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Aging in Place – A Program for Seniors and Caregivers

Seniors are living longer due to medical advances, and it is predicated that by the year 2050 almost 450 million people worldwide will be aged 80 years or older. Unfortunately, longevity has not translated to perfect health.  The high prevalence of chronic medical conditions (like diabetes, heart disease, Alzheimer’s, osteoporosis, and others) illustrate the increased disease burden we face in the United States.  And despite ailing health, most seniors report they prefer to live at home.  In these cases, the family members are usually left to be the elder’s caregiver.

We believe that families want to play a role in the care of their loved ones as they age, and we know that most families will eventually experience the inability for their loved one to remain independent at home. At this crossroad, we want to help caregivers to be informed and engaged in the decision-making process for their loved ones.  This is why we’ve developed a program called Aging in Place.

Aging in Place is a Family Physicians of Greeley (FPG) program for our elder patients and their families or caregivers to learn about resources in the community that support the aging process and the families providing care.  Our goals with this program are to improve health outcomes and quality of life for both seniors and their caregivers, as well as to increase knowledge of local resources and options when faced with the difficult decision of staying at home or transitioning outside the home.

With many factors to consider, such as cost, safety in the home, level of care needed, quality of life, and more, we will offer multiple educational sessions that address many topics.  Each session will include 4 different speakers who will give a brief presentation on their topic, followed by time for questions and answers.  All sessions offered are independent of the others, and our patients are invited to attend as many sessions as they find useful.  Due to limited space, we ask that each patient in attendance bring only one family member or caregiver as a support.

The first Aging in Place session will be on September 26th, 2019, from 2 – 4 pm at our West Office location (6801 W. 20th Street, Suite 101, Greeley 80634).  Speakers include the following:

  • Anne Jorgenson, Esq. (Elder Law, medical and financial decision making)
  • Alan Heileman, Coordinator of Community Resources at University of Colorado Health (Understanding Medicare and Medicare Advantage Plans)
  • Mark Hout, CEO UNI-Design, an Aging in Place Contractor (Home redesign for safe aging)
  • Maria Sanchez, RN, PhD., Care Manager at Family Physicians of Greeley (Advance Care Planning)

Also included in this session will be a breakdown of the average costs to remain at home with care or transition outside the home to a care facility.

To register for this session, please call 970-352-9444, option 7, and speak with Maria.  You may also leave a message confirming your participation.  Please include the FPG patient’s name and date of birth, as well as the total number of attendees (maximum of 2).  Space is limited and will fill up fast, so RSVP early!  We kindly ask that you register by Friday, September 13th.

Our next Aging in Place session will be held on October 10, 2019.  Once the speakers and class time have been confirmed, details will be available on the Health and Wellness Classes page of our website.  We look forward to providing these educational sessions and partnering with you and your loved ones in health.  Cheers!

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5 Ways to Stay Hydrated This Summer

Water is an essential nutrient needed to stay well, and during hot summer months it is extra important to replenish the body’s water.  Humans lose water throughout the day in a variety of ways – breathing, sweating, urination, and bowel movements – and heat, longer daylight + waking hours, and increased activity in the summer means we need more water to stay well hydrated.  Additionally, the high altitude and dry atmosphere in Colorado impact breathing and water use, so individual water needs are greater.

If you struggle to drink enough water through the day, don’t fret.  There are plenty of ways to get your fluid needs!  While plain water is ideal for the majority of our drinks, we can achieve adequate water intake through a variety of means.  Listed here are 5 ways to help you stay hydrated:

  1. Prepare infused water for subtle flavor and a pop of color. Infused water is simple to make and adds a mild touch of flavor to otherwise plain water.  Fill a pitcher with water, add fruit or veggie slices plus a fresh herb, if you like, and chill in the refrigerator overnight.  By morning, you will have a delicious infused water to enjoy throughout the day.  Infinite combinations exist – get creative and find what you like best!  Here are a few combos to get you started: cucumber mint, lemon basil, blueberry lavender, orange raspberry + rosemary, strawberry lime + mint, watermelon honeydew + mint.  This post gives more in depth instructions and ideas.

  1. Enjoy unsweetened tea. Traditional iced tea is made by steeping tea leaves in hot water until a natural flavor is acquired, and then it’s chilled and served cold over ice.  Without cream or sweeteners added, each cup of tea can be counted towards a person’s total water intake.  Nowadays, there are many tea varieties, flavors, and brands available, including instant tea that comes as a powder and prepares in seconds.  There are also iced tea bags that steep in cold water and are ready for consumption in 3 – 5 minutes.  These options are convenient and can be a nice solution to drinking more non-caloric fluid; however, they do not have the same antioxidant benefit of brewed teas due to the extra processing required.  If you want the antioxidant power, take extra time to brew tea bags or loose-leaf tea in hot water, then chill.

  1. Put some bubbles in your water. Adding carbonation to water is a fun and harmless way to add some interest to plain water.  Carbonated, or sparkling, water is simply water that has been infused with carbon dioxide gas under pressure.  Some retail brands have also had sodium added to improve the taste, so it’s important to read ingredients to make sure the drink fits your health needs.  Many sparkling water options can be found in stores, and the best options are those without added sugars or sodium.  Natural sparkling mineral waters (like Perrier or San Pellegrino) are different.  These waters are captured from a mineral spring and tend to contain natural minerals and sulfur compounds. Another fantastic option is to buy a sparkling water maker for your home.  With one of these and a bottle of carbon dioxide gas, you can make unlimited sparkling water at the touch of a button from your tap water at home.

  1. Add ice cubes of 100% fruit juice to your water bottle. If you’re still learning to enjoy unsweetened drinks, try a step-wise method of incrementally reducing the sweetness in your drinks.  One excellent idea for this is to use fruit juice ice cubes in your water.  As the ice cubes melt, the water will be mildly sweetened.  Simply fill ice cube trays with your favorite flavor of 100% fruit juice (pineapple, grapefruit, apple, grape, orange, lemon, etc.), freeze for at least 4 hours, and then use 1 cube per every 8 ounces of water.  Try to use less over time.  As we change our eating habits, our taste preferences also start to change.  Challenge yourself to consume less sugar over time.

  1. Eat more fruits and veggies. Natural foods contain varying amounts of water, and fruits + vegetables are the best source for this additional fluid.  It all counts towards our daily water needs, so eat up!  Adults needs at least 2 cups of fruits and 3 cups of veggies each day.  Include berries at breakfast; eat a salad with lunch; snack on carrots and dip; add grilled veggie skewers to dinner; enjoy an apple with cinnamon for dessert.  The options are endless for enjoying fruits and veggies.  If you’re feeling stuck, do an internet search for creative uses of your favorite fruit or veggie to help break out of the rut, and get adventurous in the kitchen.  Chat up your local farmer at the market to learn about their favorite ways to prepare and eat what they’re selling.  For curiosity’s sake, this list contains information on the water content of many fruits and veggies.

So there you have it, five ways to stay hydrated this summer!  What are your best tips and tricks for getting enough water?  Share with us in the comments below.

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De-Stress Your Summer – Positive Parenting Ideas

While summertime incites joy for kids – no school, no responsibilities, sleeping in, video games all day – it often induces stress for parents who now have to balance normal daily responsibilities with caring for their children an extra 8 hours of the day.  This can be especially challenging for parents of children with attention deficit hyperactive disorder (ADHD).  Below, we’ve gathered a few summer parenting ideas that may be helpful while children are home from school:

  1. Maintain a schedule – People, and especially children, thrive when they have a schedule to guide them. Although the schedule may differ from the school year, it’s helpful to have normal waking and bedtime hours.  This sets an expectation of structure and can help to minimize arguments and power-struggles during transition times.  Next, plan regular meal times, and recognize that meal times may change from day to day based on your activities.  That is okay!  Generally speaking, children may want to eat a meal or snack about every 2-4 hours, so schedule meals accordingly and pack or plan for healthy snacks halfway between meals.  Finally, plan some structured activities a few times each week – swim lessons, bike rides, sporting games, art classes, summer camps, time with friends, library visits, etc.  This will help children stay active, engaged, and learning through the summer while still having fun!
  2. Fuel with good nutrition – a balanced and healthful diet helps to regulate mood, balance emotions, and provide for better problem solving and interactions with others. Keeping a regular meal routine may prevent “hangry” outbursts, and focusing on whole foods that are minimally processed will offer the best nutrition.  Use some of the extra time in the summer to cook at home and prepare meals from fresh ingredients.  Children can even be involved in the food preparation, which not only teaches new skills but encourages kids to try new foods.  Try these snack ideas and check out these tips for less processed foods.
  3. Remember reminders – with any change in routine comes an increased chance of forgetting essential items and/or feeling unprepared, both of which increase stress and the possibility for frustrated meltdowns.  Use checklists to make sure you have everything needed for outings (sunscreen, snacks, extra clothes, towels, a hat, bug spray, etc.) and pre-pack the day before.  Organizing ahead of time will cut down on last-minute scrambling, allow for a less rushed, more enjoyable morning, and increase the likelihood of beginning your fun day out on a positive note.  If your child will be participating in an outing without you, discuss details with your child in advance, and provide visual or audible reminders, as needed.  Phone reminders or a note packed with lunch or a snack can be very helpful, or try linking responsibilities with other actions (for example: remember to re-apply sunscreen when you stop for lunch). 
  4. Screen time rules – More free time often means more screen time, whether it be phones, tablets, video games, movies, TV, computer, etc. It is important to limit screen time for a number of health reasons, and a maximum of two hours per day is the general recommendation for children under 18 years of age.  Setting clear limits on screen time and enforcing those limits helps children to learn time-management and stay on top of other household responsibilities.  Many parents find that visual timers are helpful, and separating time between playing games and bedtime helps to improve sleep.
  5. Create opportunity for independence, learning, and success – School can often be a major source of stress and pressure for a child with ADHD.  Summer vacation, then, should be a time to relax and allow your child to feel competent and happy, while still staying active.  Give your child a sense of independence by allowing him to have a part in decision making.  A great way to do this is through offering choices.  For example, ask “Would you like oatmeal and berries or an egg with toast for breakfast today?”  Or, if you’ve signed your child up for an activity she admits she didn’t enjoy, ask “Can you think of another activity you’d like to try instead?”  Another great strategy that helps a child to learn, provides a degree of independence, and reduces parental “nagging” is cause & effect phrasing: If/Then, First/Then, When/Then.  Here are some examples:
    • If you play with your brother outside for an hour, then you can play video games until dinner.
    • First we need to go to the store, then we’ll stop at the park for 20 minutes.
    • When your bed is made and you’ve brushed your teeth, then we will get ready to go to the pool.

Using this structure sets a clear expectation for the child and puts the responsibility on him to get the outcome he desires.  Of course, it is critical for the parent to follow through and do what was promised to build trust and positively reinforce the child’s actions.

  1. Be prepared with activities for times when boredom strikes – Children love the freedom and extra time that comes with summer vacation, but inevitably the day comes when they don’t know what to do with themselves. If leaving them to their own devices has proved problematic in the past, help them stay entertained with a list of activities.  Try creating lists together, and include a variety of activities: independent play, play with others, indoor activities, outdoor activities, and possible spontaneous outings with the family.  Pending the day and situation, provide the appropriate lists to the child when they complain of boredom.  Here’s a few ideas to get you started –
    • Assemble a Lego set or block set
    • Do a puzzle
    • Play a board game
    • Write a poem or song
    • Bake homemade granola bars
    • Help with cooking
    • Build a blanket fort
    • Take a trip to the library
    • Pack a picnic and take it to the park, stay and play a while
    • Go for a bike ride
    • Plan a scavenger hunt for a sibling or parent; make the treasure something special to the family, like a favorite picture (Make sure to remember where you hide it in case the scavenger hunt doesn’t get solved!)
    • Build an outdoor obstacle course to complete
    • Play four-square
    • Draw with sidewalk chalk
  2.  Start off the school year on the right foot – After months off from school and the “normal routine,” many children have a hard time adjusting back to long days of learning and strict schedules.  This can be even more challenging for a child with ADHD.  Help your child succeed by preparing him adequately.  Maintain a “learning mode” through the summer by asking your child to complete workbooks or other fun learning experiences (see additional resources below).  A few weeks before school resumes, start the transition back to the school-year routine: set earlier bed times and have your child wake-up at the time he would need to for school.  Try filling the days with more activity to start preparing for longer days, lots of learning, and no opportunity to nap.

With everything be safe, wear sun protection, and stay hydrated with water.  Happy summer!

Additional resources:

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Ten Ways to Enjoy Veggies

Raise your hand if you’ve ever been served a plate of mushy peas, overcooked broccoli, slimy carrots, or a wilting salad.  Has anyone, then, been forced to eat those vegetables before being allowed to leave the table?  Negative experiences like these are enough to make a person go years without eating vegetables simply because of the poor memories. Others may avoid veggies because they dislike the taste or texture or because they don’t know how to prepare them.

Vegetables have numerous health benefits including prevention of cancer, diabetes, heart disease, and many other diseases; they aid in weight management; and they support healthy regulation of bowels, metabolism, mood, and most processes in the body.  In fact, a single dietary modification that supports improvement for many chronic health conditions is to increase vegetable intake such that the portion of veggies at a meal is equal to or more than the other portions of food on the plate.  This can be a tough feat, though, for someone who has bad memories of or really dislikes vegetables, for any reason.

The good news is there are a lot of options to try, and a simple difference in the preparation of vegetables can completely change the texture, flavor, and overall experience.  If you’re one who struggles to eat enough vegetables, try some of the ideas below.  And remember, it takes time for our taste preferences to change.  Be patient through the process and keep these things in mind:

  • It may take a few tries with the same veggie before you learn to like it. Give each new vegetable a fair chance before ruling it out completely.
  • For those veggies you don’t like right away, try it prepared a different way (raw veggies taste different than cooked veggies, and different cooking methods can change the flavor, too).
  • Experiment with different vegetable options and be willing to be a little adventurous.
  • Remember that our tastes change over time. If you didn’t like a food as a child, or even at your current age, it doesn’t mean you won’t like that same food a few years down the road.  Don’t be afraid to try again.
  • You may decide there are some vegetables you don’t like, and that’s okay.  Eat the ones you enjoy.
  • Again, because this can’t be said enough, be patient through the process and try to have fun with it.
Photo Credit: Whole Living

Idea #1 – Try new vegetables that belong in the same “flavor family” as other veggies you already know you like.  Vegetables (and fruits) can be lumped into groups with other fruits and veggies that have similar flavor profiles.  For example, carrots have a slightly sweet flavor and will taste more similar to snap peas or bell peppers than radishes, which are somewhat spicy.  When you try foods with similar flavors, you will be more likely to quickly find new veggies you may enjoy. Click through a full list of “flavor families” here.

**Please note: all veggies should be washed in lukewarm water (no soap) before cooking and/or eating to remove germs and bacteria.**

Idea #2 – Roast your veggies.  Cooking vegetables at a high temperature for a length of time allows the natural sugars in the veggie to come to life in the flavor.  Don’t like broccoli, cauliflower, or brussels sprouts?  Give them a second chance, and this time try roasting them.

Here’s how to do it: heat your oven to 400°, chop your vegetables into similar size pieces so they cook evenly, spread veggies in a single layer on a baking sheet, drizzle with cooking oil, toss with a spatula so the veggies get evenly coated, and bake for 20 minutes.  You can stir half-way through the cook time to get a nice browning and crisp on the surface of two sides.  Try roasting asparagus, brussels sprouts, zucchini, yellow squash, cauliflower, mushrooms, onions, bell peppers, cauliflower, sweet potatoes (double the cook time), and more.

Idea #3 – Prepare veggies on the grill.  The concept here is like roasting veggies, but grilling gives a slightly different flavor due to the direct heat from the flame.  Be careful not to char your veggies!

Here’s how to do it: chop your veggies into similar sized pieces, place in a bowl and toss with a small amount of veggie oil, place in a grill pan or skewer on kebob sticks, then place on the grill.  Cook time will vary based on the heat of your grill and the veggies you’re using, but 5-10 minutes should do it.  If using a pan, stir midway through cook time, or turn the kebobs after a few minutes to achieve even cooking.  Err on the side of under-cooking; you can always put food back on the grill, if needed.

Idea #4 – Sauté vegetables.  This method usually softens veggies more than grilling or roasting, where veggies become crispy on the outside.  This is one of the quickest ways to prepare veggies, and is a great method for cooking veggies before adding to other dishes, such as a burrito or fajitas, stir-fries and casseroles, or eggs.  Using different oils will provide a slightly different taste, as well.  Coconut oil leaves a slightly sweet, tropical flavor; sesame oil is savory and a little nutty; and canola or avocado oils are very mild, leaving little taste at all.

Here’s how to do it: heat a tablespoon of vegetable oil in a skillet over medium heat, add your chopped veggies, and cook for about 3 – 5 minutes, stirring often.  The longer you cook veggies, the more their texture will break down, meaning they will become mushy.  Veggies are often enjoyed more when they’re thoroughly cooked but still retain a little crispness.  If at first you don’t succeed, adjust the cook time and try again.

Idea #5 – Steam veggies.  This may be the “purest” way to prepare veggies, meaning nothing is added or taken away in the cooking process.  Steam from simmering water rises to cook the vegetables so they retain all nutrients (boiling vegetables in water decreases the nutritional content because vitamins and minerals will “leak” into the cooking water, which later gets tossed out), and no additional flavors or nutrients are added via a cooking oil.  Steamed vegetables have a slight change in flavor from their raw form, and texture will depend on how long the veggies are steamed.

Here’s how to do it: Fill a sauce pan with an inch or two of water.  Place a steam basket in the pan and load your chopped veggies into the basket.  Cover with a lid and heat over medium-high heat on the stove.  Once the water begins to boil, the steam will begin to cook the veggies.  Allow veggies to cook for 7-10 minutes, or until they reach your preferred texture.  Use a gloved hand to pull the basket out of the pan, and transfer veggies to a serving bowl (you can also use a spoon to transfer the veggies).  Enjoy plain or seasoned.

Idea #6 – Spice up your veggies.  Spices and herbs can completely change the flavor of a vegetable.  If you’re getting tired of the same 3 veggies you like so far, change up the flavor to keep it interesting while you experiment with other options.  Garlic, ginger, lemon pepper, rosemary, basil and oregano, thyme, sage, parsley, cilantro, cumin, turmeric, simple salt (a little goes a long way) and black pepper, red pepper flakes, balsamic vinegar, lime juice, lemon zest, a drizzle of honey, a sprinkle of parmesan cheese, Cajun seasoning…  The options are nearly endless!  Mix and match as you please.

Idea #7 – Add veggies to foods you already love: pizza, eggs, stir-fry, pasta dishes, casseroles, tacos, burritos, sandwiches, the list can go on… If you’re just learning to like vegetables, chop them into smaller pieces (the flavor in each bite will be less significant) and cook them first, using any method above.  Some suggestions to try: thin sliced zucchini, red onion, and mushroom on a pizza; spinach, yellow onion, and bell peppers in scrambled eggs; broccoli, snap peas, and carrots in stir fry; sun dried tomatoes, asparagus, and yellow squash in a pasta dish; broccoli and cauliflower in a casserole; lettuce and tomato or a cabbage slaw on tacos; sautéed onions, peppers, and fresh veggie salsa in a burrito; spinach, tomato, and onion in a sandwich.  Be as creative as you want!

Photo credit: Sassy Townhouse Living

Idea #8 – Make (or buy) fresh salsas to add to meals or enjoy as a healthy snack.  Fresh salsas can be a great topping for eggs, burritos, open-faced sandwiches, casseroles, grilled meats, and more.  It’s a fun and flavorful way to add veggies to a meal.  Search the internet for ideas that sound good to you, and keep in mind you can go spicy, mild, sweet, and savory with salsas.  Tailor the flavor to the dish you’re preparing.  Salsas can also be a nice way to get veggies in your snacks: top a piece of whole grain toast with a ¼ avocado and your favorite salsa or enjoy salsa with some tortilla chips.  Include some beans in the salsa and you’ll add a healthy dose of protein and fiber!

Idea #9 – Get creative with salads.  Salads can be a main meal, side dish, or snack; and they don’t always have to include lettuce or other greens.  Great options for snacks are this quinoa salad or 3-bean salad.  Eat with a fork or use as a topping on a few tortilla chips or whole grain crackers.  Don’t like something in the recipe?  All salads (and most recipes in general) are completely adaptable to your preferences!  Swap for veggies you enjoy better, dice ingredients into smaller pieces, try adding some fruit to salads, or make any other modifications that make you happy.  And remember, we can’t learn to like new things if we don’t step outside our comfort zone every now and then.

Idea #10 – Snack on raw veggies or include them as a side dish with meals.  Keep in mind, enjoying vegetables with a dip doesn’t make the veggies any less nutritious.  Rather, it gives additional nutrition, which can be beneficial if you choose healthful dips a majority of the time.  Hummus adds smooth, satisfying protein with lots of flavor.  Peanut or almond butters add creamy, filling fats and protein that are heart-healthy. Low-fat cottage cheese mixed with a dry ranch dressing packet will offer a more nutritious dip (loaded with protein, calcium, and vitamin D) than a traditional dressing.  Or add some spice with a homemade buffalo sauce-infused dip (mix ¼ cup plain Greek yogurt with 1 tbsp buffalo sauce).

What ideas will you try, and do you have others to offer?  Share in the comments section below.

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The Process of Un-processing Our Food

As a follow-up to last week’s post, let’s review the main points: The food scene in America is changing, and much of it has to do with the fact that the majority of what we eat is not real food, but rather highly processed food products put out by the multi-billion-dollar food industry.  When we focus on eating whole foods and products made with whole food ingredients, it benefits our health.  Additionally, to support a healthy relationship with food, there is no need to demonize or rule-out any food in the diet (even the highly processed ones).  Doing so often leads to an unhealthy, guilt-ridden, avoid-and-binge cycle with food.  Instead, learning about, understanding, and taking the time to enjoy and appreciate food for the way it fuels the body and connects people can lead to an incredible transformation of food freedom and improved health through moderation.  Changing the way we eat is as much a journey of the mind and way of thinking as it is of physical behaviors.  After all, every change starts with the decision to do so, followed by acquiring the motivation, knowledge, and skills to make it happen.  (It also helps to know you can still eat the doughnuts and french fries when you want.)  The key is in remembering that our daily and weekly habits are what determine our health trajectory, and every small change towards the “ideal” results in health improvement.

If you’re ready to start making some changes, listed here are 7 ways to start replacing processed foods with more natural, whole foods.  Pick one or two ideas that sound realistic to you and start there.

  1. Swap heavily processed food items for more natural options

Try This…

Instead of That…

Natural Peanut Butter

(the only ingredients should be nuts and salt)

Most brand-name Peanut Butters

(you’ll find sugar and added oil in the ingredients)

Lightly sweetened or Unsweetened Cereals

(look for options with 6 grams of sugar or less)

Sweetened and artificially colored cereals

(examples: many cereals marketed to children)

Whole Grain Crackers

(example: Triscuits have only 3-5 ingredients)

Refined white flour crackers

(example: Ritz and Club crackers)

Real Maple Syrup

(it’s still sugar, so watch your portion)

Artificially flavored pancake syrup

(the main ingredient is often high fructose corn syrup)

Natural Cheese Options – cheddar, swiss, etc.

(buy in blocks & slice for snacking or sandwiches)

Processed Cheese Items

(examples: American cheese, shelf-stable cheese)

Natural food that is nutritious and filling – fruits, vegetables, beans, and whole grains with minimal added fat and sugar Highly processed “diet” foods
  1. Take time for food prep. There is no getting around this – if we want to eat healthier and feel better, we must make time for it.  Pick a day or two of the week that you typically have extra time (or can make time), and prepare some of your foods for the week.  Chop veggies for the next few nights’ dinners or snacks (or spend a little more and buy the pre-chopped varieties), portion and pack your snacks so they’re ready to grab on busy days, prepare a casserole or other dish that can be refrigerated until you’re ready to bake it on a tiring weekday, prepare a bunch of breakfast burritos and freeze them individually for later use, freeze leftover homemade pancakes and pop them in the toaster for a quick breakfast, bake a pan of homemade granola bars for snacks to last a couple weeks, or make a big pot of soup for many lunches and dinners.  Use leftovers for lunch the next day so you get two meals out of the effort for one.  And try to make food prep fun: involve the family, turn on music, listen to a podcast, pretend you’re the host of a cooking show, or watch a favorite movie in the background.

  1. Spice up plain and unflavored foods at home.  Buying unflavored varieties of food can cut out a lot of added sugar, fat, and salt.  This can be done for many food items including oatmeal, cereal, yogurt, popcorn, frozen veggies, canned fruits and veggies, and more.  Add a tablespoon of peanut or almond butter to oatmeal, then top with fresh or frozen fruit and a sprinkle of cinnamon for some sweetness.  Use fruit or just a sprinkle of sugar at home on plain cereals.  Add 2 teaspoons of honey to plain yogurt and top with your favorite fruit and ¼ cup granola.  Try grating some parmesan cheese on plain popcorn, or season it with parsley, lemon pepper, red pepper flakes, or cinnamon for a few different varieties.  Buy frozen veggies without any added sauces, canned veggies with no added salt, and canned fruit packed in its own juice or water for less sugar.  Use various spices to flavor the veggies.

  1. Use snacks as an opportunity to get some quality nutrition. Snacks can be a great way to get extra nutrition throughout the day, if we choose balanced options.  Try to include at least 2 food groups at each snack, and work to make 1 of those foods a fruit or vegetable.  Many snacks can be prepped at home from simple ingredients: a cheese stick and fruit, carrots and hummus, edamame and grapes, popcorn and sliced bell pepper, an apple and almonds, celery and peanut butter, yogurt and berries, peanut butter and graham cracker sandwiches with a clementine, cottage cheese and peaches, trail mix (dried fruit, nuts, dark chocolate), crackers topped with spreadable cheese and cucumber slices, veggie chips and cherry tomatoes, corn chips and veggie salsa, a hard-boiled egg and a pear, and many more.

  1. Choose your condiments carefully. Many condiments are loaded with sugar and fat. Check the ingredients list and try to find those made with the most natural ingredients possible.  Palm kernel oil and coconut oil are saturated fats, which increase risk for heart disease; so it’s best to find products made with other types of oil.  To decrease sugar, be aware that sugar takes many forms, including corn syrup, high-fructose corn syrup, corn syrup solids, molasses, dextrose, brown sugar, fructose, invert sugar, and more.  Sometimes a single food item may include multiple types of sugar in the ingredients list.  Best food choices for a regular basis will include minimal forms of sugar and find sugar lower on the ingredients list (ingredients are listed by volume used, the most to the least).  Jam or jelly, for example, would ideally include the fruit, sugar, pectin, and lemon juice or citric acid.  Many of the large companies make jam and jelly products with primarily high-fructose corn syrup and fruit juice concentrate, not real fruit.

  1. Swap refined, white food products for whole grain options. Pretty much everything you can find as a refined food product can also be found in a whole grain version (with the exception of cake, pastries, and many desserts). Try these substitutions, and remember any change is a good change.  Maybe you’re unwilling to give up white rice, but you don’t mind eating whole grain bread and pasta.  Great!  Start there.  You can also do a 50/50 mix of white and whole grain.

Processed Version

Whole Grain Options

white rice or “enriched” rice brown or wild rice
white pasta whole wheat pasta
white bread, buns, or bagels whole grain wheat bread, buns, or bagels
white or corn tortillas whole grain wheat flour or corn tortillas
many ready-to-eat cereals oatmeal, whole grain ready-to-eat cereals
Ritz, Club, Wheat Thins, and many crackers Triscuits or other whole grain crackers
Goldfish crackers, pretzels, many “snacks” popcorn
all-purpose wheat flour whole grain wheat flour
corn bread mix whole grain corn meal
Try other whole grain options: quinoa, barley, couscous, amaranth, millet, farro, and more…
  1. Spend more time shopping the perimeter of the grocery store. You’ll notice the center of the grocery store is where the aisles and packaged food items are primarily located.  These items are more shelf-stable – meaning they don’t require refrigeration – because many of them are heavily processed. (Please remember that many nutritious foods are found in the aisles, too.  We just need to read the labels!)  The border of the store is where the fresher food items are located.  Fill your cart with more fruits and veggies (fresh, frozen, and canned are all good options), low-fat and unflavored milk and yogurt products, and lean and unprocessed protein options (fish, seafood, poultry, lean red meat, eggs, low-fat cheese, hummus, tofu).  Dive into the aisles for staple foods like whole grain bread, cereal, pasta, and rice; nuts, beans, and other legumes; spices, oil, and cooking essentials; and some healthy snack options like whole grain crackers, low-fat popcorn, or dark-chocolate for a sweet treat.

Learning to change the way we eat can often be confusing and overwhelming.  Be patient with yourself and remember to set small and realistic goals.  Every little step is progress!  If you have questions or this is a topic you’d like to explore more, please talk with your healthcare provider about scheduling an appointment with the Registered Dietitian at Family Physicians of Greeley.

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Can Food Be Medicine?

“Let thy food be thy medicine and thy medicine be thy food.”

I’m sure this isn’t the first time you’ve heard the famed quote allegedly spoke by the ancient Greek physician, Hippocrates.  But whether you have heard this or not, have you ever stopped to really consider it?  Let’s pause to think about food objectively for just a moment.

Eating and drinking is likely the single act we do more than anything else daily, arguably making it the most important act of the day.  Therefore, logically, shouldn’t the things we ingest be of utmost importance?  Just as we consider the purpose of a medication before taking it, shouldn’t we consider the purpose of our food before eating it?  As we carefully consider the side-effects of a new medication before starting it, shouldn’t we consider the “side-effects” of our food?  Would you think twice if a food label read, “This product contains added sugar. Excess sugar may cause serious side-effects including increased risk of cancer, heart disease, diabetes, and inflammation, which leads to many chronic conditions and pain.”  What about a label that read, “This product contains palm kernel oil.  Palm kernel oil is a saturated fat that may lead to excess weight gain, high blood pressure, increased cholesterol levels, and significant risk for heart attack and stroke.”  I don’t mean to be an alarmist, but these statements are true.

Now, I’ll be the first to acknowledge that food is more than an object and eating more than a necessary act for life.  Food is a very personal thing for most of us and something that is tied to emotion, tradition, culture, and celebration.  There is no escaping this truth.  They are intrinsically interwoven, and it would be futile and counterproductive to try to separate them.  Additionally, food is to be enjoyed; satisfaction and enjoyment of food are critical components that signal fullness.  The point of this post is not to cause alarm and anxiety about food.  In fact, it is just the opposite.  So much of the worry, confusion, and guilt felt about food choices is a result of the disconnect between the people eating food and the food itself.  But why would it be any other way?  We aren’t taught about food and good nutrition in school, health claims on food products are confusing, and the messages we hear about food in the media tell us as many different things as there are people to tell it.

Rather than taking the joy out of food and eating with ridiculous food rules, I am simply advocating for more intention where it comes to food and health.  This includes an increased recognition of the purposes of food, more awareness of the effects of food choices, a return to quality real food, and increased mindfulness in eating behaviors.  Just as you would inform yourself about a new medication or any important decision, I urge you to inform yourself about food and good nutrition.  Then, take that knowledge and nourish yourself accordingly, recognizing that food is both the fuel for your body and a universal method for connection, celebration, and tradition of culture.  Coincidentally, in doing so, you may find health and joy in eating.  (Disclaimer: food and nutrition is not intended to replace medicine.  It should be used along with medicine, when prescribed, to improve health.)

March is National Nutrition Month, so we’re putting the spotlight on food and nutrition in this month’s blog posts.  To get started, here are 4 things you may not know about your food:

  1. We have an abundance of food choices in this country, and more options are not always a good thing. In grocery stores alone (this doesn’t include fast food, gas stations, convenience stores, etc.), there are between 40,000 – 50,000 products for consumers to choose from.  In the 1990s – just 30 years ago – there were only 7,000 items in most stores.1  Let me be clear: 33,000+ new food items have not been discovered in the last 3 decades.  Food companies and manufacturers found 33,000+ ways to take existing whole foods and modify them in a factory to create the heavily processed food items that make up the majority of Americans’ diets today.  Sure, the convenience is nice, but the effects on our health and relationship with food are not.  (It’s important to note that not all processed foods are bad; and in America, it is nearly impossible to completely avoid processed food in the diet.  For example, unless you’re drinking milk straight from the cow, milk is a processed food.  The same is true for many healthy, single ingredient foods like oatmeal and frozen veggies.  Most of us live too far from the source of our food to avoid the processing required to keep it safe and sanitary from harvest to the market. The degree of processing is what we need to watch out for and minimize.)

Helpful Tip: Choose mostly whole foods; and when you’re buying packaged foods, read the ingredients list.  Ingredients provide much more insight than the nutrition facts alone.  If the list is a mile long, full of words and ingredients you can’t pronounce, and limited in whole food ingredients, it’s probably not the best choice for a regular basis. (Many processed foods are loaded with unnecessary and unnatural ingredients.  Protein bars, for example, are thought of as a healthy food, but most won’t recognize half the ingredients listed.  A hard-boiled egg or handful of nuts is a whole-food approach to get some protein.)  Also, if you can’t identify a food’s natural origin, or if the answer is “a factory,” it’s a highly processed food that should be reduced in the diet. (For example, where is the hot dog located on a cow, or what about the pepperoni on a pig?  I’d like to see the plant that grows a Hot Cheeto.  And, again, where does a protein bar come from?)

  1. The quality of our food is changing, and it’s moving in the wrong direction. Studies show that food produced today is less nutrient rich than it was 70 years ago due to a variety of factors.2  In some cases, nutrient-depleted soil from land overuse is the cause of nutrient declines; and in other cases, efforts to breed new varieties of crops are to blame.  New varieties of crops are bred to increase yield, resist pests, and adapt to various climates, but the plant’s ability to uptake nutrients seems insufficient to keep up with the rapid growth.  This results in a less nutritious but more abundant food supply.

Helpful Tip:  Avoid highly processed foods as much as possible.  The more natural the food, the more nutritious and beneficial for your body and health.  Shop local whenever possible (farmer’s markets are a great option), organic if it’s affordable, and choose naturally nutrient-rich foods like fruits, vegetables, whole grains, nuts, and legumes most of the time. Naturally raised animals (example: grass-fed and pasture raised cattle and chicken, and wild-caught seafood) will produce the most nutritious animal protein options.  You can also grow some of your own foods in a home garden, if you have the ability and desire to do so.  Whatever you do, don’t use this point as reason to eat more processed foods.  Fruits, veggies, whole grains, and other natural foods (or products made from natural foods) are still the most nutritious foods we can choose and should make up most of the diet.  If you can’t afford organic food and pasture-raised protein, buy the other options.  They’re still highly nutritious!

  1. Speaking of more abundant but less nutritious food, let’s talk about grains for a moment. Grains like rice, bread, cereal, and pasta have come to have a bad reputation in recent years, but these are very healthful foods if you know what to look for.  Here’s the breakdown: all whole grain kernels – whether it’s corn, wheat, rice, oat, barley, etc. – have three parts.  These are the germ, bran, and endosperm.  The germ is where most of the vitamins, minerals, and a small amount of protein and healthy fat live.  The bran is the hard-outer shell of the grain; this is the source of a grain’s fiber, along with important antioxidants and B vitamins.  The endosperm, which is the largest part of the grain, houses all the carbohydrates, a small amount of protein, and, therefore, the majority of the calories.  Refined, processed grains (white bread, rice, pasta, etc.) are grains that have had the germ and bran removed, leaving us with calorie-rich foods that have little nutritional benefit, aside from providing energy.  Whole grains, on the other hand, provide a great source of vitamins, minerals, fiber, and other nutrition, along with the calories.  These are beneficial for our health and a crucial component of a balanced diet.

Helpful Tip: Read the ingredients list on the label.  Most processed foods are made with refined grains, and the only way to know is to check the ingredients list.  If you see the word “Enriched” in front of the type of flour, it is a processed and refined grain with less nutritional benefit.  A true whole grain product must list the first ingredient as “100% whole grain” or “whole grain” in front of the type of grain.  For example, cracker ingredients listed as “whole grain wheat,” or bread that reads “100% whole grain rye flour,” or pasta that lists “Whole grain wheat durum” as the first ingredient on the label are all whole grain products.  Multi-grain simply means there are multiple types of grain in the product.  Ignore the tricky marketing claims on the front of the food package and go straight for the ingredients list.

  1. Food waste is a big problem contributing to the global burden of food supply. Each year, roughly one third of the food in the world produced for human consumption is lost or wasted.  That’s approximately 1.3 billion tons of food.  In industrialized countries, 40% of losses occur at retail and consumer levels;3 and in the United States, specifically, an estimated 31% of food is wasted each year, correlating to approximately 133 billion pounds and $161 billion dollars’ worth of food in 2010.4  Fruits and vegetables have the highest wastage rates of any food (45%), followed by fish & seafood (35%), cereals (30%), and lastly, meat, dairy, and oil seeds (20%).

Helpful Tip: Try to reduce your personal food waste through prevention, intervention, and re-purposing.

Prevent food waste: Shop the marked down food section of your grocery store.  These foods are nearing their “Best by” date, and grocery stores won’t sell food past this time.  Food can still be safely consumed beyond this date, but the quality, texture, and taste may be slightly affected.  On the up side, you’ll save money!  If this isn’t for you, you can still reduce personal waste by planning meals, buying appropriate container sizes (meaning, if you never use a full gallon of milk before it turns sour, buy the half gallon size), and saving leftovers for a second meal or a re-purposed meal.

Intervene before food is wasted: fresh berries that are nearing the end of their shelf life can be frozen and used in smoothies, pancakes, oatmeal, or made into a compote; apples and bananas can be made into bread or applesauce if no longer ideal for snacking; wilting veggies can be sautéed, finely diced and mixed into a sauce, or used in a soup without notice of a change in texture; bread can be kept in the refrigerator to prolong its shelf-life; nuts can be stored in the freezer if you find they go rancid before you finish the bag; and meats can be frozen until you are ready to use them.  These are just a few ideas to try.

Re-Purpose: Finally, if you aren’t able to prevent or stop food waste from occurring, you could consider using food waste to create compost.  Compost is a necessary component of farming and gardening, and many towns will collect it just like garbage and recycling.  Look into your local options!

To sum up, remember that no food is off limits entirely (unless you’re managing a medical condition and have been advised otherwise).  It is the habitual food choices and behaviors that impact our health most; and therefore, these are the habits we want to become aware of and work towards balancing.  Hot dogs can be a once-in-a-while food choice, as can refined white flour food products (like Cheetos), french fries, or protein bars.  The message here is to simply get back to the root of real food.  When we take the time to understand, prepare, and appreciate our food more, our relationship with food changes.  This is where we will find our best health.

In the brilliantly simple words of Michael Pollan, “Eat food. Not too much. Mostly Plants.”


  1. Interview with Michael Ruhlman, the author of “Grocery: The Buying and Selling of Food in America,” published on Market Watch website; June 17, 2017.  Accessed March 5, 2019.
  2. Changes in USDA Food Composition Data for 43 Garden Crops, 1950 to 1999.
  3. Food and Agriculture Organization of the United Nations. Key Facts on Food Loss and Waste You Should Know.  Accessed March 12, 2019.
  4. United States Department of Agriculture. Food Loss and Waste.  Accessed March 12, 2019.
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How’s Your Heart?

In honor of February – the month of hearts – today’s post is all about heart health.

According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death in the United States for both men and women.  Approximately 1 in every 4 deaths is related to heart disease, and about 735,000 Americans have a heart attack every year.1  Heart disease is known as a silent killer because there are often no symptoms until one experiences a heart attack or stroke, both of which can be fatal.  In fact, 50% of men and 64% of women who die suddenly of coronary artery disease had no previous symptoms.2

Heart disease is a term that refers to many conditions that affect the heart or cardiovascular system.  This includes coronary artery disease, congestive heart failure, arrhythmias, congenital heart defects, heart valve disease, heart attack, and more.  While symptoms and warning signs may be similar between these conditions, each requires different treatment.  It is important to talk with your health care provider to have a plan in place if you have existing heart disease.

For individuals without known heart disease, it is critical to do regular screening through appointments with your health care provider, as well as through self-assessment of your lifestyle habits.  Here are 5 things you can do to reduce your risk for heart disease and/or prevent potentially fatal cardiac events if you already have heart disease:

1. Know Your Numbers. Blood pressure, total cholesterol, and LDL cholesterol (also known as “bad” cholesterol) are strong indicators of risk for heart attack or stroke. Work with your health care provider to make sure you know your blood pressure and cholesterol levels, and take action to improve these numbers if they are too high.

  • Blood Pressure should be at or below 130/90 to reduce your risk. A healthy diet, physical activity, maintaining a healthy weight, quality sleep, stress management, and medicine can help to reduce blood pressure.
  • Total cholesterol should be at or below 200 and LDL (“bad”) cholesterol should be less than 100. HDL cholesterol is a “good” cholesterol and adequate levels can help to reduce risk for heart disease.  HDL cholesterol should be equal to or greater than 40.  A healthy diet, physical activity, maintaining a healthy weight, and medicine can improve numbers.
  • If you have diabetes, monitor your blood sugar. High blood sugar increases the risk for heart disease.  If you need more information on this topic, talk with your health care provider.


2. Move more. Physical activity not only helps with weight loss, but also reduces stress, improves sleep, and strengthens the cardiovascular system.  It is an essential factor in having a healthy heart.  Adults should get a minimum of 150 minutes of moderate physical activity each week.  This equates to 30 minutes five days per week and includes any activity that slightly raises your heart rate while allowing you to maintain a conversation.  If it helps, keep in mind you do not need to get all 30 minutes of activity at once.  Break it up: take two 15-minute walks during the day; rake the leaves and later go for a bike ride; walk around the store for 10 minutes before shopping and later take a walk with your family.  If 30 minutes of activity seems too difficult, just start somewhere: stand for 5 minutes 5 times per day, take the stairs instead of the elevator, get off the bus a stop early, park further from the door, take the long way back to your desk after making copies.  Wherever you are starting, simply find ways to move more.  (If you want to start a more vigorous exercise routine, talk with your health care provider first to ensure safety.)


3. Eat a healthy diet. Our food choices have a huge impact on our overall health, and the great news is a single well-balanced diet can address a myriad of health problems.  Choose nutrient-rich foods with lots of fiber such as fruits, veggies (especially the non-starchy colorful ones), whole grains, nuts, and beans most of the time; and round out the diet with moderate portions of low-fat dairy and lean animal protein (if you choose), such as fish, seafood, poultry, and eggs.  Limit red meat, high fat cheese, and cream-based dressings and sauces.  Avoid fried foods, processed foods, and sugary drinks.  Alcohol should be limited to a maximum of 1 drink per day for women and 2 drinks per day for men.  Nothing needs to be off-limits entirely, but portions and frequency do matter.  Saturated and trans fats, added sugars, and salt are the biggest contributors to heart disease.



4. Lower your stress level. Stress creates toxic reactions in the body and can also lead to unhealthy behaviors.  Find healthy coping strategies and methods for relaxation that you can use daily.  Take a walk, sit in nature, call a friend, read or write, color, enjoy a long bath or shower, breathe deeply, meditate, establish a routine that supports restful sleep, seek help from a counselor.  Self-care is critical to good health and longevity.




5. Quit smoking. Smoking damages blood vessels, speeds up hardening of the arteries, and greatly increases risk for heart disease.  If you don’t smoke, don’t start.  If you do smoke, talk with your health care provider about options to help you quit.  You might start by reducing the number of cigarettes you smoke daily; this can have a great impact on your health, too.



You can find more information on prevention and wellness here, and also check out the wellness classes offered at Family Physicians of Greeley.


  1. Centers for Disease Control and Prevention website. Heart Disease Facts. Accessed February 18, 2019. Website:
  2. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics—2012 update: a report from the American Heart Association ExternalCirculation. 2012;125(1):e2–220.
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Re-framing New Year’s Resolutions

New year, new resolutions, new you, right?  While statistics on the subject vary from source to source and year to year, one thing remains common: most new year’s resolutions don’t stick for the majority of people.  Enter One Word, a book written by Jon Gordon, Dan Britton, and Jimmy Page, which promotes the idea of selecting a single word to be an individual’s guiding principal for the year rather than setting ‘resolutions’ and goals that often get forgotten a few months into the year.

To give an example of how this might work, let’s imagine a scenario.  Perhaps you want to start an exercise routine and improve your physical fitness.  Your resolution is to go to the gym four times each week.  At first, things are going great, but then you come down with a cold and miss a week and a half of workouts.  Next, visitors come to town, and you can’t find time to slip away to the gym.  Then you must travel for work, and the schedule is very busy, not to mention the fitness center at the hotel doesn’t have your favorite machine.  You choose to skip it.  Soon enough, your goal to exercise four times per week seems like a failure, so you give up entirely thinking, “There’s always next year.”

Now, let’s re-frame this scenario.  You want to be more physically fit, feel better, and have more energy.  You select the word MOVE as your word for the year.  You may have a plan to go to the gym four times per week, and it’s going great at first.  That’s wonderful!  Then, you get sick.  Remembering that your word for the year is MOVE, you simply try to move around the house that week you’re under the weather.  Washing dishes, folding laundry, standing up during commercial breaks, or going for a walk around the block are all things that keep you moving even while you’re sick.  When visitors come to town, you decide to go for a walk around the neighborhood, a gentle hike on a nature path, or even ice skating or bowling for a fun activity.  While traveling, you walk around the airport, choose the stairs instead of the elevator in the hotel, walk on the treadmill while watching a show in the fitness center, or ask the taxi driver to drop you off a block or two away from your destination.  Through all the unexpected changes and abnormal weeks of the year, you have continued to MOVE.  Suddenly, this story is one of success and positive change.  A new habit and lifestyle behavior has been formed.  At home, you resume the weekly trips to the gym when you can and find other alternatives to MOVE when you can’t.  Somewhere along the way, you’ve also recognized that timelines for self-improvement are arbitrary; there need not be a start and end date.  Each day is a new opportunity to make the choices that will support your health.

This concept of a guiding word for the year can be applied to any aspect of life.  With 2019 just beginning, it’s a popular time to set some intentions for the year, and we’d like to help if you like this idea of a single guiding principal in place of numerous resolutions.  Below is a list of fifteen words that represent positive steps towards health and wellbeing.  Choose one, or be inspired to find another word that may be useful as you set out to establish new habits in 2019.

  1. BREATHE – This may be a helpful word if stress, anxiety, or anger are commonly experienced emotions. Slowing our breathing and focusing on our breath helps us to come in to the present moment, slow down racing thoughts, and lower our heart rate and blood pressure. 
  2. NOURISH – This word may be useful if healthy eating is a goal. If the focus is on nourishing the body, we may be more likely to choose fruits and veggies and other minimally processed, nutrient-rich foods in place of highly processed foods with many added fats, sugars, and salts.  At the same time, occasionally we may recognize that the food which will be most nourishing is one that feeds our soul.  It is okay to have sweet treats and higher fat foods every now and then, especially if it will help you to continue making healthful choices in the long run.  Just remember, soul nourishing foods should be eaten in small portions and only occasionally.
  3. BALANCE – This could be a great word to focus on if your typical motto is “all or nothing.” It is impossible to be perfect, but we are always in progress.  Focusing on balance may help with achieving moderation in our behaviors and reduce feelings of guilt associated with decisions we tend to think of as “bad.”  In turn, this may help us to continue moving forward in our progress towards improvement and reduction of harm, rather than giving up entirely.
  4. CONNECT – Maintaining beneficial relationships and healthy social activities is incredibly important for mental health and overall well-being. Perhaps you want to focus on connecting with others this year, whether through existing relationships or the start of new ones.
  5. KINDNESS – Towards yourself and others. We tend to be our own worst critic, but it’s important to recognize that we all have bad days.  Give yourself some grace and kindness, and treat yourself the same way you would a dear friend or family member in the same situation.
  6. ACCEPTANCE – We tend to fight against distressing thoughts and feelings, which can cause a lot of anguish and stress. It can be a beneficial habit to learn to just notice some feelings and give up the struggle.  Some situations are not in our control and can’t be changed; in these cases, riding out the waves of emotions may serve us better than trying to stop them.  (If you need help from a professional, talk with your health care provider.)
  7. PERSPECTIVE – We all give different meanings to situations and see things from our point of view. Choosing perspective as a word of the year may encourage you to change perspective, broaden perspective (look at the bigger picture), or even seek new perspective (help from others) to support your general well-being.
  8. RELAX – This word could take on multiple meanings and serve as a reminder to put self-care at the top of your to-do list each day.
  9. RECHARGE – Good sleep is essential to good health. Adequate sleep supports normal blood pressure; gives our brain the time it requires to “recover” from the day’s stimulation; assists in regulating metabolism and hunger; and supports good memory, improved learning, and stable mood, among many other benefits that help to prevent chronic disease.  Our bodies need time to recharge, and many habits can help to improve restful sleep. 
  10. CREATE – Having fun or being creative helps us feel better and increases confidence. Take time to enjoy being creative in whatever form it takes: play a game with grandchildren, paint, color in a coloring book, write, make music, plant a garden, try your hand at poetry.
  11. LEARN – Learning a new hobby or skill can support health and well-being in many ways. It will increase your confidence, stimulate mental interest, allow you to meet and connect with others, and may even prepare you for finding new or different work opportunities.
  12. MOVE – Being active lifts our mood, reduces feelings of stress and anxiety, improves physical health, increases our mobility and opportunities, and gives us more energy. Getting activity in nature adds to the health benefits you may experience, but activity anywhere is excellent for health.  Find an activity you enjoy or get active with a friend – it will feel less like a chore and be fun!  Whatever you do, move.
  13. HELP – This word could serve as a reminder that it is okay to ask for help, when needed, or be an encouragement to help others. Getting involved with a community project, doing charity work, or simply helping someone you know can have a twofold effect.  When we do something to benefit others, we often feel better about ourselves in return.  Helping others also serves as a reminder that we all need a little help sometimes.  All we need to do is ask.
  14. MINDFUL – Many of our behaviors and daily routines are done out of habit, and not all habits are beneficial to us. Being mindful in our actions can be a great way to make big impacts in our health.  Think about how you spend your time; notice what, how much, and when you choose to eat; choose to take more steps through the day; disrupt routines that result in poor sleep; note tension and stress you hold through the day; be mindful of and feel your emotions.  Sometimes we choose to use alcohol and non-prescription drugs to cope with our feelings, but this only adds to our problems in the long run.  Be mindful of actions, habits, and emotions through the day, and address them accordingly.  Awareness is the first step in taking action.  Seek help from a professional if you need support.
  15. POSITIVE – Research has shown that positive thinking has the power to “re-wire” the brain. The more common our thoughts, the stronger that pathway in the brain becomes.  Think of it like a dirt path that gets worn into grass the more often the path is taken.  If we think negative thoughts, that will be the natural reaction of the brain.  But if we think positive thoughts, over time, this will become the automatic response of the brain.  So, think positively.  You might start by writing 3 things you are grateful for or 3 good things that happened at the end of each day.

Remember, whether you’re reading this the day it was posted or five months later, the best time to start is now.  So, what will be your one word of the year?  We’d love to hear your intentions so we can support you along the way.  Happy 2019!

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Diabetes Is On The Rise – Do You Know Your Risk?

Did you know someone in the U.S. is diagnosed with diabetes every 21 seconds?  According to research by the American Diabetes Association, diabetes affects 30 million children and adults in the U.S – that’s 1 in 11 Americans.  Even more shocking is that 84 million Americans have prediabetes and are at higher risk of developing type 2 diabetes, but 90% of them don’t know they have it.

November is Diabetes Awareness Month, and as the seventh leading cause of death in the United States, it is important to bring attention to this chronic disease.

There are several types of diabetes: type 1, type 2, and gestational diabetes (or high blood sugar in pregnancy that usually resolves soon after the baby is born. Be aware, even though it usually goes away, this type of diabetes increases your risk of developing type 2 diabetes later in life).  Type 1 diabetes is a condition that develops in response to an immune reaction, and it cannot be prevented.  When this occurs, the beta cells of the pancreas stop producing insulin, a hormone required to move glucose (otherwise known as sugar) from the bloodstream into our cells where it can be used for energy.  Insulin is necessary to sustain life since glucose is the body’s primary form of energy, so people with type 1 diabetes must take insulin multiple times daily to survive and maintain healthy blood sugar levels.  In type 2 diabetes, the body still produces insulin, but cells have become resistant to its effect.  This is called insulin resistance and means the body isn’t working as it should to move glucose from the blood in to cells.  Diet, exercise, and other lifestyle factors are pillars in the treatment of type 2 diabetes, and often medicine is required as well.  Type 2 diabetes is by far the most prevalent form of diabetes (95% of people with diabetes have type 2), and unlike type 1 diabetes, it can be prevented with awareness of risk factors and healthy lifestyle choices.  We will get to more on this in a minute.

Hemoglobin A1c (HgbA1c) is a blood test that correlates to a person’s average daily blood sugar from the previous three months and is used as the primary diagnostic marker for diabetes.  HgbA1c is measured as a percentage – for example, 7.0% – because it indicates the amount of a hemoglobin molecule (a protein in red blood cells) that is covered by glucose.  As glucose builds up in the blood stream it binds to hemoglobin, so the higher the percentage, the higher the average daily blood sugar level, and vice versa.  To further illustrate this concept, imagine this: the more glucose, or sugar, that is in a person’s blood stream on a daily basis, the more that glucose will stick to the hemoglobin molecule and coat the outside.  So, a result of 12.2% indicates that 12.2% of the molecule is coated in glucose.  A normal HgbA1c reading for a person without diabetes is less than 5.7%, and diabetes is normally diagnosed at a level of 6.5%.

Prediabetes – a condition diagnosed when a person’s HgbA1c is between 5.7% and 6.4% – indicates that a person’s blood sugar is higher than normal, but not yet high enough to be diagnosed as diabetes.  Don’t let the ‘pre’ in the name fool you though!  This diagnosis increases the risk of developing type 2 diabetes, heart disease, and stroke.  And most importantly to understand, prediabetes is reversible.  The development of type 2 diabetes can be prevented or delayed with proven lifestyle changes and regular monitoring at doctor visits; and some providers will prescribe a drug called Metformin, which can help lower blood sugar.  Knowing your risk factors is also helpful.

Because prediabetes is rarely accompanied by symptoms, one can live with the condition for years without knowing it.  That’s why it is important to talk to your doctor about getting your blood sugar tested if you have any of the following risk factors for diabetes:

  • Being overweight, as classified by body mass index (BMI)
  • Being 45 years or older
  • Having a parent or sibling with type 2 diabetes
  • Being physically active less than 3 days per week
  • Ever having gestational diabetes or giving birth to a baby who weighed more than 9 pounds
  • Belonging to one or more of the following racial and ethnic groups: African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans

If you have been diagnosed with prediabetes, think of this as your red flag warning.  Ignore it, and your risk for developing type 2 diabetes goes up.  Make some small changes, and your risk goes down.  In fact, research has shown that a person with prediabetes can reduce their risk for developing type 2 diabetes by 50% by making just two changes: get regular physical activity and lose a modest amount of weight.  Modest weight loss means 5% to 7% of body weight, which is just 10 to 14 pounds for a 200-pound person.  And regular physical activity means getting 150 minutes of moderate activity weekly – that’s just 30 minutes a day, 5 days a week.  To make it even more manageable, consider that time could be divided into two 15 minutes bouts of exercise.  Moderate activity includes brisk walking, bike riding, or other physical activity performed at a pace where holding a conversation would be difficult.

People with diabetes have healthcare costs 2.3 times greater than those without diabetes, and the costs continue to rise every year as medications become more expensive.  Further, because diabetes affects nearly every major organ in the body, people with diabetes have an increased risk of serious health complications including stroke, blindness, heart disease, kidney failure, and loss of toes, feet, and legs.  These complications are a direct result of poor blood glucose control, so it is critical for people with all forms of diabetes to learn and practice good self-management.  This may include following a modified diet, getting regular exercise, taking medicine, monitoring blood sugar at home, checking feet for cuts and wounds, completing eye exams, and attending regular doctor appointments.

If you have diabetes or prediabetes and want to learn more about how you can better manage your health, please talk with your doctor and use the following resources to get more connected to reliable information:


Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care journal, March 2018.  Accessed via the American Diabetes Association website on November 13, 2018:

The Staggering Costs of Diabetes.  American Diabetes Association website: Accessed November 13, 2018.

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Health Through the Holidays

Holidays are often a time of more frequent family gatherings, parties with friends, rich foods, and indulgence.  Even so, it’s important to maintain healthy habits through the holidays, especially if you’re managing a chronic disease such as diabetes or high blood pressure.  Below are 8 tips to help you balance healthy choices with enjoyment of the season.  Remember, a healthy lifestyle is all about sustainability, balance, and moderation so you can savor your favorite traditions of the season while ensuring wellness for future holidays to come!

  1. Keep Your Routine

Often people will choose to eat lighter meals or skip snacks ahead of a large holiday meal, but this only primes a person to overeat.  Instead, plan ahead for meals and snacks so you continue to eat on a regular schedule, about every 4-5 hours.  A satisfying breakfast that includes a lean protein will start your day right by stabilizing blood sugar and giving you energy for the day’s events.  Try a scrambled egg with tomatoes, peppers, and 2 tablespoons avocado wrapped in a small whole wheat tortilla; oatmeal or low-fat yogurt with fresh fruit and chopped nuts, add a hard-boiled egg for extra protein; or a piece of whole grain toast with peanut butter, a glass of low-fat milk, and fruit.  Eat a small snack if the main meal is more than 5 hours after breakfast to help regulate appetite and prevent overeating.

  1. Be Selective

Meals at the holidays often include many dishes and a variety of options to get your balance of nutrients.  Some of these dishes may be regulars that are served year-round – such as bread, rolls, mashed potatoes, or rice – and others may be special holiday traditions, like stuffing, candied sweet potatoes, or tamales.  Rather than eating some of everything, pick the foods that only come out on special occasion and leave the other foods off your plate.  If you must have a little of everything, take a small sample (2-3 bites) rather than a full portion.  If you’re watching carbohydrates for diabetes management, identify similar foods and pick one or the other.  For example, maybe you prefer stuffing instead of a roll, sweet potatoes rather than mashed potatoes, and gravy on your turkey more than gravy on your stuffing.  Even if you like it all, it’s important to pick your favorites and limit carbohydrates to those choices.  If you can’t choose only 2 or 3 carbohydrate foods, take very small portions or samples.

  1. Watch Your Portions

Holiday meals not only tend to be much larger than everyday meals, they also frequently include dishes prepared with more fat, sugar, and salt than average meals.  For this reason, it’s important to keep portions small.  Try using a smaller plate, prepare only one plate of food instead of two, serve smaller portions than normal (significantly smaller if taking a little of everything), split a full portion with someone else, avoid piling food on the plate, and eat slowly.  It takes the brain about 20 minutes to catch up with the stomach and recognize fullness; so talk with others, chew slowly, sip on water through the meal, and set your fork down between every few bites to help slow down.  Remember, you can always have leftovers the next day!  If someone else is hosting, ask if you can bring a small container to pack up one portion of leftovers to take home.

  1. Eat Your Veggies

Vegetables are not usually in abundance at holiday meals, but as with any other time of the year, they are one of the most beneficial foods we can eat!  Non-starchy veggies are naturally low in calories, fat, carbohydrate, and sodium, while they are rich in fiber, vitamins, minerals, and antioxidants.  With this nutritional make-up they support good blood sugar control, healthy blood pressure, and weight management.  By filling half your plate with veggies, you will get a healthy dose of fiber and nutrition that can help to fill you up and prevent overeating.  If veggies aren’t a common dish at your holiday gatherings, offer to bring a salad or roasted veggies.  Raw veggies and dip can also be a great appetizer!

  1. Limit Alcohol

Calories in alcohol can quickly add up and sabotage your weight loss efforts made in food choices and exercise.  One 5-ounce glass of red or white wine has about 120 calories, a 12-ounce light beer ranges from 110-150 calories (many craft beers are higher calorie), and a mixed drink with 8 ounces juice or regular soda and 1.5 ounces distilled spirit (80 proof) packs nearly 200 calories.  For comparison, you could eat a half cup of stuffing (178 calories) or mashed potatoes made with milk and butter (120 calories), 1 cup of green bean casserole (142 calories), 2 ounces of pumpkin pie (about a 1 inch sliver – 130 calories), or 3 cups of mixed veggie salad with 1 tablespoon dressing (165 calories) for about the same calories as a single drink.  You’d also be getting the nutritional benefit of some vitamins, minerals, and fiber with any of these food choices.  Rather than having it all, think about how you most want to nourish and care for your body; then make your choices accordingly.  Also consider, for best health it is recommended that women have no more than 1 drink per day and men no more than 2 alcoholic beverages per day.  For weight management, try one of these drinks that minimizes calories:

  • 1.5 ounces vodka, 6 ounces grapefruit-flavored sparkling water, a splash of 100% grapefruit juice; garnish with a slice of grapefruit and mint.
  • 1.5 ounces tequila, 6 ounces mineral water, squeeze of fresh lime juice; garnish with a lime wedge
  • 1.5 ounces whiskey or rum and 6 ounces diet coke
  • 1.5 ounces scotch on the rocks
  • Budweiser Select, Beck’s Premier Light, Anheuser-Busch Light Pale Lager, Michelob Ultra
  • Various mocktails:
    • Sparkling water, a splash of pomegranate juice, and a few pomegranate arils
    • Iced tea with a splash of mineral water for bubbles, a squeeze of fresh lemon or lime, and mint leaf
    • Sparkling water, fresh-squeezed orange, and a sprig of fresh rosemary
  1. Stay Physically Active

Make physical activity a part of your holiday traditions.  Rather than watching TV or taking a nap after a big meal, go for a walk, play a friendly game of flag football, toss a frisbee or play catch, go bowling, play active video games (like Wii tennis or Dance, Dance, Revolution), or get competitive with an active group game like charades.  You can also take advantage of extra time off work to exercise before family gatherings and parties, take a brisk walk around the mall before shopping, turn on music to add a pep in your step as you do chores, or do a fun activity like ice skating or snow shoeing with the family.  Whatever you do, continue to move!

  1. Try Healthier Versions of Your Favorite Foods

Most recipes can be modified to include less added sugar, fat, and therefore, calories.  Use the ideas below to improve the nutritional benefit of your holiday favorites!

  • Use whole grain dinner rolls instead of highly processed white rolls
  • Swap regular mashed potatoes for half mashed potatoes and cauliflower
  • Roast sweet potatoes to bring out the natural sugars rather than loading with brown sugar and marshmallows. (Hint: leave the potato skin on for extra fiber and use half the oil for less calories)
  • Add twice as many green beans to your green bean casserole recipe for an extra serving of veggies and less calories.
  • Bring a festive green salad or colorful roasted veggies as a nourishing side dish.
  • Try this apple crisp recipe rather than apple pie to reduce the fat, sugar, and carbohydrate and increase fiber.
  • Bring an alternative to the standard pumpkin pie dessert. These tarts can be topped with a dollop of ‘lite’ vanilla yogurt instead of whipped cream.
  1. Gather Support

One of the most important factors in successful health behavior change is having a good support network.  Talk with your family and friends to let them know you are working on change and share how they can help you.  This may mean asking your aunt to make a less-tempting dessert (or only 1 dessert option), inviting your cousins to join you for a walk after the big meal (plan ahead so everyone can have comfortable walking shoes and warm clothes), requesting your mom to only give encouraging words or nothing at all, allowing someone to remind you of your 1 or 2 drink limit, or gathering support and accountability from friends to help you keep up with your goals throughout the season.

Above all, remember that health and wellness is a journey.  If your day doesn’t go as planned, you skipped your daily exercise, or you ate and drank more than you wanted to at the party, it does not mean you failed and all is lost.  Every day is a new opportunity to make healthy choices.  Think ahead, prepare adequately, be patient with yourself, and know the key to health is moderation and balance.  Happy holidays!

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