What exactly is prediabetes?

According to the CDC, 1 in 3 Americans over the age of 20 has prediabetes and for those over the age of 65, it’s 1 in 2. Up to 30% of those with prediabetes will develop type II diabetes within 5 years unless they make lifestyle changes including weight loss and increased physical activity.

30% of those with prediabetes will develop type II diabetes within 5 years Click To Tweet

What does prediabetes mean?

Though not recognized as an official medical diagnosis, prediabetes is a term used when a person’s fasting blood glucose (fasting plasma glucose) and hemoglobin A1c are higher than normal but aren’t high enough for a formal diabetes diagnosis. Fasting blood glucose and hemoglobin A1c are two tests doctors use to assess glucose control and diagnose diabetes. Normal fasting blood glucose is below 100, but diabetes isn’t typically diagnosed until fasting glucose reaches 126mg/dL or higher. Glucoses in between 100-125 are typically considered prediabetic results. For the hemoglobin A1c, normal results are 5.6% or below, while diabetes is typically diagnosed at 6.5% or higher, so someone with lab results in between 5.7-6.4% may be told he or she has prediabetes.

Fasting Blood Glucose levels

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A1C levelsScreen Shot 2015-01-27 at 1.21.35 PM

What are the symptoms of prediabetes?

Unfortunately, many people with diabetes or prediabetes don’t experience symptoms. Having your doctor run a fasting glucose, oral glucose tolerance test or a hemoglobin A1c is the best way to determine your current risk.

What are the risk factors?

Knowing the risk factors for developing diabetes is also helpful in preventing the progression of prediabetes to diabetes. Risk factors include age, gender, family history, physical activity level, body weight, pregnancy history and race.

Every decade over 40 increases your risk for diabetes and men are at higher risk than women. If your family history includes an immediate blood relative (parent or sibling), then your risk also goes up. If you’re getting less than 150 minutes of exercise per week and are overweight or obese, had gestational diabetes or birthed a baby weighing more than 9 pounds, those are additional risk factors. And while prediabetes rates don’t differ across racial groups, diabetes is most common in Native Americans and Alaskan Natives, then non-Hispanic blacks, Hispanics, Asian Americans and non-Hispanic whites respectively. Certain medications, like statins, and other health conditions like polycystic ovarian syndrome can also increase your risk for diabetes, so be sure to talk to your doctor about any concerns. Click here to take the American Diabetes Association’s risk assessment test.

How can I lower my risk for diabetes?

Fortunately there are many things you can do to take control of your health. Make sure your doctor is running a hemoglobin A1c so you know your results. Start exercising, aiming for at least 150 minutes a week, and get to a healthy body weight where your BMI is under 25. You can calculate your BMI by going here. Even losing just 10% of your current body weight can make a big difference! Make sure to eat lots of fruits and vegetables and limit refined carbohydrates like white rice, white pasta, sodas, sweet tea, crackers and desserts. Cut back on portions and find an activity you enjoy that gets you up and moving around. Feeling short on time? Research has shown three 10-minute walks a day can be just as effective as one 30-minute walk, so split up the time if needed. If you smoke, consider joining a tobacco cessation program. Put yourself in control of your health and be encouraged to know that you have the ability to change from having prediabetes to experiencing normal, healthy blood glucose levels.


Making sense of health certifications

As if the world of nutrition wasn’t confusing enough, throw in the terms registered dietitian (RD), registered dietitian nutritionist (RDN), and nutritionist and you may need some help figuring out where to begin when it comes to health certifications.

Whether you have prediabetes, you’re thinking of having or have had a gastric bypass surgery or you have digestive problems, going to the right person can make all the difference. So, what is the difference and whom should you go to for expert nutrition advice?

The term nutritionist is unregulated, and is a self-designated term anyone, regardless of education, training, background or credentials can use. While some nutritionists have an undergraduate degree in nutrition, others have completed a quick online program and many simply just have a personal passion for food and weight loss. Be careful!

The term nutritionist is unregulated and can be used by anyone Click To Tweet

What about a registered dietitian compared to a registered dietitian nutritionist? They’re exactly the same. In 2013, the Academy of Nutrition and Dietetics added the term and is giving each RD/RDN the option of deciding which title to use.

Be careful who you consult with about diet. While nutritionists may be able to assist, the term is unregulated and self-designated. A healthier option is to work with a dietitian or certified health and wellness coach.

A dietitian is the only credentialed, licensed nutrition professional. They have a minimum undergraduate degree in nutrition from an accredited institution, have completed a supervised practice through an accredited internship, and passed a national board exam. Every step of their training is overseen by the Commission on Dietetic Registration and once becoming an RD/RDN, dietitians are required to undergo continuing education and work to renew their registration every five years.

What about other health and wellness areas? You always want to look for someone who has training and credentialing from a reputable organization. For example, does your personal trainer have a certification? Likely, but it isn’t required depending on where they work. The American College of Sports Medicine (ACSM) is considered the top personal training certificate, while other reputable organizations include ACE, AFFA, and NASM.

In the health coaching arena, anyone can call themselves a wellness coach, but where did that title come from? Houston Methodist Wellness Services has certified health and wellness coaches (CHWC) that undergo training through Wellcoaches, a program accredited by the International Coach Federation and requires certain undergraduate degrees, classroom instruction, practical experience and exams before credentials are earned. Certified health and wellness coaches, like dietitians and certified personal trainers, are also required to do continuing education to maintain their credentials.

So, before you trust your health and wellness to just anyone, be sure to ask about his or her background so you can proceed confidently. At Houston Methodist, we have certified and licensed massage therapists and acupuncturists, registered dietitians, ACSM-certified personal trainers and certified health and wellness coaches ready to help you achieve your goals.

What does organic food really mean?

Go to a mainstream grocery store today and you’ll see an expanded section specifically for organic food. Perhaps you’re looking for the latest nutrition bar you saw at a coffee shop; you’ll likely be directed to the “health” foods section filled with organic, extra virgin expeller-pressed coconut oil, gluten-free rice flour pasta and Annie’s organic children’s snacks.

Though organic foods have been available for over three decades, lately they have been taking the market by storm. Organic grocery sales continue to grow faster than conventional sales and the 2014 Farm Act has mandated $160 million be put toward organic farming production. Interestingly, despite growing demand, the number of farms seeking organic certification has leveled off.

Chart via United States Department of Agriculture Economic Research Service

Consumers often associate organic with healthy, but organic certification focuses solely on how crops are grown and animals are raised. While some organic products are more nutritious, others aren’t. Organic cookies typically have just as much fat and sugar as regular cookies, and those organic potato chips are still deep-fried. Let’s take a look at what organic really means.

Organic labeling standards vary by item, but the general goals of organic farming are to conserve natural resources, promote biodiversity and use only approved substances in production. If you see the USDA organic seal on an item, this means it was produced by a certified organic farm shown to follow organic guidelines such as banning synthetic pesticides, participating in crop rotation and using responsible irrigation. Each year, the USDA requires at least 5% of all farms with organic status be audited for compliance. The USDA organic seal means the following for each item: 

Organic crops like fruits, vegetables, nuts, and grains

Farmers did not use synthetic pesticides or synthetic fertilizers, irradiation, genetically modified organisms or sewage sludge.

Organic beef, pork, and poultry

Animals have access to outdoors and raised on 100% organic feed free of animal byproducts like skin and dried blood; no growth hormones, antibiotics, or other drugs; no irradiation.

Organic certification focuses solely on how crops are grown and animals are raised Click To Tweet

Organic eggs

Hens have 100% organic feed and are free of growth hormones, antibiotics or other drugs. Hens do not have to be cage-free or free-range.

Organic milk

Cows have access to outside at least 120 days of the year and have at least 30% pasture diet; no growth hormones, antibiotics, or other drugs.

There are several reasons why organically-grown crops may be more nutritious for us. Without the aid of synthetic chemicals, plants must build up their own strength to fight off pests. These healthy, natural plant defenses are then passed to humans when consumed.

Organic fruits and vegetables also tend to stay on the vine longer, ripening naturally and building up nutrient stores. They are typically grown in more nutrient-dense soil, which also helps the plants to soak up more nutrition. Think about how much better a homegrown tomato tastes compared to one from the supermarket. Some of the same factors making that garden tomato so delicious also make it more nutritious!

Not ready to pay the premium for organic? Look for U.S.-grown produce and avoid imports. Since the Food Quality Protection Act was passed in 1996, risk from American produce has dropped dramatically. You can also buy organic on selected items that are more likely to be contaminated. Skip organic bananas since the thick peel protects the fruit, but strawberries carry a higher risk. 

Each year the Environmental Working Group puts out their Shopper’s Guide to Pesticides in Produce. It highlights conventional foods that have the most and least pesticide residues.

5 nutrition tips for a healthy holiday plate

When do the holidays start for you? Is it October 1st when you pull out the fall decorations and start dreaming of pumpkin spice lattes? Perhaps it’s Halloween when candy, and the excuse to eat it, is everywhere. Maybe you even hold off until the office Thanksgiving potluck, but even then your holiday season may last from mid-November until the first full week in January.

Holiday season and the plethora of sweet and savory indulgences that tags along may extend for almost a quarter of the year! If you’re tired of the painful, uncomfortable feeling that may accompany your holiday meals and don’t want to start 2015 several pounds up on the scale, consider some of these ideas for a healthier plate.

Simplify. Whether you’re cooking or not, try reducing the number of dishes. Do you really need green bean and asparagus casserole, mashed potatoes, sweet potatoes, pasta salad, turkey and ham? It’s a lot easier to shop, prepare, and serve six or seven dishes compared to a dozen, plus you’ll help your guests limit their plates, too.

Baked sweet potato
Eliminate sugary extras from dishes. For example, instead of a sweet casserole, bake your sweet potatoes and garnish them with herbs.

Eliminate the extras. Does the sweet potato casserole really need a full cup of brown sugar plus marshmallows and crushed-up corn flakes? Try baked sweet potatoes with butter, brown sugar, and nuts on the side. This gives your guests control.

Careful with carbs. Thanksgiving is a carbohydrate nightmare! Rolls, stuffing made with more bread, cranberry sauce, applesauce, potatoes in all forms and colors, perhaps some crackers and cheese beforehand, and before dessert has even begun you’re well over what your body needs. Instead, take an extra slice of turkey, a lean meat, and pile up the vegetables.

Holiday meals have lots of carbs. For a healthier plate, opt for more lean protein and vegetables Click To Tweet

Be selective. Whether it’s setting parameters around snacking on treats in the break room, like only indulging on Fridays, or deciding to have either alcohol or dessert but not both, make your food choices wisely. Save room for the dishes you really enjoy and skip the ones you know aren’t a favorite.

Leave space. Try to leave white space on your plate as you’re adding on your favorite dishes. Don’t let your food touch and don’t pile on layer after layer. Leaving space on your plate will help leave space in your stomach, too!

So much goes into a healthy holiday, from the right food choices, to sticking with your exercise routine. Remember the holidays were originally just a day or two (not several months) and it’s refreshing to start the New Year feeling healthy and satisfied rather than lethargic and disappointed. The energy you’ll get from successfully navigating the holidays will be worth those changes you’re considering!

Looking to cut back on the carbs during the holidays? Check out our low-carb Pinterest recipe board

Follow Houston Methodist’s board Low-Carb Recipes on Pinterest.