Community Table: Nutrition, Health + Wellness in the Black Diabetes Community

This content originally appeared on Beyond Type 1. Republished with permission.

By JDRF-Beyond Type 1 Alliance

During our second Community Table discussion, Beyond Type 1 sat down with a group of experts and community members to discuss nutrition, health, and wellness in the Black diabetes community, and share helpful resources and perspectives. Watch the discussion in full!



Speakers included:

  • T’ara Smith, who served as the moderator for this event, was originally diagnosed with type 2 diabetes in 2017 but was re-diagnosed with LADA diabetes in 2019 and is Senior Manager of Beyond Type 2.
  • Keith Crear, who has lived with type 2 diabetes since 2017, is a sports photographer and multimedia specialist.
  • Alexis Newman, who has had type 1 diabetes for 37 years and is a registered dietician.
  • Dex Geralds, who has had type 2 diabetes since 2016 and works as a personal trainer and CrossFit coach.
  • Joy Ashby Cornthwaite, a dietitian and a certifies diabetes care and education specialist.

Partial transcript of conversation below, edited for content + clarity.

What does wellness mean or look like for you, and has your diagnosis changed the way that you live?

Dex: It’s balance. I know a lot of times when I’m with people who don’t typically know about diabetes, there’s a lot of things surrounding food that they believe I cannot have at all. Once you find the balance, you’re able to still eat some of the things that you’re eating before your diagnosis, maybe not at the same amount that you were eating before. Just finding balance with the way you eat, balance in the way you exercise. Whether it’s like myself who exercise maybe two hours a day or just going out for a 15-minute brisk walk. Just finding balance in what comes with that. The last thing in balance is just your mental health and making sure you check in with yourself and your feelings and your emotions and figure out what brings you happiness and joy.

Keith: It is a balance. It’s knowing what to eat, what not to eat, what to consume, when to consume it. Exercise is very, very important.

Alexis: For me, what it looks like is making sure that I am well, not only with how I’m eating, but also exercise. Making sure I’m honest and checking in with my friends and family, my support system, too. Also, the spiritual aspect of it. I’m a Christian, so making sure I’m connected in the sources that I feel encouraged in. When one of those are kind of out of whack, I don’t feel well.

Joy: I think of health on a continuum, and I encourage that in every day. In my family life, in my personal life, but also for those who I help to balance their journey with diabetes because everyone has their own journey and their whole complete individual. When someone comes to a session with me, I find out where on the continuum you are and what can we work on today? It has to come from you. It has to be what you want and not necessarily what I want. But I’m going to use my skills to get you to where you need to be.

What misconceptions have you encountered pertaining specifically to Black people with diabetes when it comes to fitness? What is some of the ways that you’ve helped your Black clients move past those stigmas and misconceptions?

Dex: The biggest thing is support in our community and in the world in general. If you’re overweight you get looked down upon and that can add to depression and lead to worse things. I know a big term going on right now is “unlearning” and taking everything, looking at it through a different scope, and then figuring out what brought you to this point and then what can I do to change this. It’s not just a one-stop shop kind of thing. It’s going to take a while for you to start to see changes for the most part. You have to create these better habits and getting through that way.

Learning to love yourself is vital, and when you learn to love yourself you want to do the things that’s right for you and you’re going to quiet that outside noise and put your blinders on and work for yourself and not think about the negative things that you might be getting from someone else. My family has a history of diabetes and obesity. My oldest sister, she’s lost 150 pounds now, but still just over 400 pounds. I remember things people would say to her growing up. Now that I support her and my family’s supporting her, she’s been on this incredible journey and losing weight because now she feels confident enough to do the things that once scared her or felt ashamed about. Being able to conversate and talk to my sister, or just clients in general, I’ve been able to learn what’s going on and been able to apply that to them in their journey in fitness.

Alexis: The kind of things that I’ve seen is that they believe that people think they’re lazy so they don’t want to push through that because they’re afraid of what people are going to think. I’ve also seen the fear of not knowing what to do overtake them in my discussions with my patients. Another idea is that they have this perceived idea of what exercise looks like, so really breaking it down into bite-sized pieces of like, “Look, as long as you’re like being consistent with the movement, whatever you choose to do, you can add on time, you can add on intensity. But, as long as you’re out there trying to move.” Those are the things that I have conversations with my patients about in terms of fitness.

Another thing too, is that an ideal weight of someone who’s African American may not be similar to another culture or race. We need to keep that in mind as we are discussing food, nutrition, health, and weight that the ideal weight that a doctor may have for you may not be appropriate. I think that needs to be said and also needs to be addressed when we’re talking to these patients about weight and health and glucose numbers and things like that.

Joy: When it comes to fitness, one of the great disservices, especially for the Black community, is to tell people that they need to lose weight if they’re moving. For many people who are living with diabetes, movement doesn’t always equate to weight loss. It also doesn’t always equate to better blood glucose values.

There’s a lot of things that go into thinking about exercise. When you’re telling someone that it’s going to make them better to exercise and they’re saying that their blood glucose is either crashing or going up way too high with exercise there’s a disconnect. You haven’t heard what they’re saying to you. You need to find out what people are experiencing in their exercise journey and then address those things and say, “Look, you may not lose weight, but let’s check your blood glucose before and after.” Celebrate the win over either the hyperglycemia that you have been feeling or the hypoglycemia that you were feeling if you didn’t pre-exercise meal or whatever reason. Celebrate the win that is more than weight.

How can we celebrate our culture or different types of Black cultures throughout the year, not just during Black History Month?

Joy: Support each other. I know for years I felt like I was the sole person saying, “Black people aren’t making ourselves sick with diabetes.” We need help. We need medications. We need diabetes health care and management. We need to know how to take care of ourselves and we don’t have to do that alone. Whatever we need to do we need to support each other and do it together and then we’re louder.

Dex: Our culture is so vast and rich, and it needs to be shared every day and whatever way possible. Whether it’s through social media or just through conversation or the way you dress, the way you wear your hair. It just needs to be expressed and be out there for people to see and enjoy and learn. I love my culture so much.

Alexis: Buy Black. There are so many amazing Black companies, I’ve been focusing on and amplifying those businesses on social media and telling my friends. I’m in a friend group and we’re talking about face care. I’m like, “All right, I’m using this” and they’re using this Black company. We’re just sharing information of these amazing Black companies that are out there. If we can’t do that, then no one else is going to. It’s really important to invest in Black businesses because they’re everywhere.

T’ara: Yes, please support Black businesses that you see, especially in the diabetes community. There’s so many Black people in the diabetes community who have businesses and organizations who could use amplifying on your social platforms. That social sharing could do a whole lot because you never know who can see their products, so please amplify it.

Keith: Constant delivery of content from Black creators. Constantly delivering things from Black history that could be done every day. The way you wear your hair, the clothes. Just something that constantly keeps it in the public eye so it’s not condensed down to just one month. There are a lot of people out there that are doing it and it’s always great to see that. If more of us continue to do that it’ll shift the narrative and it will shift the visual aspect of how we’re seen in society as a whole.

Source: diabetesdaily.com

How to Have a Healthy Relationship With Food

People with diabetes have a notoriously complex relationship with food. Food and nutrition are a cornerstone of a healthy life with diabetes, and balancing it with insulin intake, exercise, sleep, and stress management can be a lot to handle. This article will outline strategies that you can implement to cultivate a healthier relationship with food. Warning: this article may contain triggers for people who struggle with disordered eating and/or body dysmorphia.

Having a healthy relationship with food takes time and is sometimes difficult to achieve for some people, especially if you live with diabetes. Studies show that people with diabetes are more than twice as likely to have an eating disorder.

The most common eating disorders are anorexia nervosa, bulimia, and binge-eating disorder, but people with diabetes may also suffer a unique disorder to their condition: diabulimia, where one withholds insulin (and eats as per usual), letting blood sugar levels skyrocket in order to lose weight rapidly.

Combine diabetes with any of these eating disorders is a recipe for disaster, and can quickly lead to serious complications and even death. So, how can you develop a healthy relationship with food, when so much of diabetes involves counting, tracking, measuring, and constantly thinking about everything we put into our mouths?

Learn to Follow Hunger Cues

Diabetes can warp one’s thinking about food. Often, people with diabetes respond more to their blood sugar levels than their hunger pangs. One will always eat when they’re low, for example, but if their blood sugar is high but they’re hungry, they will often wait until glucose reaches more normal levels before eating. This can be healthy from a blood sugar and HbA1c point of view but does not help establish a healthy relationship with food.

If your blood sugars are well-managed, learn to follow hunger cues in addition to blood sugar needs. Eat when you’re hungry and stop when you’re nearly full. It can be helpful to eat lower carbohydrate foods if you’re hungry but your blood sugar is high, but don’t punish yourself by skipping meals altogether.

Photo credit: iStock

Practice Mindful Eating

People tend to multitask and do a million things at once, and in our fast-paced world, that can come to be expected. One thing that you should never multitask, however, is eating. Take the time to put your phone down, close your laptop, step away from the television, and really enjoy a meal without distraction. Take the time to smell your food, feel the texture, chew thoroughly, and really taste the flavors.

Practicing mindful eating helps prevent overeating, and the experience will leave you more sated. Slow down and really enjoy your meal. Practicing being in the moment and savoring your food, being thankful, and appreciating all of the work that went into growing, cultivating, and cooking a meal can help form a healthier relationship with food.

There Are No “Good” or “Bad” Foods

Understand that there are no “good” or “bad” foods. No food should be forbidden (unless, of course, you have a serious allergy or celiac disease). Labeling foods as “off-limits” puts them on a pedestal and makes people more likely to binge eat them later on.

At least one study confirmed this; a group of dieters and non-dieters were given a milkshake to drink and then were ushered into private rooms where they could eat an unlimited amount of cookies. Shockingly, non-dieters were much better at regulating their cookie intake and stopped eating when they felt satisfied, while the dieters ate significantly more cookies. Labeling the milkshake “bad”, the dieters felt that since the milkshake already “broke” the rules of their diet, they might as well overeat the cookies.

This is counterproductive, as having a treat every now and again will do nothing to “ruin” a diet, HbA1c, or your diabetes control. Treats and incorporating foods that you enjoy just for the sake of enjoying them are crucial to sound mental health and is a key to a healthy relationship with food.

Make space in your diet to incorporate treats, so you never feel deprived, and never label foods as “good” and “bad”. If you’re recovering from disordered eating, do not forbid entire food groups. For example saying, “I’ll never eat grains again” will make you much more likely to binge eat it and can cause your mental health to go into a tailspin.

Think in Terms of How You Can Nourish Your Body

People caught up in disordered eating often fixate on calories (and sometimes if you live with diabetes, severely restricting carbohydrates). Shift your thinking. Instead, ask yourself, “how can I best nourish my body today?” Make sure to include healthy fats, protein, and carbohydrates into your diet to fuel your activity and life.

Instead of exercising to “burn off” whatever it was that you ate that day, flip the narrative and ask yourself how can you best nourish yourself for the activity and day ahead? It can be helpful to look at specific vitamins and minerals as well.

This can also help incorporate new foods into your diet that you may have traditionally been hesitant to try. For example, if you have some ice cream after dinner, note the fact that it has both calcium and vitamin D in it. Bread, too, often has lots of fiber and thiamine (vitamin B1). See the good in all foods, and focus on the nutrients they provide. This will help heal your relationship with foods and incorporate new foods into your diet.

Photo credit: iStock

Seek Professional Help

Managing a chronic disease that requires constant vigilance in your diet and the foods you consume can be exhausting, but you don’t have to go it alone. Ask your doctor for a referral and enlist help from a registered dietitian or nutritionist, who can help you craft a meal plan that will work for both your diabetes and non-diabetes related goals, and will also be specific to your activity level and lifestyle.

If you’re struggling with disordered eating and think you are developing an eating disorder, get help right away. Seeing a psychologist or diabetes therapist can also be beneficial for those struggling to heal their relationship with food.

Relationships with food, especially while living with diabetes, are personal, complex, and require regular work to keep healthy. By following these strategies, it’s possible to get to a place in which food no longer controls your thoughts, and instead, fuels your overall physical and emotional well-being.

A healthy relationship with food means balancing nutrition with your diabetes needs, not labeling foods as either “good” or “bad”, seeing the value in nutrition beyond calories and carbohydrates, and remembering that food doesn’t have power over you.

Taking the first steps to fix a bad relationship with food can be complicated, but is well worth the effort.

Source: diabetesdaily.com

Emergency Changes to SNAP and WIC (Food Stamps) Adjust to Thousands of New Applicants During COVID-19

This content originally appeared on diaTribe. Republished with permission.

By Karena Yan

SNAP and WIC help connect millions of individuals and families to affordable, nutritious foods. Here are how these programs are evolving

Healthy food and nutrition are important not only for managing diabetes but also for the proper function of your immune system. The World Health Organization (WHO) recommends that people maintain a nutritious diet and limit their alcohol and sugary drink consumption to improve our bodies’ ability to fight off viruses like COVID-19.

At the Tufts’ Food and Nutrition Innovation Council (FNIC) Summit on April 16, experts in nutrition, healthcare, and policy gathered to discuss the implications of coronavirus on the affordability, accessibility, and sustainability of healthy food in our country. In addition to discussing the changes brought about by the pandemic, council members made food policy recommendations for the post-COVID future.

While coronavirus poses a challenge for the smooth operation of programs like the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), the USDA’S Food and Nutrition Service has implemented emergency changes to these programs to ensure access to healthy food for program recipients.

What are SNAP and WIC?

SNAP, previously referred to as food stamps, is a federal program that provides nutrition benefits for eligible, low-income individuals and families to support their ability to purchase healthy foods. These benefits are provided via an Electronic Benefits Transfer (EBT) card, which acts as a debit card at authorized retail food stores.

Similarly, WIC provides federal grants to low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk. WIC serves about half of all infants in the United States, and these grants supplement the purchase of foods, health care referrals, and nutrition education.

How has coronavirus impacted SNAP and WIC?

As unemployment has reached nearly unprecedented levels , enrollment for SNAP and WIC has seen a marked increase. In California, application volume to receive CalFresh, the state’s version of SNAP, has seen a 350 percent increase since the crisis began. More than 57 percent of these applicants reported that they lost a job within the previous 30 days, compared to 16 percent in January.

Graphs

Image source: diaTribe

Moreover, panic buying and stockpiling during the epidemic have made the availability of SNAP- and WIC-eligible products scarcer. This is particularly true for WIC recipients, who may only use their funds on a limited list of products that have been selected as low-cost and nutritious. For those who do not receive WIC benefits, the National WIC Association asks shoppers that if they are choosing between two items, one of which is WIC-eligible, to avoid buying or hoarding WIC-eligible products, including infant formula.

What emergency changes have been implemented to support SNAP and WIC?

The USDA has implemented a 40 percent increase in overall SNAP benefits, which amounts to a $2 billion monthly allotment in addition to the usual $4.5 billion that goes toward monthly SNAP benefits. WIC has also received $500 million in additional funding to cover increases in program participation.

Additionally, while SNAP and WIC have some requirements that are challenging to meet during COVID-19, such as mandatory in-person visits to enroll or re-enroll in the programs, the USDA has offered many accommodations to these requirements. However, the USDA’s Food and Nutrition Service has offered many accommodations to these requirements, in addition to providing extra funding to both programs. Several of these program changes are highlighted below. To see the full list of changes, please see here.

SNAP:

  • Application Processing: State agencies can extend certification periods and temporarily waive periodic report form submissions for enrolled households. Additionally, in lieu of face-to-face interviews for enrollment, states are waiving the interview requirement or conducting interviews via telephone.
  • Pandemic EBT (P-EBT): States are now allowed to provide benefits (similar to SNAP or “food stamps”) to children who normally receive free or reduced-price school meals.
  • Able-bodied Adults without Dependents (ABAWDs) Time Limit Suspension: States may temporarily suspend the time limit associated with ABAWD work requirements, which ordinarily terminate an ABAWD’s SNAP benefits after three months of unemployment.

WIC:

What happens after COVID-19 is over?

At the Tufts’ FNIC Summit, council members discussed the importance of maintaining some, or all, of these measures after the crisis. Requirements such as in-person visits and lengthy renewal processes pose barriers for SNAP/WIC recipients and risk delaying or inhibiting people’s ability to access these services, regardless of the circumstances. Moreover, given the sharp uptick in SNAP/WIC enrollments, the increased efficiency and accessibility of these programs will greatly benefit recipients long after the “end” of the coronavirus crisis.

Furthermore, council members hope even further adjustments to SNAP/WIC are made in the future. While these programs have been relatively effective in facilitating access to healthy foods for low-income individuals and families, the FNIC calls for greater emphasis on nutrition within the programs, such as by providing a subsidy for fruit and vegetable purchases or removing sugar-sweetened beverages from the list of eligible purchases.

Such incentives can provide vast benefits for both individual health and healthcare costs. For example, a 30 percent fruit and vegetable incentive for SNAP participants is estimated to save $6.77 billion in healthcare costs over a lifetime. Thus, while some headway has been made to these SNAP/WIC programs, advocates must pursue not only the permanence of these adjustments but also additional changes to the programs’ health and nutrition standards and practices.

Source: diabetesdaily.com

Keeping Your Immune System Healthy

This content originally appeared on Beyond Type 1. Republished with permission.

By Mariana Gomez and T’ara Smith

Perhaps you’ve read about boosting your immune system to protect you from infections and other illnesses, including the Coronavirus. But, there aren’t any magic foods, supplements, or one-size-fits-all solutions to boosting your immune system because it’s a complex network of cells, organs, tissues, and proteins. Still, healthy living provides its benefits, including keeping our immune systems strong, and research is being conducted to study the effects of nutrition, exercise, mental health, and others on our immune response.

How Diabetes Impacts Your Immune System

Type 1 diabetes is an autoimmune disease. There is not enough evidence to identify the cause but we know that our immune system insulin-producing cells are destroyed. We now know that people with type 1 diabetes are more likely to have a co-occurring autoimmune disorder. The reason that co-occurring autoimmune disorders are so common isn’t yet known. We also know that hyperglycemia can affect our immune system’s response so it would represent a barrier for recovery and fighting virus and bacteria. This does not happen only in type 1 diabetes (T1D) but other types of diabetes as well.

People with type 2 diabetes should be aware of the impact the disease has on their immune system as well. Hyperglycemia in diabetes is a probable cause of the disruption of how the immune system functions. Humans also produce “natural killer” cells that are critical to human immunity. A study showed people with type 2 diabetes have lower counts of these cells compared to those without diabetes and with prediabetes. This makes it harder to defend the body against viruses, diseases, and diabetes-related complications.

Overall, people with diabetes are more susceptible to common infections such as the flu and pneumonia. To protect your immune system, stay up-to-date on your doctor’s visits, get vaccinated against the flu, and get screened for complications.

Essential Nutrients for a Strong Immune System

Another way you can protect your immune system is through nutrition. With a healthy diet, food can help protect you against illnesses and help improve recovery. Different foods contain different quantities and types of nutrients and micronutrients. Therefore it is important to include a variety of food groups in your diet. Vitamins A, B6, C, E, magnesium, and zinc play important roles in our immune function.

How Vitamins + Minerals Help Your Immune System

Vitamins and minerals are known as essential micronutrients. Even though they are needed for our health, our bodies can’t make them on our own or enough of essential micronutrients, therefore, they must be obtained through food. There are nearly 30 vitamins and minerals the human body can’t make on its own. A healthy diet will include different groups of foods that contain some of these nutrients.

Micronutrient malnutrition results in a lack of vitamins and trace minerals that can affect the response of our immune system to fight different health conditions. The NIH lists the recommended dietary allowances (RDA) for vitamins and minerals. While this provides general guidelines for different age groups, please talk to a nutritionist or your doctor about recommended intakes for you.

Vitamin A is an anti-inflammation vitamin that helps develop and regulate the immune system and protect against infections. This Vitamin can be found in sweet potatoes, carrots, broccoli, spinach, red bell peppers, apricots, eggs, and milk. While vitamin A is important, it is possible to consume too much of it. High intake of vitamin A from supplements and some medications can cause headaches, dizziness, coma, and death. According to the NIH, pregnant women shouldn’t consume high doses of vitamin A supplements.

Vitamin B6 helps improve immune response to the increase in the production of antibodies, a protective protein produced by the immune system to fight antigens in the body. Vitamin B6 is found in a variety of foods. Food sources of vitamin B6 include pork, fish, poultry, bread, eggs, cottage cheese, tofu, and wholegrain foods such as oatmeal and brown rice. Getting too much vitamin B6 from food is rare. However, from supplements, long-term use for a year or more can lead to nerve damage.

Vitamin C also known as ascorbic acid, helps your immune system by fighting free radicals that cause cancer and other diseases. It’s a popular nutrient to fight or treat the common cold. While focusing on vitamin C consumption may not prevent you from getting sick, it could decrease the length and severity of cold symptoms. It also helps by stimulating the formation of antibodies. This vitamin can be found in oranges, grapefruit, tangerines, red bell pepper, papaya, strawberries, tomato juice, among others. Too much vitamin C can cause diarrhea, nausea, and stomach cramps.

Vitamin E works as an antioxidant, which protects the cells from damage by free radicals and helps the body fight infections. This vitamin can be found in sunflower seeds, almonds, vegetable oils, hazelnuts, and spinach and other green leafy vegetables. There isn’t a risk of consuming too much vitamin E from foods. Precautions should be taken when taking supplements, which could interfere with other treatments such as chemotherapy or radiation therapy.

Magnesium is a nutrient that our body needs to regulate the function and work of our muscles and the nervous system. It is involved in the process of forming protein, bone mass and genetic material. It is found in legumes, nuts, seeds, whole grains, green leafy vegetables, milk, yogurt among others.

Zinc is found in cells throughout the body. It helps the immune system fight bacteria and viruses and is needed to produce proteins and DNA. During pregnancy, infancy, and childhood, the body requires zinc to grow. Zinc can be found in oysters, red meat, poultry, crab, lobster, cereals, beans, nuts, whole grains, and dairy products.

Drinks That Help Your Immune System

You can find or create your own drinks to help your immune system. Some beverages you may want to try at home that are high in important immune-friendly vitamins are:

*Juices may be high in carbs and sugar, so if you can, opt for unsweetened teas like green/chamomile teas, or whole fruits.”

Alcoholic beverages are generally fine to consume in moderation. Drinking too much alcohol can lead to a weaker immune system. Heavy drinkers are more likely to get pneumonia and drinking too much alcohol at once can slow your body’s ability to ward off infections.

Should You Use Supplements to Help Your Immune System?

Supplements are used in cases where diet is not able to sufficiently provide micronutrients. While supplements aren’t meant to replace a balanced diet, they’re used to help people with other health conditions and may be prone to nutrient deficiencies. Many vitamin and mineral supplements can be purchased over the counter. But, check with your physician or a registered dietitian nutritionist to see if you actually need them. If you’re taking other medications, talk to your doctor on how vitamin and mineral supplements can interfere with those drugs.

Other Things You Can Do to Stay Healthy

A healthy diet is definitely a big part of remaining healthy. Other things you can do on a regular basis to maintain your health is to practice good hygiene (i.e. washing your hands), see your healthcare provider routinely, keeping an emergency medical plan and your emergency contacts updated. Also, prioritize physical activity and refrain from smoking. From a mental and emotional health perspective, practice stress-relieving techniques and know the signs of diabetes burnout.

Source: diabetesdaily.com

How to Get More Brightly Colored Food into Your Diet

This content originally appeared on TCOYD: Taking Control of Your Diabetes. Republished with permission.By Susan Thomas Recently I’ve become known to my clients as the “Vegetable Pitchman Dietitian.” I’ve gotten this name because I advise them to fill half their plates at lunch and supper with non-starchy vegetables. Unfortunately, this advice is not often popular […]
Source: diabetesdaily.com

5 Reasons Why My Child With Diabetes Eats Low-Carb

Making decisions on behalf of our children is a tough job. A choice I recently had to make after my daughter’s type 1 diabetes diagnosis was regarding the details of our new lifestyle. This is where my husband and I have landed when it comes to how to feed our family from now on–choices informed […]
Source: diabetesdaily.com

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