Diabetes Month 2008

“Diabetics don’t die from diabetes”, says Dave Leonardi, MD, Medical Director of the Leonardi Executive Health Institute in Denver. “They die of complications from the disease”.

This might seem like a minor point but it’s not. Diabetics have elevated risks for many other diseases, among them heart disease- from which many will ultimately die- and depression. But diabetes and its complications can be controlled and managed, and even- in many cases- reversed. You can do significant damage control- if not outright defeat the disease- by some simple strategies focusing on what you eat and what you do.
And of course the best strategy of all would be not to get diabetes in the first place, which might be as easy as following the very same strategies before problems arise! Interested? Read on.

Type ll Diabetes- which is what we’re talking about here as it is the form of the disease that is so powerfully affected by lifestyle and diet- is a disease whose signal characteristic is that the body does not process sugar effectively. Briefly, when you eat sugar- or foods like pasta, rice, potatoes, bread and most starches that quickly convert to sugar in the body- your pancreas responds with a jolt of insulin, a hormone whose job includes moving that sugar quickly out of the bloodstream and into the cells. When this process doesn’t work well, you wind up with elevated sugar and elevated insulin, both of which are potentially damaging to the body and if left untreated nearly always result in full blown diabetes.

The defining, cornerstone principle of the Atkins plan has always been- and always will be- controlling blood sugar and insulin through a sensible nutrient-rich diet that doesn’t elevate blood sugar. This approach has advantages even if you’re not diabetic- high glycemic diets (diets that are high in sugar or foods that convert to sugar easily and quickly) have now been linked not only with diabetes, but with cancer, Alzheimer’s and obesity. Even mainstream nutritionists now agree with the tried and true Atkins principles of a diet low in sugar and trans-fats, and high in omega-3’s, fiber and antioxidants, all things that are remarkably beneficial to those with diabetes (and to those who want to prevent it!)

A number of studies have shown the benefits to diabetics of diets that are rich in foods low on the glycemic scale, meaning high fiber foods (like beans and legumes), and foods rich in antioxidants, vitamins and minerals (like vegetables). Higher protein intakes are also recommended as protein has less of an effect on blood sugar and insulin than starchy carbohydrates. And fat- wrongfully shunned by mainstream dietitians- actually has no effect on insulin, making a higher fat diet (especially higher in really healthy fats like those in fish, nuts, avocados and olives) particularly beneficial for diabetics and those with Metabolic Syndrome (a kind of “pre-diabetes” that also involves problems with sugar and insulin metabolism).

Then there’s increased activity or exercise. Activity and exercise actually have an “insulin-like” effect on the body and here’s why. When you exercise, you create a demand in your muscle cells for glucose (sugar). In Type ll Diabetics as well as those with Metabolic Syndrome, the cells are usually “resistant” to insulin and don’t open up readily to accept sugar from the bloodstream. But exercise makes the cells “open their doors”, thus lowering blood sugar and reducing the need for massive amounts of insulin. That’s one reason why exercise- of any kind- is so essential to the management (and for the prevention) of diabetes. Besides the documented positive effects exercise has on the heart, brain and mood, it’s a natural blood sugar regulator to boot!

The holidays present a particular challenge for everyone trying to stick to a healthy, low-sugar eating style, but Christmas and Thanksgiving represent special mine-fields for the diabetic. Most family dinners are absolutely loaded with the three things that are guaranteed to send blood sugar through the roof- calories, starchy carbs and sugar. Fortunately, there are some creative solutions and with a little bit of ingenuity (and some self-control!) you can navigate this period with a minimum of difficulty. Here are seven tips to keep in mind:

1) Don’t come to the table hungry. If you starve yourself (like skipping breakfast cause you’ll “make up for it” at Thanksgiving dinner) you’re far more likely to eat everything in sight when you get there

2) Eat protein first. It tends to stabilize your blood sugar and keep you feeling full.

3) Eat on a smaller plate. Studies show that we’re psychologically influenced by such things, and people who serve themselves on smaller plates tend to eat less calories without even trying

4) Eat a small salad or a bowl of soup before the meal. Studies show that subjects who ate a 100 calorie salad before dinner spontaneously ate about 10% less calories during the meal.

5) Be creative. Mashed cauliflower makes a terrific substitute for mashed potatoes (and yes you can add some butter!)

6) Use Sucralose or Xylitol. Its sugar substitutes which have virtually no glycemic impact, (meaning it barely raises blood sugar) and it works really well in such normally sugar-heavy dishes as cranberry sauce. Note: too much Xylitol can give you gas, so use judiciously.

7) Make stuffing from nuts rather than bread. Almond stuffing is not only a terrific tasting substitute for bread stuffing, it’s also good for you!

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