Health for life

The American Diabetes Association (ADA) recently published their new Position Statement on nutrition therapy for people with diabetes:

Nutrition Therapy Recommendations for the Management of Adults With Diabetes, Diabetes Care, Published online ahead of print, 9 October 2013.

This post focuses on fat. Previous posts focused on carbohydrate and protein. The carbohydrate post summarized the grading system that the ADA used to rate their evidence.

Keeping with their recommendations for carbohydrate and protein, the panel did not designate a particular amount of fat to consume. They noted that people with diabetes eat about 36-40% of their calories from fat - an observation, not a recommendation.

For people without diabetes, the Institute of Medicine states that an acceptable amount of fat to consume (acceptable macronutrient distribution range or AMDR) is 20-35%, and that there is "evidence for increased obesity and its complications [e.g. heart disease] at high intakes of fat." Echoing this, the ADA said:

"Individuals with diabetes should be encouraged to moderate their fat intakes to be consistent with their goals to lose or maintain weight."

Here are the ADAs grades for total fat intake:

Evidence is inconclusive for an ideal amount of total fat intake for people with diabetes; theore, goals should be individualized. Grade C

Fat quality appears to be far more important than quantity. Grade B

Regarding fat quality, the ADA recommended substituting saturated fat with monounsaturated and polyunsaturated fat: "PUFAs and MUFAs are recommended substitutes for saturated or trans fat."

In people with type 2 diabetes, a Mediterranean-style, MUFA-rich eating pattern may benefit glycemic control and CVD risk factors and can theore be recommended as an effective alternative to a lower-fat, higher-carbohydrate eating pattern. Grade B

Nuts and olive oil are good sources of monounsaturated fat.

Omega-3 fatty acids are polyunsaturated fatty acids or PUFAs. The panel perred omega-3-rich food over omega-3 supplements:

Evidence does not support recommending omega-3 (EPA and DHA) supplements for people with diabetes for the prevention or treatment of cardiovascular events. Grade A

As recommended for the general public, an increase in foods containing long-chain omega-3 fatty acids (EPA and DHA) (from fatty fish) and omega-3 linolenic acid (ALA) is recommended for individuals with diabetes because of their beneficial effects on lipoproteins, prevention of heart disease, and associations with positive health outcomes in observational studies. Grade B

The recommendation for the general public to eat fish (particularly fatty fish) at least two times (two servings) per week is also appropriate for people with diabetes. Grade B

About saturated fat, they said:

The amount of dietary saturated fat, cholesterol, and trans fat recommended for people with diabetes is the same as that recommended for the general population. Grade C

They note that the general population should be aiming for less than 10% of calories from saturated fatty acids (SFAs) and less than 300 mg cholesterol/day:

"The Dietary Guidelines for Americans, 2010 recommends consuming less than 10% of calories from SFAs to reduce [cardiovascular disease (CVD)] risk. Consumers can meet this guideline by replacing foods high in SFA (i.e., full-fat dairy products, butter, marbled meats and bacon, and tropical oils such as coconut and palm) with items that are rich in MUFA and PUFA (i.e., vegetable and nut oils including canola, corn, safflower, soy, and sunflower; vegetable oil spreads; whole nuts and nut butters, and avocado).

CVD is a common cause of death among people with diabetes. As a result, individuals with diabetes are encouraged to follow nutrition recommendations similar to the general population to manage CVD risk factors. These recommendations include reducing SFAs to less than 10% of calories, aiming for less than 300 mg dietary cholesterol/day, and limiting trans fat as much as possible."

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Overweight No Excess of Nutrition - Because thin people is synonymous with malnutrition, many people think that obesity means the excess of nutrients. In fact, obesity is included in the category of malnutrition.

Overweight or obese is caused by excess of calories, because the are in excess of fat and sugar. So, the vitamin is less. That is why the overweight is include to malnutrition. said Dr.Fiastuti Witjaksono, Sp.GK, in the ceremony of announcement of winner in The + Project that handle by philips in Jakarta.

Overweight, in spite of genetic factor, but accord to Fiastuti, this is more caused by environment factor. "Usually because of eating pattern in high fat and lifestyle," said the lecturer in the Department of Nutritional Sciences Faculty of Medicine, University of Indonesia.

According to the data "Riskesdas" The Ministry of Health, 2010, current population of overweight people in Indonesia reached 10 percent and reached 11.7 percent obese.

Fiastuti explain, this time, eating have been moved to lifestyle. Now the peoples eat not because of hungry only, but also in others moment." she said.

My first attempt at a video presentation.  Check it!  And head over to You Tube and "like" it.  And comment!

If childhood obesity expert Melinda Sothern could wave her magic wand and help kids live healthier lives, shed want parents and children to dine together every night. "Research is clear that family meals equal healthier weights, emotional stability and better school performance," she says.
She would have parents insist that their kids ditch cellphones and other media devices when they come home from school and go outside to play for an hour, or if its too dark when they get home, then they can put on some music and dance inside.
"This active time will burn four to five times more calories than sitting and help prevent obesity and type 2 diabetes," says Sothern, an exercise physiologist and a professor at Louisiana State University Health Sciences Center in New Orleans, who has treated more than 3,000 overweight children over the past 23 years. Shes the co-author of Trim Kids.
She also wishes parents would make sure that kids eat a healthy breakfast daily, get plenty of shut-eye and stop snacking mindlessly. "Parents have far more power than they realize to guarantee a healthy future for their children."
Sothern and other top national researchers in childhood obesity and nutrition are presenting their latest research at the annual Obesity Society meeting in Atlanta this week. In one session on Tuesday, several experts will offer parents practical tips on how to create healthy habits at home.
Currently, about a third of kids in this country are overweight or obese, according to the Centers for Disease Control and Prevention. Extra pounds put kids at a higher risk of type 2 diabetes, high blood pressure, high cholesterol, liver disease, sleep apnea and other health problems.
Some ideas from nutrition and exercise researchers on setting up a healthier home environment:
• Plan healthy, tasty breakfasts. Offer children a lean protein at breakfast such as eggs, string cheese, Canadian bacon, turkey bacon or hummus, Sothern says. Serve them fresh fruit such as berries. Or whole-grain cereal with nuts is another option. Top off the meal with a glass of fat-free or 1% low-fat milk or a carton of low-fat yogurt, she says.
• Discourage mindless munching. Dont let kids eat in front of the TV or computer and gradually restrict all eating and drinking, except for water, to the kitchen counter, table or dining room, Sothern says.
• Get them involved. Take kids to the grocery store. Skip the soda, cookie and candy aisles and have children select one fruit and vegetable to try each week. At home, include children in lunch and dinner preparation, Sothern says.
• Reinstate family traditions. Insist on family dinners, set the table with real cloth napkins, light candles and play soft music in the background to encourage discussion. Compliment the children on their healthy food selections, cooking and manners, she says.
• Get some shut-eye. Allow kids no more than one hour of media time before bedtime. Try to make sure they get the required 9 to 10 hours of sleep a night. Research shows that lack of sleep equals unwanted weight gain, behavioral problems and difficulty concentrating the next day, Sothern says.
• Offer a nutritious starter course. Pennsylvania State University research shows that adults who eat a broth-based bowl of vegetable soup; a large, low-calorie, lettuce-based salad; or an apple before a meal consume about 110 to 190 fewer calories at the meal, including the calories in that first course. The same idea could work with kids, says Barbara Rolls, a professor of nutritional sciences at Penn State. Theyll not only fill up on fewer calories, but theyll be eating a healthy first course.
• Trick their tummies. Add their favorite fiber-rich vegetables — such as spinach, zucchini, yellow squash, broccoli, carrots, peppers and onions — to lasagna, casseroles, pasta dishes and pizza. The veggies lower the calories and increase the nutrients in each bite, Rolls says. Also increase the proportion of vegetables in stir-fry dishes, broth-based soups and stews and extra vegetables to sandwiches. Substitute vegetable or fruit purees for half or even two-thirds of the added fat in quick breads and muffins, she says.
• Use smaller plates. A study of first-graders showed that most kids served themselves more at lunch (about 90 calories more) when they used adult-sized dinner plates compared with using child-sized plates, which is about the size of an adult salad plate. "We know that adults over-serve themselves with larger plates, and this study says the same holds true for children. Using smaller plates at home may promote healthy child portion sizes," says Jennifer Orlet Fisher, an associate professor of public health at Temple University in Philadelphia.
• Teach kids to dance. Tell them youre playing Dancing with the Stars and let them waltz, do the cha-cha-cha or swing dance, Sothern says. This active time will burn four to five times more calories than sitting and improve their overall health.
• Swap sedentary time for active time. Kids only burn 30 to 50 calories when they are sitting for an hour, but they burn 400 to 500 calories in an hour if they are playing tag, dancing or doing field sports, she says. The governments physical activity guidelines say children and teens should do an hour or more of moderate-intensity to vigorous aerobic physical activity each day. Sothern recommends they do at least two hours of physical activity a day.
• Play outside with your children. Moms and dads should teach their kids to throw, pitch, catch, pass, jump and ride a bike because their kids may not be learning these important skills at school.
• Encourage physical-activity breaks. "There is a lot of evidence that kids should not sit still for more than 60 minutes at a time," says Penny Gordon-Larsen, a professor of nutrition at the University of North Carolina, Chapel Hill. When kids are doing their homework or on the computer, they need to get up regularly and move around or consider standing while they are working, she says. Every little bit of activity counts. Have them do at least 20 to 30 minutes of physical activity after school, such as shooting hoops, biking, playing soccer, jumping rope, dancing, walking or playing a fitness-related video game, Gordon-Larsen says.
• Steer clear of sugary drinks. This includes regular sodas, sweet teas, high-calorie specialty coffees, energy drinks and juices, Gordon-Larsen says. "Its such an easy way to cut out excess sugar and calories," she says. Instead offer water and low-fat milk, even low-fat chocolate milk.
_http://www.usatoday.com/story/news/nation/2013/11/10/kids-eating-exercising-healthfully/3358229/