Prediabetes in Depth

While not as serious as frank diabetes, prediabetes is, nevertheless, dangerous and common: 1 in 3 adults in the US has prediabetes and most of these people are not aware of it (unless their blood sugar or A1c has been checked by their doctor). They also have no symptoms. The risk for developing frank type 2 diabetes, heart disease, and stroke is significantly increased in people with prediabetes, so we need to take prediabetes very seriously. Go and get tested for prediabetes if you fall into any one of the following categories:

·     have belly fat

·     are over 45 years old

·     have a family history (parent or sibling) of type 2 diabetes

·     have high blood pressure (higher than 130/80 mm Hg)

·     are a woman with previously diagnosed gestational diabetes, polycystic ovaries or have given birth to a child weighing over 9 pounds

Make an appointment to see your primary care provider and make a point to exclusively focus on prevention of diabetes, heart disease, and stroke. Your provider may order blood tests beyond merely your blood sugar and A1c (cholesterol, LDL, HDL and triglycerides and your TSH to evaluate thyroid function).

Be a true partner to your provider: know your weight, waist circumference (ideally no more than 37 inches in men and 32 in women; for Asians the numbers are about 5 inches lower). Know your family history and what your average blood pressure (home measurements) is. Mention any prior history of heart or artery disease or procedures (stress tests, echos, ultrasounds of your carotid arteries, angiograms). If you have an old ECG, bring it to your appointment.

A blood pressure log with at least 10-15 measurements is especially helpful. You need to have a good blood pressure monitor and follow your provider’s instructions on how to accurately measure your blood pressure at home.  

If you smoke, you need to give up smoking. The combination of smoking and either diabetes or prediabetes is too dangerous for your arteries. It can lead to heart attacks and stroke even if your doctor prescribes adequate medications to control blood sugar, blood pressure, and cholesterol.

You have to increase the level of your physical activities, achieving at least 15,000 steps a day, grabbing any opportunity you have (at home, work or school) to move, lift light or medium weights on a daily or every other day basis and perform balance and stretching exercises like tai chi or yoga.

You also need to understand what a healthy diet is: what a portion of fruits and vegetables is and what are the healthful fats. You have to severely restrict added sugars (sugary beverages, cookies, desserts, candies, cakes, donuts), refined grains (white bread, white past, white rice, white potatoes) and fried foods. Depending on other factors, you may be more liberal with good sources of protein like fish, nuts, eggs, dairy (avoid full fat) and lean meat.

Investing in a personal trainer and/or a dietician/nutritionist is a great idea.

Getting your metabolism back on course requires motivation, willingness to invest about two hours of your personal time, and working closely with your primary care provider. Insulin resistance, prediabetes and type 2 diabetes are all serious conditions. Treat them as such.

AND THE WINNER IS... Balanced Eating vs. Detoxing & Diets

Healthy lifestyle, including healthy diet, is one of the main pillars of wellness and disease prevention and a key to a long- as disease-free as possible- and happy life. For healthy diet and healthy lifestyle to be effective, they must be practiced consistently with only occasional transgressions ( less than 10% of the time).

Given the importance of healthy diet, both the general public and scientists want to know which one is the best. The choice is not easy as so many diets are touted as the absolute best, while the scientific evidence supporting these claims may be lacking. The mere fact that celebrities follow and promote a diet should not be seen as evidence of its true superiority.

On this article we will examine a number of proposed short-term diets that belong to the “Detox” category. These are brief diets, running from as short as three days up to six weeks, and are supposed to “cleanse” our body from toxins and help us get a new, healthy beginning in life. They are also used as a jump-start for weight loss. Some diets work (in terms of losing weight) if you follow them to the letter. Are these diets a true winner or just fads, hype or a new trend? Is it realistic to think you will NEVER eat bread in any form again?

While some people may think that “cleansing” is a new concept, Pharaohs’ doctors in Ancient Egypt used to recommend enemas (colon cleansing or purging) as a way of removing toxins from the body. As an idea, it is appealing, but is it really working or necessary? Consider that our body has very sophisticated mechanisms in place, mostly through our liver, kidneys and immune system  to cleanse itself constantly from toxins and waste products. In 2011, researchers at Georgetown University conducted a comprehensive review of the medical literature and found absolutely no scientific support of the practice of detoxifying the colon.

It is true that several individuals feel better after a detox period but is this a “placebo effect”? Mayo Clinic reports that there is little scientific evidence that a detox diet actually eliminates toxins from your body.

While there is wide variation among detox diets, most of them eliminate highly processed foods. Some suggest fasting and allow only drinking natural juices. Others allow you to eat only raw vegetables and avoid sugar.  Certain diets require you to cut out carbohydrates, but in the same token other “fatty foods” are allowed.  One patient we have spoken to said she was in Las Vegas with a friend and at the breakfast buffet, the friend had bacon piled high on her plate, but you would not catch her dead with a piece of toast. Is that a good way to eat?

Here are some examples of foods prohibited by several detox diets:

• Processed, boxed or canned food
• Table sugar or foods or drinks with added sugar
• Refined vegetable oils
• Artificial sweeteners, preservatives, additives, or coloring
• Flour-based foods
• Grains (rice, oats, quinoa); some diets, though, allow non-gluten grains like rice and quinoa
• Beans and legumes (also allowed by many detox diets)
• Dairy
• Coffee and anything caffeinated
• Alcohol

Examples of recommended foods by several detox diets include:

• Fruits (excluded by some)
• Vegetables
• Non-gluten containing grains (rice, quinoa)
• Beans and legumes
• Nuts and seeds
• Oils (olive oil, hemp oil)
• Probiotic-rich organic yogurt and kefir
• Dairy substitutes
• Green tea
• Water

For “juicing”,  lemonade with spices and plant-based (for example with spinach or kale) drinks are recommended.

Some elements of detox diets are shared by traditional Western Medicine and Nutrient Science, like fruits and vegetables, whole grains, lots of water, avoiding sugary beverages, and opting for foods prepared from scratch with natural elements rather than packaged or processed food.

There are some important differences between Traditional Medicine and detox diets, however. Traditional Medicine and Nutrient Science do not advocate fasting; they recommend low-fat dairy products, accept up to five eggs per week and up to five cups of coffee per day. Healthy fats, as contained in fish, nuts, olive and canola oil, avocado and dark chocolate are also recommended by Traditional Medicine but prohibited by several detox diets.

While many of the detox diets are not dangerous (it is very possible that people who feel better after a detox cleansing period do so because they have avoided sugar and processed food), extreme fasting and drinking only juices for prolonged periods of time may harm your health.

Eating a balanced diet is better for you and easier! Whole grains won’t kill you; and lean meats/protein, whole unprocessed foods, and foods low in salt, fat and sugar are the way to go. Foods full of nutrients, vitamins, minerals, fiber and antioxidants work like medicine, supporting and preserving our health.

Think before diving into that new diet craze or a detox diet and talk to your doctor before embarking upon those diets. Keep in mind that, both for the purpose of weight loss and healthy metabolism, what is more important is consistency in the long run, not just extreme measures over a few days or weeks that allow you to go back to indiscriminate eating.

Eating healthy, exercising, getting restful sleep and making smart choices are the way to a healthy life. Making healthier choices and eating a balanced diet is the real reason for feeling good and healthy!

It is not always easy, but remember -you are in charge of YOUR health.

To your health!

Dr. Anthony

YOU CAN EAT A Healthy Diet ... with just a few easy steps

You want to eat a healthy diet, but you don’t know where to start. Don’t be discouraged, it’s not  that hard!

Cooking your own meals in your own kitchen is the best way to know you are getting a healthy and balanced diet. Start now by following these simple rules and you will begin your journey to a Healthy Lifestyle.

Healthy Food- 4 Simple Steps to remember:

Fruits and vegetables -either fresh or frozen- are important. Whole grains, which are the “good” carbs, are needed in a meal. Fats are necessary, but go for the good fats which include fish, unsalted nuts, olive oil, canola oil, avocado, and dark chocolate (who said eating healthy couldn’t be fun!). And you will need a lean protein to round it out. There are two ways to add a lean protein: non-animal protein like beans, peas, soy, tofu and certain seeds or lean animal protein found in skinless poultry and low-fat dairy.

Healthy Drinks:

Water or Club soda are the best options. Try to avoid soft drinks (regular or diet).

If you drink alcohol - remember to do so in moderation. This means one drink per day for a woman, two for a man (one alcoholic drink equals 15 grams of pure alcohol). Coffee and tea are fine choices also, just keep the coffee to no more than 5 cups a day. Green tea is rich in antioxidants and can be served hot or cold.

In your journey to eat healthy, there are also a few things to be aware of or to avoid when you choose your food.

Eggs are fine - up to 5 a week is generally accepted. Some experts say we can eat 2-3 a day (including the yolk). However, this is somewhat controversial.

Beef or red meat should be limited to once a week. Red meat contributes to colon cancer as well as artery and heart disease.

Fast food and deep fried food should be AVOIDED. They are high in calories, have a high salt content, and a high amount of unhealthy (saturated and trans-) fats.

Eating out is also acceptable, but don’t make a habit of it. You should not go out to eat more than once a week and be aware of what you order. Even a salad at a restaurant could be loaded with salt and bad (saturated) fat in the dressing. Also, the salad is usually accompanied with bread sticks which contain too much salt and bad carbs. Plus, you’ll be more tempted to order that high-fat dessert in a restaurant!

Energy drinks and sugary beverages may be unhealthy and should be used in moderation, if at all. The science behind diet drinks is unclear and their long term effects may be harmful. Even though they have zero or near zero calories, they cannot be recommended as a healthy choice.  

If you couple your healthy diet with near-daily exercise you are on your way to a healthy lifestyle. When you practice both, you feel proud about your achievements. That gives you the necessary strength to resist temptations when eating (which lead to long-term health problems, not to mention an unflattering figure).

“Enjoy a wonderful healthy meal surrounded by people you love!” - Dr. Anthony Pothoulakis

Your healthy meals should be your own free choices and should not be imposed on you. They must give you pleasure and make you happy, not miserable. Once you learn to enjoy them, you will be living a healthy lifestyle (healthy diet and exercise) and not even think twice about it!