TIPS FROM ASHLEY ALKER, M.D., ON PREVENTABLE DEATHS #8

Who knew there are so many ways to prevent death? I had never even thought about it until I ran across some articles from Dr. Alker. Maybe we need to remember the thought we started with, "The idea is to die young as late as possible." Today's post is about Stroke, and that's a big one for me. My late mother had a major stoke while home alone and wasn't found until the next day. She was left totally paralyzed on her right side. I took care of her in my home until her death almost two years later. I have some of the same health issues she had, and I am working to lower my risk. That's enough about me, let's talk about stroke.

Approximately 87% of stokes are ischemic strokes. Ischemic stokes are caused by a blockage of blood flow to the brain. Hemorrhagic strokes are caused as a result of a burst blood vessel.

In the United States more than 600,000 people will experience a first stoke each year. Yet, doctors tell us that that up to 80% off those strokes are preventable. Think about that for a minute. These numbers are from the American Heart Association.

You may be wondering what the risk factors for stroke are. The following are risk factors that can be modified by us. High blood pressure is a risk factor. If you know, or think you may have high blood pressure, get to your doctor. Get checked out and get on the proper medication. Diabetes is another risk factor. If you are a diabetic, visit your doctor regularly, keep track of your blood sugar readings at home and take your medicine! Other factors over which we have some controls are high cholesterol, smoking, and inactivity. If any of these factors are in your life, start now to lower your risk.

What can you do if you think you are having a stoke? You need to act fast to save your life and limit any effects of the stoke. Remember the following: BE FAST

B - Balance Loss

E - Eyesight Changes

F - Facial Droop (especially on one side)

A - Arm Weakness

S - Speech Difficulty

T = Time to call 911

And I might add, if you live alone, get a Life Alert or similar system so you can get help immediately.

At the 1st sign of a stroke, get to the ER. Forget the doctor's officer of an urgent care.

They will send you on to the ER. There is no time to waste.

MEN, DON'T AVOID DOCTORS AND/OR SKIP SCREENINGS

I doubt if anyone really wants to go to the doctor, but men are notoriously known for avoiding doctor visits. A Cleveland Clinic survey found that 72% of men would rather do household chores, such as cleaning the bathroom, than going to the doctor. Avoiding doctor appointments or skipping them can lead to serious health problems. Health screenings detect diseases before they show symptoms. Catching diseases before they start showing symptoms are when treatments are most effective. Below are 5 screenings doctors say every man should get:

• Cholesterol: Healthy men should have this checked every 4 to 6 years.
• Blood pressure: Men 40 and older should have this checked at least once a year.
• Diabetes: Guys, this is a big one. Diabetes can cause so many other problems, especially left unchecked. Starting at age 35, men should be tested at least every three years. If there is a family history of the disease or you are overweight, your doctor may want to check this more often.
• Prostate cancer: Age 50 is the starting age for men at average risk to start talking to their doctor about screening. Men who are black or have a strong family history of prostate cancer, should start earlier at around age 40.
• Colorectal cancer: Regular screenings should start around age 45 for men at average risk.

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METFORMIN AND VITAMIN B12

Are you aware a drug you may be taking might cause a vitamin B12 deficiency? Metformin is one of the most common drugs prescribed for type 2 diabetics.  I have been a type 2 diabetic for 19 years, taking metformin most of that time. I have regular blood work and checkups with my doctor. Vitamin B12 supplements were added to my regimen some time ago. Metformin blocks absorption of B12 often requiring supplementation. In fact, the Food and Drug Administration requires a warning with metformin prescriptions (who reads all that stuff that comes with a prescription?) to that effect. If you are taking metformin, be sure you are having your B12 levels checked regularly. By the way, Amy Rothenberg, a naturopathic doctor and educator based in Massachusetts, has stated, "Research shows that those with higher circulating B12 levels have slower decline in memory, executive function, and language usage."

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HANDLING LOW BLOOD SUGAR

If you need a quick solution to low blood sugar, one of the favorite tricks of the American Diabetes Association (ADA) is a glass of milk. 

Milk contains lactose that's broken down into glucose (sugar). It also has fat and protein in it to slow down the rise in your blood sugar and keep it steady over time. For this reason, milk is a better solution than juice or glucose tablets. 

Fat-free and reduced-fat milk have the same amount of lactose. Other studies have found that a small amount of ice cream will work as well. 

If you don't like milk or don't buy it regularly to have on hand, you might also consider graham crackers, which are easily stored in the pantry or in your glove compartment. 

The ADA recommends that you avoid high-fat treatments, such as candy bars, because they aren't absorbed as quickly, may lead to very high blood sugar levels in the hours after you eat them and can contribute to weight gain. 

DIABETICS AND DIET

The best weapon in your arsenal to fight your blood sugar and maintain weight control is a healthy diet. I talk to people all the time who say, "But I eat healthy." That may be true, but do they eat 'diabetic healthy'? There is a difference. If you have been diagnosed with diabetes it is as important to know how to combine the foods you eat as it is to eat something 'healthy'. No matter what you eat, be sure your protein to carb ratio is good. Over the course of a meal, you should be getting a ratio of at least 1/3 as many proteins as carbs (even healthy carbs).  And be sure to include fiber!

Here is an example:
I have people say, "I had a healthy meal of spaghetti and a salad. I even left off the garlic bread." Okay, let's look at that and assume we are talking about a traditional spaghetti meal. Was that a whole-grain pasta? If not, your blood sugar will go up. Did you use a sugar-free sauce? The amount of sugar in pasta sauces varies greatly. A small amount of lean ground beef or meatballs in the sauce is also helpful for added protein. What kind of salad did you have? It should consist of mixed greens, a sprinkling of kidney or garbanzo beans, and some nuts or seeds. You should go easy on the dressing, and it should be sugar free. If you eat this same meal with regular pasta, your sauce has sugar, you have things you shouldn't on the salad and the dressing has sugar, you have not eaten a diabetic healthy meal.  You can also see from this example why it is important to be careful when eating out. You can almost be guaranteed that if you eat that meal in a restaurant it will not be made with whole-grain pasta or sugar-free sauce. 

The next time you sit down to enjoy a meal really look at what you are eating. Look at each item and ask yourself if you are meeting 'diabetic healthy' guidelines.

SIMPLE WARNING SIGNS OF DIABETES

This is a repost of a 2012 post. However, it is important information and worth sharing again.

Diabetes is at epidemic proportions in the United States today.  Diabetes is a serious health problem and early detection is key with this disease.  Diabetes more than doubles a person's risk of heart disease, can lead to stroke, blindness, limb amputation, and even possibly some forms of cancer.  Some of the symptoms of the disease are so simple but can also be blamed on many other things.  I know that in my case, many of the symptoms were there, I even had a family history of diabetes, and I still didn't realize what the problem was.  Looking back after the diagnosis it was easy to see the symptoms and why I had explained them away.  By the time I was diagnosed, my blood sugar was just under 500! 

• Excessive thirst is a big clue!  Don't ignore this symptom.  I live in Texas, and the summers are hot.  I had excessive thirst but thought it was due to the record-breaking heat wave of a month of days over 100 degrees.  I should have gone to the doctor!
• Increased urination.  Yes, I had that symptom, too.  However, I assumed that was because I was drinking more.  Not so, don't make the mistake I did.
• Yeast infection in women.  Yes, had that one too.  Antibiotics also cause yeast infections.  I was dealing with a serious colon problem and had been on antibiotics for three months so didn't think anything about that one either.
• Eye problems.  Yes, had that one too.  By now you are problem wondering how I could have been so stupid as to not even consider diabetes.  Right after I first noticed some blurry vision, I got my little postcard in the mail reminding me it was time for my every-two-years eye exam.  So, I thought that was my problem.

Thank goodness strep throat sent me to the doctor.  I'm not usually thankful for strep throat but this time it was a good thing as it sent me to the doctor.  When I told him how I had been feeling, he immediately called the nurse in to test my blood sugar.  That day, I hadn't been eating because my throat was so sore, but still my blood sugar was close to 300.  He had me take antibiotics for 10 days then go in fasting for more blood sugar testing.  This time it was almost 500.

I am sharing my experience with you today because I want you to see how simple the symptoms can be and how easily they can be thought of as something else.  At the first sign of symptoms, get to your doctor, stop by a CVS Minute Clinic where they will usually test you for free, etc but do get your blood sugar checked.

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WHAT ARE CARBS?

We hear so much about carbs, especially if you are diabetic, but do you really know what a carb is?

First of all, carb/s is a shortened term for carbohydrates.  Okay, so, what is a carbohydrate? A carbohydrate, along with protein and fat, is one of the 3 macronutrients supplying our bodies with the calories they need to function.  That's right; our bodies must have calories to function properly.  Simply put, carbohydrate foods are the sugars and starches.  So, fruits, vegetables, grains, potatoes, etc are carb foods.  Many foods, milk for example, contain all 3 of the macronutrients of carbs, fat, and protein.

Diabetics are told to watch their carbs and to avoid refined carbs. When you eat foods high in poor quality carbs, such as refined sugar, bleached white flour, white bread, etc, they can raise your blood sugar.  This may cause your insulin to spike to higher-than-normal levels.  Over time, excessive sugar in the blood can be damaging to the body leading to obesity, diabetes, and cardiovascular disease.  Pictured below are some examples of healthy carbs.

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DR SEARS ON BENEFITS OF MINI-MEALS

This is another quote from Dr William Sears on the benefits of grazing or mini meals:

"People who eat frequent mini meals suffer less colon cancer, have steadier nerves, are less likely to develop diabetes, have a healthier immune system, tend to be leaner, enjoy lower blood cholesterol and levels of stress hormones, have less itis illnesses (dermatitis, bronchitis, colitis, arthritis), and just plain live longer and healthier."

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ARE YOU FAMILIAR WITH AGEs?

We are not talking about your, or my, age. We are talking about AGEs as a sneaky health sapper! AGEs are Advanced Glycation End-products or harmful compounds formed when proteins or fats combine with sugars in the bloodstream. This process, called glycation, can contribute to various health problems associated with aging and disease. AGEs are often implicated in such health problems as Alzheimer's disease, diabetes, kidney disease and atherosclerosis. By lowering your levels of AGEs, you may reduce your chances of depression, heart disease, diabetes, and more. Recent research has also suggested that it may lower risk of breast cancer by 43%. Tomorrow we will post some ways we can work to lower the AGEs in our bodies.

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WHAT IS FIBER AND WHY IS IT IMPORTANT?

Fiber is sometimes called nature's broom according to Toby Smithson, RDN, LDN, CDE, the author of Diabetes Meal Planning and Nutrition for Dummies.

Fiber, which is found in plant-based foods, is a carb that the body cannot digest. That makes fiber a necessity for diabetics in controlling the rise in blood sugar following a meal. Fiber helps to slow down the body's absorption of sugar.

There are two types of fiber and both are very beneficial:

1. Soluble fiber foods become sticky as they pass through our digestive systems and that helps to reduce the absorption of cholesterol.
2. Insoluble fiber doesn't dissolve and that helps to keep the bowels regular.

Both of these things are important for diabetics as well as the general population. Here are some of the important benefits of fiber (other than the ones mentioned above):

• Managing weight - fiber helps to make us feel fuller and more satisfied therefore we will do less overeating at meals and less snacking.
• Blood sugar regulation - The previous bullet, eating and snacking less, helps in the regulation of blood sugar levels.
• Improve heart health - everyone needs to be aware of heart health and taking care of their heart. Diabetics face double the risk for cardiovascular complications than does the non-diabetic. Fiber's ability to help lower cholesterol as well as blood pressure makes it especially important to diabetics and those with heart problems.

We should strive for 20 to 35 grams of fiber a day. 

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COFFEE IMPROVES BODY'S RESPONSE TO INSULIN

Coffee contains antioxidants and magnesium which can help improve your body's response to insulin.  Studies show that drinking 6 cups a day may reduce the risk of getting diabetes by 30%.  But drink that black, leave out the cream and sugar.  Six cups is a lot, so drink decaffinated.  Don't want six cups (that's cups, not mugs!), even a moderate amount should be helpful.  So, if, you are at risk for diabetes, have a cup of Joe.

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#1 HEALTHIEST FRUIT - BLUEBERRIES

This is a follow up to yesterday's post about the healthiest-ranked fruits. Number one on this scientific ranking list is blueberries. The following is taken directly from the Health Guide article.

"Blueberries have long been considered one of the best fruits to consume (and not just because they're delicious): Decades of research show that feasting on them can significantly improve and protect your health. Eas=ting just one cup of blueberries per day is associated with a lower risk for several health conditions, including Type 2 diabetes, strokes, and heart disease. Blueberries are high in fiber, vitamin C and other key nutrients, and serve as a concentrated source of potent antioxidant and anti-inflammatory compounds."

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BEANS FOR DIABETICS

Fiber is important to the diabetic's diet. Fiber in foods helps to satisfy hunger thus making us full sooner, helps reduce the number of calories the body absorbs, and keeps blood sugar from skyrocketing after meals. Did you know beans are a great high-fiber food and should be eaten often by diabetics. I try to eat some daily, yes daily. Add them to soup, salads, tacos, etc. One cup of black or red beans provides 13 grams of fiber and 15 grams protein. Make beans an important part of your diet. Beans are also good sources of calcium and they contain magnesium, another diabetes fighter. 

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DIABETICS AND FOOD

Today's post is a quote from diabetic specialist Richard K. Bernstein, M.D.  Dr. Bernstein stated, "Just because you're diabetic doesn't mean you can't eat well.  In fact, you are likely to eat better than the average person who hustles a bagel or donut for breakfast, scrounges fast food for lunch, then does whatever for dinner."  I so agree with Dr. Bernstein!  In fact I titled my diabetic blog, "Diabetic Enjoying Food," because I do enjoy food.  I grew up in Southern Indiana farm country.  One thing I have always loved is good food.  Yes, I have had to make adjustments to my diet now that I am a diabetic but through much research I have found that I can eat healthy and it still tastes good.  In fact, often things taste even better prepared the way I do things now.  So if you are a newly diagnosed diabetic, take heart.  You have not been condemned to a lifetime of tasteless awful meals.  If you want some good recipes, please check out my above-mentioned blog at http://diabeticenjoyingfood.blogspot.com

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KIDS AND TYPE 1 DIABETES

If your child is diagnosed with type 1 diabetes (T1D) you are not alone. As of 2021, more than 18,000 children in the United States are diagnosed with T1D every year. The diagnosis can be frightening but with the help of a good pediatrician, an endocrinologist, and a dietitian, you will find a lot of help. A T1D diagnosis will affect the whole family but remember this, T1D does not define your child. With a positive attitude and a good medical team to work with, diabetes will only be a part of your child. There is no limit to what a T1D child can do. An additional side benefit for the whole family will be more exercise and a controlled diet that will benefit everyone.

DIAGNOSED WITH TYPE 2 DIABETES AND WONDERING WHAT TO EAT?

A diabetic can enjoy a diet that is both tasty and healthy. According to Sue McLaughlin, RD, a certified diabetes educator, we should “Look for items that contain healthy fats and are high in vitamins, minerals, and fiber.” Too often people think they are to shy away from fats but that is not exactly true. There are many healthy fats that are vital to a diabetic's diet and health. It is also important to eat a wide variety of foods to make sure we’re getting a healthy mix of phytochemicals and essential fatty acids. Following is a list of foods we diabetics should be sure we are eating.

1. Legumes provide vital fiber and protein. They absorb slowly into the body which helps to regulate our blood sugar. How about this little fact - half a cup of most types of beans provides about 1/4 of our daily requirement of fiber and as much protein as an ounce of meat! In a study published in 2012 in JAMA, Canadian researchers linked eating beans, chickpeas, and lentils with improved blood glucose control and reduced blood pressure, cholesterol, and triglycerides (blood fat) levels in people with type 2 diabetes. 
2. Fatty Fish provide essential Omega-3 Fatty Acids. Suggested fish to eat are salmon, tuna, mackrel, and bluefish.
3. Tree Nuts provide, here it is again - healthy fats! Nuts are high in fiber, protein, and healthy fats. Recommended nuts are almonds, cashews, hazelnuts, pecans, walnuts, and pistachios as they seem to hold the biggest benefits for diabetics. Peanuts aren't listed because they are not tree nuts. They are legumes!
4. Blueberries are considered a superfood for type 2 diabetics. Blueberries contain a good number of antioxidants as well as vitamins and fiber.
5. Cruciferous vegetables such as broccoli. Broccoli is high in vitamins A and C as well as fiber. The fiber in broccoli can help one feel full longer and that is important to a diabetic, so they won't snack too much on unhealthy snacks.
6. The above is a short list. Additional good foods for diabetics include green leafy vegetables, sweet potatoes, oatmeal, and avocados.

If you are having problems controlling your blood sugar, try adding more of these foods to your diet!

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DIABETIC PRESCRIPTION: EXERCISE

I know! Most of us hate the word exercise, let alone the actual activity involved. Well, get over it! Once we've allowed ourselves to become diabetic, we no longer have a choice. We must exercise!

Yes, you read that right. I really did say, "Once we've allowed ourselves to become diabetic." I'm talking to us Type 2 diabetics on that one, you Type 1s don't have to accept that remark. Now before you get all mad, have steam coming out your ears and start sputtering, "Who does she think she is, telling me I'm responsible for the fact I became diabetic," hear me out. Did you know you had diabetes in your family history? Did a doctor ever tell you to lose weight? Did a doctor ever tell you to change your diet or lifestyle? Did a doctor ever tell you to get more exercise (there's that dirty word again)? Did you gorge on sweets and/or carbs? You get the point. But there is a diabetic prescription: EXERCISE!

We helped to create this problem in our bodies, now we have to take our medicines. And that doesn't stop with pills and shots. Just consider exercise another of the medicines we have to take. I read somewhere that exercise is the diabetes treatment almost everyone can benefit from. I backed up, read that again and the light bulb came on. I got it! Exercise is another of our treatments and we need to think of it as such. It's not something we know we should do, something we might get around to someday, but something we have to do just as we have to take our other prescriptions the doctor gives us.

We don't, however, have to go out and join a gym or buy expensive equipment. Of course you can if you want to and it is a good thing to do, but it isn't necessary. We can work exercise into our everyday lives! We Americans have become very lazy as a whole. This is often caused by some terrific technological advances and inventions. But we can't use that as an excuse. Following are some easy ways to get started adding more exercise into your everyday routine. Give them a try. After all it is YOUR life that matters.

1. Hide the remote controls; they make it too easy to be lazy. This includes the garage door remote. Getting in and out of the car to open the garage door is good exercise.

2. Carry your groceries from the car to the kitchen one bag at a time. More steps and lifting; more exercise.

3. Instead of stacking things by the stairs to avoid extra trips up and down, make the trips. Stairs are a great way to get exercise.

4. Push the kids or grandkids on the swings. Play frisbee with them, etc. Quality time with the children is an added benefit.

5. Go for a walk. Start with a short walk and work your way up to several blocks or 30-40 minutes. If the weather is bad, go to the local mall and walk.

6. Walk around while talking on the phone instead of plopping down in a comfy chair.

7. Stop driving around the parking lot for ten minutes trying to get a parking spot next to the entrance. Park farther away and enjoy the walk.

8. Put items you use often on higher shelves so you do more stretching and reaching to get them.

9. Housework is an excellent exercise. Vacuum an extra time per week, etc.

10. Gardening is another wonderful exercise.

I'm sure you can think of other ways to add exercise to your daily routine. Take that prescription seriously. Do whatever works for you but do something! Take that most-hated prescription: EXERCISE!

OATS AND NUTS ARE IMPORTANT TO DIABETICS

Oats and nuts should play a major role in most diabetics' meal plan. That is not to say you have to eat loads of either. but to say they are important to controlling your blood sugar. Oats are easy to work into the diet through morning cereal, snack bars (watch sugar content), sugary toppings, etc. When you eat nuts, use the unsalted variety and do not smother them in candy coatings. Try to work a small portion of both into your diet often.

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SHOULD DIABETICS EAT WHITE BEANS?

I often have people react with shock when I mention that beans are a staple in my diabetic diet. "Beans", the misinformed often say, "you can't eat beans, they are carbs." They are more than carbs! Take white beans, for instance. They are rich in fiber and protein, two of the things that make them slow to digest and help curb blood sugar spikes. Beans have been in my diabetic meal arsenal for about 14 years now and are one of my best blood sugar spike fighters.

You don't have to cook your own white beans from dried beans. Keep some reduced-sodium canned cannellini beans in your pantry. Rinse and use in recipes and salads. 

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NO CLEAN PLATES!

Do you remember your parents telling you to clean your plate? Were you told to be thankful for your food and not waste it because kids all over the world were going hungry? Are you doing that with your children or grandchildren? Those old adages need to be thrown out the window! With the obesity epidemic and diabetes being at epidemic levels, you should teach your children to take smaller portions of food and to stop eating when they feel full. Children used to be busy from the time they got up until they went to bed. They rode bikes, took walks with grandparents, played in the backyard on swing sets, played neighborhood games of stickball and baseball, etc. Now they sit in front of a TV or video game. Too much food on their plates and being forced to eat every bite could be setting them up for a lifetime of health problems.

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