Tags: Diabetes, DSME, goal setting, healthy eating, healthy habits, healthy living, New Year, portion size, SMART goals
By Annabella He
MGH Dietetic Intern
It’s 2017! At the start of year, you may be making a New Year’s resolution to better manage your diabetes by eating healthier and exercising more. In order to stick to the plan, your New Year’s resolutions should be specific, measurable and reasonable. The following are some specific tips to get you started. Pick one or a couple to work on!
- Cut down on portion size: The amount of food you eat for each meal has a huge impact on your blood glucose and weight control. Having a smaller meal keeps your glucose and insulin levels more stable. Also research shows that lowering total calorie intake helps with long-term weight loss, so portion control is the key. Use food labels and measuring cups to accurately gauge your intake.
- Eat breakfast: Have a filling breakfast to keep yourself full for longer. Eating breakfast reduces your hunger levels later in the day. A balanced breakfast like whole-wheat cereal with low fat milk and nuts, or scrambled egg with some vegetables are good options. Instead of topping the toast with butter, try avocado to make it tasty and healthy.
- Make a balanced plate: Fill half plate with fruits and vegetables, especially brightly colored ones, ¼ plate protein, ¼ plate starch.
- Eat more non-starchy vegetables: We always say eat more vegetables, but the kinds of vegetables we eat also matter. Starchy vegetables like corn, green peas, winter squash and potatoes are high in carbohydrate. Eating too much of those will increase your blood sugar, so it’s important to moderate the portion size of these vegetables. Non-starchy vegetables like carrots, broccoli, salad greens and beets contain little or no carbohydrate. Eating more of those vegetables not only stabilize your blood sugar level, but also help fill you up without gaining much weight.
- Choose healthy snacks: It’s okay to have some snacks throughout the day to keep your blood sugar stable and promote energy levels. Again, make sure to control the portion size and make healthy choices. Here are some examples of healthy snacks: whole fruits, cut vegetables, almonds, Greek yogurt and low-fat popcorn.
- Learn a new healthy recipe every month: Search for new healthy recipes and practice. Cooking at home is fun and it saves money. You are in full control of what’s in your meal. Also, by December, you will master cooking 12 recipes. How exciting is that?!
- Drink more water: The daily recommendation is 8 cups of water or other non-caffeinated beverages. Drinking enough water helps you stay hydrated and energetic. Sometimes you may feel hungry, but actually you are dehydrated. Drinking water helps you to not get hunger and thirst confused.
- Go to bed early and get enough sleep: Going to bed early keeps you from eating too late at night. Also, getting a good night sleep helps your body process carbohydrate and has a positive effect on weight control.
- Exercise more: Try different types of exercise such as walking, running, hiking, yoga or a group class at the gym. Get a pedometer or use phone app to record your steps while walking. Recording your steps can motivate you to try to reach a higher goal by walking more miles.
- Stay up to date with medical appointments: See your provider regularly to make sure everything is going well with your diabetes and that you are up to date on your health screenings (including eye exams).
Content reviewed by Melanie Pearsall, RD, CDE
Tags: balanced plate, DSME, fruits and veggies, health myths, healthy eating, nutrition, nutrition myths
By Josann Nichols
MGH Dietetic Intern
You don’t have to break the bank to have a healthy diet. Below you’ll find tips and tricks to eat well on a tight budget.
- Get produce in season. Buying produce in season and from local farmers is often less expensive. More corn on the market means competition, which drives prices down. For example: 4 ears of corn in season costs about $1 from local sources compared to $18 on Amazon during the winter. Produce you buy in season is also picked at peak ripeness, which packs in more flavor and nutrients.
- Try frozen fruits and vegetables. Frozen produce is a cheaper alternative to many fresh fruits and vegetables. They’re also picked at peak ripeness, meaning they have the same nutritional quality as fresh produce. You can also store it longer, leading to less food waste which saves money over time.
- Stock up on canned fruits and vegetables. Canned fruits and vegetables are a very cheap option and can be stored longer than either fresh or frozen produce. Make sure to buy fruit canned in its own juices to avoid added sugar. To reduce sugar and salt, rinse before eating.
- Don’t give up on meats. There are many cheaper cuts of meat available such as brisket, skirt, flank and top rump. Typically, these cuts are cheaper because they are a bit tougher but don’t be discouraged! Cooking meat like pot roast in fluid for a long period of time can make it so tender it falls off the bone! Another money saving tip: check with your local grocery store for sales on older meats. These should be used within a few days or immediately frozen.
- Substitute other protein sources for meat more often. Plant-based protein sources are inexpensive, contain fiber and higher-quality fat than meat and will last longer in the kitchen. Beans and lentils for example are usually purchased canned and/or dried. Use them as a substitute for meat in stews, salads, casseroles and side dishes to help your dollar go a little farther. Peanut butter, seeds and eggs are also excellent sources of protein. Add an egg to your breakfast for only $0.25!
- Try canned fish. A healthy diet includes seafood, which can often be pricey. Tuna is one cheap alternative, but if mercury is a concern try sardines. Not only are sardines rich in protein, they’re another source of anti-inflammatory fats. Again, watch out for added salt!
- Go whole grain. Fiber is your friend! It helps manage blood sugar levels and keep your digestive system healthy. Whole grains have more fiber than white flour products and can be affordable. Instead of expensive specialty grains, try switching to old-fashioned oats, whole wheat bread and brown rice.
- Buy in bulk. This can include frozen, canned or dried whole foods. The larger the quantity the cheaper the price per unit, so even though you pay more up front you end up saving money over time.
- Choose generic brands. These typically have significant price cuts. Check the ingredient list, though, to make sure you aren’t losing any quality of the product.
- Take advantage of sales and coupons. Stores frequently have deals on fresh, canned and dried foods.
- Don’t feel pressured to buy organic. Organic farmers do not use chemicals on their crops, but that doesn’t mean non-organic produce is full of chemicals. Many non-organic farmers use little to no chemicals on their produce and simply can’t afford to get the organic certification. Research has also shown that conventionally grown organic and non-organic produce does not differ in nutritional content. So you can be just as healthy eating non-organic foods while saving big bucks at the checkout line.
- Follow the Balanced Plate Model. Protein-rich foods tend to make the largest dent on your wallet, compared to starchy foods and vegetables. By maximizing plant-based foods and limiting your meat portions, you’ll improve the quality of your meals and make your dollar stretch farther.
Just follow the tips above to mix and match your protein, starch and vegetables to maximize your dollar and eat healthy!
Content reviewed by Melanie Pearsall, RD, CDE
Tags: blood sugar, fruit, healthy eating, veggies
Kelsey Vilcek, Dietetic Intern
We all know that fruits and vegetables are needed for our health, but sometimes it is quite difficult to add them into our meals. For anyone who thinks fruits and vegetables are “bad” for people with diabetes, think again! Fruits are great because they are an easy way to enjoy something sweet without creating large spikes in blood sugar levels compared to eating candy or desserts. This is because fruits are high in fiber, which helps to keep blood sugar levels steady. As for vegetables, only the starchy vegetables such as potatoes, sweet potatoes, green peas, winter squash and corn have an effect on blood sugar. Non-starchy vegetables (broccoli, carrots, greens, cauliflower, etc.) are important to eat because they are low in carbohydrates and calories. Eating vegetables is another simple way to feel full and satisfy your appetite, while adding vitamins and minerals and minimizing rises in blood sugar.
Some easy ways to add more fruits and vegetables to your diet:
- Use vegetables for dipping in hummus or low-fat dressings
- Make kebobs: grill vegetables such as peppers, onions, mushrooms, zucchini, and tomatoes with chicken as a fun meal (You can even do this with fruit!)
- Veggie wraps: roast vegetables and roll up in a whole-wheat tortilla
- Add vegetables as toppers to salads
- Smoothies (low-fat milk, frozen fruit, frozen spinach or kale, and nut butter)
- Try vegetables as pizza toppings
- Puree vegetables as a sauce for pasta, chicken, pork, or seafood
- Chop, grate, or shred zucchini, carrots, or spinach and add into lasagna, casseroles, or meatloaf
- Have an apple or banana and peanut butter as a snack
- Egg omelet with vegetables
- Oatmeal with fruit
- Substitute butter with avocado
- Puree prunes, bananas, peaches, or apples and use in place of ½ of the fat in recipes for muffins, pancakes, breads, etc.
- Add carrots or zucchini to baked goods
- Low-sodium vegetable soup with beans
- Leave fresh fruit out on the counter where you can see and grab it easily
- Consider making fresh vegetables juices
Content reviewed by Melanie Pearsall, RD, CDE
Tags: clam chowder, Diabetes, DSME, healthy eating, recipe
Warm up this winter with a bowl of this Be Fit clam chowder. Pair with a salad to round out the meal.
2 bacon slices
2 small onions, chopped
1¼ cups chopped celery
¼ tsp kosher salt
½ tsp dried thyme
2 garlic cloves, minced
6 (6½ ounce) cans of chopped clam
5 cups diced potato
32 ounces bottled clam juice
1 bay leaf
3 cups low fat milk
½ cup all-purpose flour
Cook bacon in a large saucepan or Dutch oven on medium heat until crisp. Remove bacon and set aside. Add onion, celery, salt, and thyme to pan and cook for 2 to 3 minutes; add garlic and cook until vegetables are tender, 1 to 2 minutes more.
Drain clams, reserve the liquid, and set the clams aside. Add clam liquid, potatoes, bottled clam juice, and bay leaf to the pan and bring the mixture to a boil. Reduce heat and then simmer until the potatoes are tender, about 15 minutes. Discard bay leaf.
In a medium bowl, combine milk and flour, stirring with a whisk until smooth. Add flour mixture to the pan and bring to a boil. Cook for 10 to 15 minutes more, or until the mixture thickens slightly; stirring occasionally. Add clams. Crumble bacon and divide among soup bowls.
Yield: Serves 6
Serving Size: 2 cups.
Nutrition Information Per Serving:
Calories: 345 • Protein: 20g • Sodium: 675mg • Carbohydrate: 40g • Fiber: 4g • Fat: 9g Sat Fat: 2g
Recipe adapted from Cooking Light. Originally posted on clubsatcrp.com.
Tags: balanced plate, blood sugar, Diabetes, healthy eating, insulin, insulin resistance, nutrition, snacks, weight gain
By Felicia Steward, Dietetic Intern
Blood Sugar Defined
Blood sugar is the measurement of the amount of glucose, or sugar, in your bloodstream. This is important because it tells us how much energy our cells and tissues are receiving from the food we eat. Some foods affect blood sugar more than others. Any food that is mostly carbohydrates will affect blood sugar levels. These include dairy (milk and yogurt), all fruits and fruit juices, starches (pasta, bread, rice, and tortillas), and starchy vegetables (corn, peas, beans, potato, and butternut squash). Eating more carbohydrates at a meal can raise blood sugar, so it’s important to think about portion size along with when we eat and what food items we choose to eat together.
Why Care About the Amount of Sugar in My Bloodstream?
Glucose provides our body with energy, and is needed for the brain to properly function and process information. Therefore, it is important that we choose foods containing small amounts of carbohydrates whenever we have a meal or a snack throughout the day so there’s enough glucose to support our tissues and cells.
When someone with diabetes eats large portions of carbohydrate-rich foods, too much sugar is released into the blood stream and, because there’s either not enough insulin or they have insulin resistance, their body is unable to use this sugar for energy effectively. It builds up in the blood stream, causing damage to the body. Over an unhealthy extended period of time, the body will eventually store much of the excess sugar as fat, which can lead to weight gain. Therefore, it is important to be aware of how the food we eat influences the amount of sugar in our bloodstream and how it affects our weight.
How is Blood Sugar Managed?
A healthy eating pattern that includes balance and portion control is an important part of managing the amount of sugar in the bloodstream. Pairing whole grain, carbohydrate-rich foods with protein and fiber helps maintain healthy blood sugar levels. Eating a meal or snack that contains foods that increase blood sugar with those that do not affect blood sugar means the glucose is absorbed slowly into the blood and prevents blood sugar from spiking too high. Paying attention to portion size will also ensure that we are providing our body with exactly what it needs each time we eat. What the body doesn’t use for energy right away can be stored as fat and cause weight gain.
Balanced Lunch Examples:
- PB&J on whole wheat bread + 1 cup carrot and celery sticks dipped in plain yogurt
- 2 cups tossed salad + 3 oz. grilled chicken + oil/vinegar dressing + 1 banana
- 3 oz. salmon + 1 cup brown rice + 1.5-2 cups cooked green beans
- 2 oz. tuna salad (with light/mayo), lettuce, and tomato on whole wheat bread + 1 small apple + 8 oz. of skim milk
Content reviewed by Melanie Pearsall, RD, CDE
Tags: appointment, Diabetes, DSME, healthcare, office visits, preparation, team
By Eileen B. Wyner, NP
Bulfinch Medical Group
A medical appointment is a really big investment. It takes time from our busy lives that may impact our employment or family commitments. It costs us financially through transportation costs, parking fees, childcare expenses and copays. It also can cause anxiety and uncertainty because of worry about the outcomes of tests (on top of all of the other things I mentioned). Even so, a medical appointment is the single best investment you can make in your healthcare. The best way to gain the most from this investment is studying the night before. That’s right, just like preparing for that all important math test it’s worthwhile to prepare for your upcoming medical appointment.
Remember, you and your health care provider are teammates working for the same goal: the best health you can achieve. Using the tips below to prepare for your appointment will help you both get the most out of your time together.
- Review your prescriptions and see if you need any refills on medications or supplies. It is also important to have updated pharmacy contact information so your prescriptions are not delayed, and check to see if you need any specialty referrals.
- Make sure that you have your updated insurance information and photo ID with you. Medical offices do not automatically receive insurance changes, so it is important to check this information at each appointment to prevent issues with bills and referrals. You can update your address and phone number at this time if they have changed since your last office visit.
- Allow plenty of time to get to your appointment and park so you are not late. We try to accommodate people who are late but sometimes it can’t be done.
- Please be patient with me if I am running late. I work very hard to keep on time because I value YOUR time, but if I have a very sick patient, I may run behind. I promise that I will still give you the time you need for your care.
- Don’t forget to bring any results from home such as blood pressure, weight, and blood sugar checks. The information I get during the office visit is just one snapshot in time; seeing it along with your home results gives me a clearer picture of your health.
- Write down any questions and concerns you want to talk about during your appointment.
- Take notes during the appointment and use the same notebook for each visit. This will help keep all of your information organized and in one place if you need to review something you’re unsure about.
I know being a patient is a full time job for many people, and it can be daunting to keep track of everything that goes into good self-care and good health. I think that preparing for your appointment, just like studying the night before the math test, can make this process less overwhelming and as successful as possible.
Tags: beets, Diabetes Education, dinner, DSME, quick and easy, recipe, weeknight meal
The addition of greens, raisins and almonds to pasta is a healthy new spin on a quick dinner. Beets are in season in Massachusetts from June to October. Beet greens are often thrown away after beets are removed. Instead, save the greens: they are a good source of many nutrients, including vitamin A, vitamin C and vitamin K. If beet greens aren’t available, you can substitute any dark green like Swiss chard or spinach.
8 ounces (1/2 of a 1-pound box) whole wheat penne pasta
¼ cup sliced almonds
1½ tbsp olive oil
1 clove garlic, minced
2 cups chopped beet greens
¼ cup raisins
3 oz goat cheese (soft variety, such as Chevre)
½ tsp salt
Black pepper to taste
Prepare pasta according to the directions on the package. While pasta is cooking, toast the almonds in a large, dry sauté pan over medium heat until they turn golden brown (about 3 minutes). Remove almonds from pan and place in a small bowl. Add olive oil to the pan and add garlic, greens and raisins. Sauté for about 3 minutes, until greens are tender and wilted. (If necessary, once greens are fully cooked, remove sauté pan from heat until pasta is cooked.)
Once pasta is cooked, reserve ½ cup of the pasta water and add it to the sauté pan with the greens. Let mixture cook for about 1-2 minutes until slightly thickened. Meanwhile, drain pasta from remaining water. Add pasta, toasted almonds, goat cheese, salt and pepper to the greens and toss to combine.
Yield: 4 servings (about 1 cup each)
Nutrition Information per Serving:
Calories: 375 • Protein: 15 g • Sodium: 380 mg • Carbohydrate: 53 g • Fiber: 7 g • Fat: 14 g Sat Fat: 4 g
Recipe adapted from Cooking Light
Tags: Diabetes, Diabetes management, Holidays, moderation, nutrition, portion size, treats
By Melanie Schermerhorn, Dietetic Intern
Most of us have heard the phrase, “everything in moderation.” Many say moderation is the key to success; for someone who has diabetes this phrase is especially true when it comes to what you eat. Moderation in relation to healthy eating habits, especially portion control, can have a huge effect on your overall health! To break the phrase “everything in moderation” down further, let’s talk about what it means. What your healthcare providers are saying is: eat a balanced diet most of the time, but do not deprive yourself of the not-so-healthy things you enjoy. In other words, it’s alright to eat them but be sure to have them less frequently and in a smaller portion.
With diabetes this is important for your blood sugar management. The goal is to not completely deny yourself things like chocolate chip cookies, but instead maintain a healthy lifestyle while still treating yourself. A tip to do this is buy smaller portion sizes, so having one small cookie won’t have as much of an effect on your blood sugar as a larger one would. Another great way to keep track of your portions is reading the labels on packages for serving sizes. Sometimes a package could be more than one serving! Sharing a baked good with a friend instead of eating the whole thing can help you consume less as well. You could make homemade treats with healthier ingredients like in the recipe below so you aren’t consuming a heavily processed carbohydrate. So aim to keep your portions in check and when it comes to sweets “Everything in moderation!”
Recipe: Healthy Banana Pancakes: Combine 1 ripe banana, 2 large eggs, and a few shakes of cinnamon in a bowl until smooth. Heat up a pan on medium heat and spray with cooking spray. Put a few spoon fulls of the “batter” into the pan. Cook until lightly brown on each side and serve.
Post content reviewed by Department of Nutrition and Food Services
Are you newly diagnosed with diabetes, or struggling to control your blood sugar? If so, DMSE/S programs can help!October 17, 2016 at 9:43 am | Posted in Announcements | Leave a comment
Tags: Diabetes, DSME, health, healthy lifestyle, Medications, nutrition
Diabetes is a chronic, complex disease. Self management is key, but what does that even mean? Where do you start? Self Management is the ‘taking of responsibility for one’s own behavior and well being.’ Living well with diabetes means you need to learn new skills and behaviors. This can seem overwhelming during an already stressful time. DSME/S programs teach you the self management skills you need to truly thrive.
You will first see a nurse or nurse practitioner (who is often usually a Certified Diabetes Educator or CDE). You will either continue to see that clinician by yourself or attend group classes with other people just like you. Group classes are a great way to learn and be supported by people who know what you’re going through. You are not alone! During appointments or classes, you will learn about important topics like nutrition, exercise, medications and more. You will also set specific behavioral goals to work towards between each visit.
Research has shown that DSME/S works. It can lower your A1C and stop complications from happening or getting worse. Attending can also improve your quality of life and keep you out of the hospital. Major organizations like the American Diabetes Association, American Association of Diabetes Educators and the Academy of Nutrition and Dietetics all believe that everyone with diabetes should have DSME/S at some time in their life.
Mass General DSME/S programs are offered at Chelsea, Revere, Charlestown, Internal Medicine Associates, Diabetes Associates and Bulfinch Medical Group. For more information, contact Jen Searl at email@example.com.
Tags: care team, Diabetes, Diabetes management, DSME, family, health literacy, healthy eating, my story, nutrition, Type 2 Diabetes
My grandmother is a tenacious and vibrant woman who was diagnosed with type 2 diabetes earlier this year. She had uncontrolled blood sugar levels along with other health issues and limited mobility. With no formal educational background, she doesn’t know much about diabetes or possible complications. Her low health literacy makes it difficult for her to utilize diabetes related health care resources. “There are too many rules in my diet!” she would exclaim in Twi, her native dialect. She also has low nutritional knowledge and at times would reduce her consumption of certain staple foods. She assumed that eating less of these foods would cure her body from the disease. Her daily diet in Ghana is mostly starchy and sugary foods with low nutritional benefits. One staple meal that she eats quite often is called fufu: a soft dough-like mix of cassava, plantain, and other flours served with different types of warm soups full of meat and/or fish. Fufu is relatively high in carbohydrates and has a significant and rapid effect on my grandmother’s blood sugar levels.
As my grandmother’s caregiver, I provided diabetes care management and education. My goal was to help her avoid blood sugar spikes keep her blood sugar in a healthy range before she went back to Ghana. Every day I checked her fasting blood sugar in the morning and again two hours after eating. These results were reviewed by her PCP and nurse case manager. I modified my grandmother’s meals and incorporated more green leafy vegetables, fiber-rich foods, whole-grain breads and old-fashioned oatmeal with almond milk and honey for added sweetness. I also introduced her to cooked quinoa and cauliflower rice as substitutes for fufu, white rice, and other fufu-like foods to give her meals a nutritional boost. After a meal, I would encourage her to take a walk to the local shopping plaza or to circle around the neighborhood for an hour. Despite her stubbornness and fiery temper towards changes to her diet, we were able to improve her eating habits by stressing the importance of portion control.
My grandmother does not know how to pronounce diabetes or manage her care on her own, but making sure she understood that her medications, changes to her diet, and daily walks to her favorite consignment stores are effective tools for managing her blood sugar levels were key components to her care plan. My experience as a caregiver was a wonderful opportunity to spend time with my grandmother, and it also highlighted the importance of diabetes education in following a care plan and reducing risk of complications. I also learned how that approaching care in a culturally tailored manner that respects individual preferences, opinions and ideas is necessary for reaching optimal health.