Am I at Risk for Prediabetes?

September 17, 2018 by  
Filed under Diabetes, Weight management

Many people are aware that diabetes and obesity rates are on the rise in the United States. But do you know how many people have prediabetes? Over 84 million adults, or 33.9% of the US population, have prediabetes. This is a condition in which a person’s blood glucose levels are higher than normal, but not high enough to be diagnosed with type 2 diabetes. One condition that goes hand in hand with prediabetes is insulin resistance. Insulin is a hormone made by the pancreas that absorbs glucose in the bloodstream and regulated blood glucose levels. Insulin resistance is when the body is unable to adequately use insulin to absorb the glucose resulting in high blood glucose levels. Preventing prediabetes can help you prevent type 2 diabetes and the long-term complications associated with diabetes including heart disease, kidney disease, and nerve damage.


The direct cause of prediabetes is unknown, however, there are a few conditions associated with this disease including high blood pressure, low levels of HDL cholesterol (the “good” cholesterol), and high triglycerides (a type of fat in your blood). The risk factors that increase your risk for prediabetes are the same risk factors for developing type 2 diabetes. These include:


  • Family history: risk increases if a parent or sibling has diabetes.
  • Weight: weight is one of the primary risk factors as it is greatly associated with insulin resistance. For people who are overweight, aim to lose 7% of initial body weight.
  • Waist size: increased waist size is also associated with insulin resistance. Men are at risk for insulin resistance with a waist size greater than 40 inches and women, 35 inches.
  • Diet: include a variety of nutrient-dense foods including fruits, vegetables, and whole grains. Avoid highly processed foods and saturated fats.


  • Lack of exercise: sedentary lifestyles increase risk for prediabetes. The recommended amount of moderate-intensity physical activity is 150 min/week.
  • Age: prediabetes and diabetes can develop at any age, however, the risk of prediabetes increase at the age of 45.
  • Race: certain races are at greater risk of developing diabetes. These include: African Americans, Hispanics, Native Americans, and Pacific Islanders.


The good news is that you can prevent prediabetes and even reverse it if you already have been diagnosed with the condition. With a lifestyle approach, you are able to use diet and exercise to maintain normal blood glucose levels. Eating well-balanced and nutrient-dense foods as well as increasing physical activity can help prevent or reverse pre-diabetes. Since weight is one of the primary risk factors, using these two approaches can also help you maintain a healthy weight. The American Diabetes Association Standards of Care 2018 recommends losing 7% of initial body weight in people who are overweight.


How do I determine if I have prediabetes?


Talk to your doctor if you are concerned about prediabetes. Testing for the condition is recommended for asymptomatic adults who are overweight or obese (BMI >25) or if over 45 years old.


There are three different tests you can undergo to determine if you have prediabetes.


  1.     Fasting Plasma Glucose (FPG): this test requires a blood glucose test after fasting for at    least 8 hours.
  2.     Oral Glucose Tolerance Test (OGTT): this test requires consumption of 75 grams of glucose and taking a blood glucose test 2 hours after.
  3.     A1C test: an A1C is the measure that reflects your average blood glucose levels over a period of 3 months.


Prediabetes is categorized as having an A1C% of 5.7-6.4%, and/or impaired fasting glucose of 100-125 mg/dL, and/or an impaired glucose tolerance during a 75-g oral glucose tolerance test with levels resulting in 140-199 mg/dL.

Remember that prediabetes can be prevented. Don’t delay, and start prevention today. Increase daily physical little by little, even if you just take a walk around the block. Include wholesome foods like fresh fruits and vegetables to balance out your meals. Try to limit highly processed foods with high fat and sugar content. Every little step of progress counts toward getting healthier and preventing prediabetes.



  1. Diabetes Statistics | NIDDK [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. [cited 2018 Sep 4]. Available from:
  2. Talmadge K, Philipson L, Reusch J, Hill-Briggs F, Youssef G, Bertha B, et al. AMERICAN DIABETES ASSOCIATION OFFICERS CHAIR OF THE BOARD. :150.


Thank you to dietetic intern Molly Lowery for her contributions to and creation of this post.

Mindful Eating

With a busy schedule full of work, family and life obligations, it is easy to rush meal times while eating our food on the run. Many of us have mastered the skill of multi-taking, only to miss out on the opportunity to enjoy our food. Do you ever stop to notice the texture of the food that you’re eating or pay attention to your body telling you that you’ve had enough?  Mindful eating is a way to bring the focus back to the peace and joy that eating can provide.

What is Mindful Eating?

Mindful eating is applying mindfulness to why, when, where, what, and how you eat. This means being aware of both the physical and emotional feelings connected to eating; it is the process of paying attention to the experience of eating.

One study suggests that applying mindful eating tools may help you to avoid overeating by being aware of portion control, taste, texture and sensations such as mouthfeel. By being mindful you will raise awareness to why are you eating (are you hungry or simply snacking?), what you are eating (is this food nourishing to your body?), and how you are eating (am I on the run, multi-taking, driving, watching TV, texting? Am I even enjoying my food?).

Individuals who apply mindful eating tools have reported an increase in self-efficacy; cognitive control, improved eating behaviors; and even decreased symptoms of depression. A mindful eating approach may increase consumption of healthful fruits and vegetables which have protective qualities to help fight against coronary heart disease, stroke, obesity, and certain cancers.

Quick Tips For Eating Mindfully:

  • Observe your body: Notice hunger and fullness signals that guide you to start and stop eating.
  • Do not judge yourself: If you want to eat something, have it; as long as eating this food will not bring about any feelings of shame or guilt. If it will, recognize this and either avoid eating it or try to change your reaction to this food.
  • Notice your reaction to food. What do you like, what don’t you like? Try closing your eyes for a moment while you are eating to experience food in a new way.
  • Savor your food: While eating, notice all of the colors, smells, flavors, and textures of the food. Focus on each mouthful. Try to engage all 5 senses when you eat (sight, smell, sound, taste, touch).

Ask yourself, “Am I…” 

  • Physically hungry? Try using a scale of 1-10 (1 very hungry and 10 very full). Ideally, you want to eat when your hunger is mild at a 3-4 and stop when it reaches a 7-8.
  • Eating quickly or slowly? If you notice you’re rushing; take a deep breath and slow down.

Mindful Eating Resources:

  1. Intuitive Eating website:
  2. Miller CK, Kristeller JL, Headings A, Nagaraja H. Comparison of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: a randomized controlled trial. Health Educ Behav. 2014;41(2):145-154.
  3. The Center for Mindful Eating website:
  4. Tylka, T. Intuitive Eating Assessment Scale. J Counseling Psychology 2006(53):226-240.
  5. Mathieu J. What Should You Know about Mindful and Intuitive Eating?J Am Dietetic Assoc 2009;109(Dec):1982-1987.

Special thanks to Dietetic Intern Carlyn Blevins for her contributions to this post.

Getting Real About Holiday Weight Gain



An often-cited statistic is that the typical American packs on 1-2 pounds over the Holiday Season. While that might not sound like much, if you do this year-in and year-out, on top of other weight gaining factors…things could get heavy!

So why do people tend to gain weight over the holidays? A number of factors could be at play:

  • Stress – the Holidays can be stressful for many reasons, and some people turn to food when emotions run high
  • Greater availability – face it: you don’t see cookies and cakes and candy ever as much as you do around the Holidays, there’s just more bad food constantly in our faces!
  • Less activity – cold weather can be a deterrent for physical activity; if you’re not offsetting your calories with motion, pounds can creep up
  • Alcohol – the Holidays mean celebration, and many celebrations come hand-in-hand with alcohol and their added calories

With parties and gatherings galore, it can seem challenging to keep your health in check. So here are a few tips to help fight the heaviness that sometimes gets associated with the Holidays:

  • Make a plan – exercise earlier in the day if you know you have a party later; bring your lunch to work if dinner means drinks and food with friends…keep in mind that, “If you fail to plan, you plan to fail.”
  • Never show up hungry – you’ve likely heard this one before, but don’t show up to the festivities when you’re famished. Have a snack ahead of time to ensure you don’t overdo it at the party.
  • Walk it off – the Holidays are a great time to get together with friends and family, so why not get everyone together outside for a brisk walk after dinner? You can spend time together in places other than on your butt!

Whatever your holiday has in store – don’t forget that it doesn’t HAVE to involve weight gain. Stay active and savor small versions of what the season has to offer!

Does Your Shape Matter More Than the Number on the Scale?

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For individuals struggling with overweight and obesity, focusing on body mass index (BMI) or the number of the scale may be the wrong health indicators.

An emerging body of literature suggests that an older measurement, the waist-to-hip ratio may be more valuable when assessing the impact of weight on health.

A new study published in the journal Obesity found that participants with a high waste-to-hip ratio had a higher risk of heart attack.

People with a high waist-to-hip ratio are often described as being “apple” shaped. Apple shaped individuals hold fat around their important vital organs. This type of fat leeches into the bloodstream easily and causes a negative effect on cholesterol and other blood fats.

The World Health Organization states that a healthy waist-to-hip ratio is less than 0.9 for men and less than 0.85 for women. It is important to note that there are no particular exercises you can do to reduce fat in one particular area of your body. “Spot reducing” does not work; rather, cardiovascular and strength building exercises can help convert fat to muscle and lower overall body fatness. For tips on calculating your own waist-to-hip ratio, click here.

Soda Sales See Serious Slide



There’s a bit of good news on the nutrition front, and that is the continued decline in US soda sales.

Recent Nielsen data from all channels including grocery, drug and convenience stores shows an 8.2% decline in the 4 weeks leading up to October 31, compared to the same period 1 year ago. Dollar sales are also on the decline, down 5.5% in that same 4 week period compared over 1 year.

Diet Pepsi has sen the most precipitous drop with an 11.4% decline in sales and 8.9% drop in dollar sales.

Soda is the low-hanging fruit, so to speak, in tackling overweight and obesity. It provides no nutritive value and contributes only sugar-fueled unnecessary calories to its drinkers’ diets.

But Americans’ intake of sugar-sweetened beverages doesn’t start and stop with soda. Other contributors of useless calories include energy drinks, vitamin waters and fruit drinks – and these category winners are also owned by the big soda companies.

When it comes to sippin’ smart, keep in mind the following tips:

  • Water is sufficient for hydration for nearly every individual with a few exceptions (elite athletes, underweight individuals, those exercising in extreme conditions)
  • If you consume dairy, stick to non-fat or low-fat (1%) milk products and avoid added sweeteners
  • Energy drinks provide “energy” primarily through caffeine and amounts are rarely disclosed on the packaging

For a great read on the entirety of Big Soda, including unscrupulous marketing practices and its contributions to the current global obesity crisis, check out Soda Politics: Taking on Big Soda (and Winning) by esteemed nutrition author and educator Marion Nestle.


Low-Fat vs. Low-Carb: Who Wins?

Agitated young woman looking up in frustration


As the end of 2015 approaches and the nutrition world anxiously awaits publication of the 2015 Dietary Guidelines for Americans, it’s worth taking a moment to consider where the world of research falls with regard to fad diets.

In the post-low-fat world that followed the 1990’s fat free and low-fat diet craze, you don’t hear much about a low fat diet anymore. The American Heart Association has moved off of recommending a “low fat” diet for heart disease prevention, and praise is now routinely heaped on the Mediterranean Diet – a relatively “high fat” (but the right type of fat!) eating pattern.

A study published last week in PLOS ONE did take a look at low-fat vs. low-carb diets and found that low-carb diets appear to be slightly better at lowing cardiovascular disease risk.

The meta-analysis looked at 1,797 obese or overweight people who were enrolled in 17 different studies. The overall weight loss was 17.6 pounds in the low-carb group and 13.2 pounds in the low-fat group.

To be fair, both of the groups showed a significant reduction in their 10-year cardiovascular disease risk score, but the study was funded by Atkins Nutritionals – the retail arm of the low-carb Atkins Diet.

The take away message is: when it comes to losing weight and cutting heart disease risk – calories do count. Eliminating added sugars, reducing white carb foods and cutting out excess amounts of bad fat have been shown to be effective ways to trim your waistline and your heart disease risk profile.

Fatherhood, Fat & the Dreaded “DadBod”

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A recent study published in the American Journal of Men’s Health found that males who become fathers experience a bump in their BMI (body mass index).

This study looked at over 10,000 men followed for 20+ years. Compared to the dad group, men who didn’t become dads were actually shown to lose weight over that time. First time dads saw a 2.6% increase in BMI (about 4.4 pounds for a 6 foot tall dad).

Not surprisingly, living with your kids had a greater impact on rising BMI than not living with kids.

So what’s the take away message? Everyone’s metabolism slows as you age, but having kids can exacerbate weight gain due to changes in lifestyle.

Here are a few tips for curbing the pound creep with kids:

  • Kids have smaller stomachs than adults and need to eat more frequently to meet their nutritional needs; don’t stoop to snacking just because the kids are.
  • The kids menu is crap! Kids AND adults should avoid “typical” kids menu foods like chicken nuggets, corn dogs and pizza.
  • Do a color check: if your plate is white and yellow from refined carbs and cheese, work on adding color from fruits and vegetables – a swap that benefits kids and adults alike.
  • Kids can eat a lot because they move a lot: and you should too. Get out with your kids and move and exercise to burn off some of those calories!
  • Stay away from sugary drinks – most kids do not need juice; juice is great if you want to gain weight – try to eat your fruit, not drink it. You’ll save calories and gain fiber in the meantime.

For more information on improving kids (and parents’) food choices, check out the KidsEatRight resources from the Academy of Nutrition and Dietetics and the MyPlate Kids’ Place from

Does Skipping Meals Lead to Overeating?


Have you ever skipped meals with the hope of losing weight? Do you find yourself eating just one meal per day due to a busy schedule? If so, you might want to rethink your current eating habits. Research indicates that this approach to eating may actually have a negative impact on your health.

In a recent study published in the Journal of Nutritional Biochemistry, researchers examined the effect of “gorging” in diet-restricted mice compared to mice in a control group that ate throughout the day. The researchers found that the diet-restricted mice developed a habit of gorging their food quickly, and they continued to gorge even after their diets were returned to the same calorie level as the control group. One researcher likened this habit to people who frequently skip meals or eat one large meal per day.

Compared to the control group, the gorging mice were found to have more abdominal fat and reduced insulin sensitivity. These outcomes are concerning as they have been linked to an increased risk for diabetes and heart disease in humans.

Although the research was performed on mice, this study highlights the significant effects of eating patterns on metabolism. Skipping meals or severely limiting your food intake can also make you more likely to over-eat at the next meal and can make it more difficult to obtain the nutrients you need for the day.

Instead, you should aim to consume meals regularly with high quality, nutrient-dense foods. Focus on vegetables, fruits, whole grains, lean proteins, and low-fat dairy products. For more information on a balanced diet, check out

Special thanks to dietetic intern Megan Fobar, MS for her contributions to this post.

Is a Detox Diet Right for You?

With the New Year upon us, people are scrambling for diet resolutions and looking to detox.

With all of the buzz about detox diets, you may have started to wonder if you should start one too?

detox-dietsWhat are Toxins?

Toxins are defined as substances that have entered the body through smoking, pollution, pesticides, or additives found in the food we eat.

Detox diets claim to help rid the body of toxins, provide more energy and help kick start weight loss; however, there is little scientific evidence to support that detox diets actually rid the body of toxins. There is also no way to measure if you are “toxic”, or to justify if you even need to detox!

If You’re Gonna Detox…Do it Right!

Here are few detox tips that are good to know:

  • Your body has a built in system to remove harmful substances: your liver, lungs, kidneys, and GI tract are always in a natural state of cleansing
  • People with medical conditions such as diabetes or certain types of cancer as well as children, older adults and pregnant women should avoid detox diets as they may be nutritionally inadequate or inappropriate
  • Detox diets do have side effects: moodiness, irritability, depression, fatigue, and constipation (from a lack of fiber and other nutrients) may occur
  • Quick fix diets only provide short-term results; most people gain lost weight back…and then some.

The healthiest way to utilize a detox diet – if at all – is for a very short period of time. Most nutrition experts agree that if a “detox diet” is kept to 1-2 days, it can serve as an important psychological break between a period of unhealthy eating (the holidays?) and a new healthier period in the New Year.

Special thanks to Dietetic Intern Jenny Legrand for her contributions to this post.

Spooky Nutrition Advice for Halloween…BOO!

October 22, 2014 by  
Filed under Dietary Patterns, Weight management

Ah, Halloween. Trick-or-treating, candy, ghosts and goblins and too many empty calories! Don’t get me wrong, it’s a fabulous holiday that all kids and young-at-heart adults love. But given the explosive rise in childhood obesity and increases in the incidence of type 2 diabetes among adolescent, we should collectively be concerned. Here are some ideas on how to lessen the nutritional impact of this fun holiday.

1) Limit daily consumption of candy as much as possible. A child may have only 100 kcals of discretionary calories available each day to maintain proper body weight. More kcals from junk foods, and weight and adiposity rise over time.

2) Buy your candy a day or two before the holiday. This way, no one is tempted to have a sugar hog fest and you might save money as these items typically go on sale as the day approaches.

3) Have dinner before going trick-or-treating. This one is for rather obvious reasons…less likelihood of snacking on the candy as one goes door-to-door.

4) Have an active evening. Take a longer walk to enjoy the decorations and burn some calories while you’re at it.

5) Practice portion control and know which ones are the healthier choices. Limit the amount that children can eat each day and don’t necessarily trust them to do this on their own. Placing the stash out of their reach or where you can control it is best.

So, have a happy Halloween and stay healthy!

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