Question of the Week: "Pre-Diabetes & Fruit. Is it ok?"

The following question was submitted by a reader for discussion this week, "I found out I have pre-diabetes.  I'm very confused and don't know what I should do to treat it.  My friend told me to avoid all fruits.  Could you help me with how to treat my new diagnosis and if it's ok to eat fruit? "

First, with any new diagnosis and any confusion you may have, I suggest you speak further with your doctor or a C.D.E. (Certified Diabetes Educator) to clarify all of your questions.

Those diagnosed with pre-diabetes are at higher risk to be diagnosed with Type 2 diabetes in the future however, there are things you can do to help prevent or delay that from occuring.   A healthy and balanced low fat diet that is also lower in calories is helpful.   Physical activity is also something that should be included into your daily routine.ay diabetes.

Fruit is a carbohydrate and that is probably what  causing you the confusion, however fruit is an excellent food to be including as part of your diet.  Instead of reaching for a cookie, or another unhealthy sweet snack - fruit is obviously a better choice.  Fruits are full of vitamins, minerals, fiber (which will keep you fuller, longer), and many other antioxidants and phytochemicals that have health benefits.

Since fruit is a carbohydrate, you do have to watch your portion sizes.  One serving of fruit has 15g of carbohydrate. 

Here are some sample serving sizes that all are equivalent to 15g of carbohydrate:

• 1 Small Apple
• 1 Small Orange
• 1 Small Banana (4")
• 17 Grapes

Keep in mind that dried fruits are also allowed but in much smaller portions.  Just 2 Tablespoons of raisins have 15g of carbohydrates!  This is because all of the water is taken out.  What would you rather have:    17 Grapes  or  2 Tablespoons of Raisins?    I think the grapes would be much more satisfying!
 
There is the same amount of carbohydrate in 4 oz of fruit juice as there is in a small piece of fruit (15g)!
 1 Small Apple has the same amount of carbohydrate as just 4oz of Apple Juice.
 And... the apple has more fiber and won't spike your blood sugar as fast.

Question of the week: Popcorn as a snack choice?

The following question was asked by one of my readers, "I have pre-diabetes and enjoy having an afternoon snack. Is microwave popcorn ok for me to have? "

Popcorn can be a healthy snack depending on how it is prepared. 3 cups of air-popped popcorn has just less than 100 calories and is equivalent to 1 carbohydrate choice. Popcorn is also a good source of fiber!

Microwave popcorn can be an okay choice but read your labels as there are some that are very high in sodium and fat. Keep in mind that a whole bag of microwave popcorn may contain anywhere from 2 - 3 servings.

Calories for microwave popcorn may vary depending on brand. The following website is very helpful in researching nutritional information on different brands, http://caloriecount.about.com/calories-popcorn-ic2508.

In addition to sodium and calories, other items to watch out for on your labels of microwave popcorn:
*Saturated Fat
*Trans Fats

The optimal way to consume popcorn would be if you could air-pop your own (being able to control the type of oil, amount of salt, and toppings that it would contain.

Suggested tasty toppings for your popcorn: A small amount of grated Parmesan, cayenne pepper, Mrs. Dash, paprika, nutritional yeast, lemon pepper, garlic powder,cinnamon, or taco seasoning.

Question of the week: Good Fats???

The following question was posted by one of my readers, " I have pre-diabetes and am confused about fats. A friend was telling me there are "healthier fats" I should be including in my diet. I thought all fats were bad? Could you tell me which fats I should include in my diet (if any)?"

Your friend is correct. When including fats in your diet, there are definitely fats that are better choices than others.

Fats play an important role in the body. Fat is essential for the proper functioning of the body. Fats provide essential fatty acids, which must be obtained from food. The essential fatty acids are linoleic and linolenic acid. They are necessary for controlling inflammation, blood clotting, and brain development.

Fat functions as the storage substance for the body's extra calories. It is also an insulator and an important energy source. Healthy skin and hair are maintained by fat. Fat helps the body absorb and move the vitamins A, D, E, and K through the bloodstream.

There are several types of fats:

The "healthier" fats are the unsaturated fats. There are monounsaturated and polyunsaturated fats. Despite being healthy, it is still important to watch your portion sizes when consuming these healthy fats.

First there are the monounsaturated fats that include, but are not limited to, avocados, oils (i.e. canola, olive, peanut, or sesame), nuts (such as almonds and cashews), olives, and all-natural peanut butter (unprocessed).

Polyunsaturated fats include oils (i.e. corn, safflower, soybean, and cottonseed), walnuts, sunflower and pumpkin seeds, and fish.

The fats that we need to reduce, or better yet, eliminate from our diets are the saturated and transfats.

Saturated fats are the biggest dietary cause of high LDL levels or bad cholesterol"). When looking at a food label, pay very close attention to the percentage of saturated fat and avoid or limit any foods that are high. Saturated fat should be limited to 10% of calories. Saturated fats are found in animal products such as butter, cheese, whole milk, ice cream, cream, and fatty meats. They are also found in some vegetable oils -- coconut, palm, and palm kernel oils.

Transfats form when a vegetable oil hardens (hydrogenation) and can increase LDL (bad cholesterol) levels. They can also reduce HDL levels ("good cholesterol"). Trans fatty acids are found in fried foods, commercial baked goods (donuts, cookies, crackers), processed foods, and margarines. Key words on food labels which indicate transfats are "hydrogenated" or "partially hydrogenated". Transfats have been linked to heart disease.

Source: Medline Plus

Question of the week: Pre-Diabetes and Weightloss

The following question was submitted by a reader for discussion on my blog, "I have pre-diabetes and my doctor has told me if I don't lose weight I will end up with type 2 diabetes. I have about 75 pounds to lose. Could you tell me the best way to do this?"

Pre-diabetes is the condition that occurs when one's blood glucose levels are higher than normal but not quite high enough for to be diagnosed as diabetes.

Losing even a small amount of weight (5-10 percent of total body weight) through diet and moderate exercise, such as walking or riding a bicycle (ie. 30 minutes a day, 5 days a week) can make a huge difference). A loss of just 10-15 lbs can make a huge difference. If you have pre-diabetes, you are at a 50% increased risk for heart disease or a stroke.

*Integrate more fruits, vegetables, and high fiber foods into your diet.
*Substitute any whole or full fat milk or cheeses with ones of lower fat or fat free varieties.
*Drink water (flavor it with a lemon or lime wedge) and eliminate any caloric beverages (i.e. soda, flavored sweetened beverages). Avoid diet sodas.
*Substitute white flour products and white rice with ones of whole grain varieties. i.e. Whole Wheat Pasta, Brown Rice, Whole Grain Bread.
*Introduce whole grains into your diet such as quinoa, amaranth, and millet.
*Watch your portion sizes.

Source: American Diabetes Association

Question of the week: Exercise?

The latest question submitted by one of my readers is: "I have been diagnosed as pre-diabetic. The doctor has not put me on any medication, but would like me to lose weight and watch my diet. I'm not sure how much or how often I should be exercising. Could you give me some tips?

Implementing exercise into your daily lifestyle is a wonderful thing whether you were diagnosed as "pre-diabetic" or not. You will look and feel better in no time! Not only will you find that daily exercise is helpful with losing weight, but you also will feel better physically and mentally as well!

Some of the possible health benefits from daily exercise include:
* lower your blood glucose, blood pressure and bad cholesterol (LDL) levels
* raise your good cholesterol (HDL)
* improve your body’s ability to use insulin
* lower your risk for heart disease and stroke
* keep your heart and bones strong and joints flexible
* lower your risk of falling and breaking bones
* help you lose weight and reduce body fat percentage
* give you more energy and reduce stress levels

Physical activity also plays an important part in the prevention of type 2 diabetes. A major Government study called the Diabetes Prevention Program (DPP), demonstrated that even losing a small amount of weight (i.e. 5 to 7 percent, 10 to 15 pounds for a 200 lb. person) can delay and/or possibly prevent the onset of type 2 diabetes. The participants in this study used both diet and exercise to lose weight.

My suggestion is to set a goal of 30 minutes of exercise, 5 days a week. Brisk walking is a great way to achieve this.

If you can get a "walking partner" it can make it a fun event. If you don't currently exercise, start small - try walking every other day until you are able to build up to your goal.

Other suggestions would be to get a pedometer, and strive for a minimum of 10,000 steps daily and/or keep an exercise journal (or mark the calendar that you use daily) with your exercise achievements. It can be a motivational factor.

Sources: National Institutes Of Health

Question of the week: What is low carb and low sugar?

A reader emailed the following question, "I have been diagnosed with pre-diabetes and a friend told me I should eat low carb and no sugar. What is considered to be low carb and low sugar in specific numbers?"

With pre-diabetes it is important to eat a balanced diet that includes carbohydrates, proteins, and fats. Your carbohydrates need to be distributed throughout the day and they should complex in nature and nutrient dense.

Some examples of complex carbohydrates are found in legumes, whole grains, and "starchy" vegetables. Other "good" carbohydrates include whole fruits, low fat/skim milk, and milk products. The "simple" or bad (empty) carbohydrates that should eliminate are the ones containing white sugar (cookies, cake, candies),white flour, white rice, (regular pasta, white bread), syrups, table sugar, soda, and fruit juices.

The Recommended Dietary Allowance (RDA) for carbohydrates is 130 grams. Your brain uses an average of 130 grams carbohydrate daily at minimum to function. This number doesn't include the rest of the parts of your body that need carbohydrates to function optimally!

In addition to eating a balanced diet with complex carbohydrates, it is important to include regular exercise and weight loss if necessary. Visit the following link for more information and tips to help prevent Diabetes: http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices.html. I suggest visiting a CDE (Certified Diabetes Educator) and or a Registered Dietitian.

Question of the week: Does the natural sugar in fruit count as carbohydrate?

The following question was asked by one of my readers, "I have pre-diabetes and am trying to learn about carbohydrate and sugar. Does the sugar in fruit count as sugar?"

Yes, sugar in fruit counts as a carbohydrate - however, this does not mean that you should avoid fruit as a pre-diabetic. In fact, fruit should be a part of your diet as they are loaded with vitamins, minerals, antioxidants and fiber.

A small piece of whole fruit or approximately 1/2 cup of frozen fruit has around 15 grams of carbohydrate. One serving of fresh berries or cut melon is around 3/4-1 cup.

I would suggest avoiding fruit juice or canned fruit. Canned fruit is usually sitting in syrup and not a great choice. Dried fruit is high in sugar (although natural sugar) and only 2 tbsp is equivalent to 15 grams of carbohydrates. Fruit juices don't have the fiber content of whole fruit and only 1/3-1/2 cup is equivalent to a serving.

You can get alot more "bang" for your carbohydrate buck by eating fresh or frozen fruit. Fruit is a better choice of carbohydrate as compared to what I refer to as "empty carbohydrates" (i.e. white bread, white sugar, cookies, cake, soda).

Source: American Diabetes Associations

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.