All posts in Diabetes

Opinion: The FDA will have it their way, so start counting calories!

In 2010, as part of the Affordable Care Act, chain restaurants and vending machines were mandated to disclose calorie counts. Four years later, the FDA announced last week that chain restaurants with 20 or more stores as well as vending machines (machine operators with at least 20 locations), movie theaters, convenience stores, amusement parks and others have up to two years to comply with the new Federal rule. 

The rule aims to close the gap in the 1990 Nutrition Labeling and Education Act signed by President George H. W. Bush. Some states have already implemented menu labeling, but the new rule will create national standards; a move that has been supported and welcomed by the restaurant industry for years.

While experts don’t believe the new rule will miraculously reduce obesity rates, it is a step in the right direction for three reasons.

First, as a nation we are getting fatter. This new rule might scare consumers into making a less caloric choice.

Second, the National Restaurant Association states one third of all calories consumed in this country are eaten outside of the home (restaurants, bars, food trucks, cuchifritos, vending machines, movie theaters, cafeterias, etc.).

Lastly, counting calories is not easy and can be confusing. How would we track the number of calories in 3 ounces of turkey, 3 ounces of pernil or ham, 4 tablespoons of gravy or cranberry sauce, a cup of cooked stuffing, 2 glasses of wine, 3 buttered bread rolls, a slice of pie, two pieces of homemade flan, homemade eggnog?  

I suspect most consumers severely underestimate the number of calories eaten in everyday meals. For example, a grilled chicken and brown rice bowl can have up to 1,090 calories; add a soda or specialty cup of coffee and that lunch adds up to almost 1,400 calories up. That’s 600 calories away from reaching the recommended daily calories of 2000.

Posting calories will make some consumers plan and choose in a more judicious manner while others will not. Data does not exist that correlates a decline in sales from higher calorie food items to lower calorie items in the states that currently post calories. That said, when I saw that my favorite banana loaf cake had almost 500 calories, I stopped eating it — cold turkey, period. After all, a banana loaf cake adds no nutritional value and I could use the $3 to buy a bag of kale. I’m serious.

I am not alone. Many consumers do forgo eating out if the calories are posted. Just ask MSNBC “Morning Joe” host, Joe Scarborough, who stated, “I walked into Friendly’s and when I saw how many calories were in the meal, I walked out.” Which is why this rule took four years: the opposition was strong. 

The National Restaurant Association is satisfied with the FDA’s new ruling but the National Automatic Merchandising Association, the National Grocers Association, the Food Marketing Institute and grocery chain Kroger are not. They cited the following reasons: “The cost of complying with the proposed requirements will be almost $1 billion in the first year,” “The requirement could mean job losses or higher grocery bills for consumers,” “The rule is costly and a regularly burden,” and  “Two years was insufficient implementation time, especially for small businesses.”  

As a matter of public health policy, no one policy can curtail our obesity epidemic. Moreover, menu labeling is challenging, costly, and somewhat confusing. How do we calculate a meal at a buffet, salad bar or the gluttonous-all-you-can-eat restaurant specials?

Ideally, I hope positive outcomes will come out of this new rule, particularly in African-American and Hispanic communities where, according to the CDC, obesity rates are at almost fifty percent. Perhaps this new rule will move the needle, and there is no better time than the holidays to think about how much we eat. 

According to Brian Wansink, Ph.D., director at the Cornell University Food and Brand Lab, most families will pile on the food by Three Kings Day (January 6) most will have gained three to five pounds. Keep in mind, it takes an additional 3,500 calories per day to gain one pound. Hopefully, this new rule will be a big-fat wake up call.

Opinion: Type 2 Diabetes in Latinos, ¡Azúcar!

November is the month of a time-honored tradition when some families get together to give thanks around a robust meal. Ironically, it is National Diabetes Month. The holidays can test our will power and make it harder to say no to a second serving of sweets. If we truly want to turn the tide on the diabetic epidemic in this country, it’s time to get real about our addiction to sugar.

Our taste buds have been hijacked by processed foods in general and sugar in particular. As a result, sugar has created an appetite for itself. Sports drinks, protein bars, fat free items, Greek yogurt, breads, sauces, milk and frozen foods – outside of vegetables- have added sugar. Moreover, sugar is hiding in 74 percent of packaged foods.

When I was a kid we went to the gas station to buy gas. Today, you have a candy store at the gas station. Also at the office supply store, the hair salon, at church, parking garages, pharmacies and hospitals.
– Katina Rojas Joy

According to the Diabetes Research Center at the Albert Einstein College of Medicine, almost 30 million (8.3 percent) Americans have diabetes and by 2050 one in three adults may develop diabetes. Within that group, multicultural communities bear the highest burden. Amongst Latinos in the U.S., Puerto Ricans have the highest rate of diabetes (14.8 percent), followed by Cubans (9.3 percent), Central and South Americans (8.5 percent) and Mexican Americans (3.9 percent), according to the Centers for Disease Control.

According to Jeffery E. Pessin, Ph.D., Director of the Diabetes Research Center, Department of Medicine at the Albert Einstein College of Medicine, obesity is the driving force in the tremendous growth in type 2 diabetes.

However, not every obese person has diabetes and sugar does not cause diabetes.

“Diabetes follows obesity and the more obese we become the more likely we are to develop diabetes,” according to Pessin, who adds: “obese individuals develop a pro inflammatory state that creates an environment in your blood that is resistant to insulin.”

Type 2 diabetes in the U.S. has doubled over the last 30 years. When I was a kid we went to the gas station to buy gas. Today, you have a candy store at the gas station. Also at the office supply store, the hair salon, at church, parking garages, pharmacies and hospitals. We celebrate Halloween, Easter, Valentine’s Day and Three Kings Day by eating what? That’s right. Sugar.

Moreover, I am positive many restaurant goers think they are making healthy choices when choosing to eat out. What’s wrong with a bowl of pasta and a side order of bread? However, they would be shocked to find out how much added sugar is in the most commonly served dishes at some restaurant chains, for example:
1 cup of marinara sauce, 24 gm
1 super size soda, 44 gm
1 serving of salad dressing 4gm
1 slice of frozen pizza 6gm

According to the American Heart Association, women should only consume 6 teaspoons of sugar (or 24 gm) a day and men should only consume 9 (or 36 gm). We don’t need sugar to function, period.

The dangers of too much sugar consumption have been widely documented; in fact Dr. Mark Hyman, founder of the Massachusetts-based Ultra Wellness Center, and Dr. Robert Lustig, Professor of Pediatrics in the Division of Endocrinology at University of California, San Francisco are leading the national charge against the overconsumption of sugar.

Author and activist Michael Pollen says, “Just eat what your great-grandma ate.” My great-grandmother and grandmother grew up in a rural town in Puerto Rico where we had to walk to the one store in the town known as the “colmado.” My grandmother would buy one potato, fresh oregano, a garlic clove, rice, a bag of beans and if there was enough money, an avocado. My grandmother would head out to her backyard to acquire our dinner, which meant plucking up one of her many chickens. Voilà, we had chicken soup with rice and a potato for dinner.

My grandmother didn’t eat snack foods, drink soda, rarely ate sweets, quit smoking and worked long hours in a physically demanding job. At age 80, she is healthy as an ox. My mother, on the other hand, was a product of the 1970’s fast food, sugar boom. She ate cake
(Valenica Bakery cakes were her favorites), drank soda, laced her coffee with sugar and had a desk job. As a result, my mother has cardiovascular disease and end stage diabetes. She quit smoking after her first heart attack at age 39, but she still continues to consume foods with added sugar.

So, how do we, as sugar craving consumers reduce our risk for type 2 diabetes?
Taking small steps is a good start:

• Stop drinking diet and regular sodas, they are fatal
• Drink more tap water, seltzer water and tea
• Negotiate your meals, skip the pie if you want wine and ask for support from family
• Pack an apple, nuts, peanut butter, banana, carrots, a cheese stick or pretzels
• Exercise at home, track your progress with a fitness monitor or a health/fitness app
• If you live in a food dessert, stock up on healthy alternatives on the weekends

After my mother’s heart attack, I was scared enough to make major changes in my life. In 1991, I gave up pork and red meat (adios chuleta), and 15 years ago I gave up rice, pasta, soda and juice — cold turkey! I have never smoked or consumed alcohol, I stopped adding sugar to my coffee and exercise a lot. That said, I am still at risk for developing diabetes based on my family history and age. While I do enjoy sweets, I struggle every day to realize that I don’t need sugar to have a sweet life and neither do you.

Stephen was diagnosed with type 1 diabetes at the age of 10 & went blind in one eye

Diabetic retinopathy (DR) is a serious complication of diabetes and is one of the leading causes of blindness in the U.S.
DR is a leading cause of low vision and blindness, with a higher prevalence in Latinos.

What you need to know about diabetes related blindness

Can early stage type 2 diabetes be reversed?

Yes, according to Jeffery Pessin, PhD., Director of the Diabetes Research Center at The Albert Einstein College of Medicine in the Bronx, compliance is essential for patients newly diagnosed in the early stages (not late) of the disease. If patients take their meds as prescribed, exercise and change their diet, they can reverse the disease.