Do you Have Pre-Diabetes or Diabetes?

On an initial consult I ask my clients to bring a copy of their most recent blood work. As I glance at the numbers I may ask "when did you get diagnosed with diabetes?" I usually get a look of astonishment with the client saying, "my doctor told me my sugar was a little high and that I am pre-diabetic but not diabetic."

How do you know if you have diabetes? The American Diabetes Association (ADA) has clear-cut guidelines. However, I find these guidelines are not known or acknowledged by many health care professionals.

There is a blood test called the glycosylated hemoglobin A1C. Basically, this is a fancy word showing what your blood sugar has been averaging over the previous 3 months.

Laboratories across the United States have differing normal values, but the average normal for A1C is 4.0-6.0. Once you go above 6 you are technically diabetic, not pre-diabetic. It is like you are pregnant or not, not just pre-pregnant or a little pregnant.

Another way to diagnose whether you are diabetic is to look at your blood sugars 2 hours after eating a meal. If your values register over 126 on more than 2 occasions the ADA guidelines state you are diabetic.

I look at my patient’s fasting blood sugar levels as well. A fasting blood sugar in the 100-115 range could indicate diabetes or that one is on the verge of diabetes. Because these values fall into normal range your physician may not alert you to your level.

Obtain a copy of your blood results and look at your values over time so you have control over your health and knowledge of what is happening in your body.

A diagnosis of diabetes is not a death sentence. If your A1C goes over 6, altering your diet and exercise program can quickly put you back into the normal range. However, your lifestyle will need to be maintained. Diabetes requires daily management.

Knowing your values and the definitions gives you awareness of your health. Hopefully if you hear your health-care professional state "you have diabetes" it will not come as a surprise.

What about Sugar?

With the holidays upon us and so many sweets around the house, office, and parties it is not hard to be bombarded with high sugar items.  We all know too much sugar is not good for us but what exactly is important to know about sugar, how much is okay to eat and will it really affect your health in a major way?

Sugar has been blamed for many things from diabetes, hyperactivity in children, and autoimmune problems to acne.  The real key is how much you consume.

Many names for sugar exist – some may be but are not limited to sucrose, dextrose, maltose, glucose, mannitol, sorbitol, molasses, monosaccharides, polysaccharides, maple syrup, maple sugar, date sugar, brown sugar, raw sugar, turbinado sugar, or high fructose corn syrup. If the product contains any of these, it could be a high sugar product.

Since American culture is accustomed to high levels of sweetness, many of our foods have additional sugar added. This includes anything from small yogurts to salad dressings, and many other foods you may be eating on a regular basis.  Many fat-free and low fat products have sugar added, causing them to become basically high sugar products.  The following list reveals foods that can have sugars or hidden sugars you may not be aware of:

• flavored, sweetened yogurts
• condiments, such as ketchup, barbeque sauce or other sauces
• relish – sweet pickle
• any low fat or fat-free product
• salad dressings
• smoothie drinks
• canned or bottled tomato sauces
• pre-made deli case salads or entrees
• teriyaki sauce
• frozen vegetables and entrees
• canned fruits – in syrups
• specialty waters and drinks (coffee, tea)
• processed meats

The new guidelines of the American Heart Association suggest limiting sugar intake to no more than 100 calories per day for woman and 150 calories for men. This translates to no more than 5-8 teaspoons of sugar per day.  On a label 1 teaspoon of sugar equals 4 grams of sugar so the label limit is 20-32 grams of sugar per day.

To put this concept in real life terms, a 12 ounce can of soda has 40 grams of sugar which is over the recommended level.  If you look at the labels of foods you normally eat, you will be able to monitor how much sugar you are consuming.

Although sugar is not the culprit for many of the adverse affects it has been blamed for it is still a concern for your health.  A high sugar diet can increase all types of inflammation in the body which can lead to many health-related problems. 

Sugar can also lower the immune system, leading to increased risk of colds and flues.  One of the most important considerations is having even blood sugars leading to good sustained energy throughout the day.  If you are consuming increased amounts of sugar in any form, your body produces high amounts of insulin, leading to fluctuation in blood sugars and fatigue.

So keep to the limits if you want to have good energy, maintain your health and avoid illness during the holiday season.  Your body will think you gave it a wonderful gift!

The Santa Claus Syndrome

This last week’s Health section of the LA Times had an interesting article called “Know thy enemy:  sugar.”  The writer, Kathy Price-Robinson, shares her story about being 275 pounds and the journey she went through in healing herself.  She went through therapy, support groups, and lost her weight.  She does not discuss how much she lost but impressively she did it without medication or surgery.  She worked on healing her relationship with food.

She discusses how she is not able to eat sugar and likens it to getting in the ring with Mike Tyson.  I would wholeheartedly agree.  For many individuals sugar or starchy carbohydrates are not safe.  When they eat these foods, their bodies release excess amounts of insulin which stores more fat and increase cravings for more sugar – like a fast speed train that one cannot exit.  I talk about this concept in A Recipe for Life by the Doctor’s Dietitian.

Simply put, insulin is the key that unlocks the cell for sugar to get in, which in turn enables your body to use the food you consume.  However, for some individuals somewhere along the line, the key either gets stuck or has difficulty getting into the lock.  Or, if it does get in, it cannot turn the lock, hence it was given the term “resistant.”  If your body develops a resistance to insulin, you are not able to utilize the food you take in, which can increase your fatigue and cravings for ever-increasing amounts of carbohydrate, which compounds the problem. 

This resistance sets up a cascade of reactions in the body which are not in your favor. It’s as if the sugar is outside the cell knocking to get in.  When it cannot get in, your body keeps craving more carbohydrate. Sort of like when you eat one slice of bread - then you want the whole basket.

This “Santa Claus Syndrome (SCS)” as I like to call it, can frequently happen over the holidays.  You attend a holiday party and start consuming some chips, crackers, or cookies.  Soon you find yourself eating a few more, and then the carbohydrate cravings go into full gear and you can’t seem to stop yourself from eating.  The next day you go to a holiday lunch where similar food is served.  Since your body has not recovered from the night before, it keeps telling you to eat more carbohydrate.  If you continue this cycle, the SCS will be in full gear, leaving you wondering how you got into this mess in the first place.

For many individuals if you want your body to run efficiently and stay in control, eating sugar and starchy carbohydrates is just not an option.  As the writer of the LA Times articles states “you can get knocked down, or you can stop getting in the ring.”  Sometimes keeping yourself safe requires not putting on the red suit.

Label Reading 101

The following excerpt is from my upcoming book and gives you a quick guide to reading labels.

If something is designed to make our lives easier, why do we feel more confused? This is how many people feel after looking at food labels. Plain and simple – food labels are not user friendly. You almost need an interpreter to figure out what information is being conveyed and how to apply it to your life. It is similar to someone who has never attempted a crossword puzzle– where do you begin?

Many things on the label are optional. For starters, we are not scientists and need only to look at key pertinent information. Percentages, numbers on the bottom are comparisons to an average male adult of a certain weight, which may or may not apply. A good starting point is to read the list of ingredients on the label or side of the box. Questions to ask are:

How many ingredients does the food have? If there are more than 5 or 6 ingredients, consider re-evaluating your food choice, since the more ingredients the more processed the food will be.

Are any of the ingredients other names or components for sugar or starches– such as sucrose, dextrose, maltose, glucose, mannitol, sorbitol, molasses, monosaccharides, polysaccharides, maple syrup, maple sugar, date sugar, brown sugar, raw sugar, turbinado sugar, high fructose corn syrup? If the product contains any of these names it is very likely it is a high sugar product.
Does the product contain MSG, or other ingredients that may contain components of MSG such as aspartame, broth, glutamate, hydrolyzed, autolyzed yeast, monosodium glutamate, HVP, yeast extract, malted barley, rice or brown syrup? MSG is a flavor enhancer for foods but also can increase appetite and allergic reactions in some individuals.

How many preservatives or stabilizers does the product contain? Sometimes one or two are okay for a week or two of extended shelf life, but many preservatives ensures the “food” would be there next year if you came across it in your cabinet.

Is there anything you do not recognize or can’t pronounce? (one clue it may not be a healthy food choice).

If a product contains less than 5 or 6 ingredients and does not have extras sugars or other preservatives you can now check the label. Look for serving size as many manufacturers make it small, (serving sizes are one of the hidden keys on a label) to make their product look healthier than it actually is. Look for “total carbohydrates” which will tell you how much carbohydrate/starch/sugar the product contains. 15 grams is equal to about a serving or a slice of bread. A product containing 45 grams of total carbohydrates is similar to consuming 3 slices of bread.

Trans fat is one major consideration. Unfortunately many manufacturers make the serving size so small it falls under the “do not need to report” guideline. If the serving size has less then .5 grams of trans fat a manufacturer can state “contains no trans fat” on the label. Do not rely on what the front of the package states. If you ate several servings of a food with “no trans fat” on the label of a packaged/processed food it could add up to well over 2-3 grams of trans fat per day, which is the most dangerous type of fat.

Researchers at Harvard, including Dr. Walter Willet, warn against consuming greater than 2 grams of trans fat per day since it can increase your risk of heart disease by 37 percent, well above any risk of consuming saturated fat. How much trans fat does processed foods contain? Check it out before purchasing. Examples:

· a medium size order of French fries has approximately 8 grams of trans fat
· a small bag of potato chips has 5 grams
· a donut has approximately 5 grams
· a regular sized candy bar has 3 grams

If you eat even small amounts of processed foods, eating 2 or more grams of trans fat easily adds up.

How much sodium does the product contain? The average consumer eats about 6000 mg. per day. The American Heart Association and many health organizations including the National Academy of Sciences' Institute of Medicine recommend keeping your sodium intake below 2300 milligrams per day. If you consume several products which contain more than 500 mg. per serving of sodium, it quickly adds up.

Summing up label reading

Start by looking at the list of ingredients. If the list passes the litmus test, then read on to see if the product is moderate in carbohydrate, sodium, and trans fat. If it has some protein, some monounsaturated fat (healthy fat) and fiber listed on the label, all the better for a balanced meal.
Otherwise, stick with fresh unprocessed foods which do not have labels and limit your exposure to foods in a package. The more ingredients a food contains, the longer it may take your body to process the food. Furthermore, if there are items you cannot pronounce or recognize on the label it might be wise to leave it on the shelf. Your body will thank you!

Eating Non-GMO?

Last night I heard a lecture on: Is Our Food Safe: The Real Story About Genetically Engineered Food. Jeffrey Smith, one of the word’s experts on non-GMO eating, gave a very informative but disturbing lecture on the health risks of GMO foods.

What does it mean to eat non-GMO (genetically modified organisms) foods? The Center for Food Safety calls genetically modifying foods a “laboratory process of artificially inserting genes into the DNA of food crops or animals...GMO’s can be engineered with genes from bacteria, viruses, insects, animals or even humans.”

Why avoid GMO foods? Simply put, changing the DNA of a food crop will ultimately change the way the food acts in our bodies. This could wipe out the food’s health properties, almost replacing nature.

If a food product is labeled “certified organic” you can be assured there are no GMO products in it. Otherwise, it is necessary to check the labels for ingredients listed. What types of foods contain GMO components? The “Big Four” ingredients in processed foods are:

Corn – corn flour, meal, starch, gluten and syrup, and sweeteners such as fructose, dextrose, and glucose
Soy – soy flour, lecithin, protein, isolate, isoflavone, vegetable oil, and vegetable protein
Canola – canola oil
Sugar – anything not listed as 100% cane sugar

The complete guide to eating non-GMO food can be food on the Center for Food Safety's website.

They have a handy shopping guide that shows which food manufacturers use only non-GMO products in addition to food products that contain GMO products. The process of eating clean now has to include non-GMO foods. It may require some effort but the health rewards are well worth it.