Category: Uncategorized

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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Nutrition, Uncategorized

More Nutrition Myths Debunked

Posted on by mghdiabeteseducation

Sydney Bates, Dietetic Intern

There is a lot of conflicting information when it comes to nutrition. It seems that every day there is a new headline that’s at odds with everything we thought we knew. Despite emerging science, many nutrition myths are still prevalent. Here’s the truth about some common nutrition myths.

Myth: Egg yolks are high in cholesterol and should therefore be avoided
Fact: For decades, we were told not to eat eggs too often (and only the whites) if we wanted to be healthier and avoid elevated cholesterol. The latest evidence, however, shows that advice was scrambled. While egg whites are an excellent source of protein, the egg yolks contain most of the major nutrients including iron, folate and vitamins that support eye and brain health. The dietary cholesterol in eggs that was demonized for decades is now largely recognized by the medical community as having little effect on blood cholesterol. Overall, eggs contain a host of valuable nutrients, and focusing on the cholesterol content of eggs as a contributor to disease is not only counter-productive but false. Maintaining a balanced eating pattern with plenty of plant-based proteins and fats with the occasional animal product is the key to keeping those blood lipids at an optimal level.

Myth: Coffee is bad for you
Fact: The majority of studies on coffee have actually shown it provides protective effects against disease. Coffee is loaded with antioxidants, and has also been shown to help reduce the risk of developing diabetes in regular consumers. It’s likely the bad reputation comes from cream and sugar many people add to their drink. Adding sweetener greatly decreases this protective effect. To reap the most benefits, limit the amount of cream, milk, sugar, or artificial flavorings you add to your coffee.

Myth: You can eat as much “healthy” food as you like
Fact: The key to a healthy lifestyle is eating a variety of foods from all the main food groups. What this means is that just because the media touts avocados and kale as healthy “superfoods,” it doesn’t mean more is better; even healthy foods still need to be eaten in moderation. Ever hear of the saying, “too much of a good thing?” It applies to so-called healthy foods too. The body needs a certain amount of nutrients to function, and any excess is either stored as fat or eliminated. Plus, when you eat from only a small selection of foods, you miss opportunities to obtain vital nutrients from other sources. No one food contains all the macro- and micronutrients we need. That’s why it’s so important to view articles that promise things such as “eat as much of these foods as you want and never gain weight” with a critical eye. These headlines are designed to grab your attention using the allure of being able to eat all day long and never gain weight. To maintain health, eat a variety of foods, from all the food groups, in portions that are satisfying but don’t leave you feeling overly full all the time.

Myth: Gluten Free is healthier…and other labeling misconceptions
Fact: The term “health halo” is given to foods with a reputation for being better for you. They may have a special title or brand that is associated with being more nutritious, but this is not always the case. For instance, foods like smoothies, granola, organic snacks, protein shakes or foods labeled “organic” or “gluten free” are often thought of as being better options. The fact of the matter is that this is simply marketing and tailoring to consumer demand. Gluten is a protein found in wheat that has received a lot of attention recently. People with celiac disease or gluten sensitivity need to avoid gluten, but there is no need for the average person to eliminate gluten from their diet. As for organic foods, if you have the resources to purchase the “dirty dozen” (produce known to have high levels of pesticides) organic, wonderful. If not, you will not be losing out on any of the health-giving vitamins and minerals found in fresh produce. Learn more about the “dirty dozen” and “clean fifteen” and make an informed decision about which foods you will purchase organic. Overall, beware of falling for labeling traps and use your best judgement!

If you have questions about nutrition or your meal plan, speak with a Registered Dietitian to shed light on the evidence.

Post content reviewed by Melanie Pearsall, RD, LDN, CDE
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Nutrition, Uncategorized

Other Whole Grains

Posted on by mghdiabeteseducation

By now you’ve probably heard about the many health benefits of whole grains (and hopefully started making half your grains whole grains).  Brown rice, quinoa and whole wheat bread are some of the go-to whole grain options but there are many, many other kinds to choose from.  Here are some other types of whole grains to try.

Barley

Barley is a really good source of fiber.  In fact, it has the most fiber of all the whole grains.  Barley has been shown to help lower LDL (“bad”) cholesterol and keep blood sugar stable.  When shopping for barley, look for hulled barley rather than “pearled” barley.  Although pearled barley cooks much faster (about 30 minutes vs. an hour for hulled barley), pearled barley has had much of the bran scraped off.  Without the bran, it is no longer considered a whole grain.

Serving ideas:  Barley can be eaten alone as a hot cereal, used to thicken soups and stews, or as a substitute for rice.

Buckwheat

Like quinoa, buckwheat isn’t really a grain (it’s a seed).  It’s also not a type of wheat – it’s more closely related to rhubarb.  Buckwheat is high in protein and gluten-free, making it a good option for people with Celiac or other gluten sensitivity.  The kernels (called “groats”) cook in about 20 – 30 minutes.  If you’re short on time, look for toasted buckwheat groats (called “kasha”) which typically cooks in 15-20 minutes.

Serving ideas:  Cooked groats can be eaten alone in place of oatmeal, or added to salads or soups.  Buckwheat flower is used to make soba noodles.

Oats

Oats are a good source of fiber and are known to help lower LDL (“bad”) cholesterol and blood pressure.  Some different types of oats you may find in the store include oat groats, steel cut oats, and rolled oats.  The difference between each of these is how they’re processed.  Oat groats are whole oat kernels.  Steel cut oats are oat groats that have been cut into smaller pieces, while rolled oats are groats that have been steamed and flattened.  Processed oats cook faster, but here’s the good news:  all processed oats are still whole grains!  Even instant oatmeal counts as a whole grain, but read the nutrition facts label very carefully and choose brands that do not have a lot of added salt and sugar.

Serving idea:  Make up a batch of this Be Fit Power Granola for a healthy snack

One final thing to remember:  whole grains are still high in carbohydrate.  While you’re trying out new whole grain options, remember to pay attention to portion size.

 Content reviewed by Melanie Pearsall, RD, CDE
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Nutrition, Uncategorized

Serving Up Satiety

Posted on by mghdiabeteseducation

By Elizabeth Daly
Dietetic Intern

In today’s society, we are constantly tempted by food. Whether we are commuting to work, out with friends or watching TV at home, we are influenced by messages encouraging us to eat more. Living in an environment surrounded by food can make it challenging for people to make healthy choices, lose weight and manage their diabetes. There are many different weight-loss diets advertised in the media, but dieting often leaves us feeling hungry, deprived and ultimately defeated. How can we better control our intake without feeling the need to eat all the time?

Satiety is the feeling of fullness that comes after eating. If we feel satiated after a meal, we are less likely to snack between meals or eat large portions the next time we sit down to eat.  Learning how to feel more satiated after a meal may help us better control how much we eat, aid in weight loss and better control blood sugar levels.

Feeling satiated takes time, often up to 20 minutes after eating a meal. It is controlled by a number of factors that begin once we take our first bite of food. When we eat, our stomach expands, we begin absorbing and digesting nutrients and the brain receives signals that lead to feelings of being full.

Not all foods produce the same level of satiety. Here are a few tips to help you feel fit and full:

  1. Add lean protein to meals and snacks

Adding protein to meals or snacks helps keep you full for longer and control blood sugar levels. Meals that only contain simple carbohydrates are digested quickly, spike blood sugar, and make you feel hungry again soon after.

~Ex.  1 oz low fat cheese or ¼ cup hummus or 1-2 tablespoons peanut butter or 1 oz nuts

  1. Add fruit and vegetables to meals

Fruits and vegetables are high in fiber and water.  Both of these help you feel full. They are also good sources of important nutrients and contribute to overall good health.

~Ex. Add a side salad with meals, add berries to cereal or yogurt, add vegetables in soup

  1. Limit sugary beverages

Sweetened beverages are high in sugar and calories but low in nutrients. They do not cause your body to feel as full as solid foods do, and can lead to spikes in blood sugar and weight gain.

~Try swapping sugar sweetened beverages with water at meals to curb your hunger!

 Content reviewed by Melanie Pearsall, RD, CDE
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Health, Uncategorized

Standards of Medical Care in Diabetes 2017 (Part 2)

Posted on by mghdiabeteseducation

Eileen B. Wyner, NP
Bulfinch Medical Group

Eileen Wyner, NP

This week is part two of my review of the revisions to the 2017 American Diabetes Association Standards of Care (click here to review Part 1).  First, a quick reminder that these are guidelines; always discuss questions about your personal health care plan with your health care provider.

Section 6: Glycemic Targets

The International Hypoglycemia Study Group has recommended that serious, clinically significant hypoglycemia be defined as a reading of less than 54 mg/dL. People who have experienced such measurements need to notify their health care providers immediately and be prescribed a glucagon emergency kit.

Hypoglycemia measuring less than 70 mg/dL is still treated by the rule of 15: 15 grams of fast acting carbohydrate with a blood sugar check in 15 minutes for an expected increase by at least 15 points. Repeat the process if the result doesn’t improve.

Section 7: Obesity Management for the Treatment of Type 2 Diabetes

The best blood sugar results occur with weight loss early in the management of Type 2 Diabetes, before beta cells begin to stop working. For this reason, metabolic surgery (formerly referred to as bariatric surgery) is now recommended for people with a BMI of 30 (or 27.5 for Asians with poorly controlled diabetes).

Section 9: Cardiovascular Disease and Risk Management

Any of the medications for managing high blood pressure can be used (except for beta blockers) as long as the person doesn’t have protein in the urine (albuminuria). One or more medications should be used at bedtime to improve blood pressure control.

The goal for blood pressure for pregnant women is 120-160/80-105.  When prescribing medications, providers should consider both maintaining the health of the mother and avoiding harm to the baby.

There is a discussion of new medications and the potential benefits for people with diabetes and cardiovascular disease: empagliflozin (Jardiance) and liraglutide (Victoza).

Section 10: Microvascular Complications and Foot Care

There is an increased risk for retinopathy in pregnant women with Type 1 or Type 2 Diabetes.  Thorough eye exams should be a part of preconception counseling as well as during pregnancy.

Anyone being treated for neuropathic pain should be evaluated for the addition of medication therapy with pregabalin (Lyrica) and duloxetine (Cymbalta). They should also be fitted for therapeutic footwear by a podiatrist.

Section 12: Children and Adolescents

Preconception counseling should begin in puberty to help to avoid the risk for birth defects in unplanned pregnancies.

When diabetic ketoacidosis appears in children, it is important to know if the child has Type 1 or Type 2 Diabetes as 6% of these cases are actually Type 2 Diabetes, not Type 1.

Section 13: Management of Diabetes in Pregnancy

Insulin is the preferred treatment for pregnant women.  Oral medications may harm the baby.

Targets for blood sugar are the same for gestational diabetes as for preexisting diabetes.

Section 14: Diabetes Care in the Hospital

It’s now recommended to use basal and/or basal bolus insulin regimes (instead of sliding scale insulin alone) when patients are admitted to the hospital.

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Nutrition, Uncategorized

Eating Healthy on a Budget

Posted on by mghdiabeteseducation

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.

  1. 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.
  1. 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.
  1. 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.
  1. 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.
  1. 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!
  1. 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!
  1. 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.
  1. 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.
  1. 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.
  1. Take advantage of sales and coupons. Stores frequently have deals on fresh, canned and dried foods.
  2. 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.
  1. 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
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My Story, Nutrition, Uncategorized

My Story: Gaining Confidence in the Kitchen

Posted on by mghdiabeteseducation

By Kait

I never used to cook at home. In fact I HATED cooking. I had no confidence in the kitchen and burned everything, even toast. Time was another reason I didn’t cook often. I always thought cooking a meal had to take a ton of time; I really just wanted my food to appear in front of me. At the same time, I wanted to eat healthier but had no idea where to start or what to do with things like vegetables and spices. Then a coworker mentioned she had signed up for Plated [a subscription meal service] and suggested I give it a try. It sounded like an interesting concept, so I went for it.

What I like most is that it saves time and effort. Everything you need to make the dish is included and portioned out for you. Some recipes use ingredients I never would have bought on my own because I didn’t know how to use them, so it’s a great way to try new things. I also discovered that cooking doesn’t take up as much time as I thought. We typically cook at home 3-4 times a week (usually dinner). We’re definitely eating as a family more often, and I enjoy getting to spend time with loved ones while preparing meals.

We’ve been using Plated for about a year now and I feel much better about my cooking skills. I know if I made a recipe once I can do it again. You get to keep the recipe cards, so we’ll usually do a little experimenting the next time we make the dish. I’m eating healthier now, too. Before, I never really ate vegetables (or if I did they were just raw). I’d go into the grocery store and see all these wonderful looking vegetables but feel intimidated not knowing what to do with them. Now that I have a better idea how to cook them, I include vegetables with my meals often.

I recommend signing up for something like Plated if you don’t have much confidence with cooking. The recipes are easy and they tell you about how much time it takes to make. You’ll learn how to cook new things and different types of vegetables. My parents actually signed up for another meal delivery service, Blue Apron, because of my experience with Plated.

 

 

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Guest Post, Uncategorized

Navigating Health Information on the Web

Posted on by mghdiabeteseducation

Jen Searl, MLS, CHWC

If you’re like the majority of Americans (over 60%), you use the internet to find health information. And why wouldn’t you? The internet is full of answers to any question you could possibly have. However it’s important to remember that not all websites are created equal. Just because you read something on the internet does not mean that is true! Read below for things to look for when evaluating health websites.

  • Source: Who is the owner of the website? For example, is it a non- profit, federal government agency, pharmaceutical company or other? Often the ‘About’ section on a website will give you this information.
  • Bias: Is the website trying to sell you something? Is it difficult to tell what an advertisement is and what is fact?
  • Quality: Where does the information come from? Is it based on solid research or personal experience?
  • Date: When was the website last updated? Is the information current? Are there broken links?

You can tell a lot about a website from how it ends:

.gov = This website is owned and operated by the government. An example would be medlineplus.gov, an excellent source of health information

.org =This website is owned and operated by an organization. When looking for diabetes information, a great reputable source of information is the American Diabetes Association at www.diabetes.org

.edu = This website is owned and operated by an educational institution, such as a college or university. An example would be www.health.harvard.edu, a division of Harvard Medical School

.com = This website is owned and operated usually by a commercial site. When looking at .coms, use the tips above. Some websites, like ours www.mghdiabeteseducation.com is a great source of health information! Others can be less reliable so use your judgment.

If you ever wonder if information you have read is true, make sure to talk with your diabetes educator. They know you and your diabetes best!

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Nutrition, Uncategorized

Trans Fat: What is it and Why Should I Avoid it?

Posted on by mghdiabeteseducation

Alison Bliven, Dietetic Intern

What is it?

Trans fat has been used since the 1950’s in order to add certain tastes and textures to packaged and prepared foods while also increasing their shelf life. These fats naturally occur in small amounts in some animal products and oils, but the product used in processed foods is man-made and differs slightly from the naturally found substance. Hydrogen ions are forced into oil in a process called ‘hydrogenation’ which turns the oil into a solid. This product is called partially hydrogenated oil (PHO for short) and is filled with trans fats. This PHO is what is used in place of butter or oil in a variety of processed foods in order to keep them fresher longer.

Why is it bad for me?

For half a decade trans fats were included on the Food and Drug Administration’s (FDA) Generally Regarded as Safe list. However, more recent studies have linked the consumption of trans fats to increased risk of coronary heart disease: by raising ‘bad’ cholesterol (LDL) and lowering ‘good’ cholesterol (HDL), trans fat contributes to the buildup of plaque in arteries which can lead to heart attack. Insulin resistance, a sign of Type 2 Diabetes, has also been shown to have strong connections with trans fat intake.

What foods contain trans fat?

Trans fats naturally occur in meat, dairy, and some oils. The amount of trans fats found in these sources make up an insignificant part of the American diet and are not considered a health concern. The majority of trans fats come from processed foods.  For example:  crackers, cookies, cakes, frozen pies, microwave popcorn, stick margarine, coffee creamer, biscuits, cinnamon rolls and ready to use frosting. Luckily, the number of foods containing trans fats is decreasing, and should soon be nonexistent.

What is being done to protect us?

As mentioned above, studies have overwhelmingly shown a direct connection between trans fats and certain negative health outcomes. This evidence has led to the FDA passing laws that will phase trans fats out of food manufacturing completely. The first step in this process is including the content of trans fats on the nutrition label. This allows the consumer (you) to know what the product contains, to an extent. Food companies are allowed to put ‘0 grams trans fat’ on their labels if the product contains less than 0.5 grams per serving. There are two problems with this: 1) foods with small amounts can add up to a significant intake when more than one serving is eaten and 2) the Institute of Medicine has concluded that there are no safe levels of artificial trans fats in the diet. Even though the FDA is attempting to preserve Americans’ health, there is only so much it can do during the lag time before trans fats are outlawed completely.

What can I do?

Read the label! Look for products that include the phrase ‘trans fat free’ – by law these products can contain no trans fats. Also, scan the list of ingredients for words such as ‘hydrogenated oils’, ‘partially hydrogenated oil’, ‘PHO’, and ‘vegetable shortening’. If the food contains any of these ingredients, there is sure to be some amount of trans fat in it. Other tips include choosing liquid oils or soft tub margarine over stick margarine, and avoiding or limiting commercially baked foods and packaged snacks. Filling up on foods naturally high in fiber (whole grains, beans, peas, fruits, vegetables) means there will be less room for foods containing trans fats and will help promote general health as well.

Remember, Trans Fat Free ≠ Healthy!

One very important takeaway from this article is that just because a food is trans fat free or has very low trans fat, it doesn’t automatically make the food well-balanced or healthy! Limiting trans fats is just one component of a healthful diet that includes lots of fruits and veggies, a focus on whole grains, and limited intake of higher fat meats and dairy products.

(Post content reviewed by MGH Department of Nutrition and Food Services)

 

 

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Fitness, Uncategorized

Use the Force (for Fitness)

Posted on by mghdiabeteseducation

By Chrisanne Sikora, Sr. Project Specialist
Diabetes Self-Management Education Program

Chrisanne headshot

Chances are “okay grab your lightsaber, get ready to move” is not something you’d expect to hear in a group fitness class. Gyms and health clubs often run special promotions after the holidays when many people begin setting up new fitness routines. Last week when I read an article about one of the nearby gyms offering a free class inspired by the new Star Wars movie, I thought it sounded a little silly but also like it could be a lot of fun. I figured why not? and called to sign up.

After we’d picked out a lightsaber and chosen our spots the instructor, Cassie, explained the class was designed around the idea of circuit training. We’d learn a sequence (or “circuit”) of about four exercises that we would do for a minute each. After we’d done each sequence three times, we’d start over with a new sequence. Cassie showed us the first sequence while a dance remix of the Star Wars theme played over the speakers, and we were off.

I couldn’t help but giggle along with the woman next to me as we swung our lightsabers side to side while doing lunges. Aside from thin disks used to slide our feet along the floor (and of course a toy lightsaber), there was no equipment used in the class. Most of the exercises were versions of basic moves like squats and push-ups that use bodyweight as resistance. Even so, the class was more challenging than you’d think! By the time we started our second sequence you could see several people were already getting tired – and we still had another whole sequence to go!

The second and third sequences were more challenging than the first, but Cassie always gave us the option of going back to an easier move if anything became too difficult. By the end of the class everyone was tired, sweaty, probably a little sore, but smiling. On the way out, I chatted with a couple of classmates about what we’d expected going in and how much fun the whole experience was. Maybe if we take the class again we’ll be able to float rocks with our thoughts.

The two key things I took away from the class were:

  • You can get a really good, challenging workout with using just your bodyweight. No equipment (or even a gym!) required.
  • The most important part of any routine is making it FUN. If you’re not enjoying yourself, it will be hard to stick with it.
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