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Couple talking to doctor about diabetes

November is American Diabetes Month. Diabetes is a serious and costly chronic disease that affects about 10% of all US adults. What’s often lost in this statistic though, is that they have loved ones who often share the burden of managing diabetes. When a person is diagnosed with diabetes they often have multiple behaviors that they are asked to adopt, including changing eating and physical activity patterns, monitoring blood sugar and taking medication. Loved ones can either help or hurt someone manage diabetes depending on how they communicate and interact.  Poor relationships between family members can lead to poor diabetes self-care, high blood sugars, stress, and many other negative health outcomes.

Family members and loved ones can help a loved one by adopting these strategies:

  • Be aware that behavior change is difficult and can take months to develop a habit. People go through different stages and can even relapse.
  • Nagging doesn’t help people change. They have to be motivated to change themselves. Others in the family can help the person with diabetes discover their own internal motivations. Asking questions that start with “what, why, how” can get loved ones thinking about what they are looking forward to in life and why it might be important to manage diabetes.
    • “What are you looking forward to within the next six months?”
    • “How will diabetes affect your plans?”
  • When it comes to discussing the potential consequences of inaction, use “I” statements and observations versus “you” statements, which can come across as shaming or nagging. For example:
    • “I care about you and I’m worried about the complications that diabetes can cause if we don’t make some changes.”
  • Listen to your loved one’s frustrations, concerns, emotions. Repeat what they say so they know you are listening.
  • Change your own habits and behaviors to support your spouse or family member. If you don’t eat healthy, it won’t be easy for your loved one!
  • Family members need to be on the same page in terms of understanding diabetes management. Visit the doctor together and ask questions or take classes together. Consider taking Dining with Diabetes: Beyond the Kitchen together. The course focuses on carbohydrates, fats, sodium, vitamins, minerals, and fiber. This easy to follow three-module course includes interactive presentations, videos, activities, and access to trusted resources and apps.
  • Encourage your family member to set their own goals, and to find someone to hold them accountable.

Sources

American Diabetes Month. American Diabetes Association. (2019). Accessed at http://www.diabetes.org

Dellifield, J., Remley, D., Baker, S., Bates, J. Communication Strategies to Support a Family Member with Diabetes. (2018). Ohioline. Accessed at https://ohioline.osu.edu/factsheet/hyg-5322

Treber, M. Set a Wellness Goal for the New Year. Live Healthy Live Well Blog. (2019). Accessed at https://livehealthyosu.com/2013/01/07/set-a-wellness-goal-for-2013-4/

Author: Dan Remley, MSPH, PhD Field Specialist, Food, Nutrition, Wellness. OSU Extension.

Reviewer: Lisa Barlage, Extension Educator, Family and Consumer Sciences, OSU Extension, Ross County.

 

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Allulose is a new low calorie sweetener that is beginning to make an appearance in foods on grocery store shelves.

If you are used to scanning the sweeteners on grocery store shelves, you may have noticed a new ingredient recently. Though it has been on the market here in the US since 2015, allulose is beginning to make an appearance in more foods for a wide variety of reasons.

Allulose is often called a rare sugar. I just figured this was a clever marketing term, but there is actually an International Society of Rare Sugars in Japan. Though we think of sucrose (that white granular substance we use while cooking and baking) as sugar, there are actually over 50 kinds of rare sugar that show up in nature. A little tweak here or there to a basic sugar molecule can result in a different sweetness level, different browning characteristics, and a different way of being metabolized in our gut.

In April of this year the FDA announced that allulose can be excluded from the total and added sugar counts on Nutrition Facts labels when used as an ingredient. Susan Mayne, Ph.D. and director of FDA’s Center for Food Safety and Applied Nutrition stated “The latest data suggests that allulose is different from other sugars in that it is not metabolized by the human body in the same way as table sugar. It has fewer calories, produces only negligible increases in blood glucose or insulin levels, and does not promote dental decay.”

So what does that mean for us? If a food contains allulose as an ingredient, it will be declared in the ingredient statement on the label. However, it will not show up on the label as an added sugar in the Nutrition Facts. Each gram of allulose can be calculated as contributing 0.4 calories per gram rather than 4 calories per gram like sucrose. I recently saw a bag of allulose in a grocery store with a front label that read “100% sugar free.” Be on the lookout for these types of claims. Allulose is still a sugar.

Allulose occurs naturally in very small amounts in foods like wheat, jackfruit, figs and raisins. However, on a commercial scale, allulose can be made through a special processing of carbohydrates from corn, sugar beets and other sources of sucrose.

Allulose is an intriguing new ingredient for food manufacturers who are striving to give consumers what they say they want: a reduced sugar product that tastes great without the aftertaste or controversy of artificial non-nutritive sweeteners. It will most likely begin to show up in products marketed toward those trying to lose weight and those with Type 2 diabetes as research continues into the effects of allulose on blood glucose and insulin levels.

Like all novel ingredients, remember that this is just one promising tool to aid in achieving sweetness at a lower calorie level. In most cases, allulose is going to be included in foods that we should only be eating occasionally as special treats anyway. It is hard work to eat a balanced diet in moderation and enjoy physical activity, yet these are the keys to healthy living. Make it a healthy day!

Written by: Emily Marrison, Family and Consumer Sciences Educator, OSU Extension Coshocton County

Reviewed by: Jenny Lobb, Family and Consumer Sciences Educator, OSU Extension Franklin County

Sources:

International Society of Rare Sugars (2019) at http://www.isrs.kagawa-u.ac.jp/index.html

Arnold, N. (2019, April 17) FDA in Brief: FDA allows the low-calorie sweetener allulose to be excluded from total and added sugars counts on Nutrition and Supplement Facts labels when used as an ingredient. athttps://www.fda.gov/news-events/fda-brief/fda-brief-fda-allows-low-calorie-sweetener-allulose-be-excluded-total-and-added-sugars-counts

The Calorie Control Council (2019) Allulose Low Calorie Sugar at https://allulose.org/

Green, E. (2018, June 27) Allulose potential: German start-up develops “real sugar without calories” at https://www.foodingredientsfirst.com/news/sugar-without-calories-german-start-up-eyes-emerging-potential-for-allulose-in-europe.html

Wenli, Z., Yu, S., Zhang, T., Jiang, B., & Mu, W. (2016) Recent advances in D-allulose: Physiological functionalities, applications, and biological production. Trends in Food Science & Technology, 54, pp.127-137. doi:10.1016/j.tifs.2016.06.004 at https://doi.org/10.1016/j.tifs.2016.06.004

Photo credit: https://pixabay.com/photos/cupcake-cake-sweets-sugar-carrot-279523/

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thyroidI’m beginning to notice a higher than normal amount of questions about the thyroid at my nutrition programs. Since January is Thyroid Awareness Month, I decided to refresh my brain and hopefully yours as well about the purpose and structure of the thyroid gland.

The thyroid is a butterfly shaped gland wrapped around your windpipe. It produces the thyroid hormone, which regulates body temperature, fat and carbohydrate metabolism, respiration, brain development, cholesterol levels, the heart and nervous system, blood calcium levels, and menstrual cycles.

How Does the Thyroid Work?

One of the clearest explanations I’ve found comes from Dr. Jeffrey R. Garber (Harvard Medical School).

“Think of your thyroid as a car engine that sets the pace at which your body operates. An engine produces the required amount of energy for a car to move at a certain speed. In the same way, your thyroid gland manufactures enough thyroid hormone to prompt your cells to perform a function at a certain rate.

Just as a car can’t produce energy without gas, your thyroid needs fuel to produce thyroid hormone. That fuel is iodine. Your thyroid extracts this necessary ingredient from your bloodstream and uses it to make two kinds of thyroid hormone.

When your body needs thyroid hormone, it is secreted into your bloodstream in quantities set to meet the metabolic needs of your cells. If the amount is unbalanced, you may develop a thyroid disorder.”

Thyroid Disorders

There are different types of thyroid disorders, but hyperthyroidism and hypothyroidism are the most common. Other thyroid disorders can range from a small, harmless goiter (enlarged gland) that needs no treatment to life-threatening cancer.

According to the American Thyroid Association, approximately 20 million Americans suffer from some form of thyroid disorder. Other details include the following:

  • Thyroid disorders are common, however 60% of people are unaware they have a thyroid issue.
  • Women are more likely than men to have a disorder. One in eight women will develop a thyroid disorder in her lifetime.
  • Stress can exacerbate a thyroid disorder (make it worse).
  • Genetics, an autoimmune attack, removal of the thyroid gland, nutritional deficiencies, and/or toxins in the environment can contribute to thyroid imbalances.
  • Untreated thyroid issues can affect other chronic diseases such as diabetes and heart disease.

Can Food Help?
Eating lean proteins, vegetables, fruits, heart-healthy fats and omega-3s, high-fiber foods, and appropriate portions can help manage or prevent illnesses associated with thyroid disease such as heart disease, diabetes, cancer, and more. Nutrients to monitor include:

  • Iodine: Iodine is a vital nutrient in the body and essential to thyroid function because thyroid hormones are comprised of iodine.
  • Vitamin D: Vitamin D deficiency is linked to Hashimoto’s (the most common cause of hypothyroidism). Sources that contain vitamin D include fatty fish, milk, dairy, eggs, and mushrooms, as well as sunlight.
  • Selenium: The highest concentration of selenium is found in the thyroid gland, and it’s been shown to be a necessary component of enzymes integral to thyroid function. Healthy sources include Brazil nuts, tuna, crab, and lobster.
  • Vitamin B12: About 30% of people with autoimmune thyroid disorder experience a vitamin B12 deficiency. Food sources of B12 include mollusks, sardines, salmon, liver, and dairy.

How do you know if you have a thyroid problem?

Many symptoms may be hidden or mimic other diseases and conditions, the best way to know for sure is to ask your doctor for a TSH (thyroid-stimulating hormone) test, a simple blood test to verify your thyroid gland’s condition. Because thyroid disease often runs in families, a review of their medical histories may reveal other individuals with thyroid problems.

Bottom Line?

If your thyroid gland isn’t working properly, neither are you.

Written by:  Donna Green, Extension Educator, Family and Consumer Sciences, Ohio State University Extension, Erie County, green.308@osu.edu

Reviewed by: Beth Stefura, Extension Educator, Family & Consumer Sciences, Ohio State University Extension, Mahoning County, stefura.2@osu.edu

Sources:

https://www.webmd.com/women/manage-hypothyroidism-17/balance/slideshow-foods-thyroid

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2935336/

https://my.clevelandclinic.org/health/diseases/17557-thyroid-disease-description

https://www.health.harvard.edu/topics/thyroid-diseases

https://www.health.harvard.edu/womens-health/do-you-need-a-thyroid-test

https://www.todaysdietitian.com/newarchives/070112p40.shtml

 

 

 

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A staggering 30.3 million people in the United States have diabetes, millions of which are undiagnosed. Diabetes is a condition where blood sugar (glucose) levels are higher than recommended for good health.  Glucose is a type of sugar found in the foods we eat and is an important source of energy for the body.  Sources of glucose in the diet include: breads, cereals, rice, noodles, fruits, starchy vegetables, dried beans (examples navy and pinto), and milk.  Insulin allows the body to use glucose for energy. Type 2 diabetes accounts for 90-95% of all diabetes.  People with type 2 diabetes, the majority of who are adults, do not have adequate amounts of insulin or the insulin they do have does not work as effectively. This results in elevated blood sugar (glucose) levels and diabetes.

The impact diabetes has on our health and wallet is eye-opening.  Diabetes contributes to cardiovascular disease, cancer, dementia, kidney disease and blindness.  The estimated cost of diagnosed diabetes in 2017 was in the hundreds of billions of dollars!

In addition to diabetes, prediabetes has become a major health concern in the United States.  Over 86 million Americans have prediabetes, a condition where blood glucose levels are higher than normal, but are not high enough to be classified as diabetes.  Prediabetes increases the risk of developing type 2 diabetes in the future.  Because prediabetes is often without symptoms, most people are unaware they have it.  Testing for prediabetes and diabetes identifies those with the disease and allows healthcare professionals to manage the disease sooner. Lifestyle changes, which include weight loss, may help to prevent or delay type 2 diabetes.  If diagnosed with diabetes, early treatment can help prevent long-term complications of the disease.

picture of finger stick blood sugar test

Symptoms of diabetes include the following: increased urination, increased thirst, unexplained weight loss, fatigue, blurred vision, and sores that do not heal.  Anyone who has these symptoms should be tested for diabetes.  People without symptoms who are overweight or obese and have one or more of the additional risk factors, should be screened for prediabetes and diabetes.  These risk factors include: parent or sibling with diabetes, African American, Latino, Native American, Asian American, Pacific Islander ethnicity, history of cardiovascular disease, hypertension, low HDL (less than 35mg/dl), elevated triglycerides (greater than 250 mg/dl), polycystic ovary syndrome, and physical inactivity.  Other forms of diabetes include type 1 diabetes and gestational diabetes. Type 1 diabetes usually is found in children and young adults. Often these individuals have diabetes symptoms and significantly high levels of glucose in their blood when they are diagnosed.  Gestational diabetes, is diabetes newly diagnosed in women between their 24-28th week of pregnancy.

Testing for diabetes is done through blood tests in a variety of ways.  These blood tests include: fasting plasma glucose, oral glucose tolerance test, random plasma glucose and a hemoglobin A1C test.  Below find a description of the main types of tests used to diagnose diabetes and prediabetes:

Fasting plasma glucose test– Blood glucose level is measured after not eating or drinking anything except small amounts of water for at least 8 hours.

Oral glucose tolerance test– Blood glucose level is measured every hour for 2 to 3 hours after drinking a glucose-containing beverage. First, you must have fasted (nothing to eat or drink except water) for 8 hours before drinking the glucose-containing beverage.

Random plasma glucose test– Blood glucose is measured at any time with no consideration to whether you have eaten or not. **Cannot be used to diagnose prediabetes.

Hemoglobin A1c test– This blood test gives you an average blood glucose level over the last 2-3 months.  This test is not accurate if you have anemia.

In order to confirm the diagnosis of diabetes it is normally verified with a second test on a different day.  A fasting blood glucose of 126 mg/dl or above on two different occasions, confirms diabetes.  A random plasma blood glucose of 200 or greater on more than one occasion is considered a positive test result for diabetes.  A hemoglobin A1C result of 6.5 % or above on more than one occasion is also symptomatic of diabetes.  Positive oral glucose tolerance test results differ between pregnant and non-pregnant populations. The main differences include the amount of glucose-containing beverage consumed, and the frequency of blood glucose measurements.  Generally, in non-pregnant women, a blood glucose value over 200mg/dl two hours after drinking a glucose-containing beverage (containing 75 grams of glucose) is indicative of diabetes.  In the pregnant population more glucose is given and blood glucose levels are measured multiple times.

Prediabetes is also diagnosed with blood testing.  Fasting plasma glucose levels between 100-125 mg/dl indicate the presence of prediabetes.  An oral glucose tolerance test between 140-199 mg/dl two hours after drinking a glucose-containing beverage also indicates prediabetes.  More recently hemoglobin A1C has been used to diagnose prediabetes.  A hemoglobin A1C result of between 5.7% and 6.4 % is consistent with prediabetes.

Please find below two links that can help determine if you are at risk for diabetes or prediabetes.

Diabetes Risk Test:  http://www.diabetes.org/are-you-at-risk/diabetes-risk-test/

Prediabetes Risk Test: https://doihaveprediabetes.org/prediabetes-risk-test.html

WITTEN BY: Joyce Riley, MS, RD, LD, Family and Consumer Sciences Educator, OSU Extension, Union County

REVIEWED BY: Daniel Remley, Associate Professor, Field Specialist, Food and Nutrition and Wellness, OSU Extension

 

SOURCES:

American Diabetes Association. Diabetes Care 2018; 41 (Supplement 1): S13-S27.  https://doiorg10/10.2337/dc 18-S002

American Diabetes Association (2018) Diabetes Risk Test.  http://www.diabetes.org/are-you-at-risk/diabetes-risk-test/

American Diabetes Association (2017) Prediabetes Risk Test. https://doihaveprediabetes.org/prediabetes-risk-test.html

Mayo Clinic (2018) Diabetes. https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444

MedlinePlus National Institutes of Health (2018) Diabetes. https://medlineplus.gov/diabetes.html

National Diabetes Education Program (2018) Guiding Principles for the Care of People with or at Risk for Diabetes.  https://www.niddk.nih.gov/health-information/communication-programs/ndep/health-professionals/guiding-principles-care-people-risk-diabetes

National Institute of Diabetes and Digestive and Kidney Disease (2016) Diabetes Tests & Diagnosis.   https://www.niddk.nih.gov/health-information/diabetes

WebMD (2016) Diagnosis of Diabetes.  https://www.webmd.com/diabetes/guide/diagnosis-diabetes#1

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hacks6

Have you heard about “life hacks”? These shortcuts or tips can help make life easier.  I started thinking about “health hacks” – things we could do to improve our health.  Many of these suggestions may be routine for you but look through them and see if you can find a new “health hack” to try.

  • Drink Water instead of a Beverage with Calories. Are you interested in seeing the savings in calories? Visit this CDC site for calorie comparisons. Water is refreshing and calorie free. If you want to jazz it up, add lemon, lime, strawberries, peaches or mint. For tasty combos, check out this blog featuring infused waters. Start slow and substitute water for a soda (diet or regular).
  • Get your Blood Pressure Checked. Uncontrolled blood pressure is a leading cause of heart disease and stroke. You may have high blood pressure and not have any symptoms – so check it to see. Many pharmacies and stores have blood pressure monitors available. Get yours checked and talk to your health professional if you have any concerns about your blood pressure.
  • Find a Healthy Weight. Do you know the weight that is right for you? Click on this link to find out. Most of us know when we are a little over our best weight. Are your clothes tight or too loose? Do you want a free tool that will help you manage your weight? Check out SuperTracker – it can help you plan, analyze and track your nutrition and physical activity. You can join a challenge; receive virtual coaching, and motivation. SuperTracker is part of MyPlate which contains many resources
  • Farmers Market. Visit your local market and pick up vegetables or fruits. Not sure how to find a market near you? Visit this USDA website to find one near you. Eating locally grown food is a great way to get in vegetables and fruits. This past week I purchased two kinds of berries, summer squash, zucchini and beets. Try something new and support a farmer from your area.
  • Move More. If your health care provider could tell you one “health hack” to do, I bet it would be to increase your physical activity. Think about these benefits: weight management, blood pressure management, and blood sugar control. Need more motivation to move?
  • Let’s add these benefits of Physical Activity:
    • Reduce your risk of Type 2 Diabetes and Metabolic Syndrome
    • Reduce your risk of Cardiovascular Disease
    • Reduce your risk of some Cancers
    • Strengthen your Bones and Muscles
    • Improve your Mental Health and Mood
    • Improve your ability to do Daily Activities and Prevent Falls

Do you have a favorite “Health Hack”? Share it with me through the comment section.

Writer: Michelle Treber, Family and Consumer Sciences Educator, Ohio State University Extension, Pickaway County, treber.1@osu.edu

Reviewer: Marilyn Rabe, Family and Consumer Sciences Educator, Ohio State University Extension, Franklin County, rabe.9@osu.edu

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President Barack Obama has proclaimed November 2016 as National Diabetes Month. In his proclamation he states, “I call upon all Americans, school systems, government agencies, nonprofit organizations, health care providers, research institutions, and other interested groups to join in activities that raise diabetes awareness and help prevent, treat, and manage the disease.” Today’s blog is one effort to help in raise awareness and inform you about a free online educational opportunity to learn more about managing diabetes.

idf_infographics_en-2Additionally, November 14, 2016 is World Diabetes Day. It was created by the International Diabetes Federation and the World Health Organization in response to rising concerns about the increasing health risks of diabetes. This year’s theme is EYES ON DIABETES. Its focus is on the importance of screening to ensure early diagnosis of type 2 diabetes.

One in two adults with diabetes is undiagnosed. Diabetes is the leading cause of cardiovascular disease, blindness, kidney failure and lower limb amputations. Over one-third of all people currently living with type 1 and type 2 diabetes will develop some form of damage to their eyes that can lead to blindness. These complications can be prevented or delayed by maintaining proper blood glucose, blood pressure and cholesterol levels.  Screenings can detect complications in their early stages and treatment plans can prevent vision loss.

Healthy eating also is an important part of managing all types of diabetes. Do you want to learn more about healthy eating and diabetes?  A team of Ohio State University Extension educators and researchers have developed a self-paced online course to help participants learn, share and chat with health professionals about managing diabetes.The course, Dining with Diabetes: Beyond the Kitchen focuses on carbohydrates, fats, sodium, vitamins, minerals and fiber. The easy to follow three-module course includes lessons, videos and activities to complete.

Participants can expect to learn:

  • How important blood sugar and carbohydrates are for managing diabetes.
  • How fats and sodium affect a healthy diet.
  • The role vitamins, minerals and fiber play in a healthy diet.
  • How to make healthy food choices when eating out and grocery shopping.

After completion of the course, participants receive a printable certificate. They are also automatically entered in a quarterly drawing for a $100 Amazon.com gift card.

Sign up is easy and free. Visit go.osu.edu/DWD_BTK and click “buy now.” The course will be added to cart for checkout at no cost. After completing the transaction, participant will be required to create an account with campus.extension.org to take advantage of all the materials.

Written by: Susan Zies, Extension Educator, Family and Consumer Sciences, Ohio State University Extension, Wood County

Reviewed by: Dan Remley, Field Specialist, Food, Nutrition, and Wellness, Ohio State University Extension

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I am the daughter of parents with Type 2 diabetes. My father passed away in 2012 due to complications with diabetes and my mother currently struggles with managing her diabetes. What does this all mean having Type 2 diabetes? It means that for my mom, her body does not make or use insulin very well. She takes pills and insulin daily to help control her blood sugar. It means she gets her A1C blood test quarterly to measure her average blood sugar over a three month period .momIt means it is important for her to eat healthy by choosing foods that are high in fiber, low in fat, sugar and salt such as fruits, vegetables, skim milk and whole grains.

Having lost a father due to complications with Diabetes, I feel strongly about educating others. I’ve had the opportunity to be part of a team of Ohio State University Extension educators and researchers who have developed a self-paced online course to help participants learn, share and chat with health professionals about managing diabetes.

dadIMG_766dad8

  • The course, Dining with Diabetes: Beyond the Kitchen focuses on carbohydrates, fats, sodium, vitamins, minerals and fiber. The easy to follow three-module course includes lessons, videos and activities to complete.

Participants can expect to learn:

  • How important blood sugar and carbohydrates are for managing diabetes.
  • How fats and sodium affect a healthy diet.
  • The role vitamins, minerals and fiber play in a healthy diet.
  • How to make healthy food choices when eating out and grocery shopping.

After completion of the course, participants receive a printable certificate. They are also automatically entered in a quarterly drawing for a $100 Amazon.com gift card.

Sign up is easy and free. Visit go.osu.edu/DWD_BTK and click “buy now.” The course will be added to cart for checkout at no cost. After completing the transaction, participant will be required to create an account with campus.extension.org to take advantage of all the materials.

For questions or assistance, contact Dan Remley at remley.4@osu.edu or Susan Zies at zies.1@osu.edu.

Writer: Susan Zies, Extension Educator, Family and Consumer Sciences, Ohio State University Extension, Wood County, zies.1@osu.edu

Reviewer: Dan Remley,Field Specialist, Food, Nutrition and Wellness, Ohio State University Extension, remley.4@osu.edu

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