Dear Jenn,
My doctor recently informed me that my blood tests results from a wellness visit were not normal. My fasting blood sugar was higher than recommended at 136mg/dl, a hemoglobin A1c test (blood sugar hemoglobin test) was 6.4%, and my lipid profile was abnormal. Apparently, my “bad cholesterol LDLs,” “blood cholesterol value” and “triglycerides value” were all elevated, and my “good cholesterol HDLs” were below the recommended level.
I was told weight loss would be helpful. I am above ideal body weight and in the “overweight” category for my BMI (body mass index). I’m a 47-year-old married woman, have three children, and work about 30-plus hours a week. My doctor told me I am considered in the “pre-diabetic” category: If I don’t get things under control, I would be at risk of developing diabetes and would require medication. My doctor was very concerned and insisted on a follow-up appointment in three months. Would you have any advice?
Sincerely,
Very Concerned Pre-diabetic mom
Dear Very Concerned Pre-diabetic mom,
It must have been distressing for you to have received a poor health report card from your doctor, especially since you went for a wellness checkup and were unsuspecting of any concerns.
It is good that you did go for a wellness check because untreated diabetes can lead to serious and unfortunate co-morbidities. The good news is that pre-diabetes can be reversed and even diabetes improved by diet and lifestyle adjustments. Below are some suggestions to “get things under control.”
Diet Recommendations—Part 1
Eating habits directly affect health and disease states. It is important to make healthy food choices, control portion sizes and count calories. Reducing fat in your diet from various food sources will help improve your lipid panel, help with weight loss and improve diabetes outcome. Controlling carbohydrate sources will help with blood sugar control and weight, too. Consider these recommendations to enhance general health and disease such as diabetes:
Selection of Proteins. Select lean cuts of meat (reduced fat) and remove skin (where fat is located) from poultry. Use egg whites (egg protein) and avoid egg yolks (fat and cholesterol) for omelets or salads. Egg beaters (egg white only) are preferred when making omelets. Avoid high cholesterol organ meats such as liver, including chopped liver. Fish is a great source of healthy protein, containing omega-3 (essential fatty acid), noted for heart health. Baking, roasting, boiling and steaming are the preferred methods for cooking proteins. Frying should be limited. Careful choice of proteins will impact both lipids and weight.
Selections of Dairy Products. Be savvy with dairy products. Use low-fat varieties of milk, cheese and yogurt. Use butter sparingly; it’s a saturated fat with cholesterol. Avoid processed trans fat products such as margarines, which are considered unhealthy.
Selections of Fat Products. Fats are essential for good health and help with satiety. Mono- and poly- unsaturated fats are best to select because they lower disease risk. Vegetable oils such as olive, canola and sunflower are good choices as are nuts, avocados and seeds. Remember, fats are high in calories, so be mindful for weight control.
Selections of Starch Products. Starches are carbohydrates and affect blood sugar. Control portion size and amounts eaten of breads, pasta, rice, potatoes and cereals. Breakfast, for example, can be one cup of cooked oatmeal or two slices of bread or a half-cup of cooked oatmeal with one slice of bread.
Check food packages for sugar content. Choose items with 12 grams or less of sugar. Note that alcohol should be consumed in reasonable amounts, preferably unsweetened varieties.
Selections of Vegetables. Vegetables are carbohydrates, low in calories and sugar, and high in essential nutrients including fiber. These can be eaten in liberal amounts—enjoy them!
Selection of Fruits. Fresh fruit is healthy and nutritious. However, fruit is converted into glucose and raises blood glucose levels. People who have high blood glucose need to control portions and amounts eaten daily. No more than two to three fruits daily are recommended. Fruit juices affect blood glucose, too. Reduced sugar varieties are preferable.
Weight Control and Lifestyle—Part 2
Physical activity is important for blood sugar regulation and weight control. Choose a physical activity that you enjoy and are likely to continue. Walking, hiking and biking are good examples. Consistent exercise is essential and goes hand in hand with diet. Find the time in your week to do at least 30 minutes three times a week.
Thoughts to Consider
A high fasting blood sugar and high Hgb A1c level are signs of a problem. Your doctor scheduled a follow-up appointment because you have a health problem. High blood glucose leads to diabetes. Untreated diabetes damages multiple organs in the body. Healthy eating practices, exercising regularly and maintaining a healthy weight may help you control pre-diabetes and avoid the need for medication.
Consider diet control and regular exercise “health prescriptions” to be practiced consistently, just as medication to be taken as prescribed.
If you or any family member has abnormal laboratory results that can be normalized or improved by diet and lifestyle adjustments Nutrition Transformations is available to help. Do not delay taking care of yourself and/or someone you love.
Yours in good health,
Jennifer B. Chapler MS RD CDN
Founder of Nutrition Transformations
718-644-1387
By Jennifer B. Chapler
