Author: mghdiabeteseducation

When you have Diabetes, life can be difficult. Managing medications, blood glucose testing, and maintaining a good diet can be a formidable challenge without the proper support. The Diabetes Self-Management Education and Support (DSME/S) Program at Massachusetts General Hospital can help patients with Type 1 or Type 2 Diabetes and their families learn to live well with Diabetes.
Uncategorized

7 Ways to Increase your Fiber Intake

Posted on by mghdiabeteseducation

Jordan Shute
Dietetic Intern

As the weather starts to warm up flowers begin blooming, trees start budding out, and fresh, local produce is right around the corner. Fruits and vegetables contain vitamins and minerals our bodies need to work correctly.  Now is the time to check out local farmers markets to taste and experience fruits and vegetables grown right here in Massachusetts! Click here to find a market near you, or check for locally grown produce at your grocery store. Worried about produce spoiling before you can eat it? Buy frozen– it’s still full of the same nutrients as fresh produce.

Fiber is a weird word, right? You may have heard that eating fiber is good for you and your health, but what foods have fiber and how much do you need each day?  Fiber is a carbohydrate found in fruits, vegetables, legumes, and whole grains. Our bodies can’t actually break down fiber to use for energy. However, fiber helps us feel full longer which helps keep hunger at bay and blood sugars in check.

Fiber comes in two different forms:  soluble and insoluble. Soluble fiber can help lower blood sugar.  Foods with soluble fiber include apples, blueberries, oatmeal, nuts, and beans. Insoluble fiber helps keep your trips to the bathroom regular and prevents constipation. Foods with insoluble fiber include carrots, cucumbers, tomatoes, legumes, and brown rice.

Adults and children need 20-30 grams of fiber per day. Increase your fiber intake by:

  • Eating whole fruits instead of drinking fruit juice
  • Snacking on raw vegetables and fruits instead of chips or candy
  • Eating whole grain pasta, bread, and brown rice instead of white bread, white pasta, and white rice
  • Eat beans or legumes a few times per week

Try one of these ideas to increase your fiber intake:

  • Layer low fat Greek yogurt with ½ cup blueberries and 1 tablespoon chia seeds (7 grams of fiber)
  • Dip raw vegetables in ½ a mashed avocado (½ avocado has 6.5 grams of fiber)
  • Steam 1 cup of edamame, top with a pinch of sea salt (8 grams of fiber)
  • Make peanut butter & banana sandwiches: spread 1 teaspoon of peanut butter between 2 slices of banana (1 banana has 3g of fiber)
  • Make an apple donut: core an apple, then lay it on its side and slice in rounds. Top with peanut butter or Greek yogurt, then add chopped nuts, berries, or dried fruit.
  • Try a fruit pizza
  • Cut 1 head of broccoli into small pieces, toss with olive oil, salt, and pepper, and roast in the oven at 350 degrees for 15-20 minutes. (1 cup of broccoli has 5 grams of fiber)
Post content reviewed by Melanie Pearsall, RD, CDE
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Nutrition

Why pair carbohydrates with protein or fat?

Posted on by mghdiabeteseducation

By Lindsay Boland, dietetic intern

Blood sugar spikes
Changes in blood sugar levels over time 

Carbohydrates are the body’s primary source of fuel. When we eat carbohydrates, they are broken down into glucose (sugar) which gets absorbed through the small intestine into the bloodstream. Normally when sugar enters the bloodstream, insulin moves the sugar into our cells to where it is either used for immediate energy or stored for energy to be used later.

When you have diabetes, this process may take a little bit longer either because the body doesn’t make enough insulin or can’t use the insulin it makes properly. This leaves sugar hanging out in the blood stream for longer than it should. Therefore, when carbohydrates are consumed in large quantities, it often causes a spike in blood sugar.  Sometimes it may be necessary to take medications or insulin to help move the sugar out of the blood and into the cells.

The good news is we can help prevent these spikes in blood sugar by pairing certain foods together. Protein, fat and fiber require a little more work to be broken down than carbohydrates. This means these foods stay in our stomachs longer and take more time to enter the bloodstream. Pairing carbohydrate foods with a source of protein or fat and some fiber helps slow the absorption of the sugars into the bloodstream. This helps us maintain more steady blood sugar levels throughout the day, which allows our body to use these sugars appropriately for energy.

Snack examples:

CARBOHYDRATE PROTEIN/FAT
1 Medium Apple 1 Tbsp Peanut Butter
5 Whole Grain Crackers 1-2 Hardboiled Eggs
1 Cup Grapes 1oz Cheese
¾ Cup Berries 6-8oz Plain Greek Yogurt
2 Tbsp Dried Fruit 12-15 Almonds
Post content reviewed by Melanie Pearsall, RD, CDE

 

 

 

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Uncategorized

Be Fit Basics: Roasted Winter Vegetables

Posted on by mghdiabeteseducation

This recipe from the MGH Be Fit program is an easy way to enjoy seasonal vegetables.

Ingredients:
1 pound carrots, peeled and cut into 1-inch cubes
1 pound parsnips, peeled and cut into 1-inch cubes
1 large sweet potato, cut into 1-inch cubes
1 small butternut squash, peeled, seeded, and cut into 1-inch cubes
3 tablespoons olive oil
½ teaspoon kosher salt
¼ teaspoon black pepper

Instructions:
Set the oven to 425 degrees. Divide the vegetables between two sheet pans (space out in a single layer).  Drizzle equally with olive oil. Sprinkle with salt and pepper.

Roast until vegetables are tender (about 25 to 35 minutes), tossing them once with a metal spatula about halfway through the cooking process.

Note: Using two sheet pans, instead of one, will allow for even cooking. Overcrowding the pan will prevent the vegetables from caramelizing.

Yield:  8 servings

Nutrition Information per Serving:
Calories: 180 • Protein: 3g • Sodium: 200mg • Carbohydrate: 34g • Fiber: 8g
Fat: 5g • Sat Fat: 1g

Recipe adapted from Ina Garten
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recipes

Meatball Mummy Crescent Bites

Posted on by mghdiabeteseducation

trick or treat ghostCelebrate Halloween with this festive appetizer recipe from the Pediatric Diabetes Clinic

Kitchen Tools:

Knife or Pizza Cutter
Parchment paper
Large cookie sheet

Ingredients:
1 can (8 oz) refrigerated crescent dinner rolls
20 frozen cooked turkey meatballs, thawed
Ketchup or mustard
Marinara sauce (1 oz or 2 tablespoons = 4 gm Carb)

Directions:
Heat oven to 375 degrees Fahrenheit. Put piece of parchment paper on work surface (counter).  Unroll dough onto parchment paper, press out perforations to make one sealed large rectangle.  Cut into 4 small rectangles with knife or pizza cutter

Using knife or pizza cutter, cut each rectangle into 10 strips. You will have 40 strips of dough after all 4 small rectangles cut.

Wrap 2 strips of dough around each meatball to look like “bandages”.

Separate “bandages” near one end to show meatball “face”. Place wrapped meatballs on ungreased large cookie sheet.

Bake 13 to 17 minutes or until dough is light golden brown and meatballs are hot. With ketchup or mustard, draw “eyes” on mummy bites.

Serve warm with marinara sauce if desired.

Prep time: 15 min lTotal time: 30 minutes l Makes: 20 servings l Serving Size: 1 meatball l Carbs per serving: 7 grams

Recipe amended from Pillsbury.com/recipes
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Health

Back to School Tips

Posted on by mghdiabeteseducation

By Leah Berthold, RN, CDE
MassGeneral Hospital for Children Pediatric Endocrine Unit

Blank Chalk Board

Have you begun getting ready to send your child back to school?  As the beginning of the  school year comes closer, here are some important things to remember:

  • Make sure you have a current Diabetes Medical Management plan (school orders) in place before the first day of school.
  • Make an appointment with the school nurse to review the plan and bring all supplies needed to school before school starts. Meeting the nurse before school starts will help build a relationship and confidence for you, your child and the nurse.  Refer to the box below for a list of supplies to keep at school.
  • Be sure your child has a 504 plan in place. Review this plan every year.
  • Give the school a hypoglycemia or “low” box with glucagon/glucose tablets/juice or whatever you prefer to treat low blood sugar
  • Be sure all school personnel, including bus drivers and coaches, are educated about Type 1 Diabetes and know what to do for low blood sugar.

 

School Supplies Box

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Nutrition, recipes

Be Fit Basics : Mango Black Bean Salad

Posted on by mghdiabeteseducation

This easy salad recipe from the MGH Be Fit Program is a great use of the leftover grain from last night’s dinner. If you don’t have a cooked grain, substitute fresh or frozen corn kernels instead.  If you can’t find fresh mango, look for frozen cubed mango in the freezer section of your grocery store.  Dislike cilantro? Substitute another green herb, like parsley.

Ingredients:
1 mango, chopped and peeled (or about 1½ to 1¾ cups)
½ cup thinly sliced green onions (scallions), the white and green parts
½ cup cooked grain (use leftover rice, quinoa, etc.) or corn kernels
¼ cup finely chopped cilantro
2 tbsp fresh tomato salsa (or diced tomato)
1-15 ounce can low- sodium black beans, rinsed and drained
juice of 1 lime
2 tbsp olive oil
½ tsp salt (or to taste)
¼ tsp black pepper

Instructions:
In a large bowl, combine all ingredients and toss gently to mix.

Yield:  Serves 6

Nutrition Information per Serving (about 2/3 cup – nutrition information calculated with brown rice):  Calories:  160 • Protein:  5g • Sodium:  250mg
Carbohydrate: 27g • Fiber:5g • Fat: 5g • Sat Fat:1g

Recipe adapted from Cooking Light.  Originally posted on mghbefit.com
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Guest Post, My Story

My Story: Nothing Holding Me Back

Posted on by mghdiabeteseducation

By Anne-Maria

I’ve had Type 1 Diabetes for 49 years – next April will be my 50th diaversary.  When I was diagnosed in the 60’s/70’s, there wasn’t as much information about diabetes out there as there is now.  But still, having diabetes never held me back from anything I wanted to do.  I still travel, and I stayed out late in my 20’s and 30’s like any other young person would.  I strongly believe that diabetes is just a part of life.  The key is to accept it and make it part of your routine.

There are professional hockey players who have diabetes.  Gary Hall, Jr. has Type 1 Diabetes and he swam the 50-meter freestyle at the Olympics.  They didn’t let diabetes stop them; they made it work.  Put your sight on what you want to do and figure out how to do it (I just don’t know if they can send you into space yet).  People are happy to work with you if you talk to them about your needs.  When I was still in school, we went on ski trip to the Alps.  At the time, they didn’t have refrigerators in the hotel rooms so I stored my insulin in the one in the kitchen.  I got to know the kitchen staff pretty well and they were happy to accommodate me.  Nobody has ever said “no” when asked to help.

The only time my health factored into any of my life choices was when I decided not to become a physician.  Sleep is very important for me and I knew I wouldn’t be able to function with the little bit of sleep med students get.  But again, it was my choice based on what I needed to take care of my own health.  I know my body inside and out, so I know when something isn’t right and how to adapt.  When I have late meetings, I’ve learned to check my blood sugar and drink some juice before it starts so I don’t go low.

My biggest piece of advice for parents or anyone who has been diagnosed with Type 1 diabetes is:  take a deep breath and relax.  If you were diagnosed as an adult, know there’s nothing abnormal about what you have.  You can maintain your regular routine without much extra effort.  The only time I need to pay more attention to my blood sugar is when I’m sick.  I might have to take some extra time off from work to recover these days, but that could be because I’m getting older.

If you’re a parent, let your kids be kids.  Let them have fun at parties and eat a small piece of cake like the other kids (maybe take of some of the frosting first).  Don’t stress too much about what they eat.  You don’t have to make big formal meals.  Sometimes when I get home late I’ll have cereal and fruit for dinner.  Just use common sense and think about what you need to do to cover it with insulin.

 

 

 

 

 

 

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Health, Nutrition

Diabetes and A Healthy Microbiome

Posted on by mghdiabeteseducation

By Christina Badaracco, Dietetic Intern 

What Is the Microbiome?

The human microbiome includes all the bacteria, both good and bad, that live in our organs. There are actually about 10 times as many bacterial cells in the body as human cells! Bacteria play many important roles in keeping us healthy, such as protecting us from invading bad bacteria and breaking down (or fermenting) the fiber in foods like vegetables that our own bodies can’t digest.

Our microbiome includes many different types of bacteria, and more diversity is typically a sign of good health. Many diseases, such as diabetes, can reduce the diversity in our gut and create environments that are better for bacteria that produce substances that cause inflammation or other harmful effects.  In this figure you can see many of the things that cause the microbiome to become imbalanced (such as taking antibiotics or poor diet) and some of the health problems that might result.  The microbiome is such an important factor in our health that the National Institutes of Health have launched two versions of the Human Microbiome Project, granting hundreds of millions of dollars into research about the connection between changes in the human microbiome and disease.

Is there a Link Between the Microbiome and Type 2 Diabetes?

Type 2 diabetes can be caused by genetics as well as diet and lifestyle.  Eating a healthy diet (one with lots of fiber-filled fruits and veggies and low in sugar and saturated fat) and exercising regularly can help keep your microbiome healthy and might help reduce the risk of developing diabetes.  The short-chain fatty acids that good gut bacteria produce when breaking down fiber can increase your body’s metabolism and how quickly glucose in the blood is used up, which can help manage blood sugar.  A recent study showed that a diet rich in fiber could improve diabetes management because it produces the short-chain fatty acids the cells of our gut lining need to be healthy.  Fiber also reduces inflammation and keeps you feeling full, which helps with managing portion sizes and keep blood sugar steady after meals. The types of bacteria in the gut also shifted to the species that love a high-fiber diet, promoting health long into the future.

How Can I Feed a Healthy Gut Microbiome?

  • Eating a diet rich in fiber keeps your good bacteria happy. They break down molecules like cellulose found in fruits, vegetables, and whole grains.
  • Limit high-sugar and high-fat meals. Bad bacteria thrive when we eat a high-sugar and high-animal fat diet. Try to limit foods like sodas, candy, large servings of fast foods, sugary baked goods, red and processed meats.
  • Try to eat some foods with probiotics. Foods that are already broken down (or fermented) contain good bacteria that can colonize and thrive in our guts. As a bonus for people with diabetes, these bacteria have already broken down some of the glucose for you! Some examples of fermented foods include:
    • Dairy: cheese or yogurt
    • Bread: sourdough
    • Grains: injera (found in Ethiopian cuisine), idli (found in Indian cuisine), atole (found in Mexican cuisine)
    • Vegetables: sauerkraut, fermented pickles, curtido (found in Salvadoran cuisine) kimchi (found in Korean cuisine) and tempeh and miso (found in Japanese cuisine)
  • Your healthcare provider many suggest taking a probiotic supplement to increase your good gut bacteria, particularly if you have recently taken antibiotics.
Post content reviewed by Melanie Pearsall, RD, CDE
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