Salvatore Vuono / FreeDigitalPhotos.net

Dietitians and consumers alike are constantly frustrated by the amount of information in the mainstream media and even the medical community about nutrition that is not evidence-based. Because Registered Dietitians are trained in providing evidence-based information backed by peer-reviewed research, it’s frustrating to see people seeking good information about health instead finding nutrition information that is at best untrue and at worst, harmful to their health.

Fad diets are often promoted by celebrities, fitness experts, and even doctors, many of whom do not have specialized knowledge in the science of nutrition. These diets often come with elegantly written “science” backing them, that sadly is not based in evidence and ignores many of the dangers to the approach, the limited long-term effectiveness, and/or the limited duration of time most people are able to sustain the diet.

In days past, dietitians gained the reputation of “food police,” only telling you what NOT to eat. In fact, a colleague of mine recently mentioned when people see her eating at a party they’re surprised and look at her like “you’re EATING?” Most of us now consider ourselves advocates for food and make sure to provide plenty of information on what TO eat for optimal health, not just what to avoid. By the same token, I think for this topic it’s important that I not just bash fad diets, but that I provide you with good resources to find sound, evidenced based nutrition information.

The following are some of my favorite nutrition resources. These are places to go to search for good information on whatever topic you’re looking for. Go straight to these sites for quality info rather than doing your standard Google search and subjecting yourself to whichever diet sites win the race of internet marketing and end up on your first search page:

Evidence-based nutrition information

http://www.webmd.com/
This is a leading source for trustworthy and timely health and medical news and information.  Features a symptom checker, drugs and medications A-Z, health topics A-Z, and a doctor directory.

http://www.medicinenet.com/
This is run by WebMD and brings even more great information on different medical conditions, nutrition information, and medication. Features a medical term dictionary and even info on pet health!

http://www.mayoclinic.com/health/nutrition-and-healthy-eating/MY00431
Information on healthy diets, healthy cooking, menus, and grocery shopping. It even has expert answers on a variety of different nutrition topics and questions, and includes an expert nutrition blog.

http://www.nhlbisupport.com/bmi/
This site includes a BMI calculator and information on achieving a healthy weight.  Includes a menu planner, recipes, shopping tips, a food/activity diary, and more.

http://www.eatright.org/
This is the website for the largest organization of dietitians and nutrition professionals. It has plenty of trustworthy, science-based information for the public as well. Click on the “public” tab for information on healthy weight loss, disease prevention, and many other nutrition topics.

http://www.consumerlab.com/
Provides independent test results, reviews, ratings and comparisons of vitamins, supplements, and herb and nutrition products. The place to go for trustworthy information on supplements.

http://health.gov/dietaryguidelines/2010.asp
Here is the link to the Dietary Guidelines for Americans, which were most recently updated on 2010. These guidelines are published every 5 years since 1980 by the Department for Health and Human Services (HHS), and the United States Department of Agriculture (USDA).

http://www.cdc.gov/
This is the Center for Disease Control website. You can easily search topics on health and nutrition and find outstanding information and research.

http://www.choosemyplate.gov/
This easy to use and interactive site helps you build your own meal plan, track your foods, and provides useful tools to helping you achieve a healthy weight with a balanced diet. The Food-A-Pedia feature allows you to input foods and get nutrition information on what you’ve eaten, and the food and physical activity trackers also help you keep track of your energy balance.

Popular nutrition tools

http://www.myfitnesspal.com/
Free online calorie counter and diet plan. You can track your caloric intake quickly and easily for healthy weight loss. Includes mobile apps and nutrition facts for over 1000000 foods.

http://www.mealstolive.com/
Healthy and delicious frozen meals created for people who want and need to eat healthfully. Includes meals for people with diabetes and other diet-specific ailments like gluten free and low sodium. Order online or find physical stores.

http://www.sparkpeople.com/
The largest online diet and healthy living community. Provides information and tools on nutrition, recipes, and more.

http://www.groceryiq.com/
Helps you create and organize your grocery lists easily. With a mobile app that includes a database of millions of items, and includes barcode scanning, integrated coupons, product details, and sorting by isle.

Online fitness classes

I am a hug proponent of fitness videos. If you can’t get to the gym, can’t afford exercise equipment, or have physical limitations that prevent you from doing certain activities, there’s still a fitness video for you. It couldn’t be cheaper or more convenient. That combined with my love of the convenience of online shopping, it’s easy to see why I love the following sites for providing fitness videos online:

http://www.flirtygirlfitnesslive.com/
http://connectonlinefitness.com/
http://www.emglivefitness.com/
http://dailyburn.com/

Check out one or more of these sites or services and share your experience in the comments section below.  To get blog posts as I post them via email, sign up below:

Image: Salvatore Vuono / FreeDigitalPhotos.net

Suat Eman / FreeDigitalPhotos.net

This recipe is so very delicious.  I never used to think a dough that didn’t contain gluten could taste so good, and be crunchy and chewy in all the right areas. This recipe, being gluten free, is great for someone with celiac disease or a gluten sensitivity.  (Please note the adaptations in italics below for LEAP clients.)  However, this recipe is a healthy option for ANYONE, to add some variety to your diet and provide an alternative to the standard “whole wheat” pizza crust.  Brown rice is also a whole grain, so this recipe is not only delicious but nutritionally superior to white pizza crust.

If some of these ingredients look unfamiliar to you, that’s because they may be hard to find at your standard grocery store.  However, they are available at most health food stores.  Bob’s Red Mill is a wonderful company that sells affordable alternative grain products such as the flours listed below.  Bob’s Red Mill products are available in health food stores and at  http://www.bobsredmill.com/.  Whole foods is also another great source:  http://www.wholefoodsmarket.com/shop/.   And, you can shop online at both of these links, a convenience I absolutely love!

Ingredients: 

• 1 Tbsp active dry yeast
• 2/3 cup 110 degree F milk (soy, cow, or rice)
• 2/3 cup brown rice flour or other allowed grain flour
• ½ cup tapioca flour (may substitute potato starch)
• 2 tsp xantham gum (may substitute guar gum or pre-gel starch) *
• ½ tsp salt
• 1 tsp vinegar
• 1 tbsp honey (or allowed sweetener), make sure honey is room temp
• 2 Tbsp olive oil (or any allowed oil)
• 2 Tbsp additional olive oil for working with dough (or any allowed oil)
• ½ tsp minced garlic
• ¼ tsp oregano
• ¾ tsp dried basil

 Directions: 

1. Preheat oven to 425 degrees.
2. Combine milk with yeast and honey/sweetener and allow to sit
3. Blend brown rice flour, tapioca flour, xantham gum, oregano, basil, and salt in a separate bowl.
4. Add olive oil, vinegar, and garlic to the bubbly liquid mixture.  Combine with flour mixture and mix well with your hands
5. Cover and let dough rest for 30 minutes
6. Press dough onto greased pizza pan (may use additional olive oil) Bake for 10 minutes.  Remove, add toppings, and bake another 10 minutes.

Makes 6 servings

Please comment below on how you like the recipe!

Image: Suat Eman / FreeDigitalPhotos.net

At the biggest time of year for people to make dietary resolutions or “nutrition resolutions,” if you will I wanted to emphasize this one heartfelt note of encouragement:  don’t do it!

It is the 2nd day of January and many are already realizing they messed up on their diet, weren’t able to do the full hour a day at the gym they had planned, and they might have even already bumped their start date to Jan 9^th (the next Monday, of course).

Although I am in the business of encouraging and assisting people in making lifestyle changes year-round, the New Year’s Resolution is a cousin of the all-or-nothing mentality.  This mentality sabotages your efforts as it leads to yo-yo behavior that leaves you eternally flip flopping between dieting and overdoing it in lieu of the life of moderation that will truly bring you what you’re looking for.  Moderation that can be practiced during the busy work week, the weekend, vacations, holidays, whenever.

Adopting a healthier lifestyle is serious business. Our lifestyles and the food we eat affect our health more than we may have ever imagined.  In medical journal after journal, it seems to always come back to the same thing with regard to reducing chronic disease risk:  eat less and better types of fat, consume less salt and more potassium, decrease refined carbohydrates, eat more colorful fruits and vegetables, eat more whole grains, don’t smoke, and on and on and on… Plus, there are many factors affecting our health that we cannot control:  environmental pollutants, pollutants in our food (can be controlled to a certain extent with organics), so why not control what we can and add years to our lives as well as making our living years enjoyable and free of illness?  (Now, when I mentioned the factors we cannot control, if your mind jumped to “yeah, we’re all going to die of something so what’s the point?”  I’ll have you reread the paragraph about the all-or-nothing mindset.)

To avoid this mentality, start implementing your resolutions as soon as you see a need for them.  Motivation can be perishable so keep your motivators in mind as you proceed.   It’s easy to think “eh, it’s not that important” or “I’ll start later” especially when others around you may not place much importance on health.  But there’s a reason you decided to make a change, a reason it’s nagging you.  Your intuition is trying to urge you to be a healthier person and have a better life.  I have found that if I eat a meal that’s too heavy it affects everything.  I’m very careful what I eat during the work week for example, because if I eat the wrong thing, I have trouble concentrating, being efficient, and staying motivated.  It reminds me of when my brother once joked “I need to go sit this off” after a big meal…it does often feel like that’s all you can do!  Of course, I might not know this if I had never experienced the contrast of eating very well and how much energy, motivation, and inspiration I have access to when I do.  How might your eating habits be affecting you in your life?

Personally, I hope you start your nutrition resolutions on the 9^th, 16^th, or 23^rd day of the month on a Tuesday, Friday, or Sunday at 10:15am, 3:08pm, or 8:53pm, any month of the year.  Make your resolution SMART:  specific, measurable, attainable, realistic, and timely.  Don’t just set out to eat better…that’s too ambiguous.  Make 1 goal and make it specific:  for example, “I will have a green salad with my lunch every day this week starting today.” (noticed I didn’t say tomorrow…tomorrow is tricky in that it doesn’t exist and life is actually made up of many many todays!)  Once eating a salad with lunch becomes a habit, continue that habit but add another goal, such as “I will go for a 15 minute walk at 6:30 before work on Mondays, Wednesdays, and Fridays starting today.”  Once that habit is established, you can easily add minutes or additional days to your regimen.  Changing habits in this manner is the most effective way to change your lifestyle.  It takes time, but time will pass anyway, so you can spend your time bouncing around like a yo-yo between following a strict diet and chaos, or you can actually change how you live.

Please take a moment to comment below if you have a SMART goal you plan to make soon…your discussion and ideas help others who are struggling with the same thing you are!

Negative self-talk can be a silent saboteur as we often do it unconsciously and have little awareness that it is happening, much less its effects on our emotions and behaviors.  Let’s look at the difference between negative self-talk and positive self-talk.

Here are some other negative and positive thought patterns:

Negative thoughts will inevitably enter our heads.  The key is to let them flow out as quickly as they flowed in, and to consciously replace them with positive thoughts.  For positive results with weight loss:

• Maintain a long-term focus and be patient and loving with yourself.  Keep focused on the emotion behind your motivating factors.  For example, instead of  thinking “I need to lose 30lb,”  think “I am doing this so I will look and feel fabulous.”
• Imagine yourself already looking and feeling the way you want to…and feel the emotions you expect to feel when that happens.  If you make this a daily practice, you will be thrust onto a one-way road to your goal and there will be no going back!
• Believe that you are worthy of your goal and all the wonderful benefits that will come along with achieving it.
• Be flexible with yourself.  Most everyone experiences set-backs along the way…don’t let it shake your emotions or mindset.  Push bad thoughts out of your head and forgive yourself, and resume the positive self talk, affirmation, and visualizations.
• Give in now and then and eat something you’re craving.  Keep the portion reasonable and hop right back on the healthy horse afterwards.  Also make it a habit to incorporate many of the foods you really like into your daily routine. This way you will not be as prone to the “I need comfort now!” and “I can’t do this!” mindsets.  Celebrate and affirm frequently, and repeat as needed!

What negative self-talk do you notice going on in your head?  What successes have you found with using positive self-talk and affirmation?

I started thinking about my life as a person who generally likes to eat healthfully.  For much of my life, my healthy behaviors have been viewed by most people I have encountered as either somewhat nerdy, square, or just boring.  I’ve been urged to “live a little” and informed that “we’re all going to die of something” in people’s efforts to impress upon me just how uncomfortable they were with my eating habits.  Never mind that it’s not generally considered polite to make fun of someone who is eating unhealthfully, many don’t hesitate to comment on the other side of the spectrum.  ”Is that spinach you got there?  Gross!”  In many a break room I’ve dealt with staff examining my Tupperware containers as if trying to make sense of the soup, stew, or stir fry I had in my container, rivaled by their easily recognizable bag of fast food.  Their eating habits were considered normal, while mine were considered strange.

I did however observe an interesting shift when our company a few years ago implemented an employee wellness program. The program offered monetary incentives to participate in certain wellness behaviors, such as exercise and eating well.  Each site had a wellness leader, who would oversee health activities (a group walk on the lunch break or everyone joining a 5-K walk together).

What really struck me was the shift I saw in even voluntary behaviors.  Whereas it had always been the norm to find boxes of donuts, cookies, and cakes in the break room, those things just sort of disappeared.  When lunches were ordered for meetings, no longer were large amounts of pizza ordered; instead deli sandwiches with salad and fruit as an alternative to the cookie were ordered for all.  And, no one complained.  In fact, if something unhealthy was ordered or placed in the break room, people would actually turn their noses up at it and criticize its presence just as they used to criticize my lentil soup!

Well, I’m sad to say that under new management at that company (at which I’m no longer employed,) the employee wellness program went away (along with a lot of the previous employees) and with it, the healthy culture.  But, it amazed me at how quickly a culture could change.  And, even more amazingly, I have noticed this sort of change starting to occur in this country.  More people than ever are making healthy habits a part of their normal lifestyle.  Junk food is being passed up in favor of healthier snacks.  Health food stores are popping up on more corners; labeling laws are being passed to cater to general health as well as subsets of health within our population, and restaurants are starting to seriously consider reducing the sodium and calorie contents of their menu items, or at least display the nutrition information on the menu.  Awareness is increasing, and the culture is changing from one that scoffed at a healthy lifestyle to now starting to rebuke the unhealthy mentality and way of life.

The essence of my store is this:  products that poke just a slight bit of good-natured fun at those who have not yet embraced a healthy lifestyle, while also displaying pride for those who have.  There are designs that work for adults and kids alike.  For men or women, on T-shirts or bumper stickers.
Please visit, enjoy, and spread the word.  A healthier culture has become viral; you may as well jump aboard!
Visit:  http://www.cafepress.com/NutritionResolution

The Diet

Paleo enthusiasts, such as Sebastien Noel of The Paleo Lifestyle, profess “you get to gorge on all the good meat, fish, and good fats you want,” while avoiding foods  we generally think of as healthy, such as grains, dairy, and legumes, and even limiting fruit.  The rationale is that before agriculture, people did not have access to carbohydrate sources and therefore, our body is not designed to process these foods.  Paleo supporters believe foods with carbohydrate lead to fat gain, diabetes, heart problems, and inflammation.  The list goes on to blame carbohydrate for obesity,  depression, mental illness, arthritis, Crohn’s disease, osteoporosis, and dental problems.

The other two macronutrients, protein and fat, are heavily promoted by the diet, especially saturated fat.   On Noel’s  website, he states  ”fat, especially saturated fat, is the cleanest energy source available to us,”  and promotes butter and coconut oil, discouraging the use of olive oil, which is a known source of monounsaturated fats.  Monounsaturated fats  raise good cholesterol and are the cornerstone of the Mediterranean diet, which has been proven to reduce the risk of certain diseases and cancers.

The Paleo Diet’s criticism of grains and legumes goes beyond the fact that they contain carbohydrate.  It focuses on two of the main chemical components that are present in some grains and legumes:  gluten and lectins.  Gluten, found in wheat, barley, and rye, is a known antagonist of Celiac disease, which is characterized by gluten intolerance.  Lectins are found in grains, legumes, seeds, nuts, and certain vegetables in the nightshade family.  Cordain states lectins harm the body by causing the immune system to attack itself.

What We Know

Lectins are found in many plant foods and are tolerated by the majority of people.  There is some research that shows certain lectins may mimic hormones and behave like insulin, causing fat gain.  People with certain digestive disorders may be particularly sensitive to lectins and should avoid them.   Just as a small percentage of people are allergic to peanuts while many others aren’t, people can have sensitivities to a wide array of foods and food components that cause symptoms, which can vary greatly between individuals.  Many children with autism have been shown to benefit from a gluten free casein free (GFCF) diet.   The important distinction here is that just because a food component can cause symptoms in some does not mean it’s harmful to all.

Although we all eat some lectins, we don’t all get diabetes, arthritis, or become obese.  Why?  According to David J Freed, allergist, it is “partly because of biological variation in the glycoconjugates that coat our cells and partly because these are protected behind a fine screen of sialic acid molecules, attached to the glycoprotein tips.”  Our cells are generally protected from potentially harmful food components.  In many cases where this protection is compromised, it is due to infection, such as a flu or strep virus that strips off the sialic acid molecules.

Pros of the Paleo Diet

Recommends fewer processed foods and emphasizes whole foods.  Processed foods contain refined grains, sugars, and excess salt that contribute to chronic disease.

Plenty of vegetables.  Vegetables contain vitamins, minerals, fiber, and antioxidants that help prevent chronic diseases and cancer.

Calorie reduction:  most people who  follow the Paleo Diet eat fewer calories than they did before, which facilitates weight loss and can contribute to longevity.

Cons of the Paleo Diet

Macronutrient Ratio:  Paleo supporters encourage a macronutrient breakdown of 20% of total calories from carbohydrate, 65% from fat, and 15% from protein.  Whereas this is consistent with dietary guidelines for protein, (ironic considering the emphasis on meat,) it is way too low in carbohydrate, as 40-60% carbohydrate is recommended for a healthy diet.  A healthy intake of fat is 20-30% of total calories, whereas Paleo enthusiasts insist up to 80% fat is safe and even beneficial.  This ratio is sadly not based on research, but on the composition of human breastmilk and the human body itself.

The Paleo Diet eliminates food groups such as dairy, legumes, and whole grains that are considered to be healthy for the majority of the population.  There is plenty of evidence that people who eat dairy are more likely to be a normal weight and have better bone density than people who do not.  Cutting out grains makes it difficult to get enough essential vitamins, such as folic acid, which reduces the risk of neural tube defects like Spina Bifida.  And legumes, including beans and lentils, serve as a source of protein, minerals, and are a great source of fiber, which reduces cholesterol. “They’re a cheap source of protein and have so many good qualities that it would be foolish to give them up,” states Joan Salge Blake MS, RD, LDN who is a spokeswoman for the American Dietetic Association.

The premise of the Paleo Diet:  even today there’s such variability in the diets of hunter-gatherer cultures that it’s impossible to identify one general type.  In fact, recent anthropological findings suggest primitive diets consisted of plentiful gatherable foods, such as seeds, berries, roots, nuts, shellfish, honey, and the occasional animal.  A recent study which analyzed archeological digs in Italy, Russia, and the Czech Republic revealed traces of starch grains on stones used for preparing food. “There is probably no single diet to which our ancestors were adapted,” said University of Arkansas anthropologist Peter Ungar.   ”Recent foragers have varied in their diet from marine mammals (the Inuit) to diets composed mostly of a few plant species in the outback.”

Modern concerns:  raising animals for food is considered the greatest contributor to global warming, and rainforest destruction.  Production of modern meat is threatening the many indigenous people who live in forests, with a lifestyle similar to the primitive man the diet is modeled around.

My advice

I want to encourage anyone who’s seeking a healthier lifestyle to go for it, and not be discouraged by the sea of confusing information.  The key is to educate yourself as much as possible and maintain an open mind.  My suggestion for those interested in the Paleo concept is to do a modified Paleo Diet that includes vegetables, lean meat, fish, and eggs (limited to 1 yolk per day), but to also add in some of the power foods that research still stands behind as healthy and disease-fighting for the majority of the population.  This includes beans, whole grains, nuts, 2-4 servings of fruit/day, and olive oil.  This is what I consider a “whole foods” diet.  Continue to avoid processed foods, refined sugars, and be cautious with saturated fat (see my last blog, Cuckoo for Coconut Oil).

I agree with the Paleo philosophy that many of the chronic diseases people experience today are caused or accelerated by our modern diets and lifestyles.  Our processed foods, consumption of refined grains and sugars, and activity are at the top of the list of the antagonists to obesity, diabetes, heart disease, and others.  I disagree that whole grains, legumes, and dairy should be cut out by the majority of the population. And my biggest concern is that in trying to be healthier, people may do themselves harm in the process.  For those wanting to improve their health, going to the extreme of cutting out three food groups is the equivalent of using a skin graft to treat a paper cut.  As you gather information and hunt for the best eating plan for you, continue to consider me a qualified resource to help you on your journey.

Even before becoming a dietitian, I grew up knowing coconut oil contained saturated fat, the type of fat usually found in animal products, but also found in tropical oils. I knew because my mother stayed abreast on the latest in nutrition, and armed with this knowledge, knew enough to refuse to buy me the Keebler Fudge-stripe cookies I remember wanting as a child. Saturated fat is known to raise LDL (bad cholesterol) and total cholesterol, which increases the risk of heart disease. However, a new perspective has made some scientists, vegans, and even health professionals cuckoo for coconut oil.

The controversy is this: the saturated fat in coconut oil is mostly in the form of a medium-chain fat, lauric aid, as well as other medium-chain fats, which raises good AND bad cholesterol (HDL and LDL). Since it raises both, scientists speculate that this particular type of saturated fat may not be as harmful as that found in animal products, which consists of long-chain fatty acids.

There is also criticism of the initial studies that labeled coconut oil as a villain in the first place. The coconut oil used in those studies was hydrogenated, meaning they artificially saturated the miniscule amount of unsaturated bonds that exist, as coconut oil is 92% saturated (far more saturated than animal fat). This is the same process that is used to turn vegetable oil into trans fats. These early studies also eliminated essential fats from the diets of test animals, making coconut oil the only fat source. Critics of these studies state the atherogenesis that resulted may have been in part due to an essential fatty acid deficiency. Also, early studies often used rabbits, rats or mice, which are considered poor models for cholesterol studies. This is leading many to the conclusion that although coconut oil was atherogenic in these studies, virgin coconut oil is not as bad for us as we thought. In fact, an enthusiastic few have taken the leap to say it’s actually healthy.

Proponents state coconut oil actually promotes heart health, weight loss, immune health, metabolism, provides immediate energy, keeps skin healthy and “youthful-looking”, and supports proper thyroid function.  However, there is a great deal of evidence indicating that even medium-chain lauric acid raises LDL.

It does raise questions, though, that in those areas in which native diets are rich in tropical oils, such as Indonesia, the Philippines, and India, there is no apparent correlation between coconut consumption via coconuts, coconut water, coconut milk, or coconut oil and heart disease. In fact, the research is mixed with some studies pointing to less oxidized LDL and better fibrinolysis (breaking up of blood clots) with coconut consumption. Talk about mixed evidence!

Yet it didn’t take much for people to jump ship. Blogs are popping up praising coconut oil to high heaven; foodies are coming out of the woodwork with coconut oil recipes for pastries, icings, brownies, muffins, stir-frying vegetables and even to put in your oatmeal! The sweet, vanilla-like, nutty flavor makes people go nutty for this fluffy oil, and it’s never been denied that coconut oil does wonders for the texture and quality of food products. After hearing of the speculation, Melissa Clark of the New York Times went on an experimental frenzy, using coconut oil in everything from home-made ice cream magic shell to roasting sweet potatoes.

My advice: at ease! Before you go pouring coconut oil on your corn flakes, let’s keep the big picture in mind. It is reasonable to say that until we have more conclusive scientific evidence, coconut oil should be consumed in moderation. All that’s safe to say is that small amounts probably aren’t harmful. The Dietary Guidelines for Americans recommend no more than 10% of dietary calories be from saturated fat, which is about 20g a day for a 2000 calorie diet. I would still rely on olive oil and other sources of monounsaturated and polyunsaturated fats (from vegetable sources) as my primary source of fat. And, don’t forget the essential Omega 3 fats. Continue to avoid hydrogenated and partially hydrogenated coconut oil, which contain trans fats that are known to have atherogenic effects. Even if coconut is not as bad for us as we once thought, that doesn’t mean it’s good for us. If nothing else, it still contains 120 calories per Tbsp. And as for your corn flakes, for the time being, milk works just fine. Your thoughts?

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Because of this, people with diabetes actually need to understand, first and foremost, the carbohydrate content of their foods. This way they may plan their meals, in advance or on the fly, in a way that protects their blood vessels from the damage that high sugars can cause. Today’s savvy dietitian and diabetes educator is focused more on education than providing a diet, and more on empowering the patient to learn to build their own meal plans than having the patient rely on them for one.

Diabetes is a progressive disease in which the treatment is different at each stage. Effectively treating diabetes early on in a way that maintains blood sugars within a normal range most of the time will prevent damage to the blood vessels and delay the progression of the disease. No matter what stage you are at, it is never too late to learn to control your blood glucose so you can prevent any further damage from being caused. Below I have outlined the basic stages of diabetes and the appropriate dietary considerations that relate to them.
Newly diagnosed:

The average person with diabetes is not diagnosed until 5 years after they actually develop insulin resistance. Getting yearly doctor’s exams will help assure you catch diabetes as early as possible, well before this 5-year average. Early on, and for the long-term if your blood sugars are well-controlled, your pancreas still has enough available insulin to cover the carbohydrate eaten at your meals. You may or may not need to take oral medication.

In this case you budget your carbohydrates like you would your bank account. You establish a maximum amount of carbohydrate you can eat in a meal and still have a blood sugar at target (<140mg/dL) 2 hours after your meal. You may eat less than that amount if you wish, as long as you don’t exceed the maximum. (Disclaimer: The Dietary Guidelines For Americans recommend a bare minimum of 130 grams of carbohydrate daily)
After Diabetes has Progressed:

If blood sugars are left uncontrolled for an extended number of years, the pancreas is forced to make so much insulin over a period of time that it wears out. At this point, insulin needs to be injected, and/or oral medications may be used to stimulate insulin production or make your cells more sensitive to insulin. This will happen, on average, around the 8^th year after the initial insulin resistance occurs. When you take insulin, you have a couple choices:

1. Static insulin dose – when you take a consistent amount of insulin daily, you must keep the amount of carbohydrate eaten at meals constant. This is because those taking insulin are at a higher risk of hypoglycemia (low blood sugar) and must eat enough carbohydrate to match available injected insulin.
2. Flexible mealtime bolus insulin dose – this is one of the best ways to control blood glucose and allows for patients with diabetes much more flexibility in what they eat, and how much. Your insulin:carbohydrate ratio is determined which tells you how much insulin you need to cover each unit of carbohydrates eaten (the insulin:carbohydrate ratio is individual to everyone). Once this ratio is determined, you can eat as much or as little carbohydrate as you like (within the Dietary Guidelines), as long as you take the appropriate amount of insulin to cover it. A diabetes educator can work with you and your doctor to establish this ratio and teach you how to count your carbohydrates to achieve this balance.

Many people with diabetes feel overwhelmed and frustrated with trying to control their diabetes. With the Western sick-care system, medications are prescribed but very little education is given on how to actually achieve healthcare. I feel strongly that this is wrong, and hate seeing people face complications from diabetes that could have been avoided. No matter what your stage of diabetes, make sure you get the education you need to keep yourself healthy. If you would like my help, please don’t hesitate to contact me via e-mail at Alyssa@nutritionresolution.com. In just a few weeks we can have you well on your way to achieving the health you deserve.

Many people are confused about HFCS, thinking it leads to obesity more so than regular sugar.  This is the claim manufacturers state there is not enough scientific evidence to support, and they are correct.  Dietitians have maintained for years that “a calorie is a calorie” whether it comes from table sugar or HFCS.  But is that really true?  It depends on what you’re talking about.  This old mantra may be oversimplified as although each form of sugar contains 4 calories per gram, their effects on the body and on our risk for chronic disease are very different.

Research tells us that free fructose is bad for us.  Fructose bypasses the metabolic control pathway which regulates sugar’s conversion into fat.  By bypassing the regulatory control, it causes the liver to increase fat production.  This leads to more triglycerides in the bloodstream (free-floating fatty acids, often tested in your cholesterol blood work panel by your doctor) which increases the risk of heart disease.  A high consumption of fructose also increases insulin resistance which can lead to Type 2 Diabetes, and uric acid levels which can lead to gout.

Let’s look at some commonly-consumed food items and their sugar breakdown:

1. Fruit – Combination of sucrose (fructose bound to glucose at 50/50 ratio), free fructose and free glucose (bound up in fiber)

2. Cane sugar – made of sucrose which again is fructose and glucose bound together, 50/50

3. HFCS – 55% free fructose and 45% free glucose

4. NEW to the market – Agave Nectar – 90% free fructose

So which is worse for us?  Well I have conveniently listed them in order from best (1) to worst (4).  Although calorie for calorie the sugars are equal, the sugars containing more free fructose will have more harmful affects to our bodies.

Cane sugar does not contain free fructose; rather the fructose is bound to the glucose and therefore does pass through the control pathway of metabolism.  High fructose corn syrup, even though it has essentially the same fructose/glucose ratio as sugar, is worse for you than cane sugar as it contains 55% free fructose.  And interestingly, Agave Nectar which is being marketed as a healthy, “natural” sugar is worst of all for you, with a whopping 90% free fructose.  Fruit, although it contains some free fructose, contains a mixture of other sugars and the free fructose that is present is bound up with fiber, which slows sugar absorption.

Despite what we know about these pathways, the American Medical Association maintains that more research is needed before we have enough evidence to restrict the use of HFCS.  Although there is no ban on  it, many food companies are restricting its use simply because of the stigma attached to it.

My recommendation:  Don’t avoid it like the plague as many people do:  it’s not poison.  If it’s way at the bottom of the ingredient list of a food item that is low in total sugar, you’re probably fine.  A little bit will not overload your liver with fructose, creating massive amounts of fat production.  But I would recommend avoiding foods with high amounts of HFCS or Agave Nectar, or sugary foods in which one of these is the main sweetener. Sodas still use HFCS as the primary sweetener, so that’s a place to start cutting back.  Finally, be aware that we may soon be seeing the phrase “corn sugar” on food labels as a fancy name for HFCS…don’t be fooled!

Try reading the food labels of some of your household products and let me know what you find by commenting below.

http://www.huffingtonpost.com/2010/09/14/corn-sugar-high-fructose-corn-syrup_n_716007.html

Healthy People 2010 Goals
75% of adults to eat fruit at least 2 times daily
50% of adults to eat at least 3 servings of vegetables per day

Actually, as reported by the CDC in 2009, 67.5% of adults eat fruit LESS than twice daily. And, 73.7% eat vegetables LESS than 3 times daily.

In fact, despite these efforts fruit consumption has DECREASED 2% over the last decade while vegetable consumption has remained the same.

We all know fruits and vegetables are good for us. Or do we? It seems judging by these numbers that although people know they are, they don’t really know HOW important they are or what they can really do for us. Of course, as the article states, there are barriers for many people to purchasing adequate fruits and vegetables, including the cost of fresh produce, accessibility, and difficulty in carrying them with you during the day.

Eating fruits and vegetables plays a significant role in helping prevent many chronic diseases, such as heart disease, diabetes, cancer, and obesity. The problem is, these are all consequences that will occur in the future that many of us don’t worry about today. And, we don’t understand how today’s choices really affect our risk.

Another major factor the article briefly touches on is that many people simply don’t like the taste of fruits and vegetables. One reason is exposure…as vegetables little by little get displaced by restaurants and food manufacturers as part of a meal, many children of today are only exposed to the basics…carrots, potatoes, corn, and green beans. They don’t like other vegetables because they’ve never had them! And foreign foods frankly scare us sometimes. Even further, the taste of even the most flavorful fruits and vegetables cannot compare to the more powerful flavors of salt, fat, and concentrated sugars we have become accustomed to in our food supply. Think for a moment of a vegetable you do like, and how it would taste to you before and after you eat a cheeseburger.

This is one area of nutrition where I have personally placed a lot of importance over the years.  I am able to eat about 5 servings of vegetables  every week day (maybe 3 on weekend days) and 2 servings of fruit on most days without much difficulty:  you just have to set up a routine for yourself. When things become automatic, you no longer have to struggle or think about them. And, 3 servings of vegetables is not as much as you may think. 1 serving of vegetables = ½ cup cooked or 1 cup raw veggies. So, a large chicken salad for lunch or a generous helping of broccoli with dinner could easily take care of your daily requirement. I get five servings per day by having a large salad of some sort with lunch (I vary them so I don’t get bored) and preparing meals that contain vegetables for dinner, or putting vegetables on the side. Fruit is easy: I have ½ banana, berries, or ¼ cup dried fruit on my cereal, and fruit in the afternoon for a snack. I know this is helping me prevent chronic disease, and I know without a doubt that it is a crucial factor in my weight control. If you don’t like vegetables, try taking 1 bite of the vegetable you don’t like on a day you’re in a good mood. Do this on 7 different occasions, and you will likely find that you no longer dislike the vegetable.

So, Americans must take responsibility for the fate of their own health and improve their own habits. For the next decade, the CDC plans to help out by striving to make the healthy choice the easy choice by promoting farmer’s markets, gardening, and by bringing more fruits and vegetables into schools and the workplace. They may also provide tax incentives for retailers to offer fresh fruits and vegetables.

For the full article, go to http://consumer.healthday.com/Article.asp?AID=642984.

Your thoughts?