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Diabetes

October 06, 2015

Ten steps to diabetes prevention — Part III

It’s not just what you eat: dodging diabetes also involves losing weight, getting enough exercise and sleep, and taking care of your mental health.

Do you have type 2 diabetes, or is your blood sugar high enough that you're at risk of developing it? By paying close attention to what you eat, there's a lot you can do to manage your condition, or even head it off. But diet is only part of the answer. Lifestyle measures such as losing some weight, getting enough exercise and sleep, and managing stress also have an important role to play.

The Diabetes Prevention and Management Cookbook by Johanna Burkhard and Barbara Allan was published in co-operation with the Canadian Diabetes Association. It concentrates on the avoidance and management of the most prevalent kind of diabetes, type 2, but the authors note that the nutrition information and menus included can be adapted for people with type 1 and gestational diabetes as well.

We covered some of the steps you can take in Ten steps to diabetes prevention — Part I; and Ten steps to diabetes prevention — Part II; now let's look at the rest:

1. If you're overweight, lose 5% to 10% of your weight

If you've battled the bulge for years, this may come as good news. For example, a weight loss of as little as 10 to 20 pounds, if you're overweight at 200 pounds, has been shown to "substantially improve insulin sensitivity, glucose control, blood pressure and lipids [blood fats]," say the authors, quoting the Finnish Diabetes Prevention Study.

Tips for getting the weight off and keeping it off include understanding and breaking the emotional bond you may have with food, mindful eating and working on a positive self-image.

2. Aim for 30 minutes of exercise a day

Upping your activity level may help you lose weight, to be sure. But exercise fights diabetes in other ways, too. Strength training helps counter and even reverse age-related muscle loss, which may contribute to increased insulin resistance. Cardio is a proven anti-diabetes weapon: a 30-minute walk or run, five days a week, has been shown to be effective in preventing diabetes. And flexibility training will help you avoid hurting yourself, particularly if you're not used to exercise. Even sitting up straight instead of slouching is a form of exercise, say Burkhard and Allen, because it helps strengthen your core muscles.

If you have diabetes, however, there are precautions to take, such as making sure to wear comfortable shoes and socks and watching for hypoglycemia (low blood sugar). If you have heart disease or diabetic retinopathy, check with your doctor before starting an exercise program.

3. Get enough sleep and look after your mental health

"More and more evidence shows sleep is essential for glucose and weight control, and lack of sleep may be a risk factor for weight gain and type 2 diabetes," say the authors. "Poor sleep is a side-effect of a busy, stressful lifestyle, and millions of people are struggling. This topic is so important that it makes our top 10 list of diabetes prevention strategies."

As diabetes prevention strategies go, this one sounds simple enough: unlike jogging or giving up ice cream, it doesn't require strenuous effort or self-denial. But if you have real trouble sleeping, then developing a restful bedtime routine, going to bed at the same time every night and making your bedroom cool, dark and tidy may help.

The stress that might be keeping you awake at night is one of several mental-health issues connected to diabetes. Anxiety and depression are also factors. "Diabetes can sometimes have an unwanted associate: depression," according to Burkhard and Allen. "These two conditions reinforce each other, and either can lead to the other."

Like depression, chronic anxiety may develop as the physical, mental and financial challenges of your condition take hold. Help is available through the programs such as the diabetes self-management workshops developed at Stanford University and offered in Canada and the United States.

4. Choose low-cal, low-carb beverages

That means avoiding unsweetened fruit juice, as well as the more obvious culprits such as regular pop, milkshakes, designer lattés and beer, because there's a lot of naturally occurring sugar in fruit juice. And despite what you may have heard, it's okay to drink alcohol — but not too much. "Moderate alcohol consumption can be healthy, but if you don't drink, there's no need to start!" say the authors. "If you do drink, enjoy a maximum of one drink per day if you're a woman or two drinks per day if you're a man."

Recommended beverages include low-fat milk, coffee and black or herbal tea without sugar, club soda with lime and fruit — or veggie-infused water.

And you don't have to give up dessert just because you're watching your diet! Try this recipe for a tasty finish to a healthy meal:

Image of the Diabetes Prevention and Management Cookbook

Lemon cream with fresh berries (page 364)

Makes 4 servings

Here's an easy-to-assemble dessert with a luscious lemon cream that hints of cheesecake and is layered with berries or fresh fruit.

  • ¼ cup (60 mL) granulated sugar
  • 2 tsp (10 mL) grated lemon zest
  • ¼ cup (60 mL) freshly squeezed lemon juice
  • 2 tbsp (30 mL) cold water
  • 1 tbsp (15 mL) cornstarch
  • ½ cup (125 mL) light cream cheese, softened
  • 1 cup (250 mL) nonfat plain yogurt or artificially sweetened lemon-flavored or vanilla-flavoured yogurt
  • 3 cups (750 mL) assorted fresh berries
  • Additional berries and grated lemon zest
  • Fresh mint sprigs
  1. In a small saucepan, whisk together sugar, lemon juice, cold water and cornstarch until smooth. Cook over medium heat, whisking constantly, for 2 to 3 minutes or until mixture comes to a full boil and thickens. Remove from heat and whisk in cream cheese and lemon zest until smooth. Whisk in yogurt. Cover and refrigerate for at least 4 hours, until chilled and slightly thickened, or for up to 1 day.
  2. Arrange half the berries in four parfait glasses or large wine glasses. Top with half the lemon mixture. Layer with the remaining berries and lemon cream. Serve immediately or cover and refrigerate for up to 4 hours. Just before serving, garnish with whole berries, lemon zest and mint sprigs.

Tips: For the berries, try raspberries, blackberries, blueberries and/or sliced strawberries.

To wash fresh berries, place them in a strainer and gently rinse under cold water. Drain and arrange in a single layer on a dry kitchen towel or paper towels to dry.

Recipe excerpted from The Diabetes Prevention & Management Cookbook by Johanna Burkhard & Barbara Allan © 2013 robertrose.ca. Reprinted with publisher permission. Find more recipes and tips in Ten steps to diabetes prevention — Part I and Ten steps to diabetes prevention — Part II.

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