How’s your carb-counting?

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The great CDE, founder of Integrated Diabetes Services and author Gary Scheiner, and his fellow CDE and Director of Lifestyle and Nutrition, Jenny Smith, conducted a Carb Quiz in May.

Below is part of the interview they conducted with three outstanding “carb-counters,” that may give you a few ideas to make counting carbs easier.

Of course I no longer call it carb-counting, but carb-guessing. And I’m sure we can all relate to that!

For more carb-guessing advice, click here.

What are some of the tools you’ve used over the years to count carbs?

 Stephanie: I’m using measuring cups and a food scale at home to be as accurate as possible.  At  times I am tempted to just pour a cup of milk without using a measuring cup, but then I think about how well controlled my BG is because I do measure and this helps me continue to use tools.

Lisa: I started by using measuring cups and a food scale.  After a few years I learned about “carb factors” and this has been most helpful for more precise counting for the portions I want to eat.  I use carb factors a lot for fruits and vegetables.   I find when I use measuring tools at home it trains my eye to be aware of what a particular portion looks like and how much carb it may contain – it’s so helpful when I don’t have a label to read.  When I’m eating out at a restaurant I look up information online or I use my Calorie King book as a reference.

Stephen:  There was a learning curve –some foods don’t “look” like they would have sugar!  I had to remember there was carb in milk!  I downloaded Gary’s book – Think Like a Pancreas and read it in one night and realized I needed help.  I use Calorie King and I look up glycemic index as well as information when I’m going to go out to eat.  I do use measuring cups and labels, as well as the estimation tricks I’ve learned from working with Integrated Diabetes Services.  I’m the primary cook at home so it’s easier to count when you know what has gone into a dish you’ve prepared.

What has worked the best for you to ensure accuracy?

S: Measuring is my best tool.  I feel measuring at home has helped me count carbs more accurately when I don’t have a label or the measuring tools to use – such as in the College dining hall.  I have learned to eyeball a portion of carb when eating out by weighing fruits and other carbs at home. I also tend to look info up before going out so I have a more specific count than a simple guess, especially if it is a restaurant that I’ve never been to before.

L: I use eyeball portions when I have to “guess”. I often refer to the size of a tennis ball because I know about how much this is as a measured portion and then I can more accurately account for the carbs when I have to guess.  My best time saving trick at home is to use a measured ladle for soups/casseroles (½ cup per ladle), and I use drinking glasses with a line that equates to a specific portion (pouring up to this line on the glass is equal to 1 cup).

Stephen: I feel the best trick is to trust my gut feeling. Calorie King may say “this is 15g carb”, but then I’ll consider my past experience with the food and what the response was on my CGM. I may adjust up or down by 2-5g based on previous experience.  The use of measuring cups and labels are also major players in ensuring I learn how to count – it helps when I have to guess something that may not have a label.

Do you take into account fiber/glycemic index/glycemic load?

S: I do consider fiber – I subtract it all off the carb count. If it is a lower glycemic index food, I may deduct a bit off the suggested bolus.

L: I don’t use anything scientific, but I keep these things in mind when meal planning and counting carbs to evaluate the effect after meals.

Stephen:  I do consider fiber – I subtract all of it off of the carb count. But, I also take into account the kind of food it is or the glycemic index of the food– sometimes I only subtract ½ the fiber count (I use this for things like granola bars because of all the added sugar, I’ve found that I really can’t subtract all the fiber noted).

Do you feel the use of “smart” pump features helps you cover your meals better?

S: I haven’t been using square/dual bolus (no one has really taught me what to use them for) – but I do use the temporary basal feature for my lacrosse practice as well as running.  I feel it’s the accuracy in counting carbs that makes the major difference in post meal control.

L:  I like to use these when grazing or when eating out at a buffet – I don’t think I use this often enough and when I look back at my pump records, I see I could probably use it for more foods/meals. It’s a question I should ask my nurse educator about so I can use this more effectively.  Since I do a good job with precise carb counting already, I assume proper use of the combo bolus would improve my BGs even more!

Stephen: I have no experience with the smart features on the pump, but I would assume that it’s accuracy in counting as well as portion estimation that makes the most difference.

Do you have any words of wisdom to help everyone become a king or queen of carb counting?

S:  “When you are home and you have access to scales/measuring cups – use them frequently. This will help you with more precise guess-timation when you are out and don’t have your tools or a label available.”

L: “Take classes or ask to take them. You might think you are good at counting carbs and there isn’t anything new you’ll learn, but there is always something new. Every class seems to teach me something I didn’t know before, even as good as I think I am at counting!”

Stephen: “Measure your portions when you have the tools available, and learn how to estimate these when you are away from your measuring tools”

My best advice – routine. If you eat the same basic foods most of the time, you’ll get to know how they affect your blood sugar.

And, if you can, eat a low carb diet. Then, for the most part, your blood sugars won’t be bouncing all over the place! Or as they say, “riding the roller coaster.”

Bronx, New York where diabetes thrives in a food desert

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Saturday I gave the A1C Champion program in the Bronx. The Bronx is one of the five boroughs of New York City. The one also where diabetes has the highest concentration, largely because it is the poorest.

I was speaking at a storefront church converted from an ordinary building. Bishop David was jamming as the afternoon’s DJ. There were about ten or twelve small folding tables in front of the church on the sidewalk where people could pick up some information about diabetes. A hot buffet table was set up where the hosts were ladling out a relatively healthy lunch – chicken, rice, beans, veggies, corn.   

Before my talk, I walked around the neighborhood. I wanted to see where you could shop for something to eat and what you would find. Certainly, I’m sure, there are supermarkets not far, but within the few blocks I walked, there were several “bodegas.” Little delis like this one above where you could run in and find food – sort of. 

This is what was on offer: sandwiches on big white bready rolls and packaged snack foods everywhere, it took up 95% of the store: candy bars, chips, bakery goods and sugary soda and juices. They covered the store from top to bottom. In one store, one lone bottom shelf held a few onions and potatoes. Those were the only fresh vegetables in the store, no fruit. In another store, I saw only rotting bananas as fresh foods go. And this food desert – the Bronx – is only a subway ride from where I live.

We keep saying people need to eat healthy; yet how are we helping them to do so? I also don’t have to tell you if it costs $1 to buy an apple and $1 to buy a Big Mac, where’s the incentive for people to spend their hard-earned cash on a piece of fruit?

It saddened me to see what I read about in article after article. The food deserts in America. Those poor neighborhoods where there is no fresh food available and fast food brothels line the landscape – McDonalds, Burger King, Kentucky Fried Chicken, Taco Bell. Places that seduce us with sugary, fatty, salty foods and low prices. 

Obesity and diabetes are not merely about individual responsibility – they are also about infrastructure, what the government subsidizes, safe neighborhoods with places to play. It is about getting healthier foods into poorer neighborhoods and helping people do the right thing for their diabetes. 

Yet, it also gladdened me to find the 20 people I spoke to were engaged, curious, thirsty for information and many were eating better than their parents. They shared their strategies from a one day a month “cheat day,” to sautéing fish with plenty of lemon and herbs instead of frying, replacing half the juice in a glass with seltzer and sneaking ten minute walks into the day.

The city councilman above gave a talk just before I went on and let people know how important it is to get exercise and about the parks he’s been building in the Bronx. His eyes were bright and clear as he greeted me and his passion for improving his community and helping people, was earnest. 

Saturday I traveled to a place so close to my home, yet so far from my world. But I also became a bridge for people to take a step from being under the thumb of this disease and its burdens to doing a little better. Riding home on the subway afterward, I was full from the adventure and my heart was light.

An alternative way of eating for health, The Primal Blueprint

 

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This is my full interview with Mark Sisson, health and fitness expert and author of the newly updated book, The Primal Blueprint.

Q: Tell me what the “Primal Blueprint” is in a nutshell?

Mark Sisson: For over 200,000 years, homo sapiens were hunter-gatherers living in “the wild,” eating plants and animals. For the last 9,900 years, our ancestors lived on unprocessed, whole foods, with few modern comforts. It’s only in the last 100 years that we’ve started eating industrialized, processed food and living sedentary lives. So, we’ve got 200,000 years of eating animals and plants versus 10,000 years eating grains versus 100 years eating mutated grains, refined sugar and vegetable oils. 

The Primal Blueprint is a lifestyle whose tenets are informed by biological evolution, traditional wisdom, and modern science to form a healthy, sustainable, enjoyable way of being. It’s a way to eat, move, sleep, and simply exist with our ancient genes in this modern world – taking advantage of modern science and drawing upon lessons of our evolutionary background.

Q: You talk in your book about one being a “sugar-burning” or a “fat-burning” person. What does that mean?

Sisson: A sugar-burner requires a steady drip of dietary sugar – fructose and glucose – to maintain energy levels. So they can’t go long without eating. They burn basically carbohydrate and have difficulty accessing their stored body fat to use for energy, and in terms of weight loss, burn their fat. A fat-burner uses both their body fat and dietary glucose for energy and end up burning fat which leads to weight loss. Also, if a fat-burner skips a meal, it’s okay because he can run for days on his own fat (adipose) tissue.

Q: Even though our earliest ancestors may have eaten as you suggest in the Primal Blueprint, our more recent ancestors have been eating grains and beans for thousands of years. Have we not adapted to this way of eating? Asians were always thin eating their diet of rice and noodles, how do you explain that?

Sisson: Rice is the least offensive grain. It’s basically pure starch as opposed to something like wheat. It has no problematic lectins or plant proteins that interfere with digestion or disrupt satiety signals to the brain. In Asian countries they used to eat only foods like rice, meat, vegetables, all cooked in animal fat, and every day life was active. Now diabetes, heart disease, and obesity are on the rise because, like us, they’re eating more wheat, sugar, and vegetable oils and moving less. And no, our bodies haven’t evolved to catch up to our diet today.

Q: Most medical professionals regard burning ketones as a bad thing. The Atkins diet was criticized for that in the 1970’s. Yet the Primal diet depends on it. How do you answer them?

Sisson: They mistakenly equate ketosis with ketoacidosis. The former is a viable physiological way of burning fat for energy. It burns cleaner than glucose and spares necessary glucose for the brain to use. The latter is a pathological condition that occurs when insulin isn’t around to keep ketone production in check. Ketosis is a perfectly healthy physiological state to dip into from time to time. Burning ketones, which isn’t the same as being in ketosis, let alone ketoacidosis, is always occurring in a healthy fat-burner.

Q: I have type 1 diabetes. Making ketones has always been regarded as dangerous for people with type 1 diabetes. Is this diet viable for people with type 1 diabetes?

Sisson: Making ketones, which leads to ketoacidosis, only occurs when there is insufficient insulin present to regulate ketone production. Making ketones is different than burning ketones. As long as a person with type 1 diabetes is aware of this and manages this, there shouldn’t be a problem. I get a fair amount of feedback from people with type 1 diabetes who have had successimplementing the Primal Blueprint.  And it can help with managing the disease. I would tell any patient to let their doctor know before undertaking any massive lifestyle change.

Q: Why do you believe eating Primal is the way we were meant to eat?

Sisson: I tried eating “the right way” for over thirty years and it nearly killed me. I was the paragon of fitness, a competitive marathoner and triathlete who ate whole grains and beans and watched my red meat intake. It didn’t work. Since I have always been a student of human evolution, I got my degree in biology, I started thinking about health in terms of nutrition and fitness. I did a lot of research and self-experimentation and trained tons of people, enough to realize that the Primal way of eating works. And I’ve found it works for just about everyone who gives it an honest try.

Q: What are people most satisfied with about the Primal diet/lifestyle?

Sisson: That it’s not a struggle, that its seems to come naturally once you get it. People like a lifestyle that emphasizes delicious, fresh, wholesome food, simple and effective exercise, lots of leisure and relaxation, good sleep and quality time with loved ones.

Q: Is there any scientific research to support this diet? 

Sisson: Careful parsing of the nutritional literature is actually the basis of many of our recommendations, but there have been several paleolithic diet controlled studies. In one notable study by Lindberg out of Sweden, diabetic heart disease patients were put on one of two diets: Paleo (very similar to Primal) or Mediterranean. Paleo allowed no dairy, no grains, and had more meat, eggs, vegetables, and fruit than the Mediterranean diet, which was high in whole grains, legumes, vegetables, fish, margarine and low-fat dairy. Both groups improved, but the paleo group showed significantly greater improvements.

Q: What other eating approaches do you respect? And why?

Sisson: I like well-designed vegetarian diets. My wife was a vegetarian for years, still is, for the most part, except for seafood, and she’s one of the healthiest people I know. As long as you’re not eating loads of pasta, but eating actual vegetables and plenty of eggs and quality dairy, I think you can be very healthy as a vegetarian. I have dozens of longtime readers who are vegetarian yet make this lifestyle work for them. 

Q: Conventional wisdom says soy, beans, whole grains and complex carbohydrates like sweet potatoes have a protective or positive influence, yet they’re not part of a Primal diet

Sisson: There’s nothing magical about beans or grains. They have no dietary monopoly when it comes to vitamins or minerals. Leafy greens, cruciferous vegetables, berries, and all the other produce we can eat provide plenty of micronutrients. Plus, many of those minerals in beans and grains aren’t absorbed. Phytic acid, found in most beans and grains, binds to minerals and prevents their absorption. Habitual grain eaters like birds and rats produce phytase, the enzyme necessary to break down phytic acid – but we don’t. So while those foods look impressive on paper, we’re not absorbing most of their nutrients. Traditional cultures that consumed grains and beans did so only after extensive soaking and fermentation, which improves the digestibility and deactivated most of the phytic acid. It also takes a lot of work and I’m just not willing to put forth that much effort.

Complex carbohydrates like sweet potatoes are not allowed on some paleo plans but they’re allowed on the Primal plan. Roots, tubers, and other starchy, underground plant organs can be an important part of your diet, especially if you’re highly active and need the glucose.

Q: How do you answer your critics like Dean Ornish who has scientifically proven that eating whole grains, and severely restricting the consumption of animal products and dietary fat reverses heart disease?

Sisson: Dean Ornish has “scientifically proven” that avoiding processed junk food plus daily meditation, stress-reduction therapy, regular exercise, and a cessation of smoking tobacco results in a slight, not a major, regression of narrowing in the coronary artery. The Ornish plan isn’t just the diet. It’s an entire lifestyle change. Stress, lack of exercise, and smoking are all causally related to heart disease, so you can’t focus on just the food.

I would agree with Dr. Ornish that removing processed carbohydrates, vegetable oils, and sugar is healthy. My program does all that too. I just disagree that removing animal products and healthy fat is a necessary component, and he has never proven that to be the case.

Q: Do you believe people with type 2 diabetes would be better served by this diet considering that they are three times more likely to have a cardiovascular event, and this diet emphasizes eating saturated fat?

Sisson: Absolutely. The last reviews of the medical literature have found that replacing carbohydrates with saturated fat does not increase the incidence of cardiovascular disease. Plus, this diet doesn’t emphasize saturated fat, it de-emphasizes toxic foods like gluten-grains and processed vegetable oils that are high in omega-6 and sugar. 

Q: I have followed the Primal diet now for almost six weeks and find it takes extra time shopping to keep fresh produce in the house, and to prepare meals. Also, since I’m not a skilled cook, I find myself cooking the same things day after day. How successful have people been staying on the ‘Blueprint?’ 

Sisson: It’s highly sustainable. A massive online community has sprung up around Paleo/Primal eating. In addition to my own cookbook, paleo cookbooks are being released every couple of months, and there are several dozen high quality Primal recipe blogs. 

We post new recipes every Saturday and link to others every Sunday. To cut down on prep time, I would devote a Sunday afternoon to making a week’s meals. A big pot of stew, chili or curry, some parboiled vegetables, some sliced fruit, grilled meat that you can simply heat up or eat cold. If you plan and prep ahead, making your own food gets a whole lot easier.

As for produce, frozen vegetables are actually a more economical, longer-lasting, and often more nutritious option than wilted “fresh” produce. 

Q: Do you know any cases where the Primal Blueprint hasn’t worked?

Sisson: I’ve seen people fail because they went too low-carb while trying to run 120 miles a week and train for a triathlon. Or because they went overboard with the “Primal treats” made out of almond flour, honey, and coconut oil, but I would say they were doing it wrong. I’ve never known anyone to fail when they removed processed, industrial junk food, started sleeping more and exercising better.

Book Review: The Primal Blueprint gives both an historical background on why we should be eating like our earliest ancestors during paleolithic times and why we’re now eating like our neolithic ancestors, and that our bodies haven’t adapted to many of these foods. Furthermore, many of the foods we eat today, especially grains, have been genetically and environmentally modified causing insulin resistance and inflammation, the root causes of many of today’s lifestyle diseases. The Blueprint in the book gives you 10 steps for reprogramming your genes to transform yourself from a sugar-burner to a fat-burner, lose weight, heal your body and boost your energy. Also, the Primal approach is not just a meal plan, and Sisson covers a life system including fasting, bursts of exercise and strength training, sleep and stress reduction. 

What I like most: The book is written very simply and is a quick, easy and fun read. Men will probably also enjoy the cartoon-like characters Sisson uses to make some of his points. If you choose to try the diet, there is much support and more information on Mark’s blog, Mark’s Daily Apple. Mark’s written hundreds of articles about going Primal and provides recipes to help on the journey. I must also confide I like that on the Primal plan red wine and dark chocolate, in moderation, are allowed.

Weaknesses: Mark’s enthusiasm will tell you this is a simple diet and lifestyle, but for the average American it probably isn’t. There is some repetition in the book and at times not as much specificity, or scientific evidence, as I would have liked. 

Take 2 and call me in the morning: With all lifestyle changes, talk to your health care provider before beginning this program. 

Personal note: I tried the diet for six weeks. I felt fine and lost 2.5 pounds, but I found myself constipated. I then put some complex carbohydrates back into my diet like oatmeal and beans. Now I follow a diet in-between the Primal Blueprint and low-carb with some complex carbs and dairy. I side with those who say too much carbohydrate, not too much fat, is the cause of most of today’s ills including diabetes.

The Food Pyramid turns into “My Plate”

Screen Shot 2015-02-07 at 4.02.39 PMMy Plate for healthy meals

Last week Michelle Obama and the US Agriculture Department replaced the 20 year old food pyramid with a simple icon, “My Plate.” 

My Plate is now the quintessential guide for healthy eating: a plate divided into quarters of slightly varying sizes representing how to create a healthy meal. It contains a larger quarter for vegetables, slightly smaller for grains, and slightly smaller for both fruits and protein. The hope is that it will help eaters avoid oversized portions and eat more nutritious meals.

Agriculture Secretary Tom Vilsack said after almost 20 years of preaching nutrition through a food pyramid that USDA officials now say was overly complex, obesity rates have skyrocketed. The new symbol is simple and gives diners an idea of what should be on their plates when they sit down at the dinner table.

In fact, it appears only one quarter of people who recognize the food pyramid ever used it. Further surveys show people are confused about what they should eat and most have no concept of portion sizes or balancing calories for weight control.

I heard about the “Plate Method” when Maudene Nelson, registered dietitian and diabetes educator at the Institute of Human Nutrition at Columbia University, reviewed a myth for my book, “50 Diabetes Myths That Can Ruin Your Life and the 50 Diabetes Truths That Can Save It”. In myth number 26, “There is one specific diabetic diet I should follow” Nelson called “the plate method” for creating healthful meals magic. It’s in the Tips Box on page 142. She gave a little more specific instruction:

Fill half your plate with any variety of colorful veggies low in carbohydrates, such as asparagus, broccoli, Brussels sprouts, eggplant, carrots, or cauliflower. Fill one-quarter of your plate with carbohydrate-dense foods such as potatoes, rice, beans, corn, or legumes, and fill the remaining quarter with lean protein such as chicken, fish, lamb, pork, or beef. Meals made with the Plate Method naturally contain a moderate amount of carbohydrates, little fat and cholesterol, and a good amount of fiber.

Funny thing is with the exception of fruit on my plate, I use fruit for snacks, this is how I typically eat. Dinner is chicken or fish, beans and a green veggie. 

Seems Mr. Vilsack should have come to me years ago! 

Reduce Your After Breakfast Blood Sugar 40%

If you haven’t heard there’s some new news about reducing those after breakfast spikes in your blood sugar if you have type 2 diabetes.

Based on research that showed a reduction in blood sugar after the second meal of the day (lunch for most of us), it was hypothesized that high blood sugar after breakfast could also be reduced if there were a pre-breakfast snack, in a sense making breakfast the second meal of the day.

Researchers studied 10 men and women who controlled their diabetes with diet or diet and metformin and gave them a high-protein, low-carb snack before breakfast. Measuring blood sugars the results showed a lower rise in plasma glucose (blood sugar) after breakfast. 

Researchers say they are still searching for the perfect pre-breakfast snack and the perfect time lapse in-between the snack and breakfast. Plus further studies need to be done to see whether a high-protein, low-carb snack before breakfast improves A1cs, but for now it seems worth a try. Why not conduct your own experiment?

For more details check out “How to Reduce After Breakfast Blood Sugars 40%” in DiabetesInControl.com.

Food Is Medicine appears on HuffPost

 

chicken on saladI posted another version of my beef with food – that food is medicine – on The Huffington Post. 

It appears as a lead story today.  

A loyal fan already wrote me,

What an inspiring article to read first thing in the morning – thank you for your latest Huffington Post piece on healthy eating.  

Great tips in there – and makes me glad I have a fridge full of fresh produce waiting for me at home for tonight’s episode of Top Chef (a weakness of mine).”

It also occurs to me maybe I should let you know one of my little secrets for health. 

I not only have a medicine cabinet in my bathroom, but I also have one in my kitchen. 

It doesn’t have a mirror on it, although to be frank that would be a great incentive to eat healthy, wouldn’t it?. But it does have these big shiny silvery doors. 

I’m sure having a medicine cabinet in my kitchen is not particular to New York City. You probably have one too.

And just to show you I’m a woman of my word that food is medicine, I’ve put up a picture of what you’ll find in my kitchen medicine cabinet most days. 

Come to think of it there’s probably more medicine in my kitchen medicine cabinet than in my bathroom medicine cabinet. 

I like to think that’s a good thing.

Food is medicine

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For the last several months I’ve really shifted my view about food. I see it as medicine. Not that I don’t enjoy it, but I see what I eat as either making me more healthy, or less. I see what I eat as being almost as important to my health as my insulin.  

Now that doesn’t mean I have a perfect diet. But it does mean I’m more motivated to eat foods that are nourishing me — infusing me with healthy anti-oxidants and strengthening my overall body and fitness, rather than degrading it, or setting me up for the side effects of unhealthy eating – heart disease, overweight, guilt and personal frustration with myself. 

So I wanted to share this great article from Men’s Health magazine giving their take on the 40 Best Age-Erasing Superfoods.  

My healthy eating, and by this I mean smaller portions and eating mostly vegetables, fruit, beans and lean protein, automatically maintains my weight. I’m trimmer these last several years than I’ve ever been, and without trying. Healthy eating also gives my psyche a reason to feel pretty good about myself every day instead of guilty and frustrated. But you got that already, didn’t you? 

And so you know I’m not just blowing smoke, it’s reflected in the blood tests I get twice yearly: A1C 5.7%, LDL (lousy) cholesterol 108, some would say a little high, yes, it’s in the family, but my HDL (good) cholesterol is an astronomical 107, triglycerides 50 mg/dl, blood pressure 90/60 and a heart Al Pacino would say is “Strong like bull.” 

If you’re curious what I typically eat here’s my day food-wise:

Breakfast – a bowl of steel cut oats, I cook, to which I add: flax seeds, sunflower seeds and fruit, and then top with a spoonful of non-fat Greek yogurt, non-fat cottage cheese, and a spoonful or peanut or almond butter. I can’t tell you how much I like this – it’s creamy, crunchy, sweet and delicious. I could eat it for every meal. Maybe having a breakfast I love and knowing I get to eat it every morning, helps me stick to my healthy eating throughout the day; I know a reward is coming tomorrow morning.

Lunch – usually left over veggies from last night’s dinner, or a spinach salad, with some feta cheese or a slice of turkey and some beans. I may add avocado or cooked squash depending upon what’s in the house. If I eat lunch out it’s usually a spinach feta omelette with one slice of whole grain toast. No butter. Olive oil, herbs and mustard are my main taste-boosters. Butter, mayonnaise, bottled salad dressing and such I don’t use anymore. 

Dinner – usually fish or chicken grilled, broiled or sauteed with a mix of veggies and beans. Snacks are usually nuts, particularly walnuts (yes, they have fat, healthy fat which you need, just don’t eat too many), veggies, less sugary fruits like berries, melon, peaches and after dinner usually some dark chocolate.

Now you’re thinking I must be a monk, or a martyr, keeping to such an austere meal plan. I know you think that, people have said it to me. But neither is true. It’s just that over the years, particularly after reading Bernstein’s book, Diabetes Solution, I’ve rid most of the refined carbs from my diet knowing how much they made my blood sugar swing from high to low; it was awful. Now I have tons more control. And feel better. And, to be honest, while rapid-acting insulin and pumps give us more spontaneity, routine as in eating similarly day to day, makes my blood sugar more predictable.

I’ve also lost my taste for most sweet and fatty foods. It happens when you begin to eat “real food” again. I’m a big fan of Michael Pollans, Food Rules.  I follow his mantra: Eat food, mostly plants, not too much. 

That said, I’m not a vegetarian and I’m not a zealot. Fried calamari, the occasional slice of cheese or flourless chocolate cake, crusty bread and olive oil, anything friends make for dinner and eating everything in my house – everything – those occasional nights when the world tips out of balance also co-exist with my healthy eating. Oh, yes, so does wine with dinner. Another reward. Thank goodness years ago some French marketing guy said it was healthy.

So, check out this list of 40 Superfoods and try to put more of them in your diet. And, if you’ve tried to eat healthy before only to have given up, perhaps this is the day it will take. Here are a few tips that may help:

1. Decide why being healthy is important to you – only to you – and keep that front and center

2. Fill your house with healthy foods and throw out the junk. If when you’re hungry you can reach for a carrot instead of pretzels, you will.

3. The day you fall off the wagon, is only a day. Start new the next day. What you do in a week counts more than what you do in a day.

4. Your history doesn’t have to be your future. Ever.

5. Honor yourself enough to make healthy eating important, and your mission.

6. Know that in a few weeks, your tastebuds will change. You will lose your taste for synthetic food, sweets, salt and grease.

7. Talk yourself through a weak moment. Tell yourself if you’re dying for that piece of cake at 10 PM, you can wait till morning. 

8. Nothing’s off limits. If you need it, eat a little of it. Parcel it out onto a plate, don’t stand over it in the kitchen. You won’t stop.

9. Go slow or cold turkey. Whatever works for you.

10. Remember, you can do it – millions do. It may take time, but depending upon what you do now, next year you’ll either be exactly where you are now, less healthy or healthier.

The 1st annual “Food for your Whole Life Symposium” shows we know a lot, but aren’t making good use of it

 

For the public and health professionals, NYC

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David L. Katz, M.D., M.P.H., F.A.C.P.M., F.A.C.P.

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Michael Roizen, M.D. and conceptualizer ofRealAge

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Eat your nuts and berries!

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The first of hopefully an annual event was held this past June 6 & 7– the“Food for your Whole Life Health Symposium” – spearheaded by Dr. Oz. It was a two-day free event held at the Grand Hyatt Hotel in New York City to explore how food and lifestyle choices affect overall health. And, to better arm dietitians to help patients make better food choices.

I happened to miss the first day that was open to the general public and drew 1,000 people, but attended the second day exclusively for health professionals, largely dietitians and some diabetes educators, and media. 

I find it interesting with all the constant information coming at us these days on health and healthy eating that people just aren’t indulging in it. So I asked the same questions of everyone I met while meandering between lectures and standing on the long line into the ladies room: “Why, with all the information out there on healthy eating, are people fatter than ever?” “Why are half the people with type 2 diabetes not managing their diabetes very well?” “What has to change so that people change their behavior?”

I heard the same reply from everyone—there is too much information out there and it has become too confusing. Some of it is contradictory, and none of it is laid out for people to act on easily.

In a private interview I conducted (yes, I’m still getting used to this Huffington Post blogger status) with a key speaker at the symposium, Dr. David Katz – a Yale University researcher and authority on nutrition, weight management, and the prevention of chronic disease and a leader in integrative medicine and patient-centered care – he confirmed these observations. He also pointed to the media’s collusion. With an endless need for “new” news and a ravenous appetite to titillate us, the media barrages us with an endless supply of findings that has left the general public reeling with confusion. The result:  heightened stress and not knowing what to do. The other result: people do nothing. 

Katz has been working along with several others on a nutritional ranking system called “NuVal™” that’s being piloted by Kroger, a chain grocery. Kroger is piloting it in 23 stores in Lexington, KY. It’s anticipated they will roll NuVal out to their additional 2500 stores in 31 states.

NuVal ranks foods from 1 to 100 as a guiding system on nutrition to help consumers make healthier choices among a category of food. For instance, you’ll know the healthiest crackers among all the available crackers in the supermarket.

Right now NuVal is in 600 stores with another 400 stores rolling it out later this year.  Katz believes if people begin to choose the most nutritious foods in most categories, these small shifts can make a significant health difference. Katz also shared with me that his wife, a PhD, returned to their house one day with five loaves of supermarket bread and said basically – You pick the healthiest one!  

Katz also said regarding diabetes that many doctors tell their patients in very vague terms what to do, like “Lose some weight” and “Get some exercise.” These directives fall right off patients’ shoulders as soon as they walk out of their doctor’s door. He also said most doctors think diabetes patients are “non-compliant” because they have no willpower, but Katz made it abundantly clear that it is not a matter of willpower, but the enormous lack of translating all this information into easy-to-understand, actionable steps.

The day I attended the symposium, the speakers elucidated us on the upcoming changing dietary guidelines, likely out in November, and took us through a healthy eating map from childhood through old age. The message, throughout however seemed pretty consistent: eat mostly fruits and veggies, whole grains, lean protein and healthy fats.

Dr. Michael Roizen, Chief Wellness Officer at the Cleveland Clinic with numerous other impressive titles behind his name, and Oz’s writing partner, closed the event outlining Cleveland Clinics’ progressive “Lifestyle 180 Program” that they first test-piloted on employees of the Clinic with remarkable results and a cost-savings to the Clinic well worth the investment.

For patients, the program encompasses a six week immersion program that is geared to change the four factors 75% responsible for chronic illness: smoking, food choices and portion sizes, physical inactivity and stress.

Very briefly, the program includes overhauling one’s cultural climate, largely your kitchen ridding it of toxic foods, having participants experience “I can do it” aha moments, muscle memory of right eating and exercise and a buddy system. One of the bottom line messages was – while our genes are our inheritance, our lifestyle determines whether they get turned on or not.

For those with diabetes who have gone through the program, Roizen said 60% were able to discontinue one or more of their medications for blood sugar, cholesterol or hypertension (high blood pressure) within six months.

Most of the people I met at the event thought it was of value and, for me, it only points to the urgency with which we are all recognizing we must turn this ship around that is so badly headed in the wrong direction.   

The principal sponsor of the event was the California Walnut Commission. Affiliated sponsors numbered 7, including Healthcorps and the Wild Blueberry Association of North America.  

I did manage to sample the delicious wild blueberries which I was told are available in my favorite grocery, Trader Joe, as well as other chain groceries. I also got to grab a few packets of 1 oz servings of walnuts – that’s about 7 whole walnuts. Unfortunately, I also managed to forget the bag I stowed them in, leaving it under my conference table. 

Obviously, I need to eat more berries and walnuts to improve my aging memory!

Eat real food, here’s how you do it

Screen Shot 2015-02-07 at 9.54.16 PMIn search of real food

From time to time I see a book worth mentioning and my latest little thrill is Michael Pollan’s, “Food Rules.” Pollan, author of Omnivore’s Dilemma, seems poised to be another Michael Moore, aiming his sword at our food giants’ factory floors and over populated animal pens. 

The American food system, according to Pollan, sets us up for obesity and ill health as 90% of what’s in our supermarkets and is easily accessible, affordable and available isn’t real food but food-like substances. Chemicals mess with our metabolism and overly sweet and salty foods leave us craving more of the same. I happen to agree with him wholeheartedly. 

Pollan says doctors encouraged him to write the book because they don’t have time to give patients the food lecture and what they’d like is a pamphlet they can hand patients with some rules for eating wisely. In Pollan’s article on the Huffington Post, “Food Rules”: A Completely Different Way to Fix the Health Care Crisis,” a cardiologist remarks, “You can’t imagine what I see on the insides of people these days wrecked by eating food products instead of food.” 

After spending years trying to answer the supposedly incredibly complicated question of how we should eat in order to be maximally healthy, Pollan discovered the answer was shockingly simple: eat real food, not too much of it, and more plants than meat. Or, put another way, get off the modern western diet, with its abundance of processed food, refined grains and sugars, and its sore lack of vegetables, whole grains and fruit. Again, he gets my thumbs up. This is, by the way, how I’ve been eating the last several years and maintaining both my weight and my A1Cs in the 5’s.

“Food Rules” weaves humor and real life practicality into simple, straightforward rules for making healthy food choices. You can read it in an hour and be a lifetime wiser.

A Taste of Mississippi Livin’

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I just returned from spending a week in Mississippi. It was a great trip: relaxing, lots of laughs, I’ve learned a few new great expressions and have come away with a much better understanding of why diabetes is an epidemic in America–to a great degree it’s the ubiquitous fry up.

I was touring Mississippi with three  girlfriends. A kind of “Ya Ya Sisterhood” on insulin. When my New York friends asked before I left, “Why on earth are you going to Mississippi?,” I told them, “Because I can.” I have always wanted to see part of the South with a Southerner. One of our Ya Yas grew up in Mississippi, so that was it: four diabetic women in a car soaking up the local life, comparing blood sugars every few hours, noticing how differently we all react to food and exercise, and in-between being charmed by the South’s hospitality and shocked, by how difficult it is to find healthy food. I didn’t realize, but Mississippi has been ranked “fattest state” for three consecutive years.

Now hearing “Yes, maam,” repeatedly is admittedly some compensation for the lack of health-friendly food. Trust me, you will never hear it in New York. And my favorite new expression, “Bless your heart…” I’ve learned is extremely useful when you’re bad-mouthing someone but want to maintain a polite demeanor. And, yes, the pleasantries unrolled like an unfurling flag, and this troupe of women were lovingly and graciously hosted to lunches and toured through town after town. Tana, a fabulous cook, whipped up an incredible melange: cream of spring soup, shrimp Louie, southern mayonnaise biscuits with home-grown herbed butter and chocolate pots ‘specially for this Yankee, and actually welcomed me with my own signboard, boa and special guest, Marilyn Monroe.

While I didn’t know (or care) what we would do in Mississippi, other than soak up local life, I found our tours revolved around visiting university campuses and churches. Initially, I kept looking for downtown and charming stores to poke my head into, being the New Yorker that I am, and it took me the first several days to realize depressed downtowns were not where life was any longer. It was on college campuses and at church. 

I experienced my first Baptist service, complete with a children’s choir, baptisms in what looked like the bell tower, singing, singing, singing and your requisite fervent preacher. Walking through a Presbyterian church, we lucked into hearing an amazing organist, and left with his CD gifted to us. We toured several antebellum houses learning about the history of the families that owned them and plantation life. Admittedly, when I walked into anyone’s house afterward I expected a tour. 

I was introduced to the very funny and bawdy series of books, The Sweet Potato Queens by Jackson, Mississippi author, Jill Conner Browne. Our Tennessee gal-pal, Ann, read passages to us in her rich Southern drawl, with tears of laughter streaming down her cheeks, as we drove past tractors and catfish ponds. I ate one of the best meals ever at J. Broussard in Colombus, pecan-crusted catfish and a nutty buddy (you figure it out!). I sampled thirty different types of pecans (peecaaahhns) in a pecan (peecaaaahhn) store in Indianola, which was all of three streets long but seemed to be experiencing rush hour traffic while we were there. 

The friends and family of my native Mississipian asked me what I found surprising about Misissippi and I told them. It’s much more rural and green than I expected…people are very friendly and welcoming…many have been to New York — and love New York.. everyone goes to church, and the food, outside of a few truly fabulous restaurants, is growing our increasing population of diabetics. 

I, in fact, had a very earnest conversation about this with the President of Jones college in Laurel, Mississippi, Jesse Smith. Jesse Smith is a sort of President Obama–young and vital and making tremendous changes to the university to expand students’ potential and opportunities, and that includes healthier meals on campus. But throughout our trip my companions and I had to work really hard to eat healthy. Fried in Mississippi is a food group: fried chicken, fried steak, fried green tomatoes, fried pickles, fried okra, fried crawfish and on and on. If it was edible, it was fried. Then of course there are the staples: biscuits n’ gravy, chicken n’ dumplings, overcooked vegetables in lard and sweet tea, 1/2 cup of sugar in 1/2 a gallon of tea. 

My eyes were open widest looking at the aisles in the little superettes at each gas station where we stopped. Aisle upon aisle of chips, crackers, fried pork rinds, soda, fried meats, and, perturbingly nothing else. Except in one, which harbored a stand of books. “Bible Cure for Diabetes” intrigued me enough to buy it but also made me think: Would we really need a bible cure for diabetes if there were more fruits and salads available?

So what will I remember from my trip? Outstretched hands and open hearts and the knowledge that all the segments I hear on the morning news about healthier food choices aren’t going to happen where it’s so hard to find them. As Dr. Smith explained to me, there was a time when the livelihood of Mississippi was based on people working the land. That required a lot of calories and a lot were burned off in their labor. Today, however, few people labor in the fields, yet the foods have not changed. Further, education about food and its consequence on health doesn’t seem to have reached many people, including the young people I saw working in the gas station superettes. 

On the last day of our trip we talked about how much opportunity there is to bring education to areas like this where it’s so vitally needed: A grass roots movement to teach people about the benefits of healthy eating like Governor Mike Huckabee is doing for Arkansas. So if anyone wants some wise women to consult on this, please do let me know, and, really, bless your heart.