cream) has 60 calories, 5 grams of fat , 3.5 grams saturated fat , and 20 mg cholesterol . Do you only use 2 T on your potato? Why waste your calorie and fat grams on this, if there is a better way, and there is:
The better ways:
- Substitute sour cream with yogurt cheese. Learn all about this trick in this month’s Food Focus, (written especially to address Renee’s request.)
2 Tablespoons: 17 calories, 0.06 g fat, 0.04 grams saturated fat and 0.61 mg cholesterol
- Recipe for Sour Cream Substitute : In a blender or food processor, place ½ cup low-fat cottage cheese , 1 ½ tsp lemon juice , and 1 tbsp skim milk , and blend on medium-high speed until smooth and creamy.
2 Tablespoons: 22 calories , 0.26 grams fat , 0.13 grams saturated fat and 1.33 mg cholesterol
Thanks again, Renee for referring your friends to the “Step-Power Weigh,” and for this great question. Expect your electronic formatted copy of this recipe and its nutritional analysis in your mail.
If you would like to see your “modified for health” recipe in this section, remember to ask your friends and family to sign up for The Step-Power Weigh ezine, then send me their names. When two people sign up that you have referred, you are eligible to be placed in a drawing to have your recipe modified. You can choose to be anonymous, or provide your name. In addition, you will be sent a copy of the recipe to add to your family recipe book. Don’t you want to start passing down your delicious and healthy recipes to the next generations?
If your recipe is not chosen and you would still like a “healthy modification” for your recipe, HealthSteps Rx offers this service at a very reasonable fee, but this service is also provided complimentary, when you sign up for one of HealthSteps Rx Wellness Programs.
If you would like more great recipe ideas, you will find plenty here: http://www.healthstepsrx.com/shops/books.htm
IV. Meal Plan of the Month
- Meal Plan Feature: 1600 Calorie Meal Plan from the “Convenient-Prep with Recipe” Breakfast & Lunch,” and “Convenient-Prep with Frozen Meal Dinner” Collection. PLUS, NEW : This month’s meal plan includes “Pictures of the meal and/or products used,” so you can get a better idea of appropriate serving sizes and specific products that can be used to meet your calorie and wellness goals.
So you don’t have time to cook healthy balanced meals, huh? Well, I challenge you on this assumption. You CAN eat healthy and FAST when you plan appropriately. Refer to this month’s meal plan, using store-bought convenience foods AND healthy recipes that you have prepared in advance. Remember-- where there is a WILL, there is a WAY!
For Breakfast: simply remove from the freezer and thaw in the microwave, a previously homemade baked muffin, such as that one in this month’s meal plan. Serve with yogurt and/or milk and fruit, and “viola”---a healthy breakfast made in less than 5 minutes.
For Lunch: Plan to either put this meal together in a thermal lunch bag the evening before, or take just 5 minutes in the morning to put it together, using previously prepared ingredients. The ingredients in this meal will require refrigeration, so if you don’t have “blue ice” and a thermal lunch kit, make sure your place of employment has a refrigerator to store it. Most places of employment generally do have a refrigerator, and a microwave and/or toaster for their employees. By just investing 5 minutes in advance to put your lunch together, you might find that you have saved so much more time by NOT going out for lunch, that you can take a 15-minute walk during your lunch break.
NOTE: This meal consists of several recipes that can be made in advance, and used over and over for other quick meals. I do want to commend The Phytopia Cookbook, by Barbara Gollman, R.D., and Kim Pierce, for the inspiration of this delicious and healthy meal.
For Dinner: Take the suggestion I made in the May 2005 Newsletter, regarding the preparation of Brown Rice, and cook it before you leave for work to go along with the “Meals Made Simple” Shrimp Stir-Fry * , found in the frozen food section of Kroger. Then, all you will need to do is reheat the rice and prepare this easy stir-fry, in less than 15 minutes.
* Note about sodium in processed foods: Generally, processed foods have a great deal more sodium than food prepared from scratch. You should limit your total sodium intake from all foods to no more than 2400 mg per day. If you have known hypertension, your sodium intake should be even less….1500 mg per day. So, if you know you will be eating a processed food that contains a high amount of sodium, make sure you keep within the total day’s allowance for sodium the rest of the day. People with diabetes are more “salt-sensitive” than the general population, and it becomes even more important if you have diabetes to be careful about your total sodium intake. Therefore, remember that if you increase the serving size, you also increase your sodium intake, and when using processed foods, it can become very easy to exceed your sodium intake.
It’s important to know how to read food labels, not only for the calorie and fat content, but also for other ingredients, especially sodium. If you would like guidance in learning how to read food labels and in knowing how much of each ingredient is appropriate, contact me for a nutrition consultation.
For Snacks: Do be sure to also “plan for” and eat your snacks! Healthy snacking can actually help you reduce “w”. Contact me for a personalized nutrition consultation, so I can help you snack the right way!
Keep in mind that all meal plans are not suitable for everyone. I offer you a sample meal plan in this newsletter because it is the number one request from my clients, but it is my goal to provide you the “tools” for you to be able to eventually design your own meal plans. What’s the old saying? “Give a man a fish and you feed him for a day, but teach a man to fish and you feed him for a lifetime.” Well, that too, is my philosophy and plan for you!
In addition, it is obvious that the calorie levels of these meal plans will not be suitable for everyone, so I encourage you to learn how many calories a day you need to promote a healthy lifestyle by setting up an individualized nutrition consultation with me. You wouldn’t try to balance your checkbook without first knowing exactly what your deposits and expenditures are, so why attempt to balance your "W" without knowing exactly how many calories your body needs? Thanks to technology, I can also easily assess your unique and personalized metabolic rate.
You will have temporary complimentary access to this meal plan for one month, and then it will only be available to all HealthSteps Rx Wellness Program clients via password.
V. Diabetes Corner
- Diabetes Corner Lesson: Two New Diabetes Drugs
Symlin: A new injectable drug for people with Type 1 and Type 2 diabetes who use insulin, to help improve “after-meal” blood glucose control. This drug is a synthetic analog of the human hormone amylin. In people without diabetes, the pancreas produces amylin and insulin at the same time. Amylin enhances the way insulin works by slowing the rate of release from the stomach to the small intestine, thereby slowing the production of glucose by the liver and helping in the control of appetite. In people with Type 1 diabetes, they do not make amylin. People with Type 2 diabetes, who have a deficiency of insulin, also have a deficiency of amylin. Symlin, therefore is meant to replace naturally occurring amylin, and it would be taken as an injection just before you eat a meal. Because Symlin must not be mixed with insulin in the same syringe, two separate shots would be required. Amylin Pharmaceuticals, the manufacturer of Symlin, has plans to release Symlin in its own pen in the future, much like insulin pens.
Byetta: This drug has only been approved by the FDA for people with Type 2 diabetes who are already taking metformin, a sulfonylurea medication, or both. Byetta is an injectable drug that would be taken less than an hour before the morning and evening meals. It is designed to mimic the action of a hormone called glucagons-like peptide (GLP-1), which is normally secreted by the cells lining the small intestine when you eat, to help promote insulin secretion by the pancreas. It’s ability to stimulate insulin secretion depends on how high the blood sugar is. The higher the blood sugar, the stronger is the effect of Byetta, but if the blood sugar is lower, Byetta’s effects are minimal because you don’t need to have as much insulin secretion. What some people appreciate the most with this medication is the resulting “w” loss. Byetta is a product of a partnership between Amylin Parmaceuticals and Eli Lilly. Byetta is dispensed via a pen, much like an insulin pen.
Both Symlin and Byetta require a prescription from your physician, and also a consultation with your diabetes educator to review information about their usage, interactions with other drugs, and side effects. HealthSteps Rx is not endorsing these medications, but only making you aware of their existence. If you would like more information, contact me.
Whether or not you have diabetes, or know of someone with this disease, learn why it is essential to become aware and educated about diabetes in Diabetes Overview: A Society Dilemma.
VI. Take the Challenge
What can you do this week that gets you closer to your goal? Taking the “first step” in trying new things or eliminating others, is always the most difficult. But, I promise you, once you are successful at this first step, all the other steps are that much easier. And before you know it, you’ll be wondering what took you so long. :-)
- Challenge: I will set my alarm 15 minutes earlier, two days this week, in order to allow me to pack a healthy lunch to take to work.
- Rationale: By taking a healthy lunch to work, instead of eating out, I can decrease my fat and calorie intake, promote a healthier “w” and increased health benefits, plus have more time during my lunch break to take a brief walk or use the stairs.
VII. To Leave The Step-Power Weigh
It’s quite understandable if you need to unsubscribe to The Step-Power Weigh, for whatever reason. One thing is always for sure: life is always changing, so our needs often change with it.
If someone has thought enough about you to share this issue of The Step-Power Weigh with you and you are not currently on The Step-Power Weigh list, please join.
For those who choose to continue to receive The Step-Power Weigh, be assured that I will not share or sell your name or email address.
Here’s to Your Health!
Cheryl Winter, M.S., R.D., R.N.
HealthSteps Rx
info@HealthStepsRx.com
www.HealthStepsRx.com
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