Should I Eat Butter?

If you watch or read the news, you may have seen a headline lately stating "Eat Butter", or this Time Magazine article - "Ending the War on Fat". I think the information circulating is confusing - let's clear up a few points.

1. The association between saturated fat and heart disease may have been overstated or overemphasized - but this does not mean there is no correlation. The two are still linked. It just seems that there are some other factors - such as what ends up replacing them in our diets, and how full we feel without them. For a more balanced analysis, check out this PubMed overview of the evidence.

2. Fat does seem to keep people more satisfied. People on low fat diets seem to feel less full and have a harder time sticking to their diets than people on the Mediterranean Diet, which emphasizes reintroducing unsaturated fats such as olive oil and nuts. These type of fats seem to be definitely beneficial for heart health. Calories still count - and fat is still a dense source of calories - but including some of these foods in moderation will definitely help you feel more satisfied.

3. Cutting out saturated fat, and replacing it with refined carbs, does not help. It seems like the biggest mistake we made in the American Diet was not reducing saturated fats, but replacing it with the wrong foods. Avoiding fat by eating unlimited amounts of bagels, sweetened yogurts, and fat free cookies was a popular strategy - and has been blamed for the simultaneous rise in rates of obesity and diabetes nationwide. Now, a new study indicates that the amount of added sugar in our diets puts us at increased risk of heart disease, regardless of how healthy a person eats otherwise!

But are we really surprised? I think we all knew that low fat cookies were not helping us. The truth about nutrition is always simpler than we want it to be.

What is the solution? A whole foods, plant based diet like the Mediterranean Diet. In other words - vegetables, fruits, whole grains, "good" fats, lean protein. Simple but delicious. For some recipe inspiration, check out oldwayspt.org.

Recipe of the Week - Cucumber and Black Bean Salad!

I don't know about you, but in this hot weather I haven't felt like turning the oven on lately (or the stove or crockpot for that matter...) and I've been looking for some no-cook options for easy suppers. I made up this recipe and it fit the bill perfectly. I made a big batch of it, and had it for both dinner and lunch the next day alongside some quick grilled chicken.

CUCUMBER AND BLACK BEAN SALAD

Recipe makes about 6 servings of 1 cup each.

INGREDIENTS

2 tablespoons extra-virgin olive oil
2 tablespoons lemon juice
1 long english cucumber or 2 smaller cucumbers - diced
1 14-ounce can low sodium black beans, rinsed
2 tomatoes, diced
1/2 cup crumbled lowfat feta cheese
1/2 of a red onion, diced up pretty small
1 medium avocado, diced
Mrs. Dash or herbs & spices of your choice

PREPARATION

Combine cucumber, beans, tomatoes, feta, onion and avocado in a large bowl. Dress with olive oil, lemon juice, and herbs and toss to coat. Serve at room temperature or chilled. Tastes just as good the next day!

NUTRITION

Per serving: 190 kcal; 19g carb; 11g fat (mostly the good kind!); 8g protein; 160mg sodium

Carbohydrate Servings: 1



Do you have a favorite hot weather recipe? Let us know in the comments section - we'd love to hear from you!!

Guest Post - "I Know Better"

Today we are excited to have a guest post from a VMG patient about his experience with diabetes. Seth has type I diabetes and has completed our diabetes education program. Thanks Seth!

My name is Seth Rothberg. Let me tell you something about myself that embarrasses me. There's a plate of homemade brownies up in the staff room. My CGM tells me I've had an even blood sugar all morning. I walked to work. And I seem to have hit the mark for my lunch time bolus. I know I should resist the brownies. But there they are, cut in small squares, with light brown crispy tops, and walnuts peeking out from fudgey sides. Carbs unknown, but maybe a square is 25 grams, plus or minus, probably plus. I'm not even hungry, so of course I bolus for 150 carbs and grab 4 and I know without thinking about it that I’ll be back in a few minutes for a couple more. An hour later my CGM beeps. It’s showing two arrows pointing up and a blood sugar about to hit 200. I don’t bother to test, I just give my self a 7 unit bolus. Why 7 units? I have no idea, but 2 hours later I’m gobbling glucose tabs. What embarrasses me about this is not just that I do it, but that I think that this kind of behavior defines me as a diabetic. I feel that I’ve just told you nearly everything there is to know about me and my diabetes.

I ask myself 2 questions after I pig out on brownies, or pretzels, or oreos, or Pepperidge Farm Sausalito cookies (to list a few of my sins). Why do I do it and (I’m sure you saw this immediately) how do I manage to not manage it? The truth is, I’ve never been able to answer these questions. I’ve done everything wrong. Either I guessed wrong for my bolus, or I over ate. What’s worse, I bolused again based on nothing but impulse.

O.k. I should give myself a little break here. After all, I started the day really well. I had yogurt mixed with blueberries and walnuts for breakfast. It was a perfect 50 degrees when I walked to work and there was a full blue sky. The gardens and hedges of the houses I walk by are blooming with flowers I can’t name, but their colors stun me. I’ve managed to keep my blood sugar in the low hundreds. It didn’t just happen. I managed it. Yes! Not to mention that I had those glucose tabs when I needed them.

Let me tell you a little more about myself. If you asked me what the most important thing to me about my diabetes was, I wouldn’t tell you the brownie story.  I would tell you that I've been diabetic for 48 years, since I was 10, and that I’m aiming for the 50 year Joslin medal. I’ve noticed, though, that when I bring this up outside of medical appointments, no one's as proud of me as I am. I guess I understand that. Who wants to hear an old man going on about how he had to walk 10 miles to school, in the snow, in bare feet. One of the few things I really do know better is not to  bore you with my early days on regular and lente insulin, or how I had to pee into a cup to test sugars. In future blog posts I will try to limit any of my “in those days” tendencies to what I hope will be stories that are still relevant to what’s it’s like to be a diabetic now. 

What Does Self-Management Mean?

We use the term "diabetes self-management" a lot. One patient recently asked me, "does that mean I have to do everything myself?"

At Valley Medical, we offer Diabetes Education, Nutrition, and Endocrinology because we want to make sure you have everybody on your team that you need to better manage your diabetes. That includes:

· Endocrinology
· Eye Care
· Foot Care
· Behavioral Health Services
· Physical Therapy

And, of course, Diabetes Self-Management Education. That means classes or one-on-one appointments with diabetes educators and/or nutritionists to help you learn more about diabetes, trouble shoot your lifestyle choices, answer your questions, and help you to set goals.

So what does Diabetes Self-Management look like? It might include:
- monitoring your blood sugars at home
- keeping a food diary
- counting carbohydrates or measuring out your portion sizes
- incorporating physical activity into your routine
- seeing your doctor regularly
- managing stress

But you don't have to do any of it by yourself - we are here to teach you how, help you through, and continuously adapt your plan to your personal wants and needs.

Our goal is to see you empowered with the tools you need to manage your diabetes effectively - but when you need us, the resources are here. That's what self-management education means to us.