Let’s Talk About Obesity and its Effect on Diabetes

According to recent information from the CDC (Center for Disease Control), “a shocking 40% of adult women are and 35% of adult men are considered obese in the United States”. In the past the rates were similar for both men and women but the rates for obesity in women started increasing at a faster rate in 2013. Dr. Yoni Freedhoff, an obesity researcher at The University of Ottawa, states “men have it easier since they are generally taller, burn more calories and are more muscular”. Women are also affected by different hormones such as estrogen and progesterone at different stages of their lives which can influence weight gain.

The American College of Endocrinologists is finally acknowledging that obesity is in itself a “diagnosis”. The FDA is becoming more involved each year with new requests being placed on the food industry including food manufacturers and restaurants. The new federal plan will include improved food labels, further examination of calories presented in larger type, updated daily values, changes in nutrients required, added sweeteners (both sugars and syrups), reassessment of serving size along with an update in footnotes. There is continued talk among state, local and federal governments discussing regulation of soda and junk food with possible added taxes.

The FDA just asked the food industry to “voluntarily” lower sodium content in processed and packaged foods. By 2018, the FDA will require food manufacturers to separate out “added sugars “on the labels and this will now show amounts of sucrose, dextrose, fruit concentrates and high fructose corn syrup. The American Heart Association states that “women should have no more than 6 teaspoons of added sugar and men no more than 9 teaspoons of added sugar per day”. This is for people without diabetes. Most American adults presently consume 2-3 times that amount daily.

With all the talk and assistance from the government to help us focus on improved eating habits, we still need to take responsibility and promote positive self behavior changes. We need to become self- empowered and finally take charge. As you know, there are no quick or easy fixes when addressing obesity issues and better nutrition but here are a few reasonable tips to help get you started with or without diabetes:

TOPS

Look into a program called TOPS, which stands for ‘Take off Pounds Sensibly’. This program was funded by The National Heart, Lung and Blood Institute. It included 65,000 American adults who participated in the program where ½ were able to take off 5% of their total weight from baseline. Research shows that a “5-7% weight loss may help diabetes control tremendously or even lower blood sugars back to pre-diabetes or normal A1C levels”. The most amazing part was that over 80-90% of these participants were able to keep the weight off for 7-8 years by continuing to attend KOPS, ‘Keep the Pounds Off’. It consisted of group meetings which were very affordable at a cost of approximately $92.00 a year. Check to see if there are TOPS/KOPS programs near you. You must become involved and stay involved for the best long term results. The program stresses that slower weight loss is better since the possibility of keeping it off increases and “to believe in you for the best outcome.”

Weight-loss Goals

Set goals around weight loss. Instead of saying “I need to lose 50 pounds in the next three months, set goals that are realistic such as “I will start to exercise by walking 2-3 days a week for a half hour and increase to 5 days a week” or “I will keep a food diary to see what I am actually eating”. This eventually leads to weight loss instead of focusing on a number. Focusing on a specific pound amount in a set time period usually leads to higher frustration levels and poor results.

Find Eating Triggers

Find triggers that make you want to eat. First identify the actual triggers. Is it boredom, stress, fear, anger, frustration, fatigue, happiness or something from your past? Many times it is difficult to actually identify the trigger on your own. It may require help from a therapist, physician, counselor, social worker or significant other. This may be the most difficult part since you may have never dealt with the emotional issues or you may not even know they exist. Try to think about what makes you “grab food” when you are not actually hungry. Many eating issues revolve around our thoughts and previous experiences.

Learn Food Techniques

Learn techniques to combat the triggers once you identify them. For example, when I counsel patients who are truck drivers then I know that speed and cost are concerns in their daily food decisions since they often stop at fast food restaurants or truck stops for quick bacon cheeseburgers, french fries and a Coke. My job is to help identify their possible triggers and help them make adjustments. I may suggest carrying a cooler with a sandwich, fresh fruit (which is easy to transport and easy to eat while driving), and a huge jug of water flavored with lemon or lime slices. I also suggest a few snack foods including a single serving of nuts and raisins or a pack of peanut butter crackers. This easy solution saves time and money and prevents them from eating a bunch of salt and saturated fat.

Keeping food on their truck may also prevent the possibility of suffering from hypoglycemia on the road. Each trigger does have a solution but it may take some soul searching to find the one that helps you. Another technique to reduce triggers could be cardiovascular exercise. According to a study at The University of Waterloo, “Cardiovascular exercise may activate areas of the brain that help you resist sweet and salty foods”. Getting outside instead of grabbing that piece of food may have more benefits than we know.

Healthy Habits for a Lifetime

Understand that the effort to maintain a new, healthy habit never really ends. If you finally reach your “goal weight” you may decide you can go back to your old ways with lots of “cheat days”. This leads to patterns of old behavior. I recently counseled a 547-pound man who wanted to have gastric bypass surgery so he could lose weight and then eat his way back up. It was suggested he not go for major surgery at this time with his present mindset. Although gastric surgery should be the last option for weight loss, it should be well thought out with the ability to make the necessary changes and attitudes towards food, keep them after surgery and for a lifetime.

Understand junk food science.

Certain foods, which may be considered comfort foods, keep us coming back for more. Sometimes there are specific reasons for these temptations and here are a few examples. Ice cream contains casein, a main milk protein. Casein “creates morphine-like molecules called casomorphins during digestion” which adds to the addiction of ice cream. Another possible additive reason is eating a big ice cream cone may signal being a kid again on a hot summer day and the attraction is simply just nostalgia. Our taste buds become more blunted with age and we often prefer complexity and depth of flavors.

Think about the new burger places which are adding competing flavors over and beyond just a burger with a slice of cheese, lettuce and tomato. New additions are truffles, creamed cheeses, rich mushroom sauces, and hot sauces with the addition of more and more fat, sugar and calories. Many burger places are offering “brisket burgers” which can be chock full of saturated fat. The soft white, bread buns are usually processed and have a high glycemic index which raises insulin levels and the need to keep eating.

Doughnuts have become more complicated and sophisticated with layers of tastes and flavors. Instead of a 150-calorie plain donut, we now have mocha, chocolate chip, pecan, swirl varieties filled with fruit jams and sprinkles. That is part of the junk food science. Donuts are both high-sugar and high-fat, are full of empty calories and can “tax your brain’s opioid receptors”. This overload can trigger dopamine which is a pleasurable neurotransmitter and cause a “sugar rush”. This only makes you want more. New 16-ounce or larger coffee drinks are in the same category. Rich coffee drinks filled with sugar syrups and flavored creams deliver a much different experience than plain, black, zero-calorie coffee. These added sugars and fats make you crave it.

There are so many factors that go into why, when and what we eat which may cause weight gain and the possibility of developing type 2 diabetes. Weight gain makes it more difficult to control diabetes if you already have it. Try these few tips to see if they may help you take charge of your weight, diabetes and better nutrition!

Have a question? Comment below or email me at RKleinman@adwdiabetes.com.


NOTE: Consult your Doctor first to make sure my recommendations fit your special health needs.

Roberta Kleinman

Roberta Kleinman

Roberta Kleinman, RN, M. Ed., CDE, is a registered nurse and certified diabetes educator. She grew up in Long Island, NY. Her nursing training was done at the University of Vermont where she received a B.S. R.N. Robbie obtained her Master of Education degree, with a specialty in exercise physiology, from Georgia State University in Atlanta, Georgia.

She is a member of the American Diabetes Association as well as the South Florida Association of Diabetes Educators. She worked with the education department of NBMC to help educate the hospital's in-patient nurses about diabetes. She practices a healthy lifestyle and has worked as a personal fitness trainer in the past.

She was one of the initiators of the North Broward Diabetes Center (NBMC) which started in 1990 and was one of the first American Diabetes Association (ADA) certified programs in Broward County, Florida for nearly two decades. Robbie has educated patients to care for themselves and has counseled them on healthy eating, heart disease, high lipids, use of glucometers, insulin and many other aspects of diabetes care. The NBMC Diabetes Center received the Valor Award from the American Diabetes Center for excellent care to their patients. Robbie has volunteered over the years as leader of many diabetes support groups.
Roberta Kleinman

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