Good Nutrition Helps Fight a Diabetes Epidemic
by Cathy Corcoran
“I ignored the symptoms for months,” says Jeanne, a 64 year-old woman from Hingham. Jean had gained weight, and was increasingly forgetful and sluggish, especially in the morning. “I told myself it because I was getting older,” Jeanne says, but there was a reason for Jeanne’s lethargy. When she had her annual physical last spring, her blood sugar was sky high. She had Type 2 diabetes.
More than 25 million Americans have diabetes, and the disease is on the rise in the US and in the world. The Centers for Disease Control (CDC) calls the situation a “diabetes epidemic.”
Complications of the disease include increased risk for heart disease, stroke, blindness and loss of limbs through amputation. Obesity, also on the increase in the US, is considered a risk factor for developing diabetes.
A long time fan of pasta, bread and sweets, Jeanne says, “When I was diagnosed, I got really scared. I knew I had to get serious about my eating habits.”
“It can take a diagnosis like diabetes or a heart attack or stroke for some people to change their diets,” says Sharon Gallagher, a registered dietician with the Brockton Visiting Nurse Association. Most people know what a good diet is, Gallagher says, but as we get older, we face bigger challenges to eating healthy.
“People over age 50 can be set in their dietary ways, and they’ve probably been cooking for their families for years,” she says. “They’re tired of cooking big meals, and especially if they live alone, or it’s just a husband and wife in the household, they’d rather open a can of soup or pop a frozen dinner in the microwave than cook a real meal.”
But these convenience foods are often high in calories, fat and sodium, things that not only put on extra pounds, they increase the risk of getting diseases like diabetes, heart disease, even cancer. And if a person already has one of these conditions, a poor diet can make everything worse.
Gallagher meets with clients to assess their diets, set goals and make recommendations for a healthier eating plan. “I can give them the facts about good eating habits,” she says, “but the motivation to change has to be there. Some people want to live to see their grandchildren grow up, others want to lose weight so they can walk around their neighborhood, others just want to be able to fit into an airplane seat. I tell my clients to focus on what’s important, and remember that when they’re tempted to slide back into unhealthy eating.”
“When I was younger, watching what I ate was all about trying to lose weight so I’d look better,” Jeanne says. “Now I’m more focused on eating good foods to keep my body healthy.”
Jeanne ‘s doctor put her on diabetes medication and she changed her diet to avoid white bread, white rice, pasta and foods high in sugar. She began to feel better almost immediately, but what surprised her most was how much better she felt mentally on the new eating plan. “I’m thinking clearly now,” she says. “I feel better than I have in years.”
“The brain is greatly affected by the foods we eat,” says Nancy Emerson Lombardo, PhD. Founder and President of HealthCare Insights. “As we age, most of us will experience some memory loss, and some will develop Alzheimer’s disease or some form of dementia, but we’re finding that a diet rich in antioxidants and good fats can slow mental decline and actually enlarge some parts of the brain.”
Dr. Emerson Lombardo’s work focuses on brain health through nutrition. An adjunct research professor at Boston University School of Medicine, she has developed a nutritional program to help people reduce their risk of Alzheimer’s disease. It also helps to slow progression and improve the lives of persons who are already living with Alzheimers’.
She says that a good diet includes more plant foods than animal foods. “Vegetables and fruits contain most of essential nutrients we need to help us reduce cholesterol, reduce inflammation in our bodies and help control blood sugar,” she says. “These not only reduce the risk of diabetes and heart disease, they are all essential to brain health.”
She recommends “good fat” that comes from olive oil, nuts, avocado and other plant based foods. Omega 3 oil, found in fish and in cod liver oil is also good for the brain.
“Most of us have come to believe that fat is bad,” she says. “But it’s saturated fat and trans fat that’s bad for us. Good fat is actually essential to brain function. In fact, we’re actually fatheads. Most of the brain is made up of lipids or fats.”
Emerson Lombardo consults with individuals, families and health care providers, and is currently implementing her Memory Preservation Nutrition program in several assisted living residences in the area.
Ry-ann Bonilla, Nutrition Director at South Shore Elder Services, said "Some seniors just can’t get out to buy healthier foods. They live alone, and may have small fixed incomes."
South Shore Elder Services, based in Braintree, operates the Meals on Wheels program in eleven communities, serving meals Monday through Friday at 17 sites on the South Shore.
Meals include meat, vegetables, starch, milk, bread and dessert, and have lower amounts of sodium, saturated fat and sugar. Special Chinese and Kosher meals are available, as well as pureed meals and ground meals for those who are undergoing dialysis or have other specialized medical needs.
Bonilla works with nutritionist Regina Njoroge to develop menus for the program. She says that some clients complain about the blandness of meals. “They miss the taste of salt that they’ve become used to,” she says. “We use spices to add flavor, and eventually, most people become accustomed to the new tastes.”
The meals are calorically balanced to include one third of the daily recommended allowances for key nutritional ingredients. “As we age, our metabolism slows down,” Njoroge says. “Our bodies and our brains still need important nutrients, but we need fewer calories than we did when we were younger. We need to make good choices in the foods we eat to avoid weight gain and maintain a healthy body.”
Jack is a 70 year-old Scituate man who was rushed to the hospital back in 2002 with severe chest pains. “They told me I needed an emergency angioplasty,” he says. “They inserted a stent into my artery to keep it open and keep the blood flowing. It was the scariest night of my life.”
After a successful surgery, Jack’s doctor put him on medication and told him he had to change his diet, exercise more and lose weight. “I had the fear of God put into me,” Jack says. “I joined a gym, cut my calories, and stopped eating junk food entirely.” Within six months, Jack’s cholesterol had dropped dramatically, he had lost 30 pounds and he felt great.
But after several years, the weight started creeping back on, and this past year, Jack had two knee replacement surgeries that kept him from exercising for months. “I spent most of last year sitting on the couch feeling sorry for myself and eating potato chips and cookies,” Jack says. He has gained back all the weight he lost in 2002, and added a few more pounds as well. “I feel terrible,” he says.
At his last physical, his doctor had to increase his blood pressure medication and told him he had to lose weight.
Jack sighs. “I know I shouldn’t eat better, but I seem to have lost my motivation. Having this extra weight just makes me feel bad about myself.”
“I tell my clients that diet is not a moral issue,” says Betsy Cohen, founder of Whole Health for Women. “People know they should eat better, but there are so many emotional issues involved with food, it’s hard to do what we know is right.”
A former therapist, Cohen is a graduate of the Integrative Nutrition Program at Columbia University. She says that many people turn to food for comfort, especially during times of stress. Others love the foods they had as children, even though as adults, they know they shouldn’t eat them.
“If you grew up eating lots of pizza and pasta, or your mother baked cakes and pies for the family, you associate those foods with comfort and pleasure. Of course you’re going to want to eat them, especially if you’re stressed, you’re lonely, or you’re in poor health.”
Cohen counsels individuals and groups in a program that combines nutrition and lifestyle, as well as physical, emotional and spiritual health. Her clients are typically women who are frustrated with their health, stressed and overwhelmed and ready to change. Often, they are confused about their relationship with food and want to lose weight, control cravings, incorporate exercise and control or minimize health issues.
She focus on helping clients understand how their bodies work and why they sometimes manifest disease. Then they acknowledge the role that emotions play in eating habits, and begin to nourish their bodies from the inside out with wholesome foods. Clients also learn to become aware of how environmental factors affect them, and learn more about women's health issues, including weight loss, stress, menopause, perimenopause, fertility, and other conditions. Finally, they work to develop a belief system that bypasses denial and deprivation and instead promotes inner peace and satisfaction.
Cohen says that most of us have lost touch with what our bodies really want and need. “I often say that the food we eat is actually secondary,” Cohen says. “The real issue is what do our bodies crave? How can we give our bodies and our souls what we really want?”
“When I discovered I had diabetes, I had to become more aware of my body and its needs,” Joan says. “I have to stick my finger with a lancet and monitor my blood sugar every day. If I eat right and exercise, I feel good. If I don’t, I know I’m going to pay the price.”
She says she wishes she hadn’t ignored her symptoms for months, and blames her hectic life - working an irregular schedule, commuting, and caring for her husband, who also has a chronic disease.
“When you’re living a busy life and taking care of your family, it’s easy to put your health last on the list,” she says, “but especially if you’re over 50, you need to listen to your body and take care of it. I’m sorry I got diabetes, but I’m grateful that it’s made me more aware of my body, and made me willing to make changes so I could live a healthier life.”