I gotta tell ya folks, sticking to the diabetes recommendations is exhausting, especially when life gets busy. With Halloween festivities and a rapidly filling schedule I’ve found it tougher to stick with the recommendations this week.

I did overdo my official dinner carb budget on Halloween, but I did it in a planned and intentional way. I spread my carbs out throughout the evening and only exceeded my carb budget by 15 grams. And that’s okay. It’s another case against the “diet mindset”: the recommendations are not hard and fast rules and it’s ultimately your life – you get to decide when to push on the guardrails, how often, and how far. The results are yours to own.

It’s going to be particularly tough this upcoming week, as I’m adding in goals to move for 3 minutes for every 30 minutes of sitting, check blood sugars daily, give myself a syringe poke daily (to simulate an insulin injection), and take a daily vitamin (to simulate taking oral medication for diabetes). It is definitely feeling a bit daunting, and I am only committed to this for another week!

The mental and emotional burden of managing diabetes is very, very real and goes far beyond what I’m facing here. When I don’t meet the recommendations, my body compensates and I chalk it up as a “Whoopsie, I’ll do better next time.” While that mindset applies for someone who has diabetes, they have the additional awareness that ongoing “whoopsies” can really do them harm.

For all those with diabetes, I salute you. Your road is not an easy one to walk. The obstacles and struggles on your journey can lead to diabetes burnout , which happens to everyone with diabetes from time to time.

 If you do feel lost, overwhelmed, or depressed (people with diabetes are more likely to be depressed, and depression worsens control of diabetes), please seek out some support and resources. A great care team, support group, dietitian, or even resources at www.diabetes.org can really help bolster your spirit and help you navigate all those tough barriers. You are not alone!

Hey everyone! The American Diabetes Association just released new recommendations for physical activity for managing blood sugar and I figured I’d share them since I’m carb counting at the moment!

In addition to getting 30 minutes of activity most days of the week, they also recommend spending 3 minutes doing gentle movement for every 30 minutes you spend sitting. This helps send sugar from the blood into the cell and also improves circulation, which can be poor in people with diabetes.

Not sitting too long is a fantastic idea, but for me the biggest challenge is remembering to do it! I have heard about some apps that are designed to help you get up and move more often, so I think I’ll give those a shot this week to try it out. I’ll be testing out Move – Daily Activity to Stay Healthy that gives you specific little activities to do at regular intervals, and Stand Up! The Work Break Timer, which lets you select time intervals anywhere between 5 minutes and 2 hours while at work to remind you to get up and move.

Update: You can find my reviews of these two apps here.

I love pumpkin in the fall. Love it. Stereotypes be darned, I do not care. This scrumptious squash finds its way into curries, soups, muffins, cookies, pancakes, and steamers around my house as soon as the leaves start to turn.

Pumpkin takes a front seat in this seasonal smoothie that is filling, nutritious, and delectable. I started with the Pumpkin Pie Smoothie recipe here and modified it to boost the protein, control the carbs, and add some greens, because if you’re making a shake, why not add greens? You can’t taste them and it’s an easy-as-pie (…see what I did there?) way to get an extra serving of veggies.

Try it for a tasty breakfast that is (bonus!) carb-controlled, heart healthy, and contains servings from 4 different food groups.

Ingredients:

1 cup unsweetened vanilla almond milk (you can definitely use dairy milk but carb-counters be aware it will add about 12 grams of carbohydrate)

1 handful spinach or kale

½ cup pureed pumpkin

¼ cup light vanilla Greek yogurt

1/8 cup plain whey protein (I love the bulk whey protein from Winco!)

½ medium banana

½ tsp pumpkin pie spice

1 tsp honey (or your sweetener of choice)

Instructions:

1. Add almond milk and greens to blender. Blend for 30-60 seconds or until leaves have been completely blended and the mixture looks like green, frothy milk.
2. Add remaining ingredients. Blend until smooth. Enjoy!

Makes 1 16-oz serving. Contains 303 calories, 35.1  g carbohydrate, 14.6 g protein, 2.9  g fat, 0.1 g saturated fat, and 251 mg sodium. Includes 1 serving dairy, 1 serving fruit, 1 serving vegetables, and 1.5 oz protein.

So far, we’ve covered carbohydrate counting as the primary method of managing blood sugars. It is by far the most important nutritional factor to pay attention to. There are, however, other lifestyle factors that affect blood sugar and are critical to know.

If you have diabetes, have a family history of diabetes, or just want to promote health and prevent chronic conditions, check out the list below to learn about the types of things that can affect blood sugar aside from your diet:

• Stress – This one is HUGE. Stress of many kinds raises levels of a hormone called cortisol that raises blood sugar (1). It’s important to keep in mind here that stress is more than mental and emotional stress (bills, relational issues, busy schedules…you get the picture). It also includes physiological stress (think chronic pain, poor sleep quality and/or quantity, infections, illness, etc) that may not come to mind when we think of the word stress. It is important to make a priority of identifying effective methods of managing stress by addressing the roots of these issues.
  • Mental/emotional stress – The “best” methods of stress management vary for each person but good options include yoga, walking, meditation, deep breathing, and enjoyable hobbies. If you struggle with depression, anxiety, or trauma that causes ongoing stress, find a qualified counselor you trust to help you work through these very real and overwhelming conditions.
  • Physiological stress – Pursue the root cause of your physiological stress. If you suffer from chronic pain, discuss pain management options with your doctor (there are many options beyond pain pills!) or talk with a Registered Dietitian who is knowledgeable about methods of eating to reduce inflammation. If you have poor sleep quality, practice good sleep hygiene habits and consider asking your doctor to have a sleep study done (especially if you snore!) to see if you might have a potentially serious condition called sleep apnea.
• Physical inactivity – Our bodies are designed to move and groove. Doing so activates receptors to let more sugar out of the blood and into the cell to make the extra energy we need for all that movement. My favorite part about the benefit of exercise for blood sugar is that just 30 minutes of moderate exercise (brisk walking, dancing, swimming, biking – whatever you like!) can improve blood sugars for 1-2 days afterward (2). Talk about return on your time investment!
• Inflammation – Inflammation is a type of stress, so I could have included it under physiological stressors, but it’s such a big deal I felt it deserved its own bullet point. Type 2 diabetes is an inflammatory disease, and inflammation is one of the causes of the insulin resistance that is a precursor to type 2 diabetes. Reducing inflammation through exercise, anti-inflammatory eating, and achieving a healthful weight can significantly improve blood sugars (3).
• Medications – Certain medications can raise blood sugar significantly in some people. This typically resolves after they stop taking the medications, but not always. For people with diabetes, these meds raise blood sugars even farther. Taking these medications is not always avoidable, but if you’re concerned about your blood sugars, check the side effects on any medications you take and discuss them with your doctor.

1. Aronson, D. (2009) “Cortisol – Its Role in Stress, Inflammation, and Indications for Diet Therapy. Today’s Dietitian, 11(11). Retrieved from http://www.todaysdietitian.com/newarchives/111609p38.shtml
2. Colberg, SR, et al. (2010) “Exercise and Type 2 Diabetes: American College of Sports Medicine and the American Diabetes Association: Joint Position Statement.” Medicine and Science in Sports and Exercise, 42(12). Retrieved from http://europepmc.org/abstract/med/21084931.
3. Shoelson S, Lee J, & Goldfine A. (2006) Inflammation and Insulin Resistance.” The Journal of Clinical Investigation, 116. Retrieved from http://www.jci.org/articles/view/29069?search%5Babstract_text%5D=&search%5Barticle_text%5D=&search%5Bauthors_text%5D=&search%5Bfpage%5D=1793&search%5Bissue%5D=&search%5Btitle_text%5D=&search%5Bvolume%5D=116.

Have you ever been following a “diet” and then been faced with that darn thing called life?

Stress, donuts in the break room, or (like for me) date night can throw the best-laid plans out the window and then many people sit, riddled with guilt and feeling like a failure, wondering whether or not to throw their healthy goals out the window simply because they ate something their over-restrictive plan “didn’t allow.” That’s why I am all about focusing on including lots of nutritious choices, being aware of harmful foods and ingredients, and especially having a plan that includes the foods that make your life worth living!

Check out this great article written by a fellow RD about building a healthy relationship with food! I’m in agreement that the mental game of dieting and restriction can be just as destructive as poor eating habits!

“Yes, I’m a registered dietitian and I care deeply about nutritious, wholesome foods and eating. But I also wholeheartedly believe that there’s a time and a place for a treat.”
– RD Paige Smathers, quoted from KSL.com

Check out this haul from my first grocery shopping trip for Carb Counting!

Yes, we drink a LOT of milk at our house.

I think I’m going to like this particular meal plan that I am using because it offers more flexibility than other meal plans I have used in the past. It gives lists of sample breakfasts, lunches/dinners, and snacks and allows me to pick and choose the ones I like, as well as repeat meals to use leftovers, which definitely helps with some of the issues I have with meal plans in general (which I described here).

So I thought I’d start out by describing what carb counting is all about. As described here, eating too many carbohydrates at one time can raise blood sugar too high for someone with diabetes. First thing’s first: which foods have significant amounts of carbohydrates?

• breads and grains like rice, pasta, and oats
• beans and legumes
• starchy vegetables like potatoes, peas, and corn
• milk and yogurt
• fruit and fruit juice
• sweeteners like sugar, brown sugar, agave, syrup, honey and sugary beverages like soda and sports drinks

These are the foods we primarily “count” as we count carbohydrates. The specific goal for carbohydrate intake varies between individuals based on height, weight, gender, activity levels, and blood sugar control goals. If you have diabetes and don’t know how many carbohydrates you should eat, find a Registered Dietitian who can help you find out.

For me, my goal is going to be 45-60 grams of carbohydrate per meal and 15 grams of carbohydrate per snack, as well as meeting the recommended activity goal of 30 minutes of moderate exercise 5 days per week (This can really help blood sugars!)

To help make carb counting easier, something called a “carbohydrate portion” or a “diabetes portion” was introduced. This is basically the amount of any carbohydrate food that contains 15 grams of carbohydrate.

As you can see by my carbohydrate counting goals, they are in multiples of 15 grams. So basically, at meals I can select 3-4 “carbohydrate portions” and at snacks I can choose 1. I can then fill in the gaps with non-carbohydrate foods like meat, eggs, cheese, vegetables, nuts, or seeds.

Carb counting can be tricky, but with some practice, awareness, and strategy, most people with diabetes find that they can live a relatively “normal” food life. I’ll see if I can make it happen in these three weeks and, if so, hopefully I can pass some useful info on to you!

No matter how you say it, it’s serious. Diabetes is common and can wreak havoc on someone’s body, so I’m more than happy to spend some time focusing on this condition and how to manage blood sugars by counting carbohydrates.

For anyone who is looking for a review of what carbohydrates are or what they do in the body, check out this post. Carbs are the numero uno focus when it comes to managing diabetes and reducing risk of complications.

To understand how diabetes works, let’s go back to the house/insulin key/sugar explanation I wrote about here. Check it out because my upcoming explanation will likely not make sense if you’re not in on the metaphor. Let’s also bring my highly sophisticated representative drawing back for a second look:

 In people with diabetes, the sugar people are not able to get into the house, causing a buildup of sugar people in the streets. They get crowded and angry and start flipping cars, breaking windows, and rioting all over the place. It makes for a pretty hostile environment.

This buildup of sugar people in the streets typically happens for one of three reasons:

1. The person has an autoimmune condition that prevents the body from being able to make insulin keys at all. This is called Type 1 diabetes.
2. The person’s locks are all rusty and take a long time to open. While the lock and key are fumbling around, sugar people build up in the street. This happens for a variety of reasons including genetics, obesity, stress, and inflammation, among others. This is called Type 2 diabetes.
3. The person’s locks are temporarily rusty because of the effects of hormones associated with pregnancy. This is called Gestational diabetes and most of the time it goes away after the baby is delivered, though it does increase a woman’s risk of having type 2 diabetes later in life.

In order to keep there from being too many angry sugar people in the blood, nutrition recommendations include portioning total amounts of carbohydrates eaten at one time. In other words, we send sugar people into the street single file all polite-like rather than stampeding en masse. That is why, in support of my patients and anyone with diabetes, I will be counting and moderating intake of carbohydrates at each meal and snack starting on Monday. We’ll also be going over more specifics about what types of foods are carbohydrates.

There are several other things we can do to help keep the sugar people from building up and rioting – look for more info in upcoming posts!