AUGUST 2014 – NEWSLETTER

Gearing Up for a New School Year!

By: Jessica Cook MS, RD, LD/N, CDE (Director of Education)

The end of the summer brings a season full of change and as many children are heading back to school, many people start planning for fall events and feel

an inherit urge for change as the season fades into fall. While all these changes are occurring and your schedule is filling up it is important to remember to think about yourself! Many people struggle with the idea of making time for themselves during the daily hustle and bustle of life, but if you

don’t make yourself a priority, you may suffer the consequences. Not taking care of oneself may lead to depression, feelings of becoming overwhelmed or may negativity affect your blood sugar control and/ or overall health. Here are a couple strategies to help put yourself back in the driver’s seat in your life:

1. Make a plan for exercise. Exercise doesn’t just happen when you are cramming activities into your daily routine. You need to plan for exercise! Think about which days and which time of the day works best for you and put it in your calendar just as you would a meeting or doctor’s appointment.
2. Prioritize activities. This way the most important tasks are completed first and you will have more time to complete tasks that are less important to help relieve stress.
3. Practice stress management. It is also important to include activities you enjoy in your weekly planner to help relieve stress as well. This could mean planning time to read a book, meet with friends or go see a movie. After all life is not as significant without the simple pleasures!

I hope this inspired you to make yourself the priority in order to relieve stress, control blood sugar levels and live more healthfully. Please enjoy this issue of Healthy Living with Diabetes written by our team of specialists to help you live healthfully while managing diabetes.

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Update on Obesity

By: Dr. Barry Horowitz

Let’s face it, we are in the middle of an obesity epidemic in the United States. The latest statistics tell us that there are approximately 111 million American adults who are overweight or obese. What is very concerning is that almost 90% of these people have at least 1 weight related risk factor for cardiovascular disease and almost 20% have 3 risk factors. For example, if you look at the curve of the increasing incidence of diabetes in the United States, you can superimpose in on the obesity curve. The bottom line is that being overweight or obese is a risk for heart disease in and of itself, but also because it increases the occurrence of other risk factors for heart disease.

At the cornerstone of treatment for weight issues are diet and exercise. However, patients are often not successful with lifestyle changes alone. The National Institutes of Health recommend that medications for weight loss can be used in overweight individuals with other risk factors for heart disease or in anyone who is obese (overweight is defined as a body mass index (BMI) of 27 or above
and obesity 30 or above). Bariatric surgery could be considered for patients with significant obesity, a BMI over 35 with other risk factors for heart disease or anyone with a BMI over 40.

The American Association of Clinical Endocrinologists recommends that medications to treat obesity should be used initially with lifestyle modification and should not wait until later. Until recently, there has been a lack of medications available for the treatment of obesity. Phentermine has been around for several decades (it was one of the original medications in Phen-Fen), but its effects on appetite suppression wane over time. Two new medications were approved over the past year for the treatment of weight issues, Qysmia and Belviq. Each of these has good evidence that they lead to significant weight loss by suppressing appetite. You can speak with your physician to see if they might be appropriate for you.

As far as surgery, this should obviously not be considered lightly. Several surgical procedures are approved for obesity. Lapband surgery is when a band is surgically implanted around the stomach which can be loosened or tightened, constricting the amount of food that the stomach can hold. The gastric sleeve surgery is where part of the stomach is removed so it then resembles a small hot dog. Finally, bypass surgery is when the stomach is size is surgically decreased and is then attached to the intestine below where it usually empties, bypassing a portion of the intestine so that nutrients cannot be absorbed. Each of these procedures has specific risks and benefits and should be discussed with your doctor if you are contemplating them.

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Losing Weight is Hard, Smart Phone Apps Can Make it Easier!

By: Monika Lambertson MS, RD, LD/N, CDE

Knowing your daily calorie goal is an essential part of losing weight. What I frequently find when counseling clients on weight loss is that most people have no idea how many calories they are eating. Since weight is determined by calories consumed vs calories burned, this information is essential for successful weight loss! If you consume more calories than you need, you gain weight. If you consume less, you lose weight. Even though you may be eating healthier, if you are still eating too many calories, you may not lose any weight.

Here’s where Smart Phone apps can help!

Using a food diary app on your iPhone or Android is an easy way to figure out how many calories you need to lose weight and to keep track of your daily calorie intake. There are lots of free apps available for download on your mobile device. The app will estimate your calorie level based on physical information and activity level and will calculate your daily calorie needs. Then it will subtract calories to give you an estimated daily calorie level for weight loss. A weight loss rate between ½ to 2 pounds a week is recommended. To lose one pound, you need to create a calorie deficit of 3,500. So to lose a pound a week, cut calories by 500 a day and over a week you will lose one pound!

Using a food diary app can help you:

• Discover what foods are providing the most calories in your diet. For example, 2 ounces of mixed nuts (about ½ cup) provides a whopping 400 calories, and ¼ cup blue cheese or ranch salad dressing 300 calories. Simply cutting back on foods that make up a large percentage of your daily calorie intake can have a big impact on weight loss.
• Make an informed decision when dining out. If your dinner meal selection tallies in at 1148 calories, you may be more inclined to eat only half or make a different selection altogether.
• Keep on track. If it is mid-day and you’ve already reached your daily calorie goal, you’ll be more conscious of what choose for dinner. Keep in mind that some days you may eat 300 more than your goal, some days you may eat 300 less. It’s your weekly average that counts!

As with any food diary, make sure to enter in the correct measurements of the foods you are eating. If you regularly underestimate your portions you may be eating more calories than you think. Make sure measuring cups and spoons are handy.

So whether you need to kick-start or ramp up your diet and fitness program, consider downloading a food diary app today. To learn more about an eating plan and calorie level that’s right for you, consider meeting with one of our Registered Dietitians. Make an appointment today!

Interested in meeting with a registered dietitian to customize your meal plan?

Here at Palm Beach Diabetes & Endocrine Specialists we are offer the opportunity to meet one on one with a registered dietitian to discuss ways you can choose the foods you enjoy, but still lose weight and achieve optimal blood sugar control. Our registered dietitians will customize a meal plan for you using your personal food preferences and weight loss goals. Plus our dietitians can teach you about which foods provide best blood sugar control and which foods to avoid. Most insurance plans cover medical nutrition therapy visits with a diagnosis of diabetes, so if you’re interested in setting up an appointment with one of our dietitians please contact our scheduling department at (561) 513-5100.

At Healthy Living with Diabetes we want to ensure that you are satisfied with all services received. We also would like your input on educational workshops that you would like us to offer, information you would like to read about in our Healthy Living with Diabetes Monthly or feedback on any workshop that you may have attended.

You can contact the director of education personally by email: jcook@PBDES.COM or leave a message at (561) 513-5100.

We Look forward to hearing from you!