Tag Archives: diabetes

Tomorrow is Healthy Lunch Day. Here’s why it matters and why you should do it every day.

Tomorrow is National Healthy Lunch Day, an event promoted by the American Diabetes Association to raise awareness about the need to make healthy choices at lunchtime. We all know that eating breakfast is an important way to start the day. What we may not appreciate is the role a good lunch plays in promoting good health, from helping with weight control to managing diabetes. A healthy lunch can also affect your focus and attention, helping your performance at work or school.


lunch

A healthy lunch is important for treating and preventing many health problems. Diabetes is a perfect example. Perhaps the most important aspect of managing diabetes is to control blood glucose levels throughout the day. Obviously, eating a meal will raise blood glucose. But eating a meal that is relatively low in carbohydrates, especially sugar [https://drbrianparr.wordpress.com/2016/02/29/sugar-and-your-health/], can provide energy without contributing to a spike in blood glucose. The glycemic index (GI) is a useful tool for selecting foods that have a lower impact on blood glucose. Keep in mind that the amount of carbohydrates you eat is important, too, so focusing only on GI isn’t enough. This is especially important for diabetics who take medications, including insulin, to help manage their diabetes.

The idea that eating lunch promotes weight loss sounds counterintuitive, but it works! Skipping a meal can lead to stronger feelings of hunger later in the day. And if you are hungrier you will likely eat more. So, an appropriate midday meal can help you eat less later in the day. Combined with regular exercise, eating appropriate meals and snacks is an essential aspect of weight loss and weight control.

Eating lunch provides energy and reduces hunger at a time when your breakfast is likely “wearing off.” This may help you feel more energetic and can enhance your attention, focus, and productivity. Of course, what you eat for lunch is as important as when you eat. Lots of sugar can make you feel sluggish, both physically and mentally. Unfortunately, added sugar is a big part of many restaurant meals and convenience foods, so the afternoon slump is a reality for many of us. Limiting sugar in both food and drinks can help you make healthier choices at lunch that can make you feel and work better in the afternoon.

“That afternoon slump you feel may be due to what you ate for lunch.”

A good lunch is especially important for children. In addition to providing energy to support growth and learning, lunch also presents an opportunity to teach children about healthy eating. This is critical since formal nutrition education isn’t part of the curriculum at most schools. Sadly, most school lunch programs provide meals that include too much added sugar and refined carbohydrates, inappropriate for growing and learning kids.

Many adults don’t fare much better with their lunch. For a lot of people, the two key criteria for lunch are that it is quick and convenient. And as we know, quick and convenient foods are rarely considered healthy, so this requires some effort to plan ahead and make careful choices.

What makes a healthy lunch? Pretty much the same recommendations for other meals also apply for lunch: low in added sugar and refined carbohydrates and high in fiber. Your lunch should include vegetables, fruit, whole grains, and protein, all of which are foods that can make you feel full longer. In the end, the effort and planning pay off by making you a healthier you!


Nutrition, exercise, and health information can be confusing. 
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Sugar and your health

You are probably aware that eating too much fat and sugar is bad for your health. Excessive consumption of both sugar and fat is associated with obesity and other chronic diseases. You are probably also aware that there has been a movement toward reducing the amount of fat in the food we eat. This can be seen in the vast selection of “low-fat” and “fat-free” foods at the grocery store and, likely, your own kitchen. In place of the fat, many of these foods have added sugar in order to maintain a desirable flavor. This also leads to the “Snack Well effect” after the popular low-fat prepackaged foods that were lower in fat but, in some cases, had the same number of calories as the full-fat version.

The majority of processed foods contain some form of sugar or other sweetener. Sugar as most of us know it is called sucrose and typically comes from sugar cane or sugar beets. If you look closely at a food label, though, you may not see sucrose listed. This is because there are a variety of “sugars” used by food manufacturers. For example, high fructose corn syrup (HFCS) is a sugar derived from corn that is sweeter than regular corn syrup. This is worth mentioning because, thanks to corn subsidies, HFCS is cheap for food manufacturers to use.

The effect of added sugar on health is the topic of my Health & Fitness column in the Aiken Standard this week.

Sugar cubes


Many public health medical professionals are increasingly concerned about the high sugar consumption in our population. Despite eating more reduced-fat foods, Americans have been getting fatter, and high sugar intake is thought to play a role in this trend. The individual and public health effects of excessive sugar consumption have been known for years. In addition to the extra calories from sugars that lead to weight gain, the way that sugar is metabolized is associated with hypertension, high blood glucose, and high blood lipids. This combination of conditions is called the metabolic syndrome and is linked to a high risk of diabetes and heart disease.

Obviously, reducing sugar consumption would be beneficial to many. Once controversial suggestion for how to reduce sugar consumption is through taxation and regulation. The idea of taxing added sugar is not new and the idea of a “fat tax” was proposed years ago as a way of limiting the amount of added fat in foods. Although controversial, one potential benefit of taxing products that contain added sugar—soda, other sweetened beverages, and sugared cereal, for example—is that significant revenue could be generated. This money could be used to subsidize the cost of healthier foods or to offset the health care costs associated with obesity.

Even more controversial is a recommendation that children be restricted from purchasing sugar-sweetened foods and beverages, similar to the age requirement to purchase alcohol. This would limit access for children, who stand to experience the greatest health consequences from excessive sugar intake.

It is unlikely that these regulatory measures will be enacted any time soon, if ever. But it does start a conversation about the negative effects our food supply has on us. You should note that the focus is on added sugars in processed foods, not naturally-occurring sugars in fruit and plain milk or the sugar you add to your coffee.  In the meantime, you should make efforts to reduce your consumption of added sugars. One easy way to limit the amount of added sugar you eat is to avoid processed foods and eat more “real” food. You should also pay attention to food labels and look for foods and snacks that have no added sugars.

 


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drbrianparr@gmail.com | http://twitter.com/drbrianparr

 

 

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Raise money to cure diabetes while simultaneously developing your own case of diabetes!

I should’t be surprised to see this. But I still am.

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I should point out that this isn’t new–it dates back to 2011–but it was shared with me this week, so it is new to me!


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drbrianparr@gmail.com | http://twitter.com/drbrianparr

How low should you go?

When it comes to your health, making even small changes can lead to big improvements. Whether you are trying to eat a healthier diet, get in shape, or lose weight, a little effort can go a long way. But doing more can produce even more meaningful changes.

The same is true for risk factors including blood pressure, cholesterol, and glucose. For example, if you have high blood pressure, you can reduce your risk of having a heart attack or stroke by lowering it, even if it doesn’t get into the “normal” range. This is often a goal for patients with high cholesterol or diabetes, too.

According to recent news reports, a major study suggests that treating risk factors—specifically, hypertension—to bring them well below previous targets has even greater benefits. This study, and how it applies to other health indicators, is the topic of my Health & Fitness column in the Aiken Standard this week.

blood pressure


The study, which examined the effect of lowering blood pressure on heart attack and stroke risk, produced such remarkable findings that the results will be published two years ahead of schedule. The researchers found that lowering systolic blood pressure (the top number) to less than 120 mmHg resulted in a risk of heart attack or stroke that was significantly lower than that of treating blood pressure to a typical goal of below 140 mmHg.

This suggests that getting your blood pressure out of the “high” category isn’t enough and that lowering it more is beneficial. Not only is this is good news for people with hypertension, but it also likely applies to other conditions as well. For example, the goal for people with type 2 diabetes is to get blood glucose level, frequently determined by the “A1c” number, as low as possible to prevent complications like blindness, kidney failure, and amputations. And it seems that the risk of heart problems are reduced proportionally to how low LDL cholesterol gets.

This concept can also be applied to health behaviors. For people who are mostly sedentary, something as simple as a 30 minute walk each day can lead to big improvements in fitness. And simply swapping high-calorie drinks like soda or sweet tea for water or other calorie-free beverages can result in noticeable weight loss for many people. And overweight individuals can reduce their risk of diabetes by losing as little as 10% of their excess weight.

But greater changes to activity level or diet almost always have even bigger benefits. Cutting back on calories from drinks is a good start, but losing significant weight almost always requires making other changes in what you eat and how active you are. Walking is an excellent exercise, but greater improvements can be achieved by doing more, either longer duration or a higher intensity. And building muscle will require doing some form of resistance training—walking typically isn’t enough.

It’s true that every pound of weight loss matters, and many people notice changes in how they feel or how their clothes fit after losing as few as 10 pounds. But real transformations in appearance or health require more significant weight loss, especially for people with greater obesity.

Although the SPRINT study focused on only one factor, blood pressure, we shouldn’t limit ourselves to making only one change when it comes to our health. Indeed, the benefits of increasing activity, losing weight, and eating healthier together far exceed doing only one. And, while even small changes make a difference, doing more will almost always result in bigger benefits.

Affordable care acts

The Affordable Care Act is in the news again, this time because the U.S. Supreme Court recently ruled on the legality of subsidies offered to help people afford health insurance. Health care has long been an important and contentious topic in both political and social circles. Given the importance that accessing quality health care has for everyone, it is unfortunate that promoting good health has turned into a political debate.

In addition to expanding access to health care, the Affordable Care Act should also make it easier for people to get preventive care. This is important since preventable chronic diseases including diabetes and heart disease, are among the leading causes of disability and death as well as contributing to high health care costs. It turns out that adopting some simple lifestyle modifications can go a long way toward making you and your family healthier, as well as saving money.

This is the topic of my Health & Fitness column in the Aiken Standard this week.

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Here are a few affordable care acts you can implement today:

1. Move more

Significant health benefits, including weight loss and improved fitness, can be achieved with as little as 30 minutes of activity per day, but more is better. The activity doesn’t have to be “exercise.” It can include walking the dog, yard work, or house work. Research shows that sitting too much is just as unhealthy as not exercising. Spending less time sitting at work, home, or in the car is another easy way to improve health. And getting up and moving for even a few minutes is better than staying seated for long periods of time. Every little bit of activity really does count.

2. Eat smart

Making dietary changes can be difficult, but a few simple changes can lead to big benefits. Eating more real food including fruits, vegetables, whole grains, and lean meats and less added sugar is a good place to start. Fresh fruits, vegetables, and whole grain bread, pasta, and cereals are rich in vitamins, minerals, and fiber and most are low in calories. Eating less added sugar in sweets and processed foods can help you cut down on calories and lead you toward healthier food choices. Controlling portion sizes plays as big of a role in weight gain and loss as the types of food you eat, so pay attention to how much you eat, especially when you eat out. Chances are, it is more than you think!

3. Chill out.

Reducing and managing stress is essential for good health. Uncontrolled stress can lead to high blood pressure, poor immune function, and weight gain. Daily exercise will help, as will using stress management techniques like progressive relaxation. When you can, avoiding stressful situations is wise. Taking time to do something you enjoy each day is a good idea, too. Getting enough sleep (most adults require 7–9 hours) is also important for good physical and mental health.

4. Don’t smoke

Cigarette smoking more than doubles your risk of heart disease and stroke, and is by far the leading cause of lung cancer and other lung diseases. If you smoke, quitting now is one of the most important things you can do to improve your health—and the health of those around you. Nicotine replacement therapy and prescription medications can help, but quitting really does require serious dedication. It’s well worth the effort and the benefits of quitting can be realized almost immediately.

Regular activity, quitting smoking, managing stress, and the types of dietary changes described here can have a profound effect on preventing and treating many health problems. Best of all, these affordable care acts are basically free to implement and can lead to both health and financial savings now and in the future.


Nutrition, exercise, and health information can be confusing. 
But it doesn't have to be that way.
What can I help you with?
 drbrianparr@gmail.com | http://twitter.com/drbrianparr

Exercise, like all prescriptions, only works if you use it as directed.

Earlier this week  I wrote about the Exercise is Medicine initiative and why physicians should prescribe exercise to all of their patients.

Despite the widely-known benefits of exercise, many physicians—and people in general—believe that chronic health conditions should be managed using medications, not  proper nutrition and physical activity. This is a misguided approach considering that weight gain and health conditions related to weight gain  accumulate over a period of years, resulting from eating too much combined with low levels of activity.

One reason that physicians are hesitant to prescribe exercise (and, similarly, good nutrition) is that in their experience, it doesn’t work. What they mean is that the results they see after recommending lifestyle modifications are typically not sufficient. So the assumption made by doctors and patients is that lifestyle modifications don’t work. But this is not necessarily the case

This debate comparing lifestyle modification with medical management of chronic diseases is familiar. Consider statins, the popular lipid-lowering medications that are currently among the most-prescribed drugs (examples include Lipitor, Zocor, Crestor and Vytorin). The effect of statin drugs on lowering blood lipids is significant in most patients. This, together with clever marketing to both patients and physicians, explains why they are so widely used.

It is possible to lower blood lipids as much as statins by carefully controlling diet and regular exercise, but it is difficult. How difficult depends on the individual, but everyone would agree that successful lifestyle modification takes more effort and dedication than taking a pill. In order for any treatment to work, it has to be followed. A patient who doesn’t follow their diet or exercise program is no different from a patient who doesn’t take their medication as directed. In both cases, the response to the treatment will fall short of expectations.

If someone didn’t take their statin medication and their blood cholesterol didn’t go down, no one would label the drug a failure. The medication may well have worked if the patient took it. But people routinely claim that diet and exercise don’t work, when the real problem is that these treatments aren’t followed. This could be because the patients weren’t provided with appropriate and actionable information or because they didn’t faithfully follow the instructions they were given.

The problem isn’t that lifestyle modification isn’t effective, it’s that people don’t implement healthy changes for the long-term. Whereas a statin drug results in rapid changes, the benefits of behavior change are realized more slowly. This can lead to the incorrect conclusion that diet and exercise aren’t working, even though they are.

In reality, medication can be part of a treatment plan, but should not be the only prescription.  Long-term health benefits come from changing eating and activity patterns. Medications should be used as a  “jump start” to treating a condition, with a goal of developing a new way of eating and regular activity as the long-term treatment.

For example, medications like statins can lower cholesterol quickly. Then, lifestyle changes can keep the cholesterol down, reducing the need for the drug. Since side effects depend on the dose and duration of treatment, this approach would reduce the risk of potentially dangerous side effects.

For many patients, lifestyle changes are effective on their own, meaning the medication isn’t necessary. And consider this: maintaining a healthy body weight, proper nutrition, and regular exercise has been proven to be the best—and at this point, only—way to prevent most of the health problems most of us will face. Good nutrition and physical activity really are the best medicine!

Numbers you need to know to prevent and treat heart disease.

February is American Heart Month, an ideal time to assess your risk of heart disease and take steps to improve your health. When it comes to heart disease, there are several numbers, including your blood pressure, cholesterol, and glucose, you (or your doctor) may be monitoring. But there is another set of numbers that are equally important for preventing and treating heart disease that you may not be familiar with: 0, 5, 10, 25, and 30.

What these numbers mean and why they are so important is the topic of my Health & Fitness column in the Aiken Standard this week.


 

Blood test results

0 is for no smoking. Cigarette smoking more than doubles your risk of heart disease and stroke, is by far the leading cause of lung cancer and other lung diseases, and is responsible for over 400,000 deaths per year. If you smoke, quitting now is one of the most important things you can do to improve your health. Nicotine replacement therapy in the form of gum, lozenges, and patches as well as prescription medications can help, but quitting really does require serious dedication. It’s well worth the effort and some benefits of quitting can be realized almost immediately.

5 is for eating five fruits and vegetables each day. A healthy diet is one important aspect of good health. While there is no one single measure of a healthy diet, adequate fruit and vegetable consumption is widely considered to be essential for good health. Fruits and vegetables contain vitamins, minerals, and fiber and most are low in calories. At a minimum, you should eat five servings per day with an emphasis of fresh fruits and vegetables. Your real goal should be to include fruits and vegetables in all meals and snacks, but five servings per day is a good start.

10 is for 10,000 steps per day. Regular physical activity is essential for good health. Almost any activity counts, and a good goal is to be as active as possible throughout the day. You can track your physical activity using a pedometer (step counter) or an app on your phone. A target of 10,000 steps per day is a commonly cited goal, but you should try to take as many steps as possible. You can do this by minimizing the time you spend sitting, taking the stairs instead of the elevator, and walking instead of driving when possible. More steps are better, even if you don’t get to 10,000.

25 is for maintaining a healthy body weight, or a body mass index (BMI) of less than 25. The BMI is a measure of weight relative to height. A BMI of 18–25 is considered healthy, 25–29 is considered overweight, and 30 and higher is considered obese. The risk of health problems like diabetes, heart disease, and some cancers goes up with BMI, so maintaining a healthy body weight is good for your health. If you are overweight you should lose weight, even if you don’t achieve a BMI of less than 25.

30 is for 30 minutes of exercise per day. In addition to being as active as possible throughout the day, you should dedicate a minimum of 30 minutes for exercise or other activity. Considerable research shows that as little as 30 minutes of moderate to vigorous activity leads to improved fitness and health with greater benefits coming from longer duration or higher intensity activity. This can include exercise—a brisk walk or jog, lifting weights, or other aerobic exercise—as well as other activities like housework and yard work. Your goal should be to sit as little as possible, move as much as possible, and make time each day to be active.