Continuous Glucose Monitoring for Type 1 & Type 2 Diabetes

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Can you imagine knowing what your blood glucose is 96-288 times each day and only doing a finger stick 0-2x daily? This is possible with continuous glucose monitors (CGM’s) now available for patients use. These monitors have been available for over a decade but most people with diabetes are unfamiliar with this technology and how affordable it is. Two CGM’s on the market are DEXCOM and Freestyle Libre. DEXCOM provides glucose monitoring every 5 minutes and requires a fingerstick 2x/day for calibrating. Freestyle Libre provides glucose monitoring every 15 minutes with no finger sticks. The glucose data is available for real time viewing on a hand-held reader device and to download for review and pattern management with your dietitian.  Many mistakenly believe a CGM is only for those with type 1 diabetes or who inject insulin.  CGM’s are for anyone who really wants to be aware of their glucose level, so they can make informed lifestyle adjustments to improve their health.

Current studies indicate wearing a CGM does lower glucose levels and A1c. Hypoglycemia (low blood glucose) was also shown to be less frequent in the group of research patients wearing a CGM. Another study showed patients were very good overall about wearing their CGM and had a higher level of satisfaction with their treatment. Experience in our office at Banister Nutrition has shown once a patient has had access to their daily continuous glucose data they don’t want to be without their CGM.  They like knowing what their glucose is constantly (without finger sticks) and they know they make better management choices with food and exercise because of this easily accessible glucose data.

Will your insurance cover the expense of your CGM?  You won’t know until you ask. Insurance companies must become aware patients want these devices so contact your insurance company and inquire. Some insurance companies and policies are covering these devices. If your insurance company denies coverage, ask your pharmacy about a “pharmacy discount card” such as Good Rx, which will cost you nothing but will help decrease your cost for the CGM.  Banister Nutrition has learned from their patients with the pharmacy discount card patient cost for the Freestyle Libre was $65 for 3 sensors (sensor to be worn for 10 days) which will last for one month. The Freestyle Libre Reader patient cost was $65. Your physician must write two prescriptions: one prescription for the reader, and one prescription for the sensors.

Having access to continual information is far better than checking your blood glucose 2-3x/day. Continuous glucose monitors are moving to center stage for diabetes management and finger sticks will gradually be non-existent.

CB

 

*Picture provided by thediabetescouncil.com*

Making Healthier Choices @ Fast Food Chains & Restaurants

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We all have those moments when we don’t feel like cooking, we want to go out to eat with family/friends, or we are on-the-go so we end up at a fast food chain or restaurant. It happens to everyone! I am here to give you a few easy pointers on how to eat-out in a healthier way. I have also attached a list of some examples of healthier options at a few of the more common restaurants. When making this list I looked for keywords like “grilled” and “fresh”, while also looking for the smallest portion size the restaurant has to offer. If you haven’t noticed… Restaurants tend to give us WAY more food than we actually need. It is always okay to order a half portion, or if that is not an option you can order the full portion with a to-go box, so you can go ahead and put away half for later. Remember… eating until you are not hungry anymore INSTEAD OF eating until you are full is the ideal mindset to have!

 

Keep in mind…

  • You don’t have to have the fries that come with your entrée, ask to see their other options such as steamed veggies, or a side salad.
  • Don’t rush through your meals. This helps give your body time to signal to you that you are no longer hungry.
  • Rethink your drinks! Water is always the best option, and it won’t add any extra calories to your meal.

 

Here are a few of the lower calorie options on the Menu’s at McDonald’s, Taco Bell, Outback Steakhouse, and On the Border Mexican Grill:

McDonalds

  • Fruit ‘N Yogurt Parfait: Calories 150, Total Fat 2g, Total Carbs 30g (10% DV), Protein 4g
  • Egg White Delight: Calories 280, Total Fat 10g, Total Carbs 29g, Protein 18g
  • Side of Apples: Calories 15, Total Fat 0g, Total Carbs 4g, Protein 0g
  • Southwest Grilled Chicken Salad: Calories 350, Total Fat 11g, Total Carbs, 27g, Protein 37g
  • Regular Hamburger: Calories 250, Total Fat 8g, Total Carbs 31g, Protein 13g
  • Side Salad: Calories 15, Total Fat 0g, Total Carbs 3g, Protein 1g

Taco Bell

  • Breakfast Soft Taco: Calories 230, Total Fat 14g, Total Carbs 15g, Protein 12g
  • Sausage Flatbread Quesadilla: Calories 330, Total Fat 18g, Total Carbs 27g, Protein 14g
  • Hash brown: Calories 160, Total Fat 12g, Total Carbs 13g, Protein 1g
  • Soft Taco: Calories 180, Total Fat 9g, Total Carbs 18g, Protein 9g
  • Chipotle Chicken Loaded Griller: Calories 340, Total Fat 16g, Total Carbs 36g, Protein 14g
  • Beefy Mini Quesadilla: Calories 210, Total Fat 11g, Total Carbs 17g, Protein 9g

 

Outback Steakhouse

  • Side salad with Light Balsamic Vinaigrette Dressing: Calories 80, Total Fat 5g, Total Carbs 8g, Protein 0g
  • Cup of Chicken Tortilla Soup: Calories 170, Total Fat 9g, Total Carbs 13g, Protein 1g
  • Center-Cut Sirloin (6oz): Calories 60, Total Fat 7g, Total Carbs 0g, Protein 38g
  • Grilled Asparagus: Calories 60, Total Fat 4g, Total Carbs 4g, Protein 2g
  • Fresh Mixed Veggies: Calories 160, Total Fat 10g, Total Carbs 17g, Protein 4g
  • Grilled Chicken on the Barbie (Half Order-4oz): Calories 180, Total Fat5g, Total Carbs 8g, Protein 27.5g

 

On the Border

  • Chicken Enchilada w/ Sour Cream Sauce: Calories 210, Total Fat 12g, Total Carbs 15g, Protein 14g
  • Ground Beef Tostada: Calories 180, Total Fat5g, Total Carbs 14g, Protein 12g
  • Grilled Chicken Fajita Taco: Calories 150, Total Fat 4g, Total Carbs 17g, Protein 12g
  • Side of Grilled Vegetables: Calories 50, Total Fat 0g, Total Carbs 10g, Protein 2g
  • Side of Cilantro Lime Rice: Calories 190, Total Fat5g, Total Carbs 38g, Protein 4g
  • Chicken Tortilla Soup (cup): Calories 300, Total Fat 14g, Total Carbs 26g, Protein 18g

*This list is intended to be a visual aide of how to choose healthier options when you find yourself eating out.

KM

The Jungle of Eating Disorders

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Monsters in the eating disorder jungle: Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Rumination Disorder, Avoidant/Restrictive Food Intake Disorder (ARFID), Night Eating Syndrome, Orthorexia, Diabulimia,

How much time do you spend daily thinking about your food, weight, body size/shape, comparing yourself to others, and thinking if you weighed less you would be happy? Be honest – do you spend enough time thinking about these things that it interferes with your peace, fun, and social activities? Be brave – consider you might be dealing with an eating disorder or at least the beginning of one.

Eating disorders appear as food issues but are actually mental health disorders with food as the tangible resource to manipulate. Frequently, “control” is at the root of the disorder. When life feels overwhelming, painful, or insecure and you think you have no “control” over these feelings, the one thing you can always control is what you choose to do with your food. The style of food control or manipulation you choose does provide you with a degree of temporary relief from the painful feelings. A few minutes or hours pass, the painful feelings return, and you have layered on top of these feelings shame, guilt and frustration with another declaration “I just want to be normal, eat normally.”

The American Psychiatric Association defines the following eating disorders:

Anorexia Nervosa: Severe food restriction leading to low body weight-intense fear of gaining weight-unable to see how thin they are – very reliant on their body weight and shape for self-esteem- on occasion weight may be restored but the individual still suffers from an anorexic food controlling mind.

Bulimia Nervosa: Recurrent episodes of binge eating within a 2-hour time period, hiding all evidence this behavior occurs- strong feelings one cannot control or stop the excessive amount of food intake—binge eating is followed by trying to get rid of (purge) the calories consumed by vomiting, excessive exercise, laxatives, diuretics- very concerned about their weight/shape – typically of normal weight or slightly overweight.

Binge Eating Disorder: Recurrent episodes of eating large amounts of food with an overwhelming feeling of lack of control – eating rapidly, eating until feeling uncomfortably full, eating large amounts of food when not hungry, the overeating is typically always alone because of embarrassment, feeling disgusted, depressed and guilty.

Rumination Disorder: Re-chewing, re-swallowing or spitting out food occurring over a month. Frequently the individual wants to taste the food but does not want to swallow the calories.

Avoidant/Restrictive Food Intake Disorder (ARFID): An eating or feeding disturbance leading to inadequate nutritional and energy intake- ARFID may arise from a texture, tactile, visual, or taste disturbance.

When you meet some of the criteria for an eating disorder, but not all, you may be in the category of Other Specified Feeding or Eating Disorder (OSFED):

Purging Disorder: No binging but purging occurs via vomiting, excessive use of laxatives, suppositories, diuretics, exercise. You may try to justify the purging declaring your stomach is always upset or you are always feeling constipated.

Night Eating Disorder: 25% of intake occurs after dinner, bedtime snack and/or waking up during the night to eat.

Orthorexia: Eating in the name of good health – many food rules and food restrictions based on the individuals personal ideas of what they have decided must be consumed or restricted to be healthy.

Diabulimia: A person with insulin dependent diabetes restricts their insulin medication as a method to eliminate calorie absorption and lose weight – very dangerous!

Have you decided or been told you do not have an eating disorder because you are not under-weight?  You can be underweight, normal weight or overweight and suffer from an eating disorder. Eating disorder patients at Banister Nutrition have been from 10 y/o – 73 y/o, males and females. Males and females of all ages consume food which makes everyone a possible candidate to have a ship wreck with their food relationship. Listen to your body and your feelings, if you think you might have an eating disorder then something is askew and worthy of a conversation with a dietitian (RD/LD) who is experienced working with eating disorders. Don’t postpone your health care or self-care, there is only one you!

CB

“Romaine” calm and Recycle

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We have heard scary reports of how the environment in which we live is changing, but “romaine” calm; there is still hope for a healthy planet! There are some small changes we all can make to help! While we’re at it, there’s always hope for a healthier you, too, so let’s get started!

Why Should I Care About Being Green?

Being conscious of how our actions impact the environment helps connect us to the planet we call home as well as prepare for a healthy future for ourselves and our loved ones. There was a recent report of the methane gas produced by food waste decomposing in our landfills; this greenhouse gas can contribute to global warming. While the EPA is working on strategies to measure, trap, and treat these gas emissions to use them for more positive things such as renewable energy, there is room to improve our food waste and environmental impact. Many of the things that can help us accomplish this will also serve to promote good health.

How Can I Make Small Changes?

  1. Recycle…. food!

We all know that recycling our trash helps to better the environment, but did you know you can apply this same principle to your food? Try cooking extra portions of foods that can be safely re-used in the day or two after. For instance, you can cook some extra meat at dinner, save it in the fridge, and cut it up for a different dish tomorrow, which saves time and keeps you on track with your healthy diet plan. Instead of boring leftovers going to the trash, use leftover grilled chicken from last night’s dinner to make today’s stir fry or salad. Mix it up to keep it fresh!

  1. Shop right!

We need to make a list and shop reasonably. It is all too easy to buy too much of something or buy things that don’t go well together and waste food that cannot get used before going bad. Think ahead. We know this takes time to sit down and plan a meal pattern for the week, but it will save you time and even money in the long run! Buy the right amounts, even if it means shopping more often. Get only what you need on your list, and know how to store your foods.

  1. Store food properly.

Along with buying the right amounts to prevent waste, storing food is very important! If you know you will have chicken one night and beef several days later, you can freeze the beef so it is fresh and safe when you are ready to cook it instead of wasting it and adding it to the landfills. We’ve all heard that proper planning prevents poor performance, but it also prevents poor health (not as catchy, but equally true!). We love the tip to stock on those delicious summer berries while they are in season and more budget-friendly; wash and freeze them for later use! It’s a “berry” good idea; frozen fruits and vegetables can last 6 months to a year when stored properly in the freezer!

For More information, please refer to this great infographic from the Academy of Nutrition and Dietetics: https://www.eatright.org/homefoodsafety/multimedia/infographics/reducing-food-waste-infographic

Try one or more of these and “lettuce” know what you think!

Mindful versus Mindless

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Have you ever cleaned out the last few crumbs from the chip bag? How about those cookies that were a few days old, luke warm french fries, ice cream with frost bite, or the last dinner roll because it shouldn’t go to waste? Infants and toddlers eat in response to intuitive information from their gut, then they evolve into adults who eat for external reasons. If you are overweight, your reasons for eating exceed hunger and may include boredom, fun, entertainment, stress, all of which are generally mindless automatic routines.

Mindless behavior is defined as an act done without concern for the consequences. What would happen if you drove your car, packed your bags for a trip, took a test, or conducted a meeting in a mindless state? The very perplexing aspect of human mindless eating behavior is, that it’s repeated frequently with continual complaints about the consequences (those extra pounds) and no lasting efforts to change the behavior.

No one goes to bed skinny and wakes up overweight. If you are overweight, you may not remember changing your eating and exercise habits that produced the body you are seeing in the mirror today.  When do you start or stop eating? Most Americans stop eating when they are full, while those in leaner cultures stop eating when they are no longer hungry. Americans also frequently start eating when they are not experiencing hunger. The foods consumed when hunger is not the indicator to start/stop eating more than likely fall into the mindless category.

If you are mindful enough to identify when you are no longer hungry and STOP at this point opposed to mindlessly continuing to eat until you are full, your calorie intake will likely decrease about 20%. The calorie difference between full and too full/miserable is an additional 20%.  Translated into real calorie numbers: if you are mindlessly eating until you are full 3 meals/day and your calorie intake is 2100 calories/day, then you decide to be mindful and stop eating when you are no longer hungry this will decrease your calorie intake approximately 420 calories each day which will produce one pound of weight loss in about 8 days.

 

Mindful vs. Mindless is a great way to discover the truth about what you are eating and avoid the consequences of those extra pounds. Making this behavioral change from mindless to mindful is not an easy task. It requires guidance, support and encouragement from an RD/LD who is experienced in this cognitive behavioral change process. Consider for a moment the thought of losing weight, changing your relationship with food, enjoying all food and social occasions which include awesome food in the absence of  feeling worried, deprived, or guilty… what are you waiting for?

CB

It Takes Two to Mango

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Did you know that more fresh mangoes are eaten around the world every day than any other fruit? They come in numerous sizes, shapes and colors (yellow, orange, red, and green). In many countries, giving someone a basket of mangoes is considered a gesture of friendship 🙂

Mangoes have a wide range of health benefits due to having high amounts of vitamin A and vitamin C. Just 1 cup of mango contains 35% of your daily value for vitamin A and 100% of your vitamin C. Vitamin A is an antioxidant that fights inflammation, and it also aids in brain function, skin, heart, kidney, and lung health. Vitamin C helps protect against cardiovascular disease, immune system deficiencies, eye disease, and even helps the skin. With only 100 calories in 1 cup of mango this can be a great snack and ingredient to add to your fun summer dishes.

If you are wondering how you can incorporate mangoes into your daily life, here are some fun ideas to try before the summer ends! (find recipes at the websites listed in parenthesis)

  • Mango Sorbet (Brit + Co)
  • Grilled Mango with Jalapeño (Food Network)
  • BBQ Chicken and Mango Quesadillas (Jo Cooks)
  • Mango Chia Popsicles (Jelly Toast)
  • Honey Mango Dipping Sauce (The Cozy Apron)
  • Green Mango Salad (Food for My Family)
  • Mango Salsa (Cookie and Kate)

Mangoes are so nutrient dense, they have multiple health benefits. They aid in healthy immune function, normalizing blood pressure, good vision and strong bones. Mangoes also help protect against lung, mouth, colon, breast and prostate cancers. So, next time you’re in the produce isle pick up a few mangoes and try a new recipe!

KM

Summer Salad Meal Prep

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Break out and try something new with these easy salad recipes! Summer is a great time to try a variety of light and easy meal prep options that won’t weigh you down while you’re out in the heat. Here are four summer salad recipes to try out, and the best part is they are practical and cute when you save them in a mason jar! All of these recipes are packed full of nutrient dense fruits and veggies for every occasion.

  1. Southwest Chicken Salad: 2 Tbs southwest ranch, 1 roma tomato (diced), 1/4 C cucumber (diced), 1/4 C corn, 1/2 C black beans, 1/2 jalapeno (sliced), 3/4 C grilled chicken breasts (diced), 1/4 avocado (sliced), 1 C chopped romaine lettuce.
  2. Greek Salad: 2 Tbs balsamic dressing, 1 tomato (diced), 1/4 C cucumber (diced), 1/2 C chickpeas, 2 Tbs diced red onion, 3/4 C grilled chicken breasts (diced), 1/4 C kalamata olives, 2 Tbs feta, 1 C chopped romaine lettuce.
  3. Chicken Quinoa Berry Salad: 2 Tbs raspberry vinaigrette, 1/4 C quartered strawberries, 1/2 C cooked quinoa, 1/4 C blueberries, 3/4 C grilled chicken breasts, 1/4 C goat cheese crumbles, 1/4 avocado (diced), 2 Tbs almonds, 1 C arugula.
  4. Thai Peanut Chicken Salad: 2 Tbs peanut dressing, 1/4 C red bell pepper, 2 Tbs green onion (diced), 1 carrot (shredded), 1/2 C cooked quinoa, 2 Tbs cilantro (diced), 1/4 C mango (diced), 3/4 C grilled chicken breasts (diced), 1 C romaine, 2 Tbs chopped cashews.

Notes* Add all ingredients in the order in which they are written to keep fresh

For additional details check out the recipes at https://www.ambitiouskitchen.com/four-mason-jar-salads-with-just-bare-chicken/

-KM

 

 

Low Cost OKC Metro Workouts

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There are several events offered around the OKC metro that are free or low in cost encouraging you to be active. Take advantage of these while the weather is nice! Other free activity ideas: phone apps (example: couch to 5K), websites (example: yoga yak) or trials at a gym.

Red Coyote Running and Fitness: Free 3 mile walk or run http://redcoyoterunning.com/weeklyruns.html

  • Tuesdays, 6PM @ Red Coyote Edmond location – loops through Mitch Park
  • Wednesdays, 6PM @   Anchor Down – through downtown OKC
  • Thursdays, 6PM @ Red Coyote Classen Curve location – through Nichol Hills trails

Sunrise Yoga: $5 yoga https://www.visitokc.com/event/sunrise-yoga/9165/

  • Thursdays, 6:30 AM @ Will Rogers Gardens

Fitness Meetups:

https://www.meetup.com/topics/fitness/us/ok/oklahoma_city/?_cookie-check=l5wiUojbjwZo-66e

  • Group Training at Energetic Wellness: Tuesdays/Thursdays mornings/evenings
  • Oklahoma City Sports Fitness: Sunday afternoons – pickup games (soccer, touch football, touch rugb,y baseball, kickball, volleyball, ultimate frisbee, etc.)
  • Lake Hefner Walk Meetup: Saturday mornings @ parks around Lake Hefner – walking
  • MWC Walk Meetup: Thursday evenings @ Joe B. Barnes Regional Park

 

Oklahoma City Running Club – The Landrunners: free run or walk http://www.okcrunning.org/

  • Meets on the weekends in the Spring to train for the Oklahoma City Memorial Marathon and half marathon @ OKC metro locations. Meets on the weekends  in the Fall to train for The Williams Route 66 Marathon and half marathon @OKC metro locations.

Yoga in the Park – Oklahoma: Free yoga @ parks around the OKC metro. Facebook Groups

  • Yoga in the Park – Edmond: Thursdays, 6:30PM & Saturdays, 10AM
  • Yoga in the Park – Downtown OKC: Sundays, 10AM
  • Yoga in the Park – Northwest OKC: Saturdays, 10AM
  • Yoga in the Park – Moore: first Saturday of the month, 9AM
  • Yoga in the Park – Norman: Mondays/Tuesdays/Wednesdays/Thursdays, 6PM & Saturdays, 9AM
  • Yoga in the Park – Midwest City: Wednesdays, 7PM

Fire Up the Grill

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Here is my go-to meal when I’m not sure what I want to eat. It’s easy, nutritious, and tastes amazing!

Grilled Pork Chop with Green Beans & Red Potatoes

Ingredients

  • 1 small/thin cut pork chop (3 ounces)
    • (I add a dash of salt, pepper and smoked paprika to mine!)
  • 1 cup of green beans
  • 1 cup diced red potatoes
  • 2 Tbsp Olive Oil (divided use)
  • Salt & Pepper to taste

Instructions

  • Preheat grill over medium heat (350F-400F)
  • In a bowl combine one tablespoon of the olive oil with potatoes & season to taste
  • Stir to make sure all potatoes are evenly covered
  • Prepare grill pan and add potatoes
  • Cover grill and allow potatoes to cook for 12-15 minutes, occasionally stirring
  • Meanwhile, combine green beans with one tablespoon olive oil & season to taste
  • Add green beans to grill pan and stir gently, continue to cook for about 8-10 minutes
  • Prepare pork chop and grill for 4 minutes, then flip and cook for another 3 minutes or until fully cooked

That’s it! Enjoy, and let us know how yours turned out on our Banister Nutrition Facebook page.

KM

You Had Me at Avocado

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Avocados are IN. The major fat in avocados is monounsaturated, which is considered a healthy fat when eaten in moderation. Monounsaturated fats have shown to reduce cholesterol, known to be a main contributor to heart disease. It also reduces the risk of a stroke. This type of fat is satisfying and leaves us feeling full. So how often is it okay to eat avocados and what does the food label tell us? Keep in mind that moderation is key when choosing what to eat, as there is no perfect food.

One serving is about 1/3 of a medium avocado, containing around 80 calories. The serving size seems small, but an avocado is extremely nutrient dense and high in calories.

Avocados contain almost 5 grams of dietary fiber per serving. Fiber helps protect against heart disease, regulate bowel movements and contributes to the feeling of satiety.

FUN FACT – Avocados have more potassium than bananas. At the recommended daily intake of 3500 to 4500 mg per day, potassium helps prevent cramps, stabilize blood pressure and blood sugar levels.

They are also extremely versatile, here are 5 ways to incorporate avocados into your diet:

1) In smoothies

2) In salad dressing

3) In hummus

4) As a topping

5) As a replacement for mayonnaise

Avocados are also high in vitamin E, C and A. Vitamin A is critical for vision health while vitamins C and E boost immune health. Along with being high in fiber, good fats and vitamins, avocado’s help the body absorb nutrients more efficiently. Moderation is the key factor to consuming a healthy amount of avocado’s every day, and when moderation is achieved avocado’s and heart health are the perfect ‘avo-couple’.

-KM