World Diabetes Day: November 14, 2011

November 10th, 2011

World Diabetes Day is observed on November 14th, every year. As part of National Diabetes Awareness Month, World Diabetes Day focuses on engaging people throughout the world to raise awareness of diabetes. World Diabetes Day was initiated in 1991 by the International Diabetes Federation (IDF) and the World Health Organization (WHO) because of the increasing number of people around the world who have diabetes.  November 14th was selected to honor the birthday of Frederick Banting, who was part of the discovery of insulin in 1922. World Diabetes Day is now an official United Nations World Health Day.

World Diabetes Day continues to be led by the International Diabetes Federation, and is supported by the American Diabetes Association, Diabetes UK, Diabetes Australia, the Canadian Diabetes Association, Diabetes South Africa, Diabetes New Zealand and the Diabetic Association of India. Check around your neighborhood for educational workshops, events and diabetes screenings. There are a number of fund raising events which are hosted throughout National Diabetes Awareness month. As a certified diabetes educator and advocate for my patients, friends and family who have diabetes, I support organizations who are focused on finding a cure for diabetes.

Take Action

The International Diabetes Federation (idf.org) is encouraging communities across the globe to GO BLUE! You’ll see buildings and businesses boost the blue color and symbol of diabetes awareness to unite us all in the fight against this disease. Let’s all get on board. The same way the red ribbon is a symbol of AIDS awareness, the blue symbol needs to become the unified symbol of diabetes awareness.

In keeping with the blue theme, Cherise Shockely (the founder of Diabetes Social Media Advocacy) encourages us all to wear blue each Friday during November, as well as on November 14th. It would also be awesome if NFL football players would wear blue during games each week. During October, NFL players wore pink in support of Breast Cancer Awareness month. Other advocacy groups wear red during February for National Heart Month. It’s time to increase awareness in large venues by getting behind the “blue” theme, during November.

Manny Hernandez (tudiabetes.org) is an incredible diabetes champion and resource. Manny and the diabetes Hands Foundation work together to promote the “Big Blue Test” (bigbluetest.org).  The idea is to test your blood sugar, exercise for 14 minutes, and then test again. With the broad reach of computer technology, Manny suggests that people with diabetes share their blood sugar numbers with each other online. Roche Diabetes Care will donate to a diabetes charity for each person who participates. What a great way to encourage blood glucose testing, and raise funds at the same time.

No Cure…Yet

Today, there is no cure for diabetes. More research is needed to find a cure and to help educate people with diabetes and their families who need to manage the disease. As a registered dietitian and certified diabetes educator, I listen intently to my patients needs. Diabetes can be overwhelming, and as a health care professional I will continue to coach, educate and support my friends, family members and patients who have the disease. In particular, I like what the Diabetes Research Institute is doing to help with this scourge. Diabetes affects everyone differently, but we all need to unite behind the common goal of living a healthy life with diabetes and hopefully celebrating a cure in the near future. What will you do to participate in World Diabetes Day? Please share your thoughts and comments.

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Healthy Halloween Tips and Treats

October 24th, 2011

All year long, we encourage our children to eat well and  fill their plates with multicolored fruits and vegetables. However, on Halloween your child will attempt to accumulate as many colorful M&M’s, Skittles and Snickers candies as humanly possible. For the nutrition conscious, candy  is considered  a “sometimes” food, which means it should be eaten occasionally, but not instead of healthier foods. Although candy shouldn’t be completely discouraged throughout the calendar year, it is also not a substitute for well balanced meals. Eating sugary treats  in lieu of family meals is never a good idea!

So what can parents and children to do on Halloween? Consider these strategies:

Don’t let your child go trick or treating hungry

Kids race home from school (where they probably already had a few Halloween orange cupcakes and ghoulish gooey cookies), and change into their vampire or princess costumes. Your son or daughter will  grab an over sized pillow case or sturdy shopping bag and announce they are ready to begin their candy quest.  To avoid temper tantrums due to hunger while trick or treating, have a healthy snack ready for them when they arrive home. A sliced apple with peanut butter, or cheese and whole wheat crackers is quick and fun.

Discuss how much candy they can keep BEFORE trick or treating

In order to avoid a candy buffet on (and after) Halloween, discuss the amount of candy your child can keep from their collection. Sort out the candy on a large table (or floor, if the family pets are not close by). First, make sure all the candy is wrapped. Next, ask your child to select their favorite candy. Before Halloween, find out if there is a dentist in your area who is willing to “buy” back the candy. Additionally, some service organizations (and food pantries) do accept gifts of candy for care packages. Here are some ideas for candy donation:

Assure your children that you won’t be “picking” at their candy collection

“Fun Size” Halloween candies can be very dangerous. How many times have you indulged in sampling a few of your child’s fun or bite sized candy treats? They look small, but they add up very quickly. Once you’ve gone through the candy with your child, avoid grabbing too many “unplanned” pieces for yourself. Be mindful of your candy selection.

An example:

1 fun sized Snickers 72 calories 3.7 gm Fat 7 gm sugar
1 fun sized M&M package 90 calories 4 gm Fat 11.5 gm sugar

 

Give out non-food items (fewer problems with left over candy!)

Hand out mini Play Dough or Silly Putty, stickers, temporary tattoos, bubbles, spider rings, pumpkin key chains, super balls, glow in the dark teeth or orange pencils. A study done at Yale University (and published in the Journal of Nutrition Education and Behavior) showed children were as happy with toys as with candy.

Halloween can be a great opportunity to start walking with your child. Include the family dog, so everyone can get some physical activity. As a parent, follow these Halloween guidelines, so your youngster can enjoy the holiday festivities, without overdosing on candy! Focus on “giving back”, by donating some of the candy to worthy organizations. Make Halloween an opportunity to begin more family walks and discussions about mindful food practices. How will you change the way you trick or treat this year?  Please share your thoughts and comments.
Ask yourself if you can eat one fun sized Snickers?  (Do the math… what if you eat 5 pieces)? Are you are popping a few in every time you pass the Halloween bowl? If you are giving out Halloween candy, buy it RIGHT before Halloween begins. Don’t buy your favorite. Just because we are adults, doesn’t mean we lose our lust for mini Milky-Way bars.

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Nutrition and Polycystic Ovary Syndrome (PCOS)!

October 16th, 2011

This past March, I spoke at an obesity conference  in New York on “Nutrition and PCOS”. The audience was primarily OB-GYNs and Endocrinologists, many of whom treat women with PCOS.  I’ve been working with women who have PCOS for years, and have come to realize that so many of these patients are undiagnosed or misdiagnosed unless they see a dietitian or physician who recognize the symptoms.

Many young women contact me because they are extremely frustrated with their inability to lose weight despite repeated attempts at restrictive  dieting. They share common complaints of  hair loss (on the head),  hair growth on their face, chest or stomach, low blood sugar episodes and weight gain around their belly’s. These young women have irregular periods and difficulty getting pregnant.

If left untreated,  PCOS can increase the risk of endometrial cancer, heart disease and type 2 diabetes. Women with PCOS often have high testosterone levels and suffer from insulin resistance. It can be managed with nutritional changes, medical intervention and a good dose of understanding from family and friends.

Insulin resistance  leads to weight gain and difficulty losing weight. These young women may experience intense cravings for carbohydrates as well as hypoglycemic (low blood sugar) episodes.

  Sleep apnea, darkened skin patches, depression, anxiety and body image issues are all common symptoms of PCOS.  The good news is that losing 7-10% of  body weight can  reduce many symptoms of PCOS. But as we know, weight loss is not always an easy journey.

What is insulin resistance?

Insulin is a  hormone (chemical messenger) that is produced by the pancreas after eating  food, especially carbohydrates. Insulin  SHOULD  take sugar (or glucose) out of the blood and into cells.  Insulin resistance causes cells to become less responsive to insulin  and  more insulin is needed  to move glucose (or blood sugar) into cells.  It’s common for women with PCOS to have a dramatic drop  in blood sugar (often late in the afternoon), and start to want  more  “simple” carbs (such as candy or cookies).  Eating more sugary foods (which have little nutritional value and a lot of calories) can lead to weight gain and INCREASED  insulin resistance. This process requires nutritional intervention!

Dietary Recommendations for PCOS

  1. Reduce the amount  of  simple carbohydrates (such as cake, candy, cookies) that you eat.  Choose carbs such as fruits, vegetables and whole grains which provide vitamins, minerals and fiber.  ( I’m not suggesting a lower carb diet during pregnancy. Adequate carbohydrate is needed for the developing baby).
  2. Carbs should not be eaten alone! Instead, combine them with lean protein or healthy fat (i.e. nuts or avocado).
  3. Select lower glycemic index foods as they will cause a slower rise in blood sugar. The lower glycemic carbohydrates tend to have more fiber than the higher glycemic foods. Try to select whole grains that are unprocessed (i.e. quinoa).
  4. Drink a minimum of 48 -64 ounces of water per day.
  5. Increase intake of Omega 3 fats.
  6. Eat a high fiber diet.
  7. Try to eat every 3-4 hours.
  8. Consume an adequate amount of Vitamin D. Ask your doctor to check your Vitamin D level.
  9. Eat phytosterols (found in almonds,walnuts, broccoli, brussel sprouts, whole grains, and flax seed). They compete with cholesterol for absorption and are generally heart healthy).
  10. Use cinnamon. Although the studies are not conclusive, it may help to improve insulin resistance.
  11. If you are considering other supplements (such as inositol), please discuss it with your doctor.

In addition to improving your diet, you MUST exercise.

Exercise lowers blood sugar and improves insulin sensitivity.  Find some type of physical activity that you enjoy (both cardio, such as walking and strength training such as weight lifting). You can lower your risk of developing type 2 diabetes if you exercise. Don’t forget that exercise burns body fat and helps to control appetite. Find an exercise buddy and reap the benefits of physical activity today. Remember, if you are physically active, you have a greater chance of maintaining your weight loss.

As a registered dietitian and certified diabetes educator, I help people with PCOS put together the pieces of the nutrition puzzle. If you think you have PCOS, seek out the help of a doctor who can help manage your medical issues. How do you cope with PCOS? Please share your thoughts and comments.

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Family Dinners Fuel Healthier Kids

October 11th, 2011

I wrote this post as a participant in the Eat Better, Eat Together Balancing Act blog carnival hosted by MealsMatter and Dairy Council of California to share ways families everywhere can make time for family meals that include foods from all the food groups. A list of other registered dietitians and moms who are participating in the Balancing Act blog carnival can be found at MealsMatter.

We are only as happy as our least happy child. I’m not sure who coined that saying, but I use it all the time. Think about that for a moment. If you have an unhappy child, chances are it is difficult for you to enjoy the day (or sometimes the year). If a child doesn’t feel well physically, how can he or she be completely happy? Good nutrition is essential to health. Having a supportive family provides comfort and security, which is necessary for happiness. Family dinners are a great way to show children the importance of health and well being.

This week, start planning family dinners. Laurie David (the ex-wife of Larry David, co-creator of “Seinfeld” and “Curb Your Enthusiasm”) wrote an article titled ”Family Dinner After Divorce”, excerpted from her book ”The Family Dinner: Great Ways to Connect with Your Kids, One Meal At a Time”. Before their divorce, the David’s shared family dinners together (including the ritual once a week “take out” night). Knowing how important family dinners are (and how they improve communication between parents and children), this strong family continued the tradition, even after divorce. Of course this was awkward and challenging at first, but after a while, the family dinner tradition helped heal the entire family as they went through the crisis of divorce. Unusual? Yes. But what a great concept . . . continuing to communicate with children while eating healthy traditional family meals.

Comfort Food

Eating together as a family is not always easy due to our busy schedules. But eating as a family unit is truly comforting for toddlers as well as teens. Dining together gives kids comfort and predictability in their day. Of course, there is no established definition of a family! Some families have one parent, while others have extended families living under the same roof. But the rule is the same. Children and their parents or caregivers will all benefit from preparing and eating meals together.

Reasons, Tips and Tricks

Teenagers who are peer influenced in so many ways (including food choices) will surely benefit from family dinners. Set an example by offering healthy choices at dinner (lean protein such as fish and poultry along with vegetables and tasty grains such as quinoa, cous cous or whole wheat pasta). Offer low fat milk or almond milk with meals and snacks. Ask your children to help you design “homemade smoothies”, with low fat yogurt, fruit and nut butters.  Developing smoothie recipes at home can help save a lot of money. Additionally, putting together an ingredient list with a tween or teenager will encourage even the most fussy eater to enjoy a delicious and nutritious snack that includes his or her specific food preferences. Now that’s a winning combination of family, food and fun!

Discussing dinners in advance and offering a variety of foods may also help even the pickiest child try new foods. Keep mealtime calm. It’s not a time for arguing with your children. Use these precious moments as a time to reconnect with your child and “listen” to the events of the day.

The key to making a family dinner is to plan! Although you might not be able to have a family dinner every night, it’s important to plan several nights each week that you can eat as a family unit. Look at your schedules. If a child has a sport or after school activity several times each week, eat a little later. Wait for them to come home! If you’re working late, check out some healthy crock pot recipes, or cook a bit more on the weekends and freeze meals in individual portions. If you don’t have time to food shop, check out local supermarket food delivery services. One thing is certain, if you don’t plan your dinners, they won’t magically happen!

Ask your family members to help with the food planning and preparation process. Younger children tend to eat better when they help with simple meal preparation tasks like setting the table or stirring a sauce. Teenagers can slice and dice vegetables, collect ingredients from around the kitchen and even prepare a side dish. All children appreciate being involved in the process (including cleaning up). Praise their efforts! Learning to cook healthy meals at an early age can improve long term cooking skills and set the stage for a healthier lifestyle.

Sitting down together for family meals will help you and your children eat better. At the same time, it’s a necessary time for family togetherness. As a busy parent or care giver, don’t “serve” your family while they eat. Everyone can participate with the meal preparation in some way. Sitting down together as a unit gives children something comforting and stable to look forward to at the end of the day. Your kids are looking to YOU for direction. Make family meals the most rewarding part of your day. What can you do TODAY to start enjoying more family meals at home? Please share your thoughts and comments so we can continue this discussion.

Don’t stop here! Other bloggers share their stories and tips on how they juggle the balancing act of getting a well-balanced meal on the table!

  1. 10 Commandments for Guilt-Free Feeding – Maryann Tomovich Jacobsen, MS, RD
  2. Beating the Lunch Box Blues – Katie Sullivan Morford, MS, RD
  3. Dinner Time – Michelle Rowe, RN and Health Educator
  4. Eat Better, Eat Together– Jessica Fishman Levinson, MS, RD, CDN
  5. Family Dinners Fuel Healthier Kids – Susan Weiner, RD, MS, CDE, CDN
  6. Families that Cook Together Eat Together – Kia Robertson
  7. Making Time for Family Meals: How I’ve Earned My “RDH” – Trina Robertson, MS, RD
  8. Meal Planning: Taking the Stress Out of the ‘What’s for Dinner’– Laura Everage
  9. Pressed for Time? Moms Know Best: Tips for Getting Food on the Table – FAST! – Samantha Lewandowski, MS, RD, LDN
  10. Roasted Cinnamon Apple Oatmeal – Cheri Liefeld
  11. Sunday Night Family Dinner, In the Dining Room – Jill Castle, MS, RD, LDN 
  12. The Balancing Act – Ann Dunaway Teh, MS, RD, LD
  13. The Power of Family Meal Time & How to Squeeze It In! – Bridget Swinney MS, RD, LD
  14. The Truth About Family Dinner – Sally Kuzemchak, MS, RD
  15. Toughen up: Give Two Choices for Dinner – Take it or Leave it! – Glenda Gourley

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Nutrition and Breast Cancer

October 2nd, 2011

1 in 8 women (or about 12% of the female population in the United States) will be diagnosed with breast cancer during their lifetime. Breast cancer became personal 10 years ago, when my best friend was diagnosed with the horrific disease. After accompanying her to chemotherapy and watching her go through the various stages of treatment (including chemo, radiation, a double mastectomy and eventual re-constructive surgery), I  am pleased to say that she survived and persevered.

I’ve worked with many breast cancer resource groups and organizations, in the hopes of helping women eat better to help prevent cancer. It’s also been my honor to assist women with food choices after diagnosis. Navigating the side effects of nausea and weight loss during chemotherapy, or experiencing taste alterations from radiation can be very challenging. There are a few general guidelines or tips that can help prevent breast cancer. Several risk factors are not controllable, such as gender, age or family history. But we can change our nutritional and physical activity habits.

Tips to help prevent breast cancer:

-Exercise regularly
Studies show that women who engaged in an exercise program for more than 6 hours per week had a 23% reduction in breast cancer risk. Start moving today. Find an exercise buddy and get moving. If you have a dog, go for an extra long walk!

-Maintain a healthy body weight
This is especially true for post-menapausal women. Obese women (BMI > 30) have much greater risk of developing breast cancer than women with an acceptable BMI. It seems that additional body weight many increase the hormone estrogen which has been linked to increased breast cancer risk.

-Eat more fruits and vegetables
Eating a small salad with dinner is not enough. At least 2/3 of your plate should be made up of “colorful” fruits and vegetables, which are high in fiber. Fruits and veggies are rich in vitamins, minerals, antioxidants and phytonutrients which help to fight breast cancer. Eat fresh veggies throughout the day. Take a walking tour of a produce market and select a variety of nutrient packed seasonal vegetables and fruits. Cruciferous veggies such as broccoli, cauliflower and brussel sprouts have superior cancer fighting properties.

-Eat healthy fats, and less saturated fat
Saturated fats found in red meat and whole milk dairy products have been linked to an increased risk of breast cancer. Increase your consumption of healthier fats such as unsalted nuts, avocado and canola oil.

-Reduce alcohol consumption
Even one drink per day can increase breast cancer risk. One serving of alcohol = 12 ounces of beer or 5 ounces of wine.

-Check your Vitamin D levels
Ask your doctor to check your vitamin D level. Vitamin D rich foods include: Vitamin D fortified low fat dairy products, salmon and sardines. Vitamin D3 supplements are inexpensive. It’s an important topic to discuss with your health care provider.

-Add some Turmeric and Curry to your meals
Turmeric and curry powder many have some anti-tumor effects. Buy a new spice rack and add these delicious spices to your veggies and soups.

-Avoid processed meat, too much red meat and simple sugars
Eating a more natural diet including fresh fish, lean poultry, whole grains, omega 3′s and seasonal fresh fruits and vegetables. Limit most simple sugars (such as excess candy, cake and cookies).  Anti-oxidant rich foods such as berries, dark green leafy vegetables, tomatoes and garlic are all part of a healthy anti-cancer meal plan. Many studies have shown that a plant based diet has anti-cancer properties.

-Drink Green Tea
Research conducted in Japan and China suggests that green tea can help fight the disease.

I’m pleased to see Target donate money for the fight against breast cancer. Once again the N.F.L. is supporting Breast Cancer Awareness Month by having the players wear hot pink gear (gloves, sweatbands and cleats). For more information, please check out www.aicr.org How will you support the fight against breast cancer? Please share your thoughts and comments.

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