Article # 602. Diabetes Prevention

Diabetes prevention: 5 tips for taking control

When it comes to type 2 diabetes — the most common type of diabetes — prevention is a big deal. It's especially important to make diabetes prevention a priority if you're at increased risk of diabetes, for example, if you're overweight or have a family history of the disease.

Diabetes prevention is as basic as eating more healthfully, becoming more physically active and losing a few extra pounds — and it's never too late to start. Making a few simple changes in your lifestyle now may help you avoid the serious health complications of diabetes down the road, such as nerve, kidney and heart damage. Consider the latest diabetes prevention tips from the American Diabetes Association.

Tip 1: Get more physical activity

There are many benefits to regular physical activity. Exercise can help you:

·         Lose weight

·         Lower your blood sugar

·         Boost your sensitivity to insulin — which helps keep your blood sugar within a normal range

Research shows that both aerobic exercise and resistance training can help control diabetes, but the greater benefit comes from a fitness program that includes both.

Tip 2: Get plenty of fiber

It's rough, it's tough — and it may help you:

·         Reduce your risk of diabetes by improving your blood sugar control

·         Lower your risk of heart disease

·         Promote weight loss by helping you feel full

Foods high in fiber include fruits, vegetables, beans, whole grains, nuts and seeds.

Tip 3: Go for whole grains

Although it's not clear why, whole grains may reduce your risk of diabetes and help maintain blood sugar levels. Try to make at least half your grains whole grains. Many foods made from whole grains come ready to eat, including various breads, pasta products and many cereals. Look for the word "whole" on the package and among the first few items in the ingredient list.

Tip 4: Lose extra weight

If you're overweight, diabetes prevention may hinge on weight loss. Every pound you lose can improve your health, and you may be surprised by how much. Participants in one large study who lost a modest amount of weight — around 7 percent of initial body weight — and exercised regularly reduced the risk of developing diabetes by almost 60 percent.

Tip 5: Skip fad diets and just make healthier choices

Low-carb diets, the glycemic index diet or other fad diets may help you lose weight at first, but their effectiveness at preventing diabetes isn't known nor are their long-term effects. And by excluding or strictly limiting a particular food group, you may be giving up essential nutrients. Instead, think variety and portion control as part of an overall healthy-eating plan.

When to see your doctor

If you're older than age 45 and your weight is normal, ask your doctor if diabetes testing is appropriate for you. The American Diabetes Association recommends blood glucose screening if:

·         You're age 45 or older and overweight

·         You're younger than age 45 and overweight with one or more additional risk factors for type 2 diabetes — such as a sedentary lifestyle or a family history of diabetes

Share your concerns about diabetes prevention with your doctor. He or she will applaud your efforts to keep diabetes at bay, and perhaps offer additional suggestions based on your medical history or other factors.

Article # 491. Training Program for Diabetes and Pre-Diabetes

A Comprehensive Training Program for Diabetes and Pre-Diabetes

Below is a weekly training program, with progression advice, that combines both aerobics and weight training. It does not assume much previous physical activity. A combination of aerobic exercise and strength training -- as for healthy people -- is likely to be the ideal combination of physical activity for diabetics but it should be followed under supervision for safety and best results.

Day 1. Aerobic exercise. Walk, jog, treadmill or outdoors for 30 minutes at moderate intensity. Moderate intensity means in the range 50% to 70% of maximum heart rate or at a pace at which you can still talk easily enough or recite a poem for example. Treadmill, Elliptical (EFX) and cycling are fine for aerobic conditioning, but you don’t get the advantage of bone building that you do with impact exercise. Generic, step and pump group aerobics classes are excellent.

Day 2. Weight training. Use the Basic Strength and Muscle program as a guide. You can do this at a gym or you can do most of the exercises at home with a home gym or even a set of dumbbells. The individual exercises are not that critical, but you need to work all of the major muscle groups including the upper and lower legs, arms, shoulders, back, chest, abdominals and buttocks. The reason for this is that the more muscle you exercise and build, the more depots for glucose disposal and storage you create.

Do 8 to 10 exercises including 3 sets of 8 to 12 repetitions in each set. Adjust the load so that you can get through a complete set and that the final repetition, say number 10, is getting a little harder to do. At the end of the third set of any exercise you should be working somewhat hard. Rest for two to five minutes before the next exercise.

When you’re starting out, it is important not to overdo things. Do fewer sets or repetitions and use less weight but do all exercises and progress to higher volumes and intensity. However, strength and muscle training needs to stress the muscles appropriately. Lifting light dumbbells for 20 repetitions, although not useless, is not what’s required here. Take it easy, but not too easy!

Day 3. Aerobic training as for day 1.

Day 4. Aerobic training as for day 1.

Day 5. Weight training as for day 2.

Day 6. Aerobic training as for day 1.

Day 7. Rest.

Exercise Progression

With increasing fitness, you can gradually increase the intensity and volume of your exercise program. This is best done under the supervision of a qualified trainer. Here are some tips on how to do that.

·    Increase the intensity of the aerobic workouts by increasing heart rate from 50% to 70% to closer to 70% or slightly above. At this intermediate pace, you should be able to talk less easily, although you should not be struggling for breath.

·    Increase the time of the workout from 30 to 45 minutes.

·    Include intervals in your walking or running by striding out at a much increased pace for a one-minute interval in every five minutes for the length of the session.

·    Gradually increase the weight load you lift in your weight-training program as you get stronger. You should struggle to do that last lift of the third set. Don’t increase the number of sets or repetitions; just increase the weight you lift as you get stronger. You can vary the exercises but remember to work all major muscle groups.

·    Add a third weight training session to your weekly program, preferably on one of the aerobics days so that you maintain at least one day of complete rest.

·    Be aware of niggling injuries of the joints, muscles and tendons and don’t train through acute pain or persistent sub-acute pain. See your doctor. When weight training, be especially aware of shoulder impingement pain or discomfort in the rotator cuff, which can be an issue in older trainers. Go easy on the shoulder exercises if this gives you warning.

·    Every month, take 3 consecutive days off to allow the body to recover and rebuild.

Article # 351. Best and Worst Foods for Diabetes

If you've got diabetes, you need a guide to help you quickly determine if a food is a good choice or a bad one, whether you're at the supermarket or standing in front of your refrigerator. Making the best choices will help you maintain good health and control your blood sugar levels, keeping them as close to normal as possible. WebMD has compiled a list of best and worst food choices for diabetes.

The categories for the food choice list are taken from the diabetes food pyramid. They include six food groups. The pyramid starts with breads, grains, and other starches at the base and rises to fats, oils, and sweets at the top. Here's the full list of categories from the bottom up:

·         Breads, grains, and other starches

·         Vegetables

·         Fruits

·         Meat, meat substitutes, and other protein

·         Dairy

·         Fats, oils, and sweets

Your goal for shopping and preparing meals is to choose more food from the base of the pyramid and less as you move toward the top.

What follows are some of the best and worst choices that can be made from each group. In addition, you'll find tips for making the best beverage choices. Keep in mind, though, if a food falls in the worst group, that doesn't mean you should never eat it. You can think of it as an occasional treat. But in general, it will be easier to manage your diabetes if you choose most of your foods from the best lists.

Breads, Grains, and Diabetes

Along with essential vitamins, minerals, and fiber, foods in this first category contain mostly complex carbohydrates that your body turns into sugar for energy. Even though carbs make glucose levels rise, complex carbs are absorbed more slowly than simple carbs, and you need carbs for energy. Use this list as a guide to help you choose the complex carbs that are best for you. 

Best Choices	Worst Choices
Whole-grain flours, such as whole wheat flour	White flour
Whole grains, such as brown rice	Processed grains, such as white rice
Cereals containing whole-grain ingredients and little added sugar	Cereals with little whole grain and lots of sugar
Whole-grain bread	White bread
Baked potato or baked steak fries	French fries
Whole-grain flour or corn tortillas	Fried white-flour tortillas

Diabetes and Vegetables

Vegetables contain carbohydrates, vitamins, and minerals. They usually contain fewer carbs than fruits. Many vegetables contain fiber and are naturally low in fat and sodium (unless they are canned). Starchy vegetables, such as potatoes and corn, aren't included in this category. They are considered part of the breads, grains, and other starches group. Use this list to guide your shopping and cooking choices. 

Best Choices	Worst Choices
Fresh vegetables, eaten raw or lightly steamed, roasted, or grilled Frozen vegetables, lightly steamed	Canned vegetables with lots of added sodium Vegetables cooked with lots of added butter, cheese, or sauce
Fresh cucumbers	Pickles (only if you need to limit sodium; otherwise, pickles are a good choice)
Fresh shredded cabbage or coleslaw	Sauerkraut, (same as pickles; limit only if you have high blood pressure)

Diabetes and Fruits

Fruits contain carbohydrates, vitamins, minerals, and fiber. They are naturally low in fat -- except for avocados -- and sodium. Fruits often contain more carbs than are found in vegetables. 

Best Choices	Worst Choices
Frozen fruit or fruit canned in fruit juice	Canned fruit with heavy sugar syrup
Fresh fruit	Chewy fruit rolls
Sugar-free or low-sugar jam or preserves	Regular jam, jelly, and preserves (unless portion is kept small)
No-sugar-added applesauce	Sweetened applesauce
100% fruit juice or low-carb juices	Fruit punch, fruit drinks, fruit juice drinks, sweetened soda

Diabetes, Meat, and Other Protein

These foods are high in protein. They include beef, chicken, fish, pork, turkey, and seafood. This group also includes beans, cheese, eggs, nuts, and tofu. Selecting non-meat sources of protein can help lower the amount of fat you eat. Use this list to guide your protein choices. 

Best Choices	Worst Choices
Baked, broiled, grilled, or stewed meats	Fried meats
Lower-fat cuts of meat, such as top sirloin	Higher-fat cuts of meat, such as ribs
Turkey bacon	Pork bacon
Low-fat cheeses	Regular cheeses
Skinless breast of chicken or turkey	Poultry with skin
Baked, broiled, steamed, or grilled fish	Fried fish
Tofu lightly sauteed, steamed, or cooked in soup	Fried tofu
Baked or stewed beans	Beans prepared with lard

Diabetes and Dairy

This group includes milk and foods made from milk, such as yogurt and sour cream. Milk contains a lot of protein and minerals, including calcium. Use this list to guide your selection of milk products. 

Best Choices	Worst Choices
1% or skim milk	Whole milk
Low-fat yogurt	Regular yogurt
Low-fat cottage cheese	Regular cottage cheese
Nonfat sour cream	Regular sour cream
Frozen low-fat, low-carb yogurt	Regular ice cream
Nonfat half and half	Regular half and half

Diabetes and Fats, Oils, and Sweets

Fats, oils, and sweets -- and foods containing them -- often provide lots of calories and little nutrition. Many snack foods are filled with fats or oils and sugar. Eating too much of these kinds of foods can lead to weight gain, making it harder to keep diabetes under control. That doesn't mean you have to avoid fats, oils, and sweets altogether -- just select and eat them wisely. Here are some suggestions. 

Best Choices	Worst Choices
Baked snacks, such as baked potato chips, baked corn chips, puffed rice, or corn snacks	Snacks fried in fat, such as potato chips, corn chips, pork rinds
Vegetable oils, non-hydrogenated butter spreads, margarine	Lard, hydrogenated vegetable shortening, butter
Reduced-fat mayonnaise Light salad dressings	Regular mayonnaise Regular salad dressings
Air-popped or calorie-controlled popcorn	Butter-flavored stove-top popcorn

Diabetes and Beverages

Many beverages are not found on the food pyramid. Some beverages contain lots of carbohydrates while providing very little nutrition. This makes it easy for beverages to contribute to weight gain. Here are some best-choice and worst-choice examples. 

Best Choices for Beverages	Worst Choices
Water, unflavored or flavored sparkling water	Regular sodas
Light beer, small amounts of wine or non-fruity mixed drinks	Regular beer, fruity mixed drinks, dessert wines
Unsweetened tea (add a slice of lemon)	Sweetened tea
Coffee, black or with added low fat milk and sugar substitute	Coffee with sugar and cream
Home-brewed coffee and hot chocolate	Flavored coffees and chocolate drinks
Sport drinks	Energy drinks