Nutrition Pair

Make That Change!

Happy Thanksgiving, Diabetes Style

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From our family to yours…we wanted to wish everybody a Happy, Healthy and Safe Thanksgiving!  This is the kickoff to the Holiday Season and as a person with Type 1 Diabetes, I am frequently asked how I handle eating during this time of year and still control my blood sugars.  My approach is simple.  First, I maintain my exercise program!  Exercise is part of the blood sugar control program. Second, I never say or let it be said, that I cannot have a certain food.  I do not forbid myself from eating anything.  I do continue to watch portion sizes and keep track of the amount of carbohydrate that I have eaten.  And, I check my blood sugars more often to help me identify how my body is reacting to the foods I’ve had.  Checking blood sugars allows me to better dose my insulin and maintain control.  Most importantly, I try to shift the focus from the foods to the people.  To me Thanksgiving is about sharing memories about the past year and looking toward the future.  Cherish the time with one another and enjoy the love, laughter and warmth the Holidays can bring.

It’s Your Health.  It’s Your Life.  Make That Change!

~ John

Keep National Nutrition Month Alive!

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So March is ending and with it the celebration of National Nutrition Month. Well, we don’t really let Nutrition Month ever end! We need to be alert and focused on our health at all times. That’s not to say we can’t enjoy our favorite “not so healthy” foods every now and then.

I bring this up to point out an interesting find Angie made. Angie was traveling this week and had to stay in hotels. She found one that had a freezer and microwave which would allow her to “prepare” her own meals and not eat out as much. She decided to find some healthy, single serve frozen entrees and add frozen vegetables to them to enhance the nutrition profile of the meal. Along with the added vegetables, Angie also added a piece of fruit to the meal. If you are not careful, using frozen meals will result in a high sodium, fat, and calorie meal.

Angie found some ninutrition monthce entrees to use and enjoyed them. She foundhow to read food labels the “Amy’s Gluten Free, No GMO, Cheese Enchilada, Made with Organic Tortillas & Tomatoes”, with other single serve frozen items and glanced at the Nutrition Facts. Once she got to her hotel room and started preparing her meal, she realized the small package was actually contained 2 servings! Instead of getting 440 mg of sodium, she consumed 880 mg. We generally counsel clients to keep sodium goals to 2000 mg a day or 500-600 mg per meal. While she did not exceed her overall daily sodium intake for the day by too much, that was an excessive amount for her at one meal. And for the record, no, Angie did not purchase the item because of the gluten free, organic ingredients and No GMO claims!

We often say that you can’t judge a book (or packaged food) by its cover. Unfortunately, its the cover that usually sells the book (or food)! So be alert when you shop. Have a plan and know what you are looking for in your meals. We’ve included a guide, Finding a Healthy Frozen Meal, Finding a Healthy Frozen Meal to help you choose frozen meals and stay within your dietary guidelines.

Keep celebrating Nutrition Month each day to help you reach the health you want.  Add in some extra activity and you’ll be on your way. Never forget, you hold the keys to better health!

It’s Your Health. It’s Your Life. Make That Change!

~John

Four Ways to Stay on Track with your Health & Fitness Resolutions

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It’s almost the end of January which means it’s a good time to check and make sure you’re staying on track with the health and fitness resolutions that you had in mind on December 31st.  How is your progress going?  If you have not yet been successful, you are not alone!

According to www.statisticbrain.com, 42% of those who make resolutions do not keep their resolutions.  But, there is some good news…if you are a regular resolutions maker, you are 10 times more likely to reach your goals that those who never make resolutions.  And, the most common resolutions are health and fitness-related:  to lose weight, exercise more and eat healthy.  So, what are four ways that you can be successful at keeping your health and fitness related resolutions? Read on:

  1. Resolve to make a plan!  No matter how well intentioned we are, if we don’t develop an outline or guideline, our goals may seem too elusive.  So, write down what you want to accomplish!
  2. Resolve to patient.  Many resolutions involve a long term commitment.  However, we get eager for the results before we put in the work to gain those results.  Give yourself time, but be accountable to your plan.  A great way to do this is to break down your goals into smaller, more manageable steps.  For example, if you want to exercise more, How are you going to exercise?  Where are you going to exercise?  How often or what days?  Are you ready to exercise?  Have clothes, shoes, facility available?  Are you comfortable exercising in group sessions or by yourself?  Asking and answering those questions can help you get more specific with your plan.
  3. Resolve to celebrate all successes, no matter how small or how big they may seem!  Recognizing successful change can sometimes be difficult.  That’s another reason why being specific with your goals and plan of action is so important. If you wanted to change the way you eat by adding one piece of fruit to one meal a day, celebrate the week of eating 7 pieces of fruit!  Change starts in small increments and carries on as you become more aware of that change.  So celebrate all success!  If you want to celebrate more, share your goals with a friend or work with a coach.  They can help hold you accountable to the process and help you truly recognize successes.
  4. Resolve to seek out high quality advice!  Don’t rely on methods that promise huge results without putting in work. Fad diets, supplements, and other “health” products are usually not the best way to progress.  Use the trained and licensed professionals you have access to: Registered Dietitians, Certified Integrative Health Coaches, and Exercise Physiologists. Always remember the saying, “If it sounds too good to be true, it usually is!”
  5. Bonus Resolution: Resolve to be forgiving!  While we may always need to be forgiving of others, we must also be able to forgive ourselves. Hold yourself accountable to making changes but don’t allow yourself to be held hostage by them. You’re going to have difficult times and setbacks as you work toward change.  It’s ok to hit a barrier but don’t let that stop you. Forgive yourself for not sticking to your plan but get right back to it.  Barriers are meant to strengthen you.  Find a way over, under or around that barrier. Then, celebrate your new found path for accomplishing your goals!

Remember:  It’s Your Health. It’s Your Life. Make That Change! 

Developing a Game Plan to Reach Your Health Goals!

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a-goal-without-a-plan-is-just-a-wishgame-planning-12-30-2016

Team up with a health coach for a winning game plan to reach your health goals!

The New Year is here! What does that mean for you and your health?  Are you one of the many planning to make resolutions and health goals for the New Year?  Let’s talk about that.  Change can be difficult to accomplish.  To set the stage, we need a game plan!  Like sports teams that have a goal to win championships, making health changes can be similar.  We have an “opponent” – the behavior we want to change. We have “practice” – the other times we’ve made changes. We may even have a “scouting report” on our opponent – what has worked or not worked when making changes in the past. If we have that information, we can make a game plan!

Our plan doesn’t have to be as in-depth as a game plan for a football team playing in the Super Bowl but we still need to have a plan.  The plan will help to provide guidelines of how to make changes.  The plan needs to include action steps that follow the SMART system…Specific, Measurable, Achievable, Realistic, and Timely action steps.  Write your plan  down and have it available to refer back to.  When we attempt change, we are bound to run into barriers and setbacks.  Having a plan helps you be prepared to face barriers and find ways over, under, around or through them.  Your health game plan needs to include contingency plans to help you use barriers as a springboard to greater things.  We can’t plan for all barriers but we can be prepared.  Hold yourself accountable to making changes but don’t allow yourself to be held hostage by them. If you run into a barrier, adjust your plan to get you back on track.  Don’t let that barrier be an excuse to stop! What may also help you drive through a barrier is working with a coach.  A health coach can provide you with accountability, guidance, motivation, celebration and cheer leading. A coach can also refer you to the professional services you may need to keep you moving forward.  They can help you identify different action steps or take a new perspective on a problem that may help you find a new approach.  Remember, you hold the keys to better health!

Warm wishes for a Happy, Healthy and Safe New Year!

It’s Your Health. It’s Your Life. Make That Change!

~John

World Diabetes Day 2016

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The month of November we celebrate Diabetes Awareness Month and tocdc-diabetes-infomatic-2014day is World Diabetes Day.  These celebrations are held to raise awareness of the disease and to help find a cure.  Those are great goals to celebrate. But let’s get personal.  What does diabetes mean to you?  With more than 29 million Americans, almost 1 in 11, having diabetes, chances are you or someone you know may have diabetes. Or, are you like the 1 out of 4 people with diabetes that are not aware they have it? How has diabetes affected your life?  We’d love to hear your stories, both good and bad, about diabetes.

Please share them with us!

It’s Your Life. It’s Your Health. Make That Change!

~John

Breastfeeding with a Dad

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Jonathan&Bayleigh 2003 Edited

Big brother checking out lil’ sis, 2003

Since my last blog about the importance of starting early on the road to good nutrition, I have received many questions about breastfeeding.  One that keeps recurring is, “You’re a dad.  Why are you so into breastfeeding?”  Well, lets get this straight.  I’m a Dad but not a Breastfeeding Dad, at least in the literal sense! The question I keep getting refers more to the inability of the father to provide the same type of nourishment mothers can provide.  While I can talk about the benefits of breastfeeding from a physical, mental and emotional state, it is true I can not talk about it from a personal state.  But, what I can talk about is how the father can benefit from and provide benefit to the nursing mother.  When our first child was born, there was no question that “we” would breastfeed. Being dietitians, many people expected that from us.  What we didn’t expect was the difficulty, frustration and anxiety that came with it.  It was our first child, so naturally, we were a little cautious about every thing. Because he gained weight slowly after we left the hospital, Angie worried about her breastfeeding techniques, was she making enough milk, was he not latching on correctly, should she just give up and go with formula?  Next came the problem of thrush, a fungal infection in the baby that can spread to the breast, making feeding painful.

Daddy with Jonathan 2001-First UVA Game Edited

First UVA football game~ 2001

Things eventually eased up and became much more enjoyable and manageable. As the father, and unable to truly share in the process, I did all I could to support and comfort Angie.  I knew she was tired and needed her rest so when the baby cried, I’d make sure I got up to get him.  That way, I could have a small bonding time with him, singing him the “Good Ol’ Song”…(yep, that song that you sing at Virginia football games when they score a touchdown!)…as we walked through the house to deliver to mom.  I’d put him back in his crib when he had finished his snack and made sure I changed diapers any time he needed it. I saw my role as Dad to provide the support for Mom.  That included, and still includes, cooking, cleaning, and doing laundry.  What it didn’t include was mixing formula, warming formula, checking formula to be sure it was not too hot, not too cold, but just right.  I didn’t have to clean up bottles, nipples, and other paraphernalia associated with using formula. Anything I could do to make things easier for Angie was what I wanted to do.  This is the team approach we have always subscribed to.  Plus, it teaches children that every person  has a responsibility in the family and we must all pitch in and do our part.

Daddy with Bayleigh 2004 Edited

Reading Elmo’s “Shall We Dance?”

All the difficulties we experienced with our first certainly made the second much easier to deal with.  We continued with the same pattern of assistance.  Most of the difficulties we had the first time around did not occur the second time. But now, having two little ones meant quadruple the responsibility and more fatigue. Keeping on top of things, providing support and encouragement helps to ease the frustration levels.  What a great learning experience.

I continue to recommend and discuss breastfeeding to all expectant mothers.  There are some mothers that can not breastfeed and others that choose not to. That’s fine.  You have to do what you can to help your child the best way possible. But at least have the discussion about breastfeeding with a health care provider.  Learn all you can about it.  And dads, provide the support that the mother of your child needs.
It may not be easy but parenting is not easy.  Teamwork is key!

It’s Your Health. It’s Your Life. Make That Change!

~John

Use Blood Sugar Monitoring for Health and Safety!

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Blood Sugars can be too low in older diabeticsNice response from Dr. Komaroff in answering a question from one his readers.  (Saw this in the Wednesday, August 17, 2016 edition of The Virginian-Pilot). Older people with diabetes definitely need to speak to their physicians about what target blood sugar levels should be.  While having chronically high blood sugars is bad over the long term, hypoglycemia, low blood sugar, can cause immediate problems!  You must treat low blood sugars with a sense of urgency. Blood sugar monitoring is important. As we age, our ability to feel low blood sugars can diminish.  Often, the older patient with diabetes may be taking multiple medications for a variety of health issues.  This too can inhibit the body’s response to recognizing low blood sugar levels.  Because of these issues, the recommendation is to allow blood sugar levels to run a little higher for this group.  Dr. Komaroff details that very well in his column.

But, I would take it a bit further.  To be sure of blood glucose levels, you must check!  Use a blood glucose monitor to track how your body responds to your diabetes medicine, dietary changes and activity levels.  For people with Medicare coverage blood glucose monitoring is approved for one glucose check a day, unless you are on insulin.  With insulin use, you are typically granted 3 times a day approval. Regardless of the coverage, if you are on hypoglycemic medications, it is extremely important to regularly check blood glucose levels.  Blood glucose monitoring can be an expensive part of your diabetes management program. But, it is a vital part! To make the most of your effort, keep a record of your results and be sure to take those results with you when you see your physician or diabetes educator.   Identifying trends in your glucose levels can help to provide better blood glucose management and keep you healthy and safe. Be an active participant of the health care team.

It’s Your Health. It’s Your Life. Make That Change!

~John

Celebrate August: Breastfeeding & KidsEatRight Month

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I believe the children are our future2We all want our children to be the best they can be. We want our children to be healthy, happy and safe. One way to make sure your child is prepared is with nutrition.  It starts an early age, a very early age!  August is National Breastfeeding Month and Kids Eat Right Month.  Both programs are geared towards helping to educate parents about the importance of nutrition throughout life.  I like that we celebrate both events together.  There is no question that breastfeeding your newborn for as long as possible will help to set a solid foundation for health.  Continuing healthy habits as your child ages will help to reduce their risk of chronic disease and illnesses.

The good news is that breastfeeding rates have increased according to the Centers for Disease Control. Recent data indicates that over 80% of newborns have been exposed to breastfeeding. Unfortunately though, the rates of mothers breastfeeding longer than 3 and 6 months remains low, 43% and 22%, respectively. While we are moving in the right direction, we still have a ways to go to capture the biggest benefits.  The American Academy of Pediatrics (AAP) recommends exclusively breastfeeding for the first 6 months.  After 6 months, addition of solid foods should be slowly attempted while breastfeeding continues for at least a year. For more information from the AAP, see their website here.

With the emphasis on people eating less processed, more organic food with reduced chemBreastfeeding Family 2016icals, it is surprising that we have not seen a jump in the length of time breastfeeding is provided.  Check out this interesting site which details the different benefits mom and baby can get over time with breastfeeding.  There are many different organizations that offer assistance with breastfeeding issues. Hospitals, health departments, pediatrician offices, and groups like La Leche League.  Many are offered free and will make home visits to help answer any questions or concerns a new mom may have. Be sure to check around and ask your physician to help you locate a breastfeeding program.  And dads, be a breastfeeding support system for the mother of your child.  While we can not personally breastfeed our babies, we can offer the love, encouragement, assistance and support that mom needs to be secure in choosing to breastfeed.

Remember, August is National Breastfeeding Month and Kids Eat Right Month.  Let’s help our children get a healthy start and keep them moving in the right direction!

It’s Your Life. It’s Your Health. Make That Change!

~John

 

Do You Consider Orange Juice an Energy Drink?

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Went grocery shopping the other day and was looking for my regular OJ.  Searching for pulp free without any added calcium or other stuff.  A new carton caught my eye.  Made by HomeMaker Premium, this OJ seemed different.  As you may know, I enjoy reading labels and analyzing what the label says and how it compares to the packaging on the front of the carton.  So, this product made me stop and read.  My first thought was, “What is OJ + Energy?”  Checking the carton, I soon realized the “Energy” was froHomeMakerPremium OJ+Caffeine Frontm added Caffeine!  Not what I was expecting from an Orange Juice.  OJ by itself provides you with enough calories in the form of carbohydrate to give you a tremendous amount of energy.  Why add caffeine?

What I did not immediately see, though, is anything telling me that caffeine had added.  Check out the front of the package.  See any evidence of caffeine?  What stands out to me is the sign stating HomeMaker Premium OJ+Energy Sign“100% Orange Juice”.  While it is 100% juice, caffeine has still been added and I’ve never seen caffeine in OJ  before.  And, the last time I checked, caffeine was not a NATURAL ingredient in oranges.  We normally buy the HomeMaker brand of orange juice because of the taste, the quality and the cost.  However, when seeing their new offering, I was disappointed.

The more I thought about this product and where it was located in the grocery store, the more concerned I became.  Would a patient with heart disease trying to eliminate caffeine from their diet recognize the added caffeine in this product? How about HomeMaker Premium OJ+Energy Warningsa child that drinks 12 ounces of OJ at time.  What happens there?  I was impressed to see that the company did add a warning box, highlighted in red, on the Nutrition Facts side of the box stating that children, pregnant or nursing women, and persons sensitive to caffeine should not drink it.

HomeMaker Premium OJ+Energy Caffeine content

They also took the time to complete a full side panel to compare the caffeine content of different beverages to the OJ with added caffeine.  However, I was still uncomfortable with seeing caffeine added to OJ and being promoted as a “Natural Energy boost”.  With the carbohydrate content in Orange Juice, it provides its own energy source and does not need an added punch to do that.  To “Wake up Naturally”, as the front of the package claims, does not have to require adding caffeine to OJ.

While I was doing research on this product, I found the contact information and decided to submit an email to offer my concerns about what I saw.  Within 20 minutes of sending the email, I received a phone call from the company. I was fortunate to be speaking with Mr. Brandon Saltmarsh, one of the family owners of HomeMaker!  He took time out of his day to call and discuss my concerns.  We spoke about why the company decided to offer this new product.  He stated that they are trying to offer a healthy alternative to the energy drinks flooding the markets.  I often discuss, especially with middle and high schoolers,  the problems/dangers of energy drinks, especially when they are marketed to teenagers!   He did ask me to take a look at the packaging and caffeine content for the energy drinks and the V8 Fusion + Energy drinks.  Interestingly, the products all contain about the same amount of caffeine, 80 mg for an 8 ounce serving. Mr. Saltmarsh’s contention was that energy drink manufacturers try to conceal the amount of caffeine in their products.  It is true, warning labels and caffeine content are more difficult to find on the energy drink packaging.  But, the difference between OJ and energy drinks is that I know what I’m looking for in an energy drink and what to expect.  If I go to the OJ section, I’m not thinking about  added caffeine…although, I guess I will now. HomeMaker Premium OJ+Energy Updated SignBut my feelings are that they don’t need to confuse the public by mixing the caffeine added OJ in with the regular versions.  One of suggestion was to add a statement indicating that caffeine has been added to the OJ.  Maybe a bit more prominent by adding it to the sign on the front of the container, like I did in the photo.

What it all boils down to is, you have to be aware of your food choices.  Use the food labels and the ingredient lists to help you find foods that will help you reach your health goal.  As we often say, no need to read food labels when you’re choosing fresh fruits and vegetables!  And when you choose juices, keep them to no more than 6 oz each day.  You’re better off eating fruit than drinking it!

I do want to thank Mr. Saltmarsh for taking the time to speak with me today!  I look forward to seeing how your new product progresses.  But C’Mon Man!  Do we have to have caffeine added to Orange Juice?

~John

It’s Your Health. It’s Your Life. Make That Change!

 

 

Diabetes ~ The Highs and Lows…

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Diabetes-The Ups and DownsA person with Diabetes will certainly tell you that it has its ups and downs.  Sure, having Diabetes can cause a ton of different feelings and emotions.  But the Highs and Lows I’m talking about today are Blood Sugar Levels.  The Highs and Lows.  Both are important and can have an impact on your overall health.  But, Lows can be even more problematic.  Hypoglycemia can cause a critical situation that might require the intervention of emergency personnel. To prevent that from happening, you must be aware of what your blood sugar levels are doing.  So, let me tell you a little story about last night (2.22.2016)….  I’ll show you my Blood Glucose log and actions taken:

7:21 pm BG: 118  Action: Ate dinner, took 12 units of NovoLog (Normal amount for meal eaten)

8:55 pm BG:  70  Action: Felt slight discomfort of Hypoglycemia. Drank 6 oz Juice

9:30 pm……………Action: Took Lantus Insulin ~ 22 units (Normal amount)

10:13 pm BG: 73   Action: Concerned that BG level was staying low. Drank another 6 oz Juice Box

11:15 pm BG: 49  Action: No symptoms of low blood sugar other than I could not sleep. 6 oz Juice Box

I was now worried that I had inadvertently taken 2 Lantus doses.  (That would not be good!)

11:33 pm BG: 66  Action: Ate protein bar and drank 8 oz of Soy Milk (31 g Carb, 19 g Protein)

(Still concerned that I may have doubled up on the Lantus.  I wanted to eat something with both Carbohydrate and Protein to help maintain BG levels.  If I had doubled dosed Lantus, it was going to be a long night. I would now be checking my BG levels throughout the night!)

12:47 am BG: 123 Action: Nothing. Set alarm to recheck BG levels in an hour

2:06 am BG: 105  Action: Drank 4 oz of OJ (Reset alarm)

3:33 am BG: 137   Action: Nothing.

4:44 am BG: 143  Action: Nothing (This is a normal wake up time. Would usually go to the gym)

6:45 am BG: 162  Action: Nothing

7:30 am BG: 177   Action: Breakfast. Normal B’Fast (NovoLog 8 units ~ this is a reduced amount. I wanted to see response to Carbohydrate and still unsure of double dosing of Lantus. It now appears as though I did not double dose.  Let’s see what happens!)

9:20 am BG: 283  Action: Added 3 units of NovoLog (Underdosed the NovoLog, need a correction.)

10:31 am BG: 300  Action: Nothing (Already had additional 3 units of NovoLog on board.  Don’t want to overload and cause hypoglycemia.  Will wait until Lunch and adjust NovoLog then, if necessary.)

12:45 pm BG: 128  Action: Lunch. Ate regular amount and took normal amount of NovoLog  (Had I taken more insulin at the 10:30 time frame, I would have dropped low prior to lunch.  Know how your insulin is supposed to work and what you need to adjust it to cover highs!)

Having Diabetes is no joke.  There are a number of things you need to be aware of.  One of my biggest worries is that I will take a double dose of Lantus.  For those of you not familiar with Lantus, like Levemir, is a long-acting (24 hour) insulin.  If you take too much of that, you will be fighting low blood sugars the whole day. NovoLog, on the other hand is a rapid-acting insulin.  It starts working in about 15 minutes and is typically out of the system within 4-6 hours.  Rapid-acting insulins (Apidra, Humalog & NovoLog) are usually taken with meals to help control meal time blood sugar rises. The long-acting insulins are designed to cover your basal insulin needs, the needs not associated with meals.

I have a system in place to help remind me that I have taken my Lantus dose for the night.  But, if you are not mindful of what you are doing, you can forget what you’ve done.  And that’s what happened to me last night.  Luckily, I have support from my wife that helped me through this event.  But what it also means is that I can’t take things for granted.  I need to stay on top of my game! Sometimes, we all need a reminder!  Now, we’ll have to figure out why my Blood Sugars were so low during the night……..

It’s Your Health. It’s Your Life. Make That Change!

~John

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Angela Lamberson, MS, RDN, LDN, CDE, Certified Integrative Health Coach

John Lamberson, MS, RDN, LDN, CDE

Phone: 252.335.WELL or 252.335.9355