RECIPES

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DIETSODAAND DIABETES

BELLYFATHOW TO LOSE THAT SPARE TIRE

HEALTHY LIVING WITH

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HEALTHY LIVING WITHDiabetes FrEE

A spare tire comes in handy if you have a fl at, but who wants one around their middle? Too much belly fat is linked with a number of health problems. Here’s how to tell if you need to trim your waistline and, if so, what you can do.

BEllY Fat and YoUr BodYThe fat that surrounds the mid-part of your body tends to wrap itself around your internal organs, too. Belly fat is also called visceral fat, and unlike the fat that lies right under your skin, it’s a more harmful kind of fat.

WHY too MUCH BEllY Fat Can BE HarMFUlStudies show that increased belly fat may lead to certain health problems, such as:

• heart disease.• type 2 diabetes.• fatty liver disease.• breast cancer.• depression.

Belly fat can cause areas of your body to become infl amed, which may cause many of the health problems listed above. Belly fat is linked with high bad cholesterol (LDL) and low good cholesterol (HDL). It’s also linked to insulin resistance,

which means your body starts to ignore the insulin you produce. Insulin resistance can lead to type 2 diabetes. If you already have diabetes, insulin resistance makes it harder for the insulin you make or inject to work well.

HoW to tEllOne look in the mirror can indicate if you have too much belly fat. Here are some tell-tale signs:

Are you shaped like an apple or a pear? If you carry your excess weight around your middle, you are shaped like an apple. If your extra weight is stored below your waist, in the abdomen and buttocks area, you are more like a pear. Those who fall into the apple group have

too much belly fat.Is your waist size

larger than your hip size? If you’re a woman and your waist size is more than 35 inches around, or if you’re a man and your waist size is more than 40 inches around, you may have too much belly fat. To measure your waist, take a tape measure and wrap it around your waist so that it crosses your navel. Keep the tape measure above your hip bones and don’t suck in your stomach. Or, ask your healthcare provider to measure your waist for you.

Is your body mass index (BMI) too high? Many people with a high BMI tend to

have too much belly fat. You can fi gure out your BMI by using a BMI calculator on the Internet, or your provider can calculate it for you.

Your BMi tells you where your weight stands in relation to your height. a BMi between 25 and 29.9 puts you in the overweight group, and a BMi above 30 indicates obesity for most people.

HOW TO LOSE THAT SPARE TIREBy Amy Campbell, MS, RD, CDE

BELLY FAT

COSTCO HEALTHY LIVING WITH DIABETES 4 I HOLDAY 2013

You may have heard about recent studies showing that people who drink diet soft drinks have a higher risk for diabetes, high blood pressure, heart attacks and strokes than those who do not drink diet drinks. But in fact, researchers have not been able to say that the diet drinks are to blame. Most of those studies are observational, meaning they simply report what they observe. Observational studies are not designed to determine cause and effect. That requires a different kind of study.

In addition, a recent study showed other differences between people who drank diet sodas and those who drank regular sodas. Overall diet, or food intake, is one important difference.

DIET SODA STUDY The most recent study to look at diet sodas followed more than 4,000 people for 20 years who were between the ages of 18 and 30 when the study began. The researchers measured how many people got metabolic syndrome after 20 years.

Group 1. The group with the highest risk for metabolic syndrome (32%) regularly drank diet soda and ate a typical Western diet high in meat, processed foods and sugar.

Group 2. The group that regularly drank diet sodas and ate a healthier diet that was rich in fruits, vegetables, whole grains and fi sh had a slightly higher rate of metabolic syndrome (20%).

Group 3. The group that had the lowest risk for metabolic syndrome drank no diet soda but ate a healthy diet (18%).

STUDY CONCLUSION Researchers found that overall diet is what matters, and the effect of diet soda is not fully known. There are some studies in animals showing that artifi cial sweeteners can increase appetite and food intake, but it is not known if these same effects occur in people.

Other studies have shown similar results and seem to confi rm that one’s overall food intake can affect the risk of developing both metabolic syndrome and type 2 diabetes. Supporting this view is another study showing that people who ate a greater quantity of vegetables and a wide variety of fruits and vegetables had the lowest risk for developing type 2 diabetes.

DIET SODA STUDY TAKE-HOME

MESSAGE

think about how diet soda affects

your appetite and desire for sweets. if you think diet sodas make you

feel hungry or lead to cravings for sweet foods, try

switching to water, unsweetened ice tea or fl avored seltzer

water instead.

• eat a healthy diet, high in vegetables and a variety of

fruits, whole grains and fi sh, as well

as less meat, processed foods and sugar. these suggestions apply

whether you are trying to prevent type 2

diabetes or have type 2 diabetes

already. because people with

diabetes are at risk for high blood pressure and heart disease, eating a healthy diet is a sound choice for

the long term. it will help to keep your blood glucose on

target and will help prevent the long-

term complications of diabetes.

Metabolic syndrome is a group of risk factors for heart

disease and diabetes, and includes too much

weight around the waist, high cholesterol,

high blood pressure and high blood glucose levels.

SODA AND DIABETES

By Martha Funnell, MS, RN, CDE

SODA DIET

COSTCO HEALTHY LIVING WITH DIABETES 6 I HOLDAY 2013

5tips to help manage your medicines

1 once-a-day medicines can usually be taken anytime.The important thing is to take them at about the same time every day. Some medicines work better when taken in the morning or at night. Ask your healthcare provider what time of day is best for the medicines you are taking.

2 take your medicines at mealtimes whenever possible. It’s usually easier to remember. And stick with a regular meal/medicine schedule as much as possible. If your schedule happens to change, ask your healthcare provider about the best way to deal with it.

3 if the label says to take after meals or on a full stomach, take them when you fi nish eating.

4 Bedtime can mean different things on different days. Choose a time and remember to take your medicines at that time, regardless of when you go to bed.

5 if the label doesn’t say anything about food, you don’t need to be concerned about when you take your medicines—though it is often easier to remember if you take them at mealtimes.

The study also found that many people did not fully understand what the instructions on their medicine bottles meant. They often took medicines more times per day than needed. Most people fi nd that the more often they have to remember to take their medicines, the easier it is to forget. So what can you do?

asK YoUr CostCo PHarMaCist tHE FolloWinG QUEstions:

1 Is there a particular time of the day it is best to take this medicine?

2 Do I need to avoid certain foods or drinks with this medicine?

3 Is it safe to drink alcohol with this medicine?

4 What are the side effects?5 How do I store this medicine?

Also, ask your pharmacist to help you make a plan or a calendar that will fi t in to your day and help you get the most from your medicine.

WHat doEs tHE laBEl on MY Pill BottlE MEan?

If the label says: It means:

Take on an empty stomach Take at least two hours after eating or one hour before you start eating

Take before meals Take right before you start eating

Take with food and liquid Take during or after your meal

Take with meals or at mealtime Take during or after your meal

Take every 12 hours Take twice daily, 12 hours apart (for example: 7 a.m. and 7 p.m.)

Take every eight hours Take three times a day, 8 hours apart (for example: 7 a.m., 3 p.m. and 11 p.m.)

MaKinG sEnsE oF

By Martha Funnell, MS, RN, CDE

meds

COSTCO HEALTHY LIVING WITH DIABETES 8 I HOLDAY 2013

Nuts, berries and oils seem to be in the news a lot lately, thanks to the health benefi ts that they provide. Here is a quick review of each of those foods, along with some new ways they can help your diabetes control.

NutsWalnuts, almonds, hazelnuts and most other types of nuts are great for your heart. They help lower LDL (bad) cholesterol levels, prevent harmful heart rhythms from forming and contain L-arginine, which can help artery walls “relax.” That can help prevent clogged arteries, chest pain and possibly heart disease.

What’s new? Nuts to the rescue. A recent Canadian study found that nuts not only help improve cholesterol levels, they can also help improve blood glucose levels. If you have type 2 diabetes, you know that if you eat too many carbohydrate-rich foods— pasta, rice, bread, cookies, potatoes, corn, peas, milk, fruit or fruit juice—your blood glucose will go too high.

In that study, researchers mixed unsalted almonds, peanuts, cashews, macadamia nuts, pistachios, hazelnuts, pecans and walnuts together. The subjects, who ate 2 ounces of the nut mixture each day in place of some of their carbohydrates, enjoyed a nice drop in their A1C. The A1C is a blood test that tells you how well your diabetes has been controlled for the past three months. People with diabetes have a lower risk of complications if they keep their A1C level below 7 percent.

Note: While eating more nuts can be helpful, don’t overdo it. Nuts are high in fat and calories and can cause you to gain weight if you eat too many of them.

Nuts, berries and oils can help you better manage your diabetes and lower your risk of health problems. Reap their benefi ts by making them a regular part of your eating plan.

ARE YOU NUTS ABOUT

By Janis Roszler, RD, CDE, LD/N

NUTS,BERRIES AND OILS?

10 I HOLDAY 2013

BerriesBerries, such as straw-berries, blueberries, raspberries and cranberries, are rich in antioxidants, substances that fi ght damage caused by toxic byproducts (free radicals). Some of these byproducts come from natural cell processes in the body, while others come from environmental sources, such as cigarette smoke, pesticides and sunlight.

What’s new? If you have type 2 diabetes and eat an antioxidant-rich diet, you may fi nd it easier to keep your blood glucose level in a healthy range. That’s because the antioxidants can improve your body’s response to insulin. Experts in Italy who observed that benefi t also believe that an antioxidant-rich diet can also help metformin, a common diabetes medicine, work better in the body. They suggest that people with diabetes eat fi ve servings of fruits and vegetables daily to

help improve their insulin levels. In addition to berries, carrots, capers, tomatoes, orange juice and tea are also good sources of antioxidants.

Note: Fruits and fruit juices will raise your blood glucose level if eaten in excess. If you add them to your diet, count the carbs and check your blood glucose regularly. Adjust your intake of fruit and fruit juices, as needed, based on your blood glucose response.

OilsThere are four types of fats: two that harm and two that help. The harmful ones are saturated fats and trans fats. Saturated fats, found, for example, in red meat and high-fat dairy products, raise your risk of getting heart disease and type 2 diabetes. Trans fats are often found in stick margarines, shortenings and baked goods. A quick

glance at a food’s Nutrition Facts label will tell you if a product contains that type of fat. Trans fats should be limited, as they raise the body’s LDL cholesterol level and increase the risk of heart disease. Try to choose foods with 0 grams of trans fat per serving.

Polyunsaturated and mono unsaturated oils are the healthy oils. They are found in nuts, fi sh and vegetable oils, such as olive, saffl ower, canola and sunfl ower oils. They don’t seem to raise LDL cholesterol and may even help bring it down. When you cook at home or dress your salads, use these healthier oils.

What’s new? Fish oils are great for your heart, but did you know that they can also help keep your mouth healthy? People with diabetes have a higher risk

of gum disease, which can make it harder for them to control their blood glucose level. Fish oils, found in salmon, sardines, mackerel, swordfi sh and other fatty fi sh, may help prevent gum disease. The oils that seemed to offer the most help are the omega-3 fatty acids DHA and EPA. Experts don’t know exactly how much fi sh will help, but they suggest that people who have diabetes eat fatty fi sh at least twice a week.

Note: Be sure to limit the amount of oil you use. All oils are high in fat and calories and may lead to weight gain if you use too much.

COSTCO HEALTHY LIVING WITH DIABETES I 11

1. Preheat grill to medium heat.

2. Place onions on grill and cook 3 to 4 minutes on each side, or until browned.

3. Drizzle 1 tablespoon olive oil on cut sides of romaine and place on grill. Cook each side 4 to 5 minutes, or just until lettuce begins to wilt.

4. Meanwhile, brush remaining olive oil on cut sides of kaiser roll and place, oil side down, on grill. Grill for 1 to 2

minutes, or until roll gets crispy. Cut roll into ½-inch cubes for croutons.

5. Place romaine on a platter; cut each half in half again. Top each romaine wedge with onion, Parmesan cheese, croutons, and Caesar vinaigrette, distributing evenly. Serve warm.

NUTRITION INFORMATION PER SERVING: Calories 215, Calories from Fat 110, Total Fat 12g, Saturated Fat 3g, Trans Fat 0g, Cholesterol 5mg, Sodium 560 mg, Potassium 475mg, Total Carbohydrate 21g, Dietary Fiber 4g, Sugars 7g, Protein 6g, Phosphorus 105mgExchanges: ½ Starch, 2 Vegetable, 2½ Fat

1 large sweet onion, cut into ¼-inch slices

1 tablespoon plus 1 teaspoon olive oil, divided

1 large head romaine lettuce, cut in half lengthwise with core intact

¼ cup shredded Parmesan cheese

1 (2-ounce) kaiser roll, split in half

½ cup light Caesar vinaigrette

evenly. Serve warm.

Recipes adapted from Mr. Food Test Kitchen’s Hello Taste, Goodbye Guilt! Published by the American Diabetes Association, 2013.

Grilled Caesar Salad Makes 4 Servings

WARM WINTER SIDES

COSTCO HEALTHY LIVING WITH DIABETES I 13HOLIDAY 2013

2 tablespoons olive oil¼ teaspoon onion powder¼ teaspoon garlic powder¼ teaspoon kosher salt¼ teaspoon black pepper4 large bell peppers (assorted colors),

seeded and quartered

1. Preheat oven to 450°F.

2. In a medium bowl, combine all ingredients except bell peppers; mix well. Add peppers to the bowl and toss to coat well. Place peppers on a baking sheet.

3. Roast 20 to 25 minutes, or until tender.

Test Kitchen Tip: The key to really good roasted peppers is to make sure the oven is hot enough. If you want, you can peel the skin off the peppers once they are cooked.

NUTRITION INFORMATION PER SERVING: Calories 125, Calories from Fat 90, Total Fat 10g, Saturated Fat 1g, Trans Fat 0g, Cholesterol 0mg, Sodium 160mg, Potassium 375mg, Total Carbohydrate 11g, Dietary Fiber 4g, Sugars 7g, Protein 2g, Phosphorus 45mgExchanges: 2 Vegetable, 2 Fat

3 tablespoons vegetable oil

½ teaspoon salt2 large unpeeled

sweet potatoes, cut into 1½-inch slices with ends discarded

¼ cup light brown sugar

¼ cup chopped ¼ pecans

¼ teaspoon ground cinnamon

1 tablespoon light margarine, softened

1. Preheat oven to 400°F.

2. In a large bowl, combine oil and salt; mix well. Add sweet potatoes and toss until evenly coated, then place on a rimmed baking sheet.

3. Cook 25 to 30 minutes, or until fork-tender.

4. Meanwhile, in a small bowl, mix together brown sugar, pecans, cinnamon, and margarine until crumbly. Sprinkle on each potato round and return to oven; cook 8 to 10 minutes, or until sugar is melted. Serve immediately.

NUTRITION INFORMATION PER SERVING: Calories 180, Calories from Fat 100, Total Fat 11g, Saturated Fat 1.1g, Trans Fat 0g, Cholesterol 0mg, Sodium 230mg, Potassium 315mg, Total Carbohydrate 19g, Dietary Fiber 2g, Sugars 10g, Protein 2g, Phosphorus 45mgExchanges: 1 Starch, 1⁄2 Carbohydrate, 2 Fat

Sweet Potato CrownsMakes 6 servings

Rainbow Roasted PeppersMakes 3 servings

COSTCO HEALTHY LIVING WITH DIABETES 14 I HOLIDAY 2013 COSTCO HEALTHY LIVING WITH DIABETES