Karen Chapman Novakovski - Associate Professor of Nutrition

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August /September 2006

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In This Issue

Diabetes - The Medical Perspective

Metabolic Syndrome: Why should you be concerned?

Metabolic syndrome is a set of risk factors that indicate a greatly increased chance to have a heart attack, stroke, or diabetes. Risk factors include being overweight (especially in the stomach area), high blood pressure, or high blood glucose levels. Taken separately, none of these risk factors would cause a doctor great concern, but combined, they indicate a person is twice as likely to suffer a stroke or heart attack, and three times more likely to die early.

What is Metabolic Syndrome? It is the presence of three or more of the following risk factors:

  • Waist-size over 40 inches in men, and 35 inches in women (measured just above the hips and around the navel).
  • Blood pressure above 135/80 mg/dl.
  • Blood triglycerides over 150 mg/dl.
  • High density lipoproteins (HDL) below 40 mg/L in men and 50 mg/L in women.
  • Fasting blood glucose levels >100 mg/dl.

It’s best to see a health professional to get these risk factors checked, as metabolic syndrome can be prevented. There are four main things you can do to lower your risk:

  • increase physical activity 
  • lower weight
  • improve your diet
  • eliminate harmful habits such as smoking.

Diabetes and Food

Make a plan and keep track of your progress when trying to reach goals for blood glucose maintenance or weight loss. A smart plan is one with measurable, achievable, and reasonable goals.

Trying to cut 1,000 calories per day and exercising for one hour is very difficult. Instead, lower intake by 200 calories and then gradually lower intake until the target goal is reached.

When your caloric goal is reached, work to maintain it daily. Consult with a dietitian on what your daily calorie intake and exercise targets should be. Keep a food diary as well. It is harder to reach for that cookie if you know you have to write down the 150 calories!

When counting calories, one should never consumer less than 1,200 calories per day, especially those with diabetes unless under close supervision by a doctor. A very low calorie diet could also cause your blood glucose to drop to dangerously low levels. “Dieting” and increases in physical activity should be done in terms of gradual changes so they become true lifestyle changes.

Exercise as a Part of Living

Exercise and Hydration

Physical activity and proper fluid intake are both very important for people with diabetes. Being properly hydrated is a good place to start.  Hydration is one of the keys to success in safely participating in physical activity. Regular physical activity should become a habit.  It  can also become a social activity that you look forward to.

Everyone should be familiar with the warning signs of dehydration and heat-related illness. Signs of dehydration include:

  • Extreme thirst
  • Dry mouth
  • Irritability
  • General discomfort followed by headache, weakness, dizziness, cramps, and nausea.

Recognizing the signs early may  decrease the severity of illness. If not corrected, dehydration can lead to serious problems that require medical attention. Purchase a water bottle and take it with you wherever you go.  Then drink up!

Recipes To Try

Southwestern Casserole (6 servings)

1-1/2 pound ground beef, at least 80% lean       
1 cup low fat shredded cheddar cheese
1/2 cup chopped onion 
2 cups water
1 (10-ounce) can enchilada sauce
3/4 cup skim milk
1 teaspoon oregano
2 cups instant potato flakes 
1 (11-ounce) can corn with green and red peppers, drained
1 (4.5 ounce) can chopped green chiles         

  1. Heat oven to 400°. In a skillet, brown ground beef with onion. Drain fat. 
  2. Add enchilada sauce and oregano. Mix well. Place in ungreased 2-quart casserole. Spread corn evenly over mixture.
  3. In a medium saucepan, bring water and milk to boil. Remove from heat. Stir in potato flakes. Add 1/2 cup cheese and chiles.
  4. Spread potatoes over corn. Sprinkle with cheese.
  5. Bake for about 15 minutes, until cheese is bubbly.

Per serving:

Calories 480
Fat  24 grams
Protein 31 grams
Calories from fat 46%
Carbohydrate 35 grams
Cholesterol 92 grams
Fiber 4 grams
Sodium 822 mg

Dill Potato Salad
6 servings

2 pounds potatoes                                           
1/2 cup reduced fat mayonnaise
2 eggs, hard-cooked and diced                         
1/4 cup reduced fat sour cream
2 ribs celery, diced                                           
1 tablespoon balsamic vinegar
1 medium red onion, diced
1 teaspoon Dijon mustard
1 dill pickle, diced                                            
1 tablespoon dried dill

  1. Cover potatoes with water in a large saucepan and boil for about 10 to 12 minutes, until just tender. Pour off water and peel. Cut potatoes into cubes and place in large bowl.
  2. Combine potatoes with eggs, celery, red onion, and dill pickle.
  3. In another bowl, combine the sour cream, mayonnaise, vinegar, dill, and Dijon mustard.
  4. Add to the potatoes and stir gently to combine

Per serving:

Calories 220 
Fat 9 grams
Protein 6 grams                          
Calories from fat 38%
Carbohydrate 28 grams
Cholesterol 75 grams
Fiber 3 grams                          
Sodium 320 mg

Medication Update

If you have diabetes, chances are you have a full medicine cabinet. You may take three to five drugs a day, and maybe more.  Taking multiple medications is not a bad thing – they all have a purpose.  Nevertheless, the risks associated with some can be confusing. The more medications you take, the greater chance you have for a harmful interaction.

Recent research has found that people with diabetes should not take the antibiotic Tequin (gatifloxin), according to Bristol-Myers Squbb Company. The drug maker has revised the label and sent a letter to physicians warning of the risks of high and low blood glucose. On its new label, Bristol-Myers says the risks apply not only to those with diabetes, but also the elderly and those with kidney problems. The drug is used to treat infections such as pneumonia and bronchitis, and also urinary tract, and kidney infections.

There are alternative antibiotics that don’t cause the same problems as Tequin.  The best thing you can do is ask your doctor about medication alternatives if you are being placed on antibiotics which may be called ‘gatafloxin’ or ‘Tequin’. Overall, understanding the risks and side effects of your medications, as well as compliance with any medication regimen is very important. Be sure you stick to your schedule and take the right dose at the right time. Ask questions of your doctor or pharmacist each time you’re prescribed a new medication.

News & Resources

American Diabetes Month: educational activities aimed at those diagnosed with diabetes, which is in November at www.diabetes.org/ADM .

Just for kids (and their parents): ‘Youth Zone’, at www.diabetes.org/youthzone).

The African American Program, which is a diabetes awareness program targeted to the African American Community, at www.diabetes.org/africanamerican ).

To find an ADA-recognized Education Program in your area, call 1-800-342-2383, or go to the web-site: www.diabetes.org/recognition/education .

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