Type 2 Diabetes = the Punishment, the Planning, and the Promise:
The PUNISHMENT:
In my almost 20 years as a Registered Dietitian, I have seen hundreds of patients with Type 2 diabetes and obesity, which we know from all the clinical research and experience, goes hand in hand. Over time, overeating causes a strain on the pancreas to produce enough insulin to cover the excess glucose (or carbohydrates/ excess calories) a person takes in, or there is an insulin resistance, where the cells stop recognizing the insulin and glucose remains in the bloodstream instead of getting into the cells for use as energy or storage as fat. The punishment in this case, is that hyperglycemia leads to other diseases, such as kidney disease, eye problems, heart disease, problems with circulation/ extremities, and for men, erectile dysfunction.
The PLANNING:
Having Diabetes requires a change in lifestyle, which many people find frustrating and challenging. Change can be good though, especially for people who are overweight, stressed out, unhappy with things in their life, and willing and ready for change. It often depends on how you view the change, especially when you weren’t expecting it. If you take it like a slap on the face, then you might not be receptive to it. There can be denial and resistance, you can hope it will just go away on it’s own. Or you can take it like someone is showing you a new way of doing things, like opening a window that hasn’t been open in 20 years, then wow, it’s a great chance to make positive changes and let the sunlight in.
Planning does take time and work. From planning how often you are going to eat, what you will have for breakfast, how many calories you are “allowed” and how you will space out your Carbohydrates, Proteins and Fats (the macronutrients), to more advanced planning like bringing snacks in your bag for the day, grocery shopping and prepping vegetables for the week on the weekends, looking at recipes for cooking, or menus in advance of eating out to see what options you will have available, this type of planning will make managing your diabetes easier in the long run.
The PROMISE:
Unfortunately I can’t make any specific promises like if you eat X you will lose Y pounds and not have diabetes anymore, but the research shows that for people who are overweight or obese and have Type 2 Diabetes, if they lose weight by watching their intake and engaging in physical activity, they can actually reverse or slow down the disease process. And I’ve seen it happen, where people lose weight, eat better, and feel better, have more energy, and are able to go off medications or prevent the need for medications.
If you are in a place of deciding which road to take, no matter how far you have been traveling, I encourage you to take the path of least resistance, the one your body desires. Open the window and see some suggestions on how to begin letting the sun shine in.
- Start writing down what you eat each day. You can do this on paper or online, using apps such as Go Meals, My Fitness Pal or Lose It! Get a scale and measuring cups for accuracy, especially if you are just starting out at tracking your foods. Get a calorie/ carb counter if you are doing this on paper, you will begin to see how many calories your favorite foods contain, and better options.
- Figure out your calorie needs. There are several tools to do this 1) the online apps have ones built so that will be easy, 2) if you are going the paper route then use the Mifflin RMR formula (also need to go online to do this just once), and 3) for last resort multiply your weight by 10 and then add your weight. This will be what you need per day so subtract from that 500 calories to lose about a pound per week or 1000 calories if you want to lose 2 pounds per week. If you are 250 pounds multiply by 10 = 2500 +250 = 2750 calories - 500 for a pound a week weight loss = 2250 calories. Don’t go below 1200 calories/ day for women and 1600 calories/ day for men.
- Figure out your meal plans for 3-6 meals/ day. How can you do it with 1500 calories/ day (for example)? 300 Breakfast/ 400 Lunch/ 500 Dinner and 300 for snacks. See what works best for you and your schedule, just don’t skip meals as this slows down your metabolism.
- Plan out your grocery lists and your meals. If you have time on the weekend to shop and make a few meals for the week, it will help you stay on your plan. If you eat out most meals, it will make sense to see what restaurants offer healthy choices.
- Food choices that fit best: lean meats and poultry, fish, low fat or non fat dairy, vegetables, fruits, whole grains (quinoa, slow cooked oats, barley, bulgar, sprouted wheat bread, low carb tortillas), good fats (olive oil, canola oil, nuts, seeds, avocado). Add seasonings like onions, garlic, lemon juice, pepper, basil, oregano, cumin, dill, cinnamon, other no salt/ no calories seasonings. Drink lots of water and other no or low calorie beverages.
- Foods to avoid: processed foods (cakes, cookies, crackers, ice cream), salty snacks (chips, pretzels, salted/ roasted nuts), fried food, fast foods, white sugar, white flour, salt and trans fats.
- Plan to do physical activity for 30 minutes/ 5 days a week. If you are just starting out, make sure you have medical clearance, and you may need to start with 10 minutes. The point is to start. And then add on as you can.
- Get help and support. Ask your friends and family for support. Join an online support group. Go to classes at your nearby office, clinic, hospital or university. There are tons of resources available, go to the public library and read (recipes, weight loss, health, diabetes). Call me to set up an appointment - you wouldn’t write up your own will, perform your own surgery, fix your own car engine, do your own taxes, design your own home, or fight your own battle in court - so why not hire an expert like me when it comes to your health, your diabetes, and your weight loss.
- Celebrate milestones. If you follow your plan for a week congratulate yourself, if you follow for a month, celebrate. Just don’t use food as a reward, try new rewards, like treating yourself to a massage, a yoga class, a ballroom dancing class, new shoes.
For more information, questions, or to shout out a victory:
I want to recognize you for your efforts and help you encourage others!
Carena Lowenthal, MS, RD, CDN
(917) 882-5033
