Nutrition, Uncategorized

Serving Up Satiety

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
Nutrition

Plant-Based Protein

Alexandra Regalado
Dietetic Intern

What is Protein and How Much Do You Need?
Along with carbohydrates and fat, protein is part of a balanced diet and is essential for life. Protein plays key roles in building and maintaining muscle, keeping the immune system working, regulating hormones, and healing wounds.  Protein is made up of compounds called amino acids. Some amino acids are made by your body, while others come from the food we eat. Amino acids that come from food are called essential amino acids. This is why it’s important to eat protein from a variety of sources, including plants!  The Recommended Dietary Allowance (RDA) for protein for the average adult is 0.36 grams per pound of body weight.  To find out how many grams of protein you need to eat each day, multiply your body weight in pounds by 0.36.

Sources of Plant-Based Protein
Protein is found in a number of plant foods.  While plants provide quality protein, they typically do not contain all of the essential amino acids. But, if you eat several sources proteins throughout the week, you will have no problem getting all the amino acids and nutrients your body needs. Some plant-based protein, such as beans and legumes, contain carbohydrates, so always check the nutrition facts label for grams of carbohydrate per serving and factor them into your meal or snack.

 Some Examples of Plant-Based Protein

  • Beans and Legumes: Black beans, chickpeas, cannellini beans, kidney beans, pinto beans, lentils
  • Nuts and Nut Butters: Peanuts, almonds, walnuts, cashews, hazelnuts, pecans, pistachios, pine nuts
  • Seeds:Chia, flax, sesame, sunflower, pumpkin, hemp, quinoa
  • Soy and Soy Products: Soy milk, edamame, tofu, tempeh
  • Meat Substitutes: Veggie burgers and sausages, seitan, faux “chicken” and “burgers”

 Benefits of Plant-Based Protein
Most plant-based proteins are naturally low in calories, saturated fat, and sodium; have no cholesterol; and are high in fiber, vitamins and minerals. The combination of protein and fiber helps to slow digestion so you feel fuller longer, and raises blood sugar gradually after a meal or snack (avoiding blood sugar spikes).  Many plant-based proteins are more environmentally sustainable and affordable than animal sources of protein, too!

Plant proteins can be incorporated into any dietary pattern. Vegetarian and vegan diets are especially high in plant proteins and are also rich in fruits, vegetables, and whole grains. The American Diabetes Association recommends plant-based eating patterns because they can help prevent and manage diabetes. Research shows plant-based diets are good at lowering A1C, blood pressure, cholesterol, and body mass index.  Studies have also shown that plant-based diets are helpful for losing weight and maintaining a healthy weight.  Including more plant-based meals in your routine, such as by following “Meatless Monday,” is a wonderful way to fuel up on more plant-based protein!

Ideas for adding Plant-Based Protein to Your Meals
Breakfast:

  • Sprinkle nuts and seeds on oatmeal or yogurt
  • Sautee tofu and veggies for a breakfast scramble
  • Spread hummus or nut butter on toast

Lunch & Dinner:

  • Use beans or lentils to make “meat” sauce
  • Add tofu or tempeh to a stir-fry meal or sandwich
  • Top salads or grain bowls with beans or edamame
  • Vegetable or black bean burger

Snacks:

  • Hummus with raw veggie sticks
  • Roasted chickpeas or edamame
  • Handful of nuts
  • Plant-based protein bar
 Content reviewed by Melanie Pearsall, RD, CDE
Nutrition

Easy and Delicious Ways to Eat More Fruits and 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
Health, Nutrition

Blood Sugar: What Does It Mean for Your Health?

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?

helthy-plate

 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

 

 

Nutrition, recipes

Beans, beans, the magical fruit…

By Kelsey Baumgarten
Dietetic Intern

What comes to mind when you hear the word “beans?” Maybe you think of chili, baked beans, minestrone soup, gallo pinto, burritos. Whatever you think about beans, you may not know how they are related to your health and blood sugar control.

While the old rhyme calls beans a magical “fruit,” they are, in fact, a vegetable! They’re part of a larger group of vegetables called legumes, which includes foods like black beans, chickpeas, lentils, and split peas. When counting carbohydrates, legumes should be counted as a starchy vegetable. However, if you can think of the rhyme, it may help you remember that a ⅓-cup serving of beans has a similar number of carbohydrates as a piece of fruit.

The more you eat, the more you toot…

Many people avoid beans because of their reputation for causing gastrointestinal discomfort. The gas related to eating beans is caused by the fiber and starches your body can’t break down. These are digested by the bacteria in your intestines.

The more you toot, the better you feel…

The fiber is part of what makes beans so good for you! Fiber can help lower your cholesterol and prevent constipation. Over time, your body will get used to it and you will notice less discomfort.

So let’s have beans at every meal!

You don’t need to have beans at every meal like the song suggests, but beans do make a great choice for balanced meals and snacks. Try swapping beans for some of your usual servings of pasta, potato, squash, and bread. You can even replace half of your starch with a half serving of legumes:

  • Eat a smaller portion of pasta, and add beans into the pasta sauce.
  • Mash black beans into a half serving of mashed potatoes.
  • Sprinkle beans on top of a thin-crust pizza
  • Add roasted chickpeas to your salad instead of croutons (just toss dry chickpeas in olive oil and salt, and broil until crispy— about 10 minutes)

Snacking on beans (15-30 g carbs)

  • 2 tablespoons of hummus or edamame dip + 6 whole grain crackers
  • ½ cup of lentil soup
  • ½ cup kidney beans, sprinkled with olive oil and Italian seasoning
  • ⅓ cup soy nuts + 1 piece fresh fruit

Don’t forget:
While legumes are a great source of plant protein, their carbohydrates will still raise your blood sugar. Legumes generally supply 15-20 grams of carbohydrates per serving. Be sure to check the nutrition label of whichever kind you are eating.

Beans can be a great addition to your diet. For increased fiber intake and heart-health benefits, aim to eat 3 or more servings every week. With so many nutrients per serving, they really are a “magical fruit”!

Did you know? You can use beans to make healthier baked goods and desserts!

Cannellini Carrot Muffins

  • BeanCarrotMuffin1 can* cannellini or kidney beans, drained and rinsed
  • 2 eggs
  • 2 tbsp canola oil
  • 2 tbsp molasses
  • ½ tsp salt
  • 1 ½ tsp cinnamon
  • 1 ½ cups grated carrots
  • ½ cup walnuts
  • ¾ cup whole wheat flour
  • ¼ cup oats
  • ¾ cup granulated sugar
  • 2 tsp baking powder

Preheat oven to 325° F. Grease a 12-cup muffin tin and set aside.

In a food processor, puree beans, eggs, oil, molasses, salt, and cinnamon until very smooth. Add carrots and nuts and blend on low speed until nuts and carrots are in small chunks. In a separate bowl, mix flour, oats, sugar, and baking powder. Add the bean mixture to the flour mixture and stir until just combined. Pour into the muffin tins and bake for 35-40 minutes.

*You can also use beans cooked from dry. 1 can = 1½ cups cooked beans.

Per muffin: 190 calories • 40g carb • 5g protein • 4g fiber • 7g fat

Black bean Chocolate Hummus
(who knew hummus could taste like dessert?)

BeanChocolateHummus
  • 1 can* black beans, drained and rinsed
  • 3 tbsp canola oil
  • 6 tbsp cocoa powder
  • 3 tbsp honey
  • ¼ tsp vanilla extract
  • ¼ tsp almond extract
  • 1 tbsp decaf coffee (or water)

Blend all ingredients in a food processor until smooth. Serves 8.

For a snack with 30g carbs, spread hummus over 2 graham cracker squares (1 full sheet), or use as dip for 1 serving of apple slices or strawberries.

Per serving (about 2 tbsp): 150 calories • 20g carb • 5g protein • 5g fiber • 7g fat

*You can also use beans cooked from dry. 1 can = 1½ cups cooked beans.

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

On Insulin and Weight Gain

By Eileen B. Wyner, NP
Bulfinch Medical Group

Eileen Wyner, NP

Does my insulin make me look fat? The answer to this question is …it might. That would make it the wrong answer because none of us want to take a medication that may cause weight gain, especially as maintaining a healthy weight is such a crucial aspect of good diabetes management. The purpose of this post is to discuss how insulin works and how it may affect your weight. I hope after reading this you’ll have fewer reservations about using insulin if it becomes necessary.

Maintaining a healthy weight is so important for general health and is particularly important for people with chronic diseases such as high blood pressure, high cholesterol, heart disease, arthritis, and diabetes. A healthy diet and weight may mean fewer daily medications or a lower dose of medications you still require. Many medications have the potential for side effects; diabetes medications are no different. Weight gain IS a possible side effect of insulin, but it may also happen with oral medications.

Let’s talk about insulin as a first step. It is, simply put, a lifesaving medication. Insulin was discovered in 1921 at the University of Toronto and has been extensively studied and improved upon since. The job of insulin is to move the glucose from the food we eat into our cells so they’re able to stay healthy and work well. It then takes the remaining glucose from the bloodstream and stores it so it can be used for energy later. People with Type 1 Diabetes are totally dependent upon this medication for survival as their pancreas does not produce insulin. People with Type 2 Diabetes can manage their disease many different ways: diet, exercise, oral medications, and insulin. Diabetes is a progressive and chronic disease that as yet does not have a cure. That is why so many people with Type 2 Diabetes will require insulin as part of their management over time.

Two common symptoms of poorly controlled diabetes are significant weight loss and excessive urination. The weight loss happens because stored fat gets broken down to provide enough fuel for bodily functions (heart and lungs, for example) to operate and maintain life. You may start to notice the numbers on the scale decrease, regardless of what you eat or drink. This is because calories consumed aren’t being properly metabolized but rather directly excreted with urination.

The treatment for extreme hyperglycemia is insulin therapy. The insulin corrects the high blood sugar, correcting the excessive weight loss in the process. The insulin is helping the body work correctly; it’s not causing new weight but rather replacing what was lost when the body was in crisis. It’s a sign the body is healing and starting to work more normally again. This is a good thing, but it can also be frustrating for people who struggle with their weight regardless of their level of glucose control. If your weight is still creeping up after your blood sugar is better controlled, there are probably other reasons for this and further investigation is needed.

Frequent episodes of hypoglycemia (low blood sugars) can cause added weight. I’ve discussed hypoglycemia in more detail in the past, but I want to review a couple of points now. Under eating, over exercising, and both oral medicines and insulin are potential causes of this frightening and potentially life threatening condition. Proper treatment is key, but it’s common for people to over treat low blood sugars because they feel so poorly and think more is faster and better. This is not the case, and the extra calories may cause added weight over time.  The strategy I encourage my patients to use is trying things like glucose tablets and gels for treatment more often than juices or regular soda because they are pre-packaged for the correct carbohydrate (15grams). It can be hard to measure out 4 oz of juice or regular soda when you are feeling so poorly and anxious during an episode of low blood sugar. I also strongly encourage all of my patients to see our RD CDE on a regular basis to review meal plans and make any adjustments as needed to assist with better weight control. It is also important to be as active as possible as any type of movement will decrease insulin resistance and improve weight and blood sugar numbers.

Insulin initiation is a daunting prospect for some. Many of my patients, especially those who are really struggling with their weight, have told me the fear of gaining weight is why they refuse insulin. I hope that my explanation helps to minimize this fear. So, this brings us back to where we started. Does my insulin make me look fat? I prefer to answer this way: It makes your body healthy so you look marvelous!!!

Health

Diabetes and the Brain

By Eileen B. Wyner, NP
Bulfinch Medical Group

Eileen Wyner, NP

I’m confident that I’m not the only one who frequently goes wild because I can’t remember where I put my T-Pass, or my wallet or gloves. I know I had them, but  can’t remember where I put them. Little memory lapses like these happen to everyone no matter  how old you are, and it’s  a pretty normal occurrence.  However, there is potentially another side that worries all of us:  When are these common lapses more than just that? When is it a signal that something is seriously wrong, like the beginning of dementia or Alzheimer’s disease?

Let me start by defining these two illnesses. Dementia is a syndrome caused by a group of brain disorders, Alzheimer’s disease being the most common cause. There is a loss of memory, language, and judgment which interferes with activities of daily living. Alzheimer’s is a fatal disease characterized by progressive worsening of these symptoms thought to be due to abnormal clumps of protein in the brain.

There have been studies conducted showing people with  Type 2 Diabetes have a higher risk of developing Alzheimer’s disease and  other types of dementia later in life, though the exact connection between these conditions isn’t well understood and is still being studied. (It still isn’t clear if people with Type 1 Diabetes have the same increased risk.) There are a few possibilities to consider, however. Type 2 Diabetes is a condition that means there is insulin resistance and insulin deficiency. Inadequate insulin means glucose can’t get from the bloodstream to the cells of the body that keep it healthy and working well. This can lead to damage of the blood vessels anywhere in the body, including the brain.  This damage may go on to cause a decrease in blood flow and even blockages of the vessels. This series of events can lead to vascular dementia.

Hypoglycemia (low blood sugar) has also been indicated as a possible cause of decreased mental functioning. Glucose is the main source of energy for the brain. When you have a low blood sugar, there isn’t enough available to fuel the brain which causes decreased brain function. There is also the possibility that frequent and prolonged hypoglycemia may cause some brain damage to the cerebral cortex (the outermost covering of the brain) and the hippocampus (area responsible for memory).

There is continuous medical investigation underway to better understand the disease process of both diabetes and dementia, and achieve cures for these diseases.  What I hope you will take away with this information is an understanding that there are steps that you can take to help stay as healthy with diabetes as is possible.  Good blood sugar control is the key.  Discuss your self-monitoring goals and HbA1C range with your health care provider at your next visit as these are different for every person.  Taking care of your health is the best holiday gift you can give to yourself and your loved ones.