The Big "D"
This November, in honor of National Diabetes Month, we’re bringing some important nutrition and exercise focused diabetes prevention tips to all of you. Before you skip the rest of this and move on to the skateboarding cat video, let’s take a look at the stats…
According to the CDC, 1 out of every 3 people in the U.S. will be diagnosed with diabetes at some point during their life. Look around you, find two other people, and ask yourself if you think that 1 person, will be you. Currently, an excess of 30 million American adults have diabetes, with 1 out of every 4 of those not even aware they have it. Having diabetes doubles your medical expenses, and you can expect that with diabetes, your likelihood of death will be 50% higher than without it. There are plenty of other statistics to shock you out of any complacency you might be feeling, but we’ll leave it there for now.
So what exactly is diabetes and what is going on in the body when someone has it? First, there are two major types of diabetes. Type 1 diabetes involves the body’s inability to produce enough insulin. That insulin is responsible for letting sugar move from the blood stream into your cells where it can be used for energy. Without enough insulin, you end up with high blood sugars. This is a less common type, and is at this time, not preventable. Type 2 diabetes is a slightly different animal, and the vastly more common type. In type 2 diabetes, your body makes plenty of insulin, but that insulin is not as effective at moving the sugar from your blood into your cells. This problem is known as “insulin resistance,” and will also result in high blood sugars as the body is eventually unable to make enough insulin to compensate. It is a developed condition, and one that can worsen and improve over time depending on a number of factors. This is the type we’re focusing on, and the type you can play a huge role in preventing. With the help of some good genetic luck, there is plenty you can do to avoid becoming that 1 out of 3.
A few points on what exactly we’re trying to prevent… What factors tend to lead to the development of Type 2 diabetes? Major risk factors include having a BMI classified as “overweight” or greater,1 exercising less than 3 times weekly, having an immediate family member with type 2 diabetes, and being of any of the following ethnicities: African American, Latino, American Indian, Pacific Islander, Asian American. Obviously, some of these things you can change, others you have no control over. Luckily, those things you can change, play a BIG role in reducing your risk factors. According to The National Institutes of Health (NIH), diabetes prevention studies show lifestyle changes resulting in weight loss as having the best outcomes, benefits extending about 10 years. That’s a long time! This is where nutrition and exercise come in…
Nutrition Essentials for Supporting a Healthy Body Weight
This is a big one. You may have heard the whole “calories in versus calories out” concept in weight management. It’s a little more complicated than that, but the basic principle remains important: If we feed ourselves more calories than we use on any given day, for an extended period of time, we’ll create a good situation for weight gain. The opposite is also true. Enter the plate method…
Basically, you’re looking at a ¼ plate of carbohydrates (foods that RAISE your blood sugar), a ¼ plate of lean and dense protein (does NOT raise blood sugar), and a ½ plate of non-starchy vegetables (will minimally raise blood sugars in the designated amounts). Add fats sparingly. Fats are needed and very good for us but are also densest in calories and can add up quickly. Use a little mindful eating, slowly eating evenly from all sections until you feel about 80% full, then stop. Voila!...portion control.
So that controls your portions within a meal, what about the whole day? In an ideal world where we’re all in touch with our hunger cues, we eat when we’re hungry. But for some people that means 1 meal a day, and for others it means 6 meals a day plus snacks. If you’re eating meals that follow the guidelines above, shooting for about 3 evenly spaced meals + 1-2 optional snacks will get you to a reasonable amount of daily calories.
Your carbohydrate choices play a big role here. Carbohydrates are foods that will turn into sugar when digested. Healthy blood sugars support a healthy body weight, which helps prevent insulin resistance. See the connection? That means choosing good quality carbohydrates that will not result in floods of sugar into your bloodstream all day every day. Generally, carbohydrates that are higher in fiber and lower in carbohydrate “density” (aka a smaller amount of carbohydrates in a given space), will support healthy blood sugars.
Do Eat: Whole grains, whole fruit, legumes (lentils, dry beans, peas), starchy vegetables, dairy.
Reduce, limit to occasionally, or avoid altogether: Refined grains, fruit juice and other sugar-sweetened beverages (ANY kind of sugar), desserts and other foods with added refined sugars (cakes, pastries, cookies, etc).
Protein quality is an easy one. Choose lean, lower fat proteins to avoid extra calories. Avoid cooking methods like frying that also add a lot of additional fat calories. Limit processed meats like sausage, bacon, etc. that are often actually higher in fat than protein, and also contain a lot of sodium and preservatives. Vary these protein sources, and remember that you have vegetarian options too like beans and lentils that also contain lots of blood sugar regulating fiber and additional vitamins and minerals. Speaking of fiber…
The real star of the balanced plate method show with regard to healthy blood sugars and weight management is the ½ plate of non-starchy vegetables. These friends are loaded with blood-sugar regulating fiber, packed with vitamins, minerals and antioxidants, and are very low in calories. It’s hard to screw up the non-starchy vegetables…so long as we aren’t breading and deep frying them. Fresh, frozen, low/no sodium canned, these veggies are the unsung heroes. Be adventurous and get a variety to maximize your nutrients.
Lastly, fats. Of your daily total, approximately 1/3 of your fats should be “saturated” or solid at room temperature, and 2/3 should be “unsaturated” or liquid at room temperature.
Hitting the Exercise Quota
Remember, exercising less than 3 times weekly is a risk factor for the development of Type 2 diabetes. A little insight into why exercise is important:
1) Yes, it burns calories and promotes a healthy weight and weight loss where needed. But…
2) It also promotes insulin sensitivity, the opposite of insulin resistance. When your muscles are working, they need sugar. Regular exercise will help put you in a balance weighted toward insulin sensitivity.
The American College of Sports Medicine (ACSM) recommends adults engage in a minimum of 150 minutes of moderate level intensity exercise weekly. Ideally this is broken up evenly across 5 days, or substituted with 3 days weekly of higher intensity exercise of similar duration. A combination of cardiovascular, resistance, and flexibility exercises is recommended for most sessions. Increase gradually toward these recommendations if you are elderly, otherwise injured or with other physical incapacitations, or currently sedentary or engaging in little activity.
As long as you’re meeting these guidelines, HOW you meet them, is totally up to you. Choose something you enjoy! There is absolutely no rule that you have to do one specific type of exercise, so if you hate what you’re currently doing, try something else. The right type of exercise is the one you’ll stick with.
Making it Happen
If this all sounds a little confusing or daunting, it’s okay! You have resources at your disposal. This is exactly what Registered Dietitians are here to help you with. Navigating lifestyle changes doesn’t have to be a struggle, and you do not have to go through it alone. Seeking out an RD to help spell out your plan and troubleshoot your personal barriers is worth it. You’ll always have someone in your corner to help you succeed.
You can start by checking out this Registered Dietitian database offered by the Academy of Nutrition and Dietetics. Just enter your zip code to get started.
If you want to read a boat load more about diabetes and healthy diet and weight management, check out the following websites.
American Diabetes Association Website
1) Center for Disease Control and Prevention. It’s Your Life. Treat Your Diabetes Well. Available at: https://www.cdc.gov/features/livingwithdiabetes/index.html. Accessed November 9, 2017.
2) American Diabetes Association. Type 1 Diabetes. Available at: http://www.diabetes.org/diabetes-basics/type-1/?loc=db-slabnav. Accessed November 9, 2017.
3) NIH National Institute of Diabetic and Digestive and Kidney Diseases. Prediabetes & Insulin Resistance. Available at: https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance. Accessed November 9, 2017.
4) USDA ChooseMyPlate.gov. ChooseMyPlate.gov. Available at: https://www.choosemyplate.gov/. Accessed November 12, 2017.
5) The Center for Mindful Eating. The Principles of Mindful Eating. Available at: https://www.thecenterformindfuleating.org/Principles-Mindful-Eating. Accessed November 12, 2017.
6) American Diabetes Association. Glycemic Index and Diabetes. Available at: http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/understanding-carbohydrates/glycemic-index-and-diabetes.html?loc=ff-slabnav. Accessed November 12, 2017.
7) Berardi J and Andrews R. The Essentials of Sport and Exercise Nutrition, 2nd ed. Precision Nutrition, Inc, 2014.
8) American College of Sports Medicine. ACSM Issues New Recommendations on Quality and Quantity of Exercise. Available at: http://www.acsm.org/about-acsm/media-room/news-releases/2011/08/01/acsm-issues-new-recommendations-on-quantity-and-quality-of-exercise. Accessed November 9, 2017.