Eating Healthy with Diabetes

by Robin Fedie, RD, CD

“You have diabetes” is a life-altering phrase that has been heard by 18.8 million people in the United States. Another seven million people have diabetes but haven’t been diagnosed with it yet. As a registered dietitian with over 30 years of experience in nutrition counseling, I have observed the emotional and physical effects of the diagnosis of a chronic illness. Type 2 diabetes accounts for 90-95% of all cases of diabetes in the United States. It usually begins as insulin resistance, meaning the body isn’t allowing insulin to function as it is meant to. Diabetes is a progressive disease and eventually the pancreas doesn’t put out insulin as it should, so the disease becomes two pronged with the insulin not working properly and not enough insulin being produced.

One of the leading causes of type 2 diabetes is obesity. Type 2 diabetes was once called adult onset diabetes because it was seen only in adults. With the current obesity epidemic we are now seeing type 2 diabetes in children. Diabetes consequences are many. It is the most common cause of kidney failure, nontraumatic amputations of the lower limbs, and new cases of blindness in adults in the U.S. It is also a major cause of heart disease and stroke.

Prediabetes is a condition characterized by blood sugar values higher than normal but not high enough for a diagnosis of diabetes. People with prediabetes are at high risk for developing diabetes and at risk for heart disease and stroke. Fortunately, research has shown that lifestyle changes in the form of weight loss (the benefits are seen at about a 7% weight loss) and increased physical activity (150 minutes per week) can prevent or delay the onset of type 2 diabetes. The same recommendations for meal planning for type 2 diabetes apply to prediabetes too.

Meal planning goals include controlling blood sugar and blood fat levels, blood pressure, respecting the personal and cultural preferences of the individual and preserving the enjoyment of eating. A registered dietitian can help you determine your food needs to meet your goals. A number of meal planning methods can be used to meet these goals. Methods include carbohydrate counting, the plate method, exchange system, and the glycemic index. Many individuals find carbohydrate counting to be very effective and often meal plans will call for 45-60 grams of carbohydrate per meal depending on the individual. The plate method of meal planning is another option for some. Research also continues on the use of the glycemic index of foods as another tool.

The glycemic index (GI) of foods measures how a carbohydrate-containing food raises glucose levels as compared to a reference food (glucose or white bread). Higher GI foods increase blood glucose more than medium or low GI foods. Using the GI for meal planning involves choosing foods with low or medium GI foods. It may be possible to balance out the intake of a high GI food by choosing low or medium GI foods. Low GI foods include dried beans and peas, non-starchy vegetables, some starchy vegetables, most fruits, whole grain breads, and cereals including barley, whole wheat, and rye bread and all bran cereals. Of note, some foods with very little nutritional value have a low GI and some foods that are high in nutrients have a high GI value, so it is important to remember to emphasize the higher nutrient foods most of the time. Meats and fats don’t have a glycemic index because they don’t contain any carbohydrate.

The glycemic index of a food can be affected by a number of factors. Fat and fiber tend to lower the GI of food. The longer a food is cooked or processed the higher the GI value will usually be, but this is not always the case. In addition, the ripeness and storage of a food can affect the GI value.

The GI is a reflection of the type of carbohydrate but does not take into account the total amount of carbohydrate in a food, so it is still important to watch portion sizes to keep blood glucose values and weight in check. The GI combined with carbohydrate counting may have an added benefit over carbohydrate counting alone and may be the tool some people need to tweak their meal planning with for improved blood sugar control. To see some of the examples of the glycemic index of foods, visit www.diabetes.org and type in glycemic index in the search box.

Type 2 diabetes is on the rise but can be prevented. If you are at risk, take steps now to decrease that risk. Those living with diabetes can improve their health by following a healthy diet and including regular physical activity in their daily routines. We would be a much healthier nation if everyone (not just those with diabetes) would follow the recommendations for more whole foods in the diet including fruits, vegetables, and whole grains, with moderate amounts of lean proteins, healthy fats, and low fat dairy products.

Robin is a Registered Dietitian (RD), a food and nutrition expert with 35+ years of experience providing individual and group nutrition counseling. Robin’s goals include the promotion of wellness through healthy food choices and physical activity and providing nutrition therapy for existing conditions. Robinleerd@yahoo.com, Ph: 715 559-6948, Fax: 715 723-0870, http://robinfedienutrition.com/.

Delightful Diabetic Snacks

For those of us who crave the flavor and sweetness of tantalizing appetizers, but need to limit our sugar intake, the healthy hors d’oeuvres listed below do more than deliver. With a variety of salads, salsas, spreads and skewers that can be found in today’s dietary cookbooks, it has never been easier to substitute sugary cravings for healthier, yet just as tasty ones. Filling and flavorful, the following recipes are sure to satisfy.

Citrus & Cilantro Black Bean Salsa

Zesty and super healthy, this salsa is fiber-rich, low-fat, and high in protein.

Ingredients:
1 can (15 ounces) black beans, drained
3 medium tomatoes, diced
2 tablespoons frozen orange juice concentrate
1/2 cup chopped cilantro
salt

Directions:
1. In a medium bowl, mix the beans, tomatoes, orange juice, and cilantro. Add salt to taste. Let the mixture stand for 30 minutes to allow the flavors to combine.

Recipe provided from: Eat Up Slim Down Annual Recipes 2006

Peppery Humus with Cilantro

This healthy snack is full of flavor and fiber. Made with roasted red peppers and chickpeas, a 1/2 cup serving of this savory spread packs in seven grams of fiber.

Ingredients:
2 red bell peppers
4 large cloves garlic, unpeeled
1 can (15 1/2 ounces) chickpeas, rinsed and drained
2 tablespoons tahini
2 tablespoons lemon juice
1 tablespoon mild cayenne pepper sauce
1/4 cup chopped fresh cilantro
assorted vegetable sticks, for dipping

Directions:
1. Preheat the broiler. Place the peppers on a foil-lined baking sheet. Wrap the garlic in foil and place on the sheet. Broil the peppers 6” from the heat for 15 to 20 minutes, turning until charred on all sides. Broil the garlic for 15 minutes. Place the peppers in a sealed bag and let stand for 10 minutes.
2. Meanwhile, when it’s cool enough to handle, peel the garlic and finely chop in a food processor. When the peppers are cool enough to handle, peel, core, and seed them. (You should have 1 cup of roasted peppers.) Add the peppers, chickpeas, tahini, lemon juice, and pepper sauce to the processor and blend until smooth. Add the cilantro and process just until combined. For best flavor, store refrigerated for at least 4 hours or up to 3 days. Serve with vegetable sticks or use as a spread for wraps or sandwiches.

Recipe provided from: Prevention’s the Sugar Solution Cookbook

Educate, Inspire, & Remind

We believe we have a unique placement among the “Natural/Organic” body care category for your stores that provide women with a product choice of Organic, Hand Made body care products that are less expensive than competitive products in this category, plus the benefit of contributing to a cause that will affect one out of three women. Our product formulator (Sandy Maine), is the original product developer of the Burt’s Bees line of products and has been developing natural, organic personal care products for twenty-eight years. One of our principle goals is to have this product line available all year, not just in October, Breast Cancer Awareness Month!  Below are some key points towards our efforts for your review.

• We are about creating more awareness & educating women about regular self-examination to help prevent the spread of breast cancer.
• Deaths from breast cancer are on the rise; 1 out of 3 women will experience this disease.
• Pink Ribbon Naturals will help expand this awareness in the Wisconsin markets, a small effort for sure, but still very important.
• We offer an all-natural, organic line of personal body care products for women that provides a gentle, daily reminder for self-examination.
• Our non-profit campaign will make contributions to local hospitals and foundations to fund breast cancer research.
• PRN is a socially responsible women-owned company.
• The products are handmade and certified as  “Made in The U.S.A.”, with more than 80% of all components made in the U.S., and with a minimum of a 75% certified organic formulation.
• There is no skin care product that delivers this cause- related message to women in retail stores today with an organic formula at these prices.
• We are running ad placements in the Gannett newspapers in WI along with articles about “Breast Cancer” in an October issue in many U.S. markets, with monthly ads over the next year.
• Our goal is to place Pink Ribbon products in local retail stores in 2012.  We are prepared to provide samples and brochures to consumers to increase awareness for the brand.

With over thirty five years of experience in the CPG industry, we realize the difficulty of placing new products in retail stores and the high failure rate associated with this endeavor.  We already have placement in many stores in Wisconsin, more added weekly.  Our overhead is low, we work with The Opportunity Development Centers here in WI to bottle and package product, helping them transition into the work place and to help assemble our products. Our plan is to grow the product line slowly, develop a grass roots consumer following in the Midwest markets.

We hope you will give us the opportunity to reach out to your consumers with a product we believe they will enjoy and also deliver to a cause that is important to women everywhere.

School Lunch Revolution: How Local Foods Can Land on Your Child’s Tray

by Amber A. Erickson Gabbey

Thinking back to my school lunches, I remember chicken nuggets, pizza and grilled cheese with tomato soup. There were raw carrots that often had a strange taste and bright green Jell-O with chunks of mystery fruit. The fruits and vegetables were second rate, appearing at the end of the line, with the starches and carbohydrates dominating.  Fast-forward to nowadays: there is a shift in nutrition guidelines and an epidemic of childhood obesity. The general public is becoming more informed. The school lunch is changing.

One of the most rapid changes to school lunches has come through farm to school programs. Today, nearly 10,000 schools nationwide participate in a farm to school program where they receive some of their product from local farmers. While each local farm to school program operates independently, they receive resources and support from the National Farm to School Network. The network formed in 2007 to help coordinate programs at the national level and to provide a framework and resources to assist the local programs. The National Farm to School Network has a network of individuals and organizations in every state.

The Program

Each farm to school program operates a little differently, depending on geographic location, community involvement, resources and prevalence of nearby farmers. “Each program is unique,” says Anupama Joshi, the Executive Director and Co-Founder of the National Farm to School Network. New or small programs may only have one food locally sourced. Developed programs could have as much as 70% of their food from local farmers. Many programs fall somewhere in between. “It’s an evolving process,” says Joshi. “There is always more to do and different ways to engage.” Vanessa Herald, Great Lakes Region Farm to School Network Coordinator adds “farm to school can mean any number of things: serving local food in the cafeteria…school gardens, farm field trips, chef in the classroom, food system and/or nutrition education, school farms …the list is really long.”

Although each program functions differently, the National Farm to School Network suggests four components: cafeteria food procurement, classroom or educational opportunities, community involvement, and school gardens. For the programs to be successful, students, staff, parents, farmers and the community must feel a sense of engagement and interaction in the process. Farm to school is meant to be a change agent – within schools, at home and in the community.  As such, the national network encourages schools to purchase not only from local producers, but local producers with sustainable practices.

Program Success

Because each program is so unique, it is difficult to gauge the success. Joshi describes the program as “quite successful” but says that success is dependent on who is leading the program in the school, how the goals are articulated and what success means to them. From the national network’s perspective, the program is successful if it focuses on nutrition, farmers and the community, regardless of size or scope. Farm to school programs have grown tremendously since 2004, driven by new interest in healthy foods, more talk about childhood obesity and the local food movement. “Public support for this kind of stuff is at an all-time high,” said Joshi. The whole food system is changing. In 2007, there were approximately 2,000 schools with a farm to school program. In 2012, around 10,000 schools have a farm to school program.

Outside of participation, another way to gauge success is through research and government support. In 2009, Wisconsin passed a Farm Bill that helped promote farm to school programs, including funding for state resources. Other states have passed similar bills and government and private institutions have provided funding to schools to implement or improve their programs.

While research around farm to school programs is in its infancy, a 2011 study conducted by the University of Wisconsin-Madison found that farm to school programs increased consumption of fruits in vegetables and knowledge about farms and healthy eating. Key outcomes concluded that in a farm to school program, students were instigating changes at home. They were asking for healthier foods and for more exercise. In addition, school personnel in farm to school programs are beginning to change their behaviors as well to further act as role models for students. Finally, the local economies in farm to school areas benefit greatly, with more money staying in the local area. In some cases, employment also increased. While data supporting farm to school is just beginning, the results are promising, says Joshi. With increases in school participation, government support, media coverage, collaboration with other organizations and research, farm to school programs are gaining in popularity.

But not all data is as positive. A study done by the Chippewa Valley Center for Economic Research and Development found that in their sample of 20 schools, only one was procuring local produce and only 0.06% of the food budgets were going to local sources. One reason was because the schools didn’t believe there was enough demand from students and parents.

Farm to School in Wisconsin

Of the nation’s approximately 10,000 schools with a farm to school program, Wisconsin is home to around 102 of those schools.  Being a large agriculture and dairy state, that is not surprising, but what about the Midwestern winters? Even in late fall, winter and early spring (the typical school season), options include root vegetables, squash and hearty greens, says Herald. Another way to combat this issue is by buying in bulk at the height of the season, when costs are low and production is high. Cafeteria staff has to get creative, through freezing or pre-cooking some items. In addition, weather becomes a great learning tool for students. Herald says students quickly learn about seasonality when their school garden is covered in snow.

How to Get Involved

If you are interested in farm to school options for your school, Joshi recommends the following steps:

1. Find out what is happening currently. Talk with cafeteria staff and school administrators to find out if something is already set up or if there is room for other options.
2. Engage parents and school staff and administrators. Start conversations and brainstorm ideas about school gardens, changes in curriculum, cafeteria options and other ways to build relationships between the school, farmers and community. Consider any potential start-up costs, such as equipment and staffing. Dream big, but also think about short-term goals.
3. Contact state representatives through the National Farm to School Network. Utilize their resources, understand what is working in nearby schools and begin discussions with interested farmers. For Wisconsin, check out the downloadable Farm to School Toolkits at www.cias.wisc.edu/toolkits/. Here, you can learn the basics of starting a farm to school program as a school food service employee or as a farmer.
4. Generate interest. The motivation to create change must come from those who will be executing the changes. Figure out how to get support from the farmers and/or school staff.
5. Do the business. Once there is interest and momentum, you’ll have to do the business portion, with meetings, contracts and schedules.

With one school at a time, one child’s lunch tray at a time, farm to school programs are gradually changing the way we think about school lunch. From children to farmers to the greater community, it’s good for everyone.

Amber A. Erickson Gabbey, MA, is a holistic lifestyle writer, grant writer and yogi.  She lives in Hopkins, MN with her life-partner, Erik.  She believes life, like yoga, is about effort, but then learning to surrender.

Connecting Technology, Health & Local Food

by Heather Hilleren

Eating fresh equates to eating healthy. To find fresh food, the solution is to find what is grown locally, which isn’t always an easy task. First, the health-conscious buyer has to find products that are produced in their area at a given time of year, and then they have to find where those products are being sold. If the buyer is able to find what is in season in his or her area and where to buy it, where can the consumer compare the farms producing the item, prices for the item and the locations where the item is being sold? With such obstacles facing the local food seeker the card is stacked against them, not only the local food consumer, but also the small farmer trying to sell their products to the consumer. Enter in “Local Dirt” and “Locavore”.

Local Dirt tackles these problems head on by filling in the gap between supply and demand. Local Dirt is an online site where anyone can buy or sell agricultural products. Potential individual customers can search for their favorite farm, farmers’ market, CO-OP, buying club or for just any local products. Local Dirt also caters business-to-business interactions, giving the wholesale businesses such as grocers, hospitals, restaurants, and schools the ability to efficiently buy from local farms of any size. By centralizing local food, Local Dirt has been able to offer features that no other local food-based site can offer, such as real time price sheets, showing the farms most current inventory and prices, online ordering, with both online and offline payment options, and automated purchase orders, which become invoices on day of delivery, just to name a few.

Locavore, similar to Local Dirt, also centralizes local food, but via your mobile internet device. Locavore is a mobile app that was created to fill the growing consumer demand for product information. How does Locavore do this? It uses GPS coordinates to map out nearby farms, farmers markets, and CSAs. It gives an “in season” listing, enables social networking, and provides recipe information for in season products. Local Dirt and Locavore provide local food consumers with access to options that didn’t exist before and provide an online selling option for farms, farmers markets, co-ops and CSAs. With the creation of Local Dirt and Locavore, the average consumer is given the ability to find and purchase local, fresh and healthy products. For more information on Local Dirt please visit localdirt.com; for information on Locavore please visit getlocavore.com.

From Apples to Twinkies: Why Local Food Really Does Matter

by Robert Andruszkiewicz, Just Local Food

Last July, WISPIRG (WI Public Interest Research Group) held a press conference comparing apples to Twinkies at Just Local Food. The event was held to help publicize a report WISPIRG wrote comparing Federal subsidies for corn against “REAL” food. These advocates for a rational Farm Bill in Washington, D.C. are fighting to help even the playing field so that an apple would actually be competitive in the market place against a tax payer-subsidized, corn syrup-laden Twinkie. When we think about food we should think about who produced this product and why.

A Twinkie has dense calories from corn sweeteners that make them deliciously sweet to some while fueling an obesity epidemic in our country for others. Families trying to make each dollar count see any calorie as a calorie.  And with corn sweeteners being artificially cheap, it is no wonder why a Twinkie is cheaper than an apple.

Before too long I realized why local food is important to nutrition and to our local economy.  Would I rather have a healthy local apple taxpayer subsidy over another large corporate handout for unhealthy food? I am not sure but I know there’s a better chance my dollar would stay here with a local farmer rather than go into the balance sheet of a national or multinational corporation.

If I want to be a no tax patriot, would cutting any subsidy for anything help us find our roots back to local food? I do not have the answer, but I suspect a local apple (and now they are here from our local growers) would be more appetizing to our taste and our pocket.

So I asked myself, what is local food and why is it important to people like me, my fellow co-workers, and our wonderful customers? But then why stop there … why not ask why local food is important to the chickens, lambs, sheep, cows, buffalos, pigs, etc?

The answer dawned on me — like the golden sun shining on the trees, shrubs and grasses that make for a healthy farm.

Pasture is LOCAL FOOD for these animals.

That same pasture makes these animals healthy, happy and wise.

We know through the marvel of science that purely grain-fed animals are unhealthy.  That is why they are pumped up with antibiotics. We know that the high caloric intake of grains for these animals produces unhealthy fats that are not good for us either.  Protein, for some of us, is the most desirable portion on our plate and could come from these large agri-business feedlots and egg factories ­— unless we buy local pasture-raised eggs and meat.

Local food for our local critters makes for healthier people. Eating local fruits and vegetables grown by small family farms makes for a healthier community. That is why local food really matters.

Imagine a pasture with Twinkies sprinkled all over and wonder whether the animals eat one or all of them? Will they enjoy it? Will they be healthy? Will the farmer be wealthier? Will they think they are eating local food? Or will they just look at the Twinkie and think they just saw a UFO.