National Nutrition Month

March was National Nutrition Month. This year's theme was "Building Nutrition from the Ground Up".

What does this theme mean to me? This mean to build a healthy and sturdy foundation and build other healthy habits upon that base.

Taking small steps that stick - and building upon them. It is better to make one small healthful change and making it part of your daily life than make one/several large ones that you stop doing a week later.

Every little bit helps and you have to start somewhere. Whether it is adding one extra serving of veggies a day, switching from switching from white bread to whole wheat or multi-grain, or swapping from 2% milk to 1% or skim, each change you make will have a positive impact.

So let's start building that foundation today! Visit the American Dietetic Association's website to learn more at www.eatright.org/nnm

Sugar-free candy for diabetics

The following question was submitted by a reader, "My doctor recently diagnosed me with type 2 diabetes. I know it is important to watch my sugar intake. Is sugarless candy really sugarless?"

"Sugar-free" candy usually contains a sweetener other than standard sugar (sucrose). Many contain artificial sweeteners such as Stevia, Splenda, or Equal. Others contain sugar-alcohols such as isomalt, maltitol, mannitol, sorbitol, or xylitol.

Foods with low- or reduced-calorie sweeteners (such as the ones listed above) may have less calories than foods manufactured with sugar and other caloric sweeteners. The effect that the sugar alcohols have on your blood glucose can vary each time so it is difficult to know how sugar alcohols will affect your levels.

Things to keep in mind with these types of products:

*Always check the Nutrition Facts on the label. Many food products containing artificial sweeteners and/or sugar alcohols still have a significant amount of carbohydrate, calories and fat, so never consider them a “free food”.

*Also check the fat grams on the label. There is usually more saturated and or trans fat in sugar free baked products to make up for the flavor/texture difference.

*Sugar alcohols may a laxative effect or other unpleasant gastric symptoms in some people. Only consume in small amounts - especially in the case of children.

BOTTOM LINE:
Pay attention to the amount of carbohydrate in the food you are eating rather than just the amount of sugar. More importantly - make sure your sources carbohydrates are complex - you are eating lots of fruits (whole) and vegetables (and fiber), and low/non-fat dairy as your main sources of carbohydrates in your diet.

Fasting Glucose Numbers

The following question was asked by a reader, "My fasting glucose number was 127. Does this sound like pre-diabetes or diabetes? What should I do to control by blood sugar?"

A fasting glucose number of 127 is indicative of diabetes. However, make note that this test is most accurate when done in the morning and repeating this test will confirm such a diagnosis.

Once this number is confirmed, it is imperative that you meet with your doctor in order to discuss treatment options. You should speak with your doctor about what kind of medicines you may need and set target blood glucose levels. Your doctor will do tests to be sure your blood glucose, blood pressure, and cholesterol are staying on track and you’re staying healthy.

Ask your doctor or check with your area hospital about meeting with a CDE (Certified Diabetes Educator) and taking diabetes education classes to get you further information that is needed. A Certified Diabetes educator may be a nurse, a dietitian, or another kind of health care worker. Diabetes educators teach you about meal planning, diabetes medicines, physical activity, how to check your blood glucose properly, and how to fit diabetes care into your everyday life.

Fruits and Vegetables For Those With Diabetes

The following question was submitted by a reader, "I have pre-diabetes and am trying to lose weight. How many servings of fruit and veggies should I have each day?"

Eating more fruits and vegetables is an excellent way to manage your diabetes as well as manage your weight. Vegetables and fruits are chock full of vitamins, minerals, antioxidants, and fiber. Most are low in calories and with the exception of on a few types, low or fat-free. Set a goal of consuming at least 5 servings of fruits and veggies daily.

Visit the website http://www.fruitsandveggiesmorematters.org/ for more ideas on how to incorporate f&v into your daily diet and delicious recipes to try.

The best type of vegetables to consume are those that are of the non-starchy variety. Choose vegetables such as broccoli, cauliflower, Brussel sprouts, spinach, asparagus, and other leafy greens. Limit starchy vegetables such as corn, peas, and potatoes as they are higher in carbohydrates and calories.

Raw and cooked vegetables are healthiest when made or served with little or not fat, sauces, or dressings. If a salad dressing is used, try a low or fat free variety. Vinegar or lemon or lime juice is another healthy option in lieu of salad dressing. Steaming vegetables is a healthy method of cooking - you can use water or a low fat and low sodium variety to add flavor.


A small piece of "hand fruit" (i.e. an apple, orange) contains on average 15 grams of carbohydrate. Berries such as blueberries, strawberries and raspberries have about 15 grams of carbohydrates per 3/4 - 1 cup. When choosing a banana, one the size of a dollar bill is the equivalent of one serving.

Fruits should be either fresh or frozen without any added sugar. Dried fruit and fruit juices should generally avoided as to their high sugar content as well as their negative effect on blood sugar levels. Whole fruit contains less sugar and carbohydrate and have added fiber.

Prebiotics vs. Probiotics?

A reader has submitted the following question: "What is the difference between prebiotics and probiotics?

Probiotics are bacteria (in the form of beneficial microorganisms that reside in our large intestine).

Probiotics are available in various foods as well as dietary supplements. Foods that contain probiotics include, but are not limited to, yogurt, miso, tempeh, and fermented/unfermented milk. Many foods are now fortified with probiotics including some cereals, non-dairy milks and yogurts.

Examples of probiotics are Bifidobacteria and Lactobacilli.

Research has shown that probiotics have many benefits that include managing lactose intolerance, improving immunity, reducing inflammation, and inhibiting some of the negative side effects that come with taking antibiotics.

Prebiotics are the nutrients for these beneficial bacteria (probiotics). They are sometimes known as fermentable fiber. One type that is used in many foods is called inulin.

Food sources of prebiotics include soybeans, artichokes, bananas, berries, chicory, flax, garlic, greens such as chard and kale, honey, leeks, oatmeal, onions, unrefined wheat and barely, and legumes.

Prebiotics also are added to some dietary supplements and some processed foods, such as yogurt, drink mixes and meal-replacement bars during fortification.

Butter vs. Margarine - Which is better?

A blog-reader wrote and posed the question today, "Is margarine healthier than butter"?

The answer is "it depends".

Despite the fat that butter is an "animal product" and is made of fat and contains cholesterol as well as high levels of saturated fat, some margarines contain transfats which are just as unhealthy.

In order to make the "better" choice, you need to read and understand the product labels. The areas of the label that you need to take special note of are the fats and cholesterol.


Most margarines are made of vegetable oils however not all margarines are created equal. The "good fats" to see on the label would be marked polyunsaturated and monounsaturated - these types of fats help reduce one's "bad" cholesterol or LDL levels. However, some margarines consist of saturated and/or transfats which can prove even worse than butter.

When a process called "hydrogenation" is implemented during manufacturing to make the margarine into more of a solid state (*i.e. stick margarines in general although tub margarines may have it as well), the more transfats it will have. Transfats behave just like saturated fats causing increases in blood fats and cholesterol and increase one's risk of heart disease. Additionally, transfats may lower levels of "good" cholesterol or "HDL" levels.

When choosing a margarine, read your ingredient labels carefully and choose the one with the lowest possible amount of transfats available as well as one with less than 2 grams of total saturated fat. If you can find a margarine that contains plant sterols that is positive. This is an ingredient that companies are starting to fortify their products with that has been found to help lower LDL (bad) levels.

If you prefer the taste of butter over margarine, it is better to choice a variety that is either whipped or light. Also important that if you choose to use butter or any other type of margarine products, that you use them sparingly.

Newly Diagnosed with Diabetes - How many Carbs and how much sugar can I have?

The following question was posed: "I was diagnosed with type 2 diabetes last month. I’m having difficulty understanding how many carbs and sugar I can have each day. I’m finding that nearly everything contains carbs and sugar! Can you help me with this?"

The answer varies from person to person. It isn't necessarily important to know simply how much carb or sugar to eat in a day, but rather what types of carbohydrates and how those carbohydrates are distributed throughout the day.

My first recommendation is for you to attend a diabetes class and speak with your physician or a registered dietitian to learn the specific amount of carbohydrate you should be consuming daily. Information regarding diabetes classes can be found in my previous blog post. They will be able to help you determine the amount of carbs/sugar that works best for you based on individualized factors such as: your height/weight, lab values, type of medication you may be taking, weight goals, the amount of physical activity you partake in daily, et al. The Recommended Dietary Allowance (RDA) for carbohydrate has been set at 130 grams/day as a frame of reference, however please speak to your diagnosing practitioner/registered dietitian for an individualized plan.

Keep in mind that you should be distributing your carbohydrate intake evenly throughout the day instead of eating them all in large meals. Spreading it throughout the day in small meals will help you keep your blood sugar levels from spiking. Be sure to read your food labels!

Also, the carbohydrates that you are choosing should be of the complex nature and nutrient dense. Whole grains, whole fruits, whole vegetables, and low fat dairy are optimal. Best to eliminate any white foods (white breads, white pasta, anything with white sugar), white rice, and fruit juices as they will cause your blood sugar levels to spike. Cakes and cookies are considered "empty calorie" carbs and should be consumed minimally if not eliminated from your diet.

Fiber intake should be optimal at 25-35 grams daily. Choose foods high in fiber as it will help you delay sugar absorption and help you control your blood sugar levels. If you are not currently eating alot of fiber in your diet - increase your intake 3 - 5 grams/daily to avoid constipation and be sure to drink lots of water.

Portion control is another important factor when it comes to monitoring your carbohydrate intake (see my first blog post for some useful measuring tips). You can achieve optimal blood sugar levels by watching the size of your carbohydrate portions.

Free Assistance for those with Diabetes without insurance - Question of the Week

Here is the question of the week: "I am trying to find a class for our grandson. He is 19 and has a part-time job but no insurance. He just found out last week that he is a type 1 diabetes after losing a lot of weight and his blood sugar was 523. He is on insulin but needs to go to a class to manage is diabetes without going hungry. Where do we start? Any suggestions would help us a lot."


My first suggestion would be to ask the health professional who made the diagnosis. He/She may know of a free program/class that your grandson may be able to attend.


Another suggestion is to check with your area hospital. Many of the hospitals do host free diabetes clinics/classes. For example, I was able to find one that is held almost monthly at a medical center located in Southern New Jersey http://www.sjhs.com/inCalendar/CalendarEvent.aspx?selcontact=&page_id=1625&view=27&category=1,2,3,4&mode=U&order_by=&selcat=1,2,3,4&evt=880&date=2/24/2010&site_id=1&kwd=&selloc=. Try googling the terms free+diabetes+classes+your city or state's initials. You may be able find a local free diabetes clinic.


Yet another option is to utilize the internet for the information. Of course, make sure that the site you are going to use is reputable. Websites that utilize the extensions ".gov " and ".edu" are your best bets. If you are linking to sites through the web sites such as the American Diabetes Association or the American Association for Diabetes Educators, that information should be valid.

Finally, check with your public health department. You may find that they host a clinic in for people in your community. Other places to look - check for listings in your local community newspaper or your local YMCA or YMHA.