Saturday, December 5, 2015

Diabetes Type 2: Facts & Lifestyle-based Treatments and Prevention

*Photo credit

The following information is about type 2 diabetes and describes how prevalent the problems is, who should get screened for the disease, and what you can do to prevent or treat it. 

The healthy lifestyle changes described here are healthy for everyone, not just those with or at risk of diabetes.

The great thing about healthy lifestyle changes is that they’re in your hands—no prescription needed! (Though, if you are diagnosed with diabetes and told to take a medication by your doctor, you should.)

Lifestyle changes can help those with diabetes cut down their need for many medications and are always a good idea unless you’ve been specifically told by a doctor not to make them.

I have also included a link to a patient handout that I created with the same information written below in case you’d like to print it out for you or someone you know. Any healthcare professionals reading this are welcome to print the handout and give to their patients free of charge and without asking permission. (If you do use it, please do send a message if you find it helpful!)

TYPE 2 DIABETES: Facts & Lifestyle-based Treatments

What IS diabetes: Diabetes refers to a group of diseases that cause your body to mishandle your blood sugar, resulting in high blood sugar. If left untreated, or not properly treated, high blood sugars can damage nearly all of the organs in your body.

Facts about Type 2 Diabetes:
  • Approximately 1 out of every 10 people in the US have diabetes,1 but
  • More than 1 in 4 people with diabetes (8 million people in the US) don’t know that they have the disease.2
  • Diabetes is the 7th leading cause of death in the US.2

The good news is that diabetes is treatable with a combination of lifestyle changes and other treatments prescribed by your doctor.

For some people diagnosed with diabetes early on, the disease can even be reversed with the lifestyle changes described below!

Who is at risk and should be screened for Type 2 Diabetes?3
  • 45 years old and older
  • Overweight or obese (Body Mass Index of 25 or greater)
  • Anyone with a first-degree relative who has diabetes
  • Those who do not exercise regularly
  • Women with a history of diabetes during pregnancy, who have delivered a baby weighing more than 9 pounds, or who have polycystic ovarian syndrome
  • High blood pressure
  • High cholesterol
  • Vascular or heart disease
  • Anyone with a history of elevated blood sugar or pre-diabetes
  • If you have excessive thirst, frequent urination, blurry vision, extreme hunger or unexplained weight loss. 

How do I get screened?
For most people, all that is required is a simple blood test—you don’t even have to be fasting.

Other conditions that people with Type 2 Diabetes are at risk of:

Heart disease
Vascular disease
Kidney disease
High blood pressure
High cholesterol
Nerve disease (neuropathy)
Eye disease
Bone disease
Sleep apnea
Hearing trouble
Fatty liver disease
Gum disease
Memory problems

Reversing Type 2 Diabetes & Preventing Complications with Lifestyle Changes
The lifestyle changes recommended to treat diabetes and prevent complications are the same healthy lifestyle recommendations for everyone. Enlist those you care about to make healthy lifestyle changes with you—everyone wins!

1. Eat a Healthy Diet

o   Make ½ of your plate vegetables and fruits (white potatoes don’t count)
o   Make ¼ of your plate whole grains
o   Make ¼ of your plate healthy proteins including beans, fish, nuts, or poultry.
o   Use healthy oils (those liquid at room temperature) and avoid trans fat found in partially hydrogenated oils
o   Drink water, coffee, or tea; skip sugary drinks; limit dairy to 1-2 servings per day.

2. Maintain a Healthy Weight
  • This means that a tape measure around your waist, at the top of your hip bones, across your belly button measures less than 40 inches for men, or 35 inches for women.
  • Alternatively, you can measure your height and weight, then input that information into this online body mass index calculator . A healthy body mass index is 18.5-24.9.

3. Engage in Regular Physical Activity
  • Minimum exercise recommendations are as follows, but you get more benefit by doing even more! 

o   150 minutes of moderate-intensity activity (e.g. brisk walking) per week —OR— 75 min. vigorous-intensity aerobic activity (e.g. running) per week
o   Strength training of all major muscle groups 2+ days per week

4. Don’t smoke
  • If you smoke or use tobacco ask your doctor, go to, or call 1-800-QUIT-NOW for help quitting. 
5. Moderate your alcohol intake
  • If you don’t drink, don’t start.
  • If you do drink, women should drink no more than 1, and men should drink no more than 2, standard-sized drinks per day (one 12 oz. can of beer, 5 oz. glass of wine, or 1.5 oz. “shot” of spirits).

1.  C Li, et al. Surveillance of certain health behaviors and conditions among states and selected local areas—Behavioral Risk Factor Surveillance System, United States, 2009. Centers for Disease Control. Surveill Summ. 2011 Aug;60(9):1-250.
 2. Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services; 2014.
3. DK McCulloch, et al. Screening for type 2 diabetes mellitus. Up-to-Date, Literature review current through Sept 2015.

Chef Michelle Hauser, MD, MPA © 2015

Monday, November 23, 2015

Substitutions to Make Holiday Recipes Vegan, Vegetarian or Dairy- and Egg-Free

Do you want to lighten-up your holiday dinner without sacrificing taste? 

Do you have a vegetarian, vegan, or someone with a dairy allergy/intolerance coming to dinner?

Try some of these tips to cut out dairy and other high saturated fat and cholesterol ingredients—essentially “vegan-ize” your meal.

Basic Tips:
  • Eating vegan just means that one is not eating animal-based foods like meat, dairy, seafood, and eggs. Since all cholesterol comes from these products, vegans eat a zero cholesterol diet! 
  • Vegetarians eat dairy and eggs, but no meat or seafood.
  • What about those who don’t want to be vegan? No problem—everyone’s health can benefit by eating more plant-based, whole foods. Most of the recipes I post are aimed at getting people to eat more vegetables, fruits, whole grains, and other plant-based foods that we know improve health.
  • If you are trying to vegan-ize recipes, the easiest recipes are those that only have one or two animal-based items and these items are not the key ingredients.
  • For dishes that do have meat, dairy, seafood, or eggs as main ingredients, there generally are ways to vegan-ize them, but those methods are either more advanced or use a lot of heavily processed plant-based foods to replicate animal-based food. However, I have given some recommendations for these processed items, based purely on taste, for those who would like to use them. I have only included widely-available brands. There are a lot of faux meat and dairy products out there that either taste terrible or don’t work well in recipes (or both!). 

Here are some quick tips on replacing some dairy and other animal-based foods in recipes:

Eggs: In baked items, an egg can be replaced with 1 Tablespoon ground flax seed mixed with 3 Tablespoons hot water. Alternatively, you can use a product called “Egg Replacer as directed on the package. Both methods only work for recipes with 1-2 eggs in them. Basically, don’t try this with angel food cake, which is mostly made of eggs.

Cream (aka. heavy cream): In items where cream is an ingredient, blend equal amounts of raw cashews and water together until completely smooth. Use as you would cream. This works for everything except whipped cream.

Milk: Silk Unsweetened SoyMilk yields the best results when substituted for milk in my experience, but you can use any unsweetened non-dairy milk (rice, almond, coconut, etc.). Beware that “plain” non-dairy milks often contain sweetener and are terrible in mashed potatoes or savory food. Make sure to find unsweetened. Plain versions are fine for using in dishes that you don’t mind being sweet.

Meat: it really depends on the recipe. If your recipe calls for a bit of bacon or sausage to flavor vegetables, just leave out and use a bit of olive oil instead to add the fat that you’d miss without the bacon/sausage. If you really want the smoky flavor, add a few drops of liquid smoke, though I won’t vouch for it’s health benefits or lack thereof. For items that are made up almost entirely of meat, you can find non-meat versions of sausage (both breakfast and link), turkey, lunchmeat, meatloaf, chicken breast, hamburger, cube steak, meatballs, and burgers on the market that taste great (but, are obviously very processed). Most are quite processed, but if you want recommendations on which taste the best, Field Roast and Gardein brands are generally good (I am not vouching for the taste of their other products). I have not found fake seafood products to be very tasty and would suggest you avoid them.

Butter: I use the EarthBalanceOriginal (the non-whipped version) or the Vegan Buttery Sticks. These have more salt than unsalted butter (the type often used in baking), so you generally have to leave salt out of your recipe if using more than a tablespoon or two.

Shortening/Lard: vegetable shortening is actually vegan but is often full of the most unhealthy thing you can eat—trans fat. I generally substitute either “butter” (as above) or unrefined coconut oil if a solid fat is needed. If liquid oil would work, I use canola, safflower, or grapeseed oils (all oils with little of their own flavor).

Cheese: Most cheese eaters will be disappointed with vegan alternatives. The exception I’ve found for eating straight out of the package is Field Roast brand Chao Cheese, which comes in three flavors (all good and not as heavily processed as many others). For shredded cheese that you cook in/on a dish, I recommend FollowYour Heart Vegan Gourmet Shreds; a runner-up is Daiya brand cheeses. Both of the shredded types are quite processed and are not passable for the real thing, but the best-tasting options widely available.

Cream Cheese: There are many on the market of varying quality, but the best-tasting is Tofutti Better Than Cream Cheese. If you can find the one with the yellow label it is made without hydrogenated oils and is much better for you than the white label one which does contain hydrogenated oils (trans fat). Again, this is quite processed.

Ice Cream: Try my recipe for Vanilla Bean Ice Cream! Otherwise, look for options that are not fat-free as these tend not to taste very good and be made up nearly entirely of sugar. Don’t be fooled by those ice “creams” that claim to have no sugar—they generally mean they have no white sugar, but can still be filled with other types of sugar. Cashew-based (and some coconut milk-based) ice “creams” tend to be less processed than soy, almond, and rice milk-based varieties.

Evaporated Milk: My pumpkin pie recipe uses Mori-Nu Firm or Extra-Firm Silken Tofu (this type is sold on the shelf in an aseptic package, unrefrigerated) in place of both the evaporated milk and eggs generally found in pumpkin pie recipes. This substitution doesn't work in all recipes using evaporated milk and/or eggs.

For full vegan holiday recipes, check out the following posts:

**I am not paid to endorse products, nor do I received free products, from any of the companies mentioned above. I am simply recommending what works based on my experience.