August 2015- In This Issue:
Education & Problem Solving
Nutrition & Recipes
Education
Diabetes and
Your MOUTH
Taking better care of your teeth and
gums as a way to treat your diabetes
may not strike you as logical. In fact, a
2014 study at the University of
Pennsylvania School of Dental Medicine
uncovered surprising results. When comparing insurance data of 500,000 people
with Type 2 diabetes and periodontal (gum) disease, they found that those who
treated their periodontal disease saved $2,800 per year in medical costs for
diabetes.
What's the link?
According to the Centers for Disease Control (CDC), people with diabetes are twice as likely to get
gum disease as those without it. Periodontal (gum) disease involves two stages: GINGIVITIS
and PERIODONTITIS.
* When bacteria stays on teeth it forms a yellow film called plaque that may harden
into tartar IF not removed through brushing. The longer bacteria and sticky plaque
stay on teeth, the more damage they can do, leading 1st to Gingivitis in which the
gums become red and swollen and may bleed.
* Untreated Gingivitis can become Periodontitis, in which the gums begin to pull
away from the teeth forming pockets where infection can develop and spread down
the roots of the teeth.
Periodontitis is a chronic inflammatory condition that has long-term destructive
effects. Untreated, the disease - which affects roughly 50% of all adults and 70% of
those over age 65 in the US - can lead to tooth and bone loss and severe infection.
The disease can also have a wider impact on health as the periodontal bacteria
can enter the bloodstream, raising inflammation throughout the body.
Inflammation is the body's protective immune response to invaders: bringing
more blood cells to the area, widening blood vessel walls, and rushing healing
matter such as cholesterol to the site to help grow new cells. In the short term,
inflammation can be necessary and helpful. But when tissues stay inflamed for
long periods, tissue damage results that can weaken or block blood vessels.
Even apart from periodontal disease, inflammation plays a role in Type 2 diabetes
and prediabetes. Inflammation can lead to insulin resistance, a hallmark of both
conditions. Insulin resistance occurs when the body's cells become less sensitive
to insulin and thus less able to absorb glucose from the bloodstream. In response,
the pancreas produces more and more insulin to help the body maintain normal
blood glucose levels. Blood glucose beings to rise when the pancreas can no
longer keep up and produce as much insulin as needed. And high blood glucose
levels trigger further inflammation, eventually leading to blood vessel damage. The
process becomes cyclical: More inflammation leads to more insulin resistance, and
more insulin resistance leads to more inflammation!
Reference: Diabetes and Your Mouth by Dorothy Foltz-Gray Diabetes Self Management April 2015
Problem Solving
How Can I get Motivated to take care of
MYSELF?!
Taking care of diabetes and getting through your
daily to-do list along with your other
responsibilities is demanding. It is easy to
understand why motivation comes and goes. Here
are a few tips to get started.
1. Move away from all-or-nothing thinking.
2. Don't judge yourself as bad or good.
3. Make one small habit change after another.
Experience success, then change another small habit, then another. Small
successes contribute to BIG successes. Start with what you want to change, not
what you know you should change but don't really want to.
Nutrition:
pantry picks
ready to make a clean sweep of your eating habits? Start with your staple foods
and compare them to these guidelines.
When hunger hits what's stocked in your pantry is ultimately what ends up on your
plate. And if you're like most people, some not-so-good options sneak into your
kitchen - maybe because they were on sale or you wanted goodies on hand for
guests. In the long run, however, food is a smart buy only if it's good for your
body!
When selecting groceries, people with diabetes have to look out for their hearts,
waistlines, and, of course, blood glucose. That means opting for nutrient-rich foods
with fiber, heart-healthy fats, (trans fat-free) and antioxidants, yet reasonable in
sodium (less than 10% DV), calories and carbohydrate. Here's help figuring out
what to keep in your cupboards. (DV = Daily Value on Nutrition Facts)
What to PITCH - A pantry is supposed to help you
prepare meals but if it's stocked with empty calorie foods it's
not helpful. Search your shelves for these 10 items and toss
them in favor of more healthy options.
1. Crumb Pie Crusts - Ready-made graham cracker and cookie
crumb pie crusts are often laced with artery-clogging trans fat,
and they rank near the top of the list of trans-fat laden foods.
2. Processed Cheese - Whether sold in shelf-stable blocks, jars
or spray cans, processed cheese offers 2X the sodium of natural
cheese. Plus, it has up to 4 grams of carbohydrate per ounce
(up from 1 gram) with only half the protein of natural cheeses.
3. Vegetable Shortening - Shortening has been trimmed of much
of the trans fat it once had but partially hydrogenated oil still hides in the ingredient
list. Even small amounts can harm heart health.
4. Canned Pasta - A 1-cup serving of canned ravioli packs 750 mg sodium + 800
mg of potassium chloride, a type of salt. Potassium is a healthful nutrient but
getting too much from salt substitutes and processed food additives could pose a
problem for those with kidney disease and those taking certain blood pressure
medications.
5. Ready-to-Spread Frosting - Rich in sugar and fat, including 1.5-2 grams of trans
fat per serving, this creamy stuff is not even worth keeping on hand for a special
occasion. Top treats with a sweet sprinkle of powdered sugar, dark chocolate
shavings, or colorful berries instead.
6. Boxed Meal Kits - Even health-sounding boxed dishes that instruct you to add
chicken or tuna contain a laundry list of questionable ingredients including small
amounts of partially hydrogenated oil, artificial colors and flavors and a heavy hit of
sodium. Boxed meal helpers could leave you short on fiber and whole grains, too!
7. Salty Salad Dressings - Want a side of salt with your leafy greens? Sodium per
2 Tablespoon serving often hits 300-400 mg. Light versions don't necessarily save
on sodium or carbs - just fat and calories. Opt for dressings with less than 240 mg
of sodium per serving.
8. Ramen Noodle Soups - These may have been standby meals in college, but it's
time to graduate to healthier options. A half package of these noodles with
seasoning top 800 mg sodium along with partially hydrogenated oil, saturated fat
and hard-to-pronounce chemical flavorings and preservatives.
9. Large Flour Tortillas - Whether makig Mexican dishes or sandwich wraps, skip
big, burrito-size flour tortillas. Made with refined white flour they offer little fiber yet
pack 200 calories, greater than 30 gm carbohydrate and 600 mg of sodium apiece
along with artery hardening vegetable shortening.
10. Too-Tempting Foods - This refers to any calorie-dense foods that entice you,
personally, to eat too much or blow your carbohydrate and fat budget. Maybe it's
chips, cookies, sugary cereal or ice cream. Try getting it out of the house or at
least out of your kitchen.
What to Buy - Now that you have more room in your
pantry boost flavor and nutrition at mealtime by stocking up on
these 10 supermarket purchases.
1.Unsalted Chicken Stock - Chicken stock can pack more than 900 mg sodium
per cup so opt for unsalted or low-sodium stock or broth. Homemade chicken
soup is the best choice and can be used as a cooking liquid for whole grains and in
place of oil to saute vegetables.
2. Low-Fat Corn Tortillas - Soft corn tortillas, typically low in fat and made without
vegetable shortening are a smart swap for hard taco shells and flour tortillas.
3. Steel-Cut Oats - Not a fan of flaked oatmeal with its sometimes-pasty
consistency? Try steel-cut oats, which are simply whole grain kernels cut into a
few pieces. Their nutty, chewy texture shines in your morning cereal bowl and
they reheat well, too.
4. Raw Walnuts - There are countless uses for this
versatile nut rich in heart-healthy omega-3 fats. Chop
finely to coat fish, sprinkle on salads, cereal and yogurt
or simply grab a small handful to a snack. Also, try
grinding walnuts into small pieces for a nutritious crust
for baked goods.
5. Oils Rich in Monounsaturated Fats - Besides
supporting healthier cholesterol levels, some studies
suggest moderate amounts of monounsaturated fats may help lower blood
pressure, improve insulin sensitivity, and lower average blood glucose (A1C). Top
picks include extra virgin olive oil and avocado, which are also rich in natural antioxidants.
6. Low-Fat Powdered Peanut Butter - If you've kissed peanut butter good-bye to
cut calories, say hello to powdered peanut butter that's had most of the fat
removed. A 2 tablespoon serving averages 45 calories, 1.5 grams of fat and 5
grams of carbohydrate. Mix it with water for a spread or dip or add the powder to
recipes such as a smoothie.
7. Canned Salmon - Wild caught salmon tops the list of omega-3-rich fish with low
mercury contamination. Swap skinless, boneless canned salmon for most dishes
you'd make with tuna. Sneak canned salmon into noodle casserole, or mix it with
low-fat mayonnaise, minced celery and pickle relish to use as a sandwich spread.
8. Low-Sodium Beans - Great in soups, salads, dips, main dishes, and even
some desserts, fiber-rich beans are as versatile as they are nutritious. Dried
legumes are naturally low in sodium, but for convenience stock no-salt-added or
reduced-sodium canned beans, too.
9. Balsamic Vinegar - Balsamic vinegar adds zing to meat marinades, vegetable
dressings and even strawberries. Plus, preliminary studies suggest that adding
about 1 1/2 tablespoons of the vinegar to high-glycemic or high-carb meals may
help improve insulin sensitivity and blunt blood glucose spikes after meals.
10. Grainy Mustard - This coarsely ground mustard is a lowfat, virtually
carbohydrate-free way to liven up sandwiches and recipes. The process of making
spreadable mustard releases the seeds' cancer-fighting compunds, making even
small amounts potent in helping reduce cancer risk.
Recipes:
Teriyaki Salmon with Asian Slaw
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3 tablespoons reduced-sodium teriyaki sauce,
divided
2 salmon fillets with skin (about 4 to 5 ounces
each and 1 inch thick)
2 1/2 cups coleslaw mix
1 cup snow peas, cut into thin strips
1/2 cup thinly sliced radishes
2 tablespoons orange marmalade
1 teaspoon dark sesame oil
Directions
Preheat broiler or prepare grill for direct cooking. Spoon 1 1/2 tablespoons teriyaki
sauce over fleshy sides of salmon. Let stand while preparing vegetable mixture.
Combine coleslaw mix, snow peas, and radishes in large bowl. Combine remaining
1 1/2 tablespoons teriyaki sauce, marmalade, and sesame oil in small bowl. Add to
coleslaw mixture; toss well.
Broil salmon 4 to 5 inches from heat source, or grill, flesh side down, over medium
coals, without turning, 6 to 10 minutes or until center is opaque and fish just begins
to flake when tested with a fork.
Transfer coleslaw mixture to serving plates; serve with salmon.
Yield: 2 servings. Serving size: 1 salmon fillet with about 2 cups slaw.
Nutrition Facts Per Serving:
Calories: 373, Carbohydrates: 27 g, Protein: 26 g, Fat: 18 g, Saturated Fat: 3 g,
Cholesterol: 62 mg, Sodium: 615 mg, Fiber: 4 g
Exchanges per serving: 1/2 Bread/Starch, 1 Fat, 3 Vegetable, 3 Meat Lean.
Brown Rice with Cranberries:
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1 can (14 1/2 ounces) fat-free reduced-sodium vegetable or chicken broth
3/4 cup uncooked brown rice or brown basmati rice
1/4 cup water
1/4 teaspoon salt
1/4 cup dried cranberries
1/8 teaspoon ground cinnamon (optional)
1/4 cup coarsely chopped walnuts, toasted*
Directions
Combine broth, rice, water, and salt in large saucepan. Bring to a boil over high
heat. Reduce heat; cover and simmer 20 minutes.
Stir in cranberries and cinnamon, if desired; cover and simmer 20 to 25 minutes or
until rice is tender. Sprinkle with walnuts before serving.
*Note. To toast walnuts, spread in single layer on baking sheet. Bake in preheated
350°F oven 8-10 minutes or until golden brown, stirring frequently.
Gluten-free variation. To make this dish gluten free, be sure to read ingredient
labels carefully and purchase gluten-free vegetable broth.
Yield: 5 1/3-cup servings.
Nutrition Facts Per Serving:
Calories: 172, Carbohydrates: 29 g, Protein: 3 g, Fat: 5 g, Saturated Fat: 1 g,
Cholesterol: 0 mg, Sodium: 162 mg, Fiber: 2 g.
Carbohydrate choices: 2 1/2 bread/starch, 1 fat.
Veggie Chili
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1 medium onion, finely diced
1 clove (or 1 teaspoon) minced garlic
6 ounces (1/2 package) meatless ground beef crumbles
1 cup frozen corn, thawed
1 small zucchini (approximately 7 inches long), diced
1 can (8 ounces) no-salt-added tomato sauce
1 can (10 ounces) diced tomatoes and green chilies, undrained
1 can (14 1/2 ounces) no-salt-added diced tomatoes, undrained
1 can (27 ounces) pinto beans, rinsed and drained
1 envelope (1.75 ounces) chili seasoning mix
Directions
Combine all ingredients in a large pot and stir to mix well. Bring to a boil, reduce
the heat to medium, and simmer uncovered for 30 minutes; stir frequently to
prevent sticking. Leftovers reheat well or may be frozen.
Yield: 9 cups. Serving size: 1 cup.
Nutrition Facts Per Serving:
Calories: 153, Carbohydrates: 26 g, Protein: 10 g, Fat: 1 g, Saturated Fat: less
than 1 g, Sodium: 770 mg, Fiber: 7 g.
Exchanges per serving: 1 starch, 2 1/2 non starchy vegetable. Carbohydrate
choices: 2.
Strawberries and Honeyed Yogurt Sauce
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1 cup plain low-fat yogurt
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1 tablespoon orange juice
1 to 2 teaspoons honey
Ground cinnamon
1 quart fresh strawberries, stems removed
Directions
Combine yogurt, juice, honey, and cinnamon to taste in small bowl; mix well. Serve
sauce over strawberries.
Yield: 4 servings. Serving size: about 1/4 cup dip with about 7 strawberries (1 cup).
Nutrition Facts Per Serving:
Calories: 88, Carbohydrates: 16 g, Protein: 4 g, Fat: 1 g, Saturated Fat: 1 g,
Cholesterol: 4 mg, Sodium: 41 mg, Fiber: 4 g.
Exchanges per serving: 1 Fruit, 1/2 Milk.
We hope you have found this newsletter helpful.
Send us educational topics of interest that you may have
regarding the management of diabetes.
Please feel free to discuss with your provider a referral to
Outpatient Diabetes Resource Institute
at Catholic Medical Center.
Share your thoughts. Contact us at:
[email protected]
Catholic Medical Center
Outpatient Diabetes Resource Institute
603-663-6431
Contact us.
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