Tag Archives: Sarah Mahoney

Can food timing prevent diabetes?

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Putting off meals for an extended period of time can lead some to over-indulge when it comes time to eat. (Courtesy Spectrum Health Beat)

By Sarah Mahoney, Spectrum Health Beat


Intermittent fasting—the fancy term for going up to 14 or 16 hours without eating anything—is all the rage these days.


Dietitians and their celebrity clients are touting it as the latest and greatest weight-loss tool.


And there’s been some promising evidence that the approach may even lower the risk of developing Type 2 diabetes, one of the most serious chronic illnesses in the world.


Researchers who have linked intermittent fasting to improved sensitivity to insulin also recently discovered it might lower pancreatic fat in rats. And that may reduce the odds of developing diabetes.


In a small study of humans with pre-diabetes, participants who ate from the hours of 7 a.m. to 3 p.m. saw significant improvements in their insulin sensitivity and blood pressure.


But don’t approach intermittent fasting without some measure of caution.


Kristi Veltkamp, MS, RD, outpatient dietitian at Spectrum Health Blodgett Hospital, said it makes sense to take intermittent fasting with a healthy sprinkling of skepticism, especially when it comes to its relationship to diabetes prevention.


“Some people do lose weight when they try this style of eating,” she said. “And the No. 1 way we know to prevent diabetes is by losing weight.”


Even shedding as little as 5 to 10% of your body weight can reduce the risk of diabetes by 58%.


“So this type of eating may be helpful because people are losing weight,” she said. “But that doesn’t mean intermittent fasting gets the credit. From that perspective, any weight-loss method can be said to lower diabetes risk.”


The strict timing of meals can have a significant downside for some people.


“Often, they get so hungry that they overeat during their eight-hour window, sometimes making poor food choices,” Veltkamp said.


For others, it’s just not convenient, especially if they are trying to eat meals as a family.


Most people consume the last meal of the day in the evening, not by 3 p.m.


“By all means, experiment,” she said. “For example, often people are surprised to discover that they feel better eating breakfast later in the day.”


But until more conclusive data emerges, pay close attention to the guidelines already proven to prevent diabetes.

5 proven ways to keep diabetes at bay:

1. Eat the Mediterranean way

If you haven’t already experimented with a Mediterranean diet, now’s the time. Eating meals with plenty of fish, vegetables, whole grains and olive oil has been linked to an 83% lower chance of developing diabetes.

2. Nix the nighttime snacks

Even if you never try intermittent fasting, those evening snacks—often scarfed down in front of the TV—can sabotage any healthy diet. Once you’ve left the dinner table, try to stop eating for the evening.

3. Pay attention to protein

Veltkamp recommends including some protein in every meal and snack. This includes dairy, nuts or cheese. “It keeps people full longer and helps with cravings,” she said.

4. Quit bashing carbs

While processed foods, soft drinks and white sugar cause rapid ups and downs in glucose levels, Veltkamp worries that too many people vilify all carbohydrates.


Whole grains and fruits are a healthy part of every diet, she said.


“Sugar isn’t all bad,” Veltkamp said. “I’ve yet to have to tell a patient that they’re eating too many apples.”

5. Strive for flexibility

Finally, when you’re looking for a lifetime approach to healthy eating, it’s smart to be gentle with yourself.


While all-or-nothing diets may be the craze—from the Keto plan to Whole 30—she advocates a much more forgiving approach, with an 80/20 rule.


Strive for solid, sensible meals 80% of the time, then relax with the remaining 20% of meals.


Reprinted with permission from Spectrum Health Beat.




Tend those tiny toes

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More oft than not, your toe problems can be traced back to an ill-fitting shoe. (Courtesy Spectrum Health Beat)

By Sarah Mahoney, Spectrum Health Beat


Toes may well be the most neglected parts on our body, but when something goes wrong they can generate plenty of pain.


And for those who like a good workout—running, hiking, soccer, walking and the like—these peanut-sized digits take it on the chin.


While a variety of things can go wrong with your toes, there is a single preventive solution to almost all of them: The right shoe in the right size, said John Harris, DPM, a foot and ankle surgery specialist with Spectrum Health Medical Group Orthopedics.


“You should wear the appropriate shoe for your activity and it needs to fit well,” Dr. Harris said. “There should be a thumb’s distance between the end of your longest toe—whether that’s the big or second toe—and the end of the shoe.”


A general athletic shoe is OK for low-level participation in any sport, but Dr. Harris recommends upgrading to a sport-specific shoe the moment you become serious about a workout.


Ill-fitting shoes are the source of many problems.


With every step, you wind up bashing the front of your toe into the shoe, causing micro-injuries that soon add up to significant issues.


This causes two of the most common toe woes: injured toenails and callouses.

Injured toenails

They go by the not-so-catchy name of subungual hematoma—a collection of blood under the nail. These wounds stem from some kind of insult, often from poorly fitting shoes.


If they are painful, have a doctor check them out.


“Sometimes, we can drain the blood out and reduce pain,” Dr. Harris said.


Even when these toenail injuries don’t hurt, healing requires some patience. It can take eight months to a year for a toenail to replace itself.

Callouses

People often accept callouses as inevitable because of the shape of their toes.


Dr. Harris said underlying conditions, such as hammertoe, certainly make callouses more prevalent.


But properly fitting shoes can prevent this problem.


Treatment for painful callouses includes modifying the style and fit of the shoe. In some cases, surgery is needed to straighten the toe. (Wondering what the difference is between a callous and corn? Nothing—a corn is just lay terminology.)


See a provider about any stubborn toe pain and rethink the way you shop for shoes. Check and double-check the fit, keeping in mind that sizes can vary from model to model.


Runners and soccer players are particularly prone to the smaller-is-better myth, resulting in plenty of toe problems.


According to Nike, the behemoth shoe manufacturer, about 60% of Americans are walking around in shoes of the wrong size.


If you’ve got growing kids, Dr. Harris suggests using the same fit-test on them at least twice a year.


“Kids’ sizes change so fast that parents have to be vigilant,” he said. “I do the thumb test on my kids at the start of every sport season. If their toes are smashing against the end of the shoe, they need a new pair.”


Reprinted with permission from Spectrum Health Beat.


Sodium stealth bombs

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Simple table salt ought not trouble you at mealtime. The real concern is how much salt went into processing and preparing the meal itself. (Courtesy Spectrum Health Beat)

By Sarah Mahoney, Spectrum Health Beat


Quick, name a food that contains too much salt.


If you’re like most people, you won’t have any trouble identifying the usual suspects. (French fries, chips and pretzels—we’re looking at you.)


The leading sources of excess sodium in the average American diet are less obvious.


Packaged foods such as bread, desserts and even canned vegetables—vegetables, for Pete’s sake!—can be prepared with alarmingly high salt levels.


That should be a cause for universal concern.


While there’s been some debate about precise levels, current guidelines call for an intake of 2,300 milligrams of sodium a day.

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The American Heart Association goes even further, recommending all American adults try to limit themselves to 1,500 milligrams per day. This is also the level recommended for people with high blood pressure and heart disease.


African Americans are also advised to stick to the lower level.


The reality? The average American eats well over twice that amount, or about 3,400 milligrams a day, and sometimes more.


“Most people don’t realize that the problem isn’t using their salt shaker, but all the foods they eat with those hidden sources,” said Caren Dobreff, RD, projects dietitian at Spectrum Health.


Such as? “Toast and cereal,” Dobreff said. “Because sodium is widely used for flavor, as a leavening agent (think baking soda), as a preservative, it turns up in places you don’t expect.” Portion sizes can add to the confusion since few people limit themselves to a single slice of bread or a half cup of cereal.


The immediate impact of too much salt can be a bloated feeling due to water retention.


“Water retention can make your socks or shoes or waistband feel snug,” Dobreff said.


Over time, too much sodium may increase the risk of high blood pressure, stroke and heart failure, as well as osteoporosis, stomach cancer, kidney disease and headaches.


The best defense: Tune up your sodium radar.


Restaurant foods contribute to about a quarter of the typical American’s dietary sodium. Meals prepared at home account for another 10 percent. Surprisingly, less than 5 percent of dietary salt is added at the table.


This means the worst offenders—about 65 percent, reports the American Heart Association—are foods we buy at the store.

Here’s how to protect yourself from sneaky salt attacks:

Read the label

Manufacturers of packaged foods must list nutritional information on the label. This includes listing sodium content.


The fine print will help you discover, for example, that 3 ounces of deli meat such as ham or turkey can contain up to 1,050 milligrams of sodium. A cup of chicken noodle soup packs 940 milligrams, a slice of American cheese has 460 milligrams and a piece of bread has 230 milligrams. That’s pretty salty.


Check chicken labels, too, especially if the package notes, “Contains broth.” Meat processors often plump the chicken by injecting it with sodium, improving moisture retention. This enhanced chicken can increase sodium content as much as 440 milligrams.


Most red meat cuts have 100 milligrams or less, but processed meat—think cold cuts, sausages and hot dogs—can have hundreds of milligrams of added salt.

Research your restaurant favorites

While it’s harder to learn what’s in your favorite restaurant foods, most national chains have nutrition details on their websites.


A little digging before you get there will help you discover that a slice of pizza at your local shop may well have 760 milligrams of sodium, while a cheeseburger has a whopping 1,690 milligrams. At some fast food joints, just 3 ounces of breaded chicken strips contain 900 milligrams of sodium.


And don’t be fooled when restaurants label something low- or reduced-sodium. Reduced-sodium soy sauce, for example, can still have as much as 500 milligrams per serving.

Cook from scratch

Cooking from scratch offers the most control over how much salt winds up on your plate. A tomato, for example, contains a mere 6 milligrams of sodium. But half a cup of canned low-sodium diced tomatoes has already more than tripled to 20 milligrams.


A helping of regular canned tomatoes is 10 times saltier, at 220 milligrams.


“Look for ways to create flavor explosions,” Dobreff said. She recommends high-impact seasoning like citrus, vinegar, herbs and spices, such as cumin and chili powder.

Don’t get duped

As appealing as some popular gourmet salts sound—pink Himalayan, Hawaiian black lava, grey sea salt, kosher salt and even dusting salt—they’re still just sodium chloride.


“Some people like to experiment with them for flavor and some are prepared more naturally,” Dobreff said. “But the sodium is roughly the same.”

Plan a counterattack

When you’ve got a major salt craving, play nutritional offense. Keep whole fresh fruits and vegetables and unsalted roasted nuts and seeds on hand. We tend to snack on what we can see and what our arms can reach.


“Buy a lower-sodium type of pretzels or chips, for example, and count out the amount of a single serving,” Dobreff said. “Then enjoy them. But be careful to balance them out with foods that day that are high in potassium, such as bananas, citrus fruits, papayas, avocados or potatoes.”


Reprinted with permission from Spectrum Health Beat.

The heal-better diet

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Rich in healthy fats and plant-based foods, the Mediterranean diet is the ideal meal plan for fighting inflammation. (Courtesy Spectrum Health Beat)

By Sarah Mahoney, Spectrum Health Beat


Looking for a better way to bounce back from a sports injury or orthopedic surgery? The solution may be as close as your fork.


Experts say choosing the right foods—and avoiding the wrong ones—can help bones, muscles, tendons and ligaments repair faster, getting you off the couch and moving again.


“There are two things to keep in mind,” said Kristi Veltkamp, RD, who counsels Spectrum Health patients on eating well. “First, make sure you are managing inflammation. And second, get the nutrients needed to help you heal and repair.”


Inflammation after any injury is normal.


“There’s often heat, swelling or redness,” Veltkamp said. “To calm that inflammation, look for foods that are rich in omega-3 fatty acids, like those found in salmon, walnuts and flax seed. Olive oil also helps. And try to eat plenty of fruits and vegetables.”


If that all sounds familiar, it should. It’s the basis of the Mediterranean diet, which is shown to reduce inflammation, Veltkamp said.


Also avoid foods that are high in sugar, refined flour or trans fats. Alcohol, which slows healing, should be avoided as well.

Building blocks

Alongside managing inflammation, you should focus on getting plenty of the nutrients required for healthy rebuilding.


Start with protein.


“The majority of our tissues are made up of protein,” said Matthew Axtman, DO, a sports medicine specialist with Spectrum Health Medical Group Orthopedics. “So even though protein is part of your normal diet, look to increase healthy sources, like chicken, fish and nuts.


Dr. Axtman recommends getting plenty of vitamin C.


“It helps build collagen, which is the basis of tendons and ligaments,” he said. Look for it in citrus fruits, kiwi, peppers and tomatoes.


Calcium is also essential, especially if you’ve injured a bone. You can find it—along with Vitamin D, which aids in absorption—in dairy products and dark-green, leafy vegetables.


Avoid salt and caffeine during your recovery because they cause you to urinate more. This makes your body lose calcium, Dr. Axtman said.


Meanwhile, those deep-green vegetables are also a great source of fiber.


“If you’re sitting around more and moving less, it can affect your gut,” Dr. Axtman said. “Fiber-rich foods will help.”

Mind and body

During the rebuilding process, it may help to take supplements for about two to four weeks. This holds true even if you typically prefer to get all your nutrients from a balanced diet.


“While you’re healing, consider adding vitamin A, naturally found in many orange vegetables, at 10,000 IUs a day,” Veltkamp said.


Look for a multivitamin that contains 2 to 4 milligrams of copper and 15 to 30 milligrams of zinc, which is shown to help with wound healing.


Veltkamp also recommends HMB, a protein that can help prevent muscle wasting. It’s found in sports supplements such as Myoplex Muscle Armor.


Finally, give a little thought to the emotional aspects of eating. Recovery can be as tedious as watching grass grow, so it’s easy to fall into the trap of eating from boredom instead of hunger.


“Have a list of things you can do when you feel like reaching for food for the wrong reasons,” Veltkamp said. “Like knitting, taking a bath, anything soothing and distracting.”


It’s normal to have food cravings during recovery, but that’s because food can make us feel better. Don’t be afraid to treat yourself now and then.


“Just look for healthier alternatives,” Veltkamp said. “Like chocolate-banana smoothies.”


Reprinted with permission from Spectrum Health Beat.