Diabetes and Healthy Eating

Diabetes and Diet: Making Healthy Choices

“The best thing patients with diabetes can do for themselves is to change their dietary habits,” says Sue Cotey, RN, CDE, Program Coordinator of the Lennon Diabetes Center at Cleveland Clinic Stephanie Tubbs Jones Health Center. “Proper nutrition can often be more powerful than medication when it comes to treating diabetes. Some people will notice a difference in as little as a day.”

But any kind of change is difficult, particularly when it comes to food. “Food is so tied to emotions,” she says. “From traditional cultural dishes to grandmother’s recipes, food is a big part of many celebrations, and some people actually are offended when told they need to change their diets.”

Why is healthy eating so important for people with diabetes? Eating nutritionally balanced meals helps to control blood glucose (blood sugars), cholesterol, triglyceride and blood pressure levels, reducing the risk of diabetes-related health problems.

Getting Started

A common misconception is that a healthy diet of unprocessed foods such as vegetables, fruits and lean meats is more expensive, more difficult to find in urban neighborhoods and takes more time to prepare. Not necessarily so, says Ms. Cotey.

“Our diabetes educational team, along with a registered dietitian, explored the East Cleveland neighborhood around the center to see what types of food were available,” she says. “We visited chain grocery stores, family-owned grocery stores and even a farmers market and discovered many reasonably priced healthy food options.” 

To make healthy options more accessible, Stephanie Tubbs Jones Health Center has started a farmers market on Tuesdays and offers free, hands-on classes teaching people how to cook differently. In addition, the center provides transportation at no charge to the center for appointments for those living within a five-mile radius.

Reaching Out for Support

When initially faced with a diagnosis of diabetes, many patients feel overwhelmed and unsure of what to do, according to Ms. Cotey. The center, along with many other Cleveland Clinic locations, offers diabetes programs to help patients succeed in managing all aspects of diabetes care.

Class topics include eating better, being physically active, monitoring blood sugars and interpreting results, taking medications safely and reducing risks of complications, and setting personal goals for managing diabetes.

“Once patients join a diabetes education program, they learn that they’re not alone. Everyone in the group feels the same way and is facing the same challenges,” says Ms. Cotey. “And because family is so important — and may someday face the same challenges — we encourage our group members to bring their families to the classes and also share what they’ve learned with neighbors and friends.”

To make a gift supporting Cleveland Clinic, visit our secure giving site or call Institutional Relations and Development at 216.444.1245 or toll-free at 800.223.2273, ext. 41245.

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STAMPEDE Trial Offers Hope

Surgery Controls Hard-to-Treat Type-2 Diabetes

A new Cleveland Clinic study shows that surgery is effective for controlling type-2 diabetes in patients who do not respond to conventional treatment.

Results of the STAMPEDE (Surgical Therapy and Medications Potentially Eradicate Diabetes Efficiently) clinical trial show that overweight, diabetic patients who underwent bariatric surgery achieved significant improvement or remission of their diabetes. Conducted at Cleveland Clinic, the trial was published March 2012 in The New England Journal of Medicine.

“After one year, patients who underwent gastric bypass or sleeve gastrectomy lost more weight and were significantly more successful in controlling their diabetes compared to those who only took medications,” says Philip Schauer, MD, Director of Cleveland Clinic’s Bariatric and Metabolic Institute and the study’s lead investigator. “We saw not only an improvement in blood sugar but improvement in blood pressure and lipids. And their dependency on medications was dramatically reduced.”

The 150 participants in the STAMPEDE trial were divided into three groups of 50: those who received intensive medical therapy and had gastric bypass surgery; those who received intensive medical therapy and had sleeve gastrectomy; and those who received intensive medical therapy only.

One year after surgical treatment:

  • More than 42 percent of patients who had gastric bypass surgery achieved normal blood sugar levels and lost an average of nearly 65 pounds.
  • Close to 37 percent of patients receiving the sleeve surgery attained normal blood sugar levels and lost an average of 55 pounds.
  • Fewer than 13 percent of the medically treated patients achieved normal blood sugar levels and lost an average of nearly 12 pounds.

“This trial demonstrates that bariatric surgery can eliminate the need for diabetes medications in many obese patients whose diabetes is poorly controlled,” says Dr. Schauer, noting that the surgical patients also showed major improvement in other measures of heart health, including reduced need for high blood pressure and cholesterol medications and a significant boost in HDL, the good cholesterol.

“Not everyone who has gastric bypass will achieve complete remission from diabetes,” says Dr. Schauer. “But results suggest that most patients will see a major improvement in their overall health, leading not only to a better quality of life, but a longer, healthier life.”

To make a gift supporting the Bariatric & Metabolic Institute or any area of Cleveland Clinic, visit our secure giving site or call Institutional Relations and Development at 216.444.1245 or toll-free at 800.223.2273, ext. 41245.

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    Surprising Sources of Salt

    Shaking the salt habit can make a big difference in your health, particularly if you have diabetes.

    “Individuals with type-2 diabetes are at greater risk for heart disease and stroke,” says Kristin Kirkpatrick, MS, RD, LD, Wellness Manager at Cleveland Clinic Wellness Institute. “Since sodium consumption is directly linked to these conditions, limiting sodium is a great idea for the diabetic patient. Consistently eating too much salt also can leave you feeling bloated and can affect blood pressure and kidney function.”

    A recent report from the national Centers for Disease Control and Prevention listed the top 10 sources of salt in the American diet. Surprisingly, breads and rolls topped the list, not because they are saltier but because people eat more of them. The usual suspects — chips, pretzels and popcorn — came in at No. 10. Other sources of sodium that made the list were cold cuts and cured meats, pizza, fresh and processed poultry, soups, fast-food hamburgers and sandwiches, and cheese.

    “Unfortunately, a typical lunch of a sandwich with two slices of bread, cold cuts and cheese could have as much as 2,000 milligrams of salt,” says Ms. Kirkpatrick. “Add in a bag of chips, and it could be 2,300 milligrams, which is the suggested sodium amount for an entire day.”

    To help you reduce your sodium intake, along with your craving for salt, Ms. Kirkpatrick suggests the following:

    Retrain Taste Buds

    Ms. Kirkpatrick recommends gradually retraining your taste buds so that you will not need additional salt on your food. “Start by eliminating salt when cooking,” she suggests. “Instead, use herbs and spices to kick up the flavor. Aim for more whole foods and fewer processed foods in your diet. This will automatically eliminate a tremendous amount of salt.”

    Read Labels

    Reading labels is key to reducing salt intake. Certain ingredients can increase sodium levels, such as baking powder and soda, monosodium glutamate (MSG), sodium nitrate and nitrate. Other high-salt foods to watch out for include soy sauce and condiments, boxed cereals, deli meats, canned vegetables, snack foods and vegetable juices.

    Understand Your Options

    One popular misconception is that sea salt is healthier than regular salt. “Manufacturers are sprinkling it on chips and pretzels, then throwing a ‘natural’ claim on the packaging. Consumers are literally eating it up,” says Ms. Kirkpatrick. “But table salt and sea salt contain the same amount of sodium chloride. Sea salt does not contain iodine, which is a nutrient essential for general health, specifically thyroid health.”

    What about salt substitutes? They can be an option, but keep in mind that they do not lessen the craving for salt. Also, some substitutes contain a small amount of salt, so be sure to read the label. Further, many salt substitutes contain high amounts of potassium, which may be problematic for anyone with kidney disease or individuals on medication for heart failure.

    Eat at Home

    One of the best ways to reduce your salt consumption dramatically is to eat out no more than once a week, according to Ms. Kirkpatrick. When you do eat out, request that your food be prepared without salt and ask about lower-sodium menu options. “The bottom line,” she says, “is that foods prepared outside the home are the highest contributor to sodium consumption.”

    To make a gift supporting the Wellness Institute or any area of Cleveland Clinic, visit our secure giving site or call Institutional Relations and Development at 216.444.1245 or toll-free at 800.223.2273, ext. 41245.

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    6 Summer Secrets to Stop Snacking

    Instead of lounging on the sofa watching summer reruns and devouring a bag of chips, why not take advantage of the warm weather and seasonal fruits and veggies?

    Amy Jamieson-Petonic, MEd, RD, CSSD, Director of Wellness Coaching at Cleveland Clinic Wellness Enterprise, shares her top summer tips for eating healthfully, boosting energy and burning calories without even trying.

    1. Get wet. Nothing’s more refreshing than a cool dip in the pool on a hot day. Be sure to apply sunscreen 15 to 20 minutes before going outside.
    2. Meet a farmer. Picking strawberries or blueberries is a great way to spend time with friends and family. Then use the fresh fruit to add antioxidants to a salad.
    3. Looking for relaxation? Head outside to a shady tree with your yoga mat or towel, and try some deep breathing. This will help you keep your mind focused and on task.
    4. Pedal power! Go for a bike ride. Reinforce the habit of making physical activity an important part of every day.
    5. Quench your thirst. With the warmer weather comes a higher risk of heat-related illness, so remember to stay hydrated. To make your beverage special, add strawberries to iced green tea or whip up a smoothie with mango and pineapple. 
    6. Brush your teeth. After eating, brush your teeth right away. Research shows that this will reduce your late-night snacking and help you control your weight.

    And when you do find yourself craving a snack, “eat fresh seasonal fruits and vegetables, and try to avoid processed foods,” says Ms. Jamieson-Petonic.

    For example:

    • For a healthy twist, try sweet potato hummus with veggies instead of chips and dip — you’ll get some vitamin A from the hummus.
    • Have a loaded veggie burger instead of a hamburger or bratwurst. Even with the works, it will have much less fat and fewer calories.
    • Eat grilled fruits such as pineapples and bananas instead of cookies, cakes and pies.
    • In place of potato salad, try whole-grain pasta salad with veggies, which will provide energy, vitamins and minerals. Pasta salad also has much less fat and fewer calories than the potato salad.
    • Drink unsweetened green tea instead of sugar-sweetened tea. Green tea provides antioxidants and cancer-fighting chemicals, unlike the sugary tea, which can increase inflammation and your risk of heart disease, diabetes and arthritis.

    “Staying active, keeping your brain focused and making healthy food choices will help keep your energy levels high all season long,” says Ms. Jamieson-Petonic.


    To make a gift supporting the Wellness Institute or any area of Cleveland Clinic, visit our secure giving site or call Institutional Relations and Development at 216.444.1245 or toll-free at 800.223.2273, ext. 41245.

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