Each month in Food, Nutrition & Science, we feature an article by a dietitian. This month's contribution on Prediabetes comes from Hope Warshaw.
Hope Warshaw, MMSc, RD, CDE
Take the U.S. stat alone. This diagnosis, yes it’s a diagnosis, affects nearly 80 million Americans, and the number is on the uptick due, in part, to our obesity epidemic. According to Centers for Disease Control and Prevention (CDC), that’s 35 percent of American adults over 20 years of age, 50 percent of adults over 65! These stats are downright scary. Prediabetes is the telltale sign that a person is on the road to type 2 diabetes. Research shows roughly 70 percent of people progress to type 2 diabetes.
Yes, this is a health epidemic! Yes, it’s November, American Diabetes Association’s Diabetes Month and an opportune time to raise awareness about prediabetes.
Two supermarket dietitians, who also hold the credential of Certified Diabetes Educator (CDE), confirm the skyrocketing numbers just by listening and responding to customer inquiries in their supermarkets. “We hear daily from people who say they have prediabetes and want to do what it takes to prevent type 2,” says Jodi Schweiger RD, CDE, Diabetes Program Coordinator with Hy-Vee Supermarkets. “We’re fielding more questions from people with prediabetes and the family members who shop and cook for them,” says Kim Kirchherr, MS, RD, LDN, CDE, Corporate Dietitian for Jewel-Osco and related supermarket chains.
But Schweiger and Kirchherr reveal that people with prediabetes, or their supermarket emissaries, are confused. “Many people still think that sugary foods and sweets are their nemesis and focus their eyes straight at the “sugars” line on Nutrition Facts panels. They haven’t a clue that the term “sugars” includes both naturally occurring plus added sugars and that the total carbohydrate count is a place to focus their attention,” says Kirchherr.
Schweiger encounters many people who’ve searched the Internet and come away thinking they can’t eat carrots, should buy products recommended by Dr. Oz or follow an Atkins-style diet. Both Schweiger and Kirchherr agree that people with prediabetes need evidence-based, easy-to-follow recommendations.
So, what are they?
It’s not skip the starches and say no to sweets!
Studies conducted around the globe over the last twenty plus years, including the famed U.S. based National Institutes of Health Diabetes Prevention Program trial, have repeatedly echoed consistent advice. Goal one: shed some pounds – about 5 to 7 percent from a person’s starting weight – to lower blood glucose and blood pressure and correct abnormal lipids. The long term goal is to help people change their eating habits and increase their physical activity (ideally 30 minutes nearly every day) to keep as many of these pounds off as possible. To lose weight people should taper their calorie count by reducing portions of sugary food and drinks, eat less fats and oils (especially saturated and trans fats), choose lean protein foods and minimize the serving sizes, and increase their consumption of vegetables, fruits, fiber-filled whole grains and low fat dairy foods. Yes, recommendations absolutely in sync with our Dietary Guidelines for Americans.
One more critical message: ACT NOW – as soon as the diagnosis is made. Why? Research shows that the earlier in the course of the progression from prediabetes to type 2 a person takes action, the greater the odds that they’ll prevent type 2 or slow the progression.
Though awareness of prediabetes is rising, a significant challenge is that relatively few people know they have it. According to a CDC conducted study, less than 10 percent of the 80 million people estimated to have prediabetes know it.
Who’s at high risk? People with a family history of type 2 diabetes. People who are overweight. Women who’ve had gestational diabetes or large babies.
One reason there could be more buzz about prediabetes in the supermarket aisles is a recently launched CDC program – the National Diabetes Prevention Program. It was put in motion with the passage of the Affordable Care Act (“Obamacare”) to prevent the progression from prediabetes to type 2 in people at high risk of type 2. People enroll in a year-long group-based program facilitated by a trained lifestyle coach with the goal of trimming off a few pounds through healthy eating and increased physical activity. The CDC program aims to raise awareness of prediabetes among citizens, health care providers, insurers and employers.
Kirchherr and Schweiger concur – the supermarket is the perfect setting to teach people with prediabetes and their loved ones. “I’m by their side when they’re selecting their foods,” says Schweiger. When counseling people with prediabetes, Kirchherr calls the timing and portions of meals and snacks priority one. Total calories, saturated fat and lightening up on sodium are a close second because the leading cause of complications and death in people with type 2 diabetes is heart disease and high blood pressure. Schweiger, who’s been instrumental in getting an accredited into her Hy-Vee store for Diabetes Self-Management Training programpeople with diabetes, encourages people with prediabetes to set up an appointment to develop a personalized eating plan and goals. Then to stay in close touch as they put their lifestyle changes into action.
Yes, these dietitians are 100% behind the growing trend of putting RDs who are also CDEs right where customers with prediabetes and diabetes need them – in the supermarket aisle.
Hope Warshaw, MMSc, RD, CDE, is a dietitian, diabetes educator, writer and author of numerous books published by American Diabetes Association including Diabetes Meal Planning Made Easy. Visit her website at hopewarshaw.com. Follow her on twitter at: @hopewarshaw. Like her at: facebook.com/eathealthylivewell.