MINDFUL EATING WITH DIABETES JESSICA GIBBONS RD CDE EAT WHAT YOU LOVE LOVE WHAT YOU EAT WITH DIABETES MICHELLE MAY, MD MEGRETTE FLETCHER, MED, RD, CDE NEW ADA GUIDELINES FALL 2013 NO ONE-SIZE-FITS-ALL • INDIVIDUALIZED • CELIAC DISEASE CAN BE AN ISSUE • NO CONCLUSIVE EVIDENCE REGARDING IDEAL AMOUNT OF CARB INTAKE • LIMIT SUCROSE BASED SUGAR DRINKS • NO GRAM RECOMMENDATION ANYMORE • WHERE DO THE CARBS COME FROM? • ?FIBER GREATER THAN 50 G/DAY TO DO ANY GOOD • ?ARTIFICIAL SWEETENERS • FAT ISN’T ALL BAD • GLYCEMIC INDEX • HEALTHY EATING PATTERNS EATING MINDFULLY IS HARD… • AND EVEN HARDER WITH DIABETES! • HOW DO WE TEACH OUR PATIENTS TO DO IT? • HOW DO WE TEACH BY EXAMPLE? • HOW DO WE EAT MINDFULLY AND CARB COUNT AT THE SAME TIME? • HOW DO WE AVOID THE GUILT THAT COMES WHEN WE DO IT “WRONG”? • LEARNING TO EAT MINDFULLY IS LIKE LEARNING TO PLAY THE PIANO BEING “MINDFUL” IS BEING AWARE OF WHAT IS HAPPENING RIGHT NOW DEFINED IS IT OK TO EAT 7 KRISPY KREMES IN ONE SITTING? AN ENTIRE BAG OF CHEETOS? A COSTCO-SIZE BAG OF CINNAMON BEARS? • DRIVING • CHILDREN • WORK • THE WEATHER • TV • FOOD! WHY DO WE EAT? • PAY ATTENTION TO YOUR BODY IN YOUR SEAT • WHY? WHAT? WHEN? WHERE? HOW? HOW MUCH? • “INSTINCTIVE” EATING • EATING FOR ALL THE RIGHT REASONS • “OVER” EATING • EATING MORE THAN IS HEALTHY/SATISFYING • “RESTRICTIVE” EATING • TOTAL OBEDIENCE TO ONE METHOD/DIET CREATE YOUR MASTERPIECE • YOU CAN MANAGE EATING WITHOUT RIGID RULES • FILTER WHAT YOU HEAR BY ASKING “IS IT RESTRICTIVE IN NATURE?” • BECOME MORE AWARE OF YOUR THOUGHTS/JOURNAL • ALL FOODS IN MODERATION NO GOOD OR BAD FOODS • NUTRITION INFORMATION IS A TOOL NOT A WEAPON • MAKE HEALTHY, NOT PERFECT, CHOICES • REGRET IS NORMAL, LEARN A LESSON DON’T DROWN IN GUILT • “I’M IN THIS FOR THE LONG HAUL, I CAN TRUST AND NOURISH MYSELF WITHOUT RESTRICTION” • THIS WORKS FOR EXERCISE TOO! POSITIVE THINKING • ENCOURAGING • AFFIRMING • POWERFUL • ABUNDANCE (TIME, MONEY) • FORWARD THINKING • UNCONDITIONAL • ACCEPTING • SHADES OF GRAY • EFFECTIVE • REALISTIC • GENTLE • INWARD FOCUS • SOLUTION FOCUSED THE BEST TIME TO PLANT A TREE IS TODAY! HUNGER SCALE • FOOD TASTES BETTER WHEN YOU ARE HUNGRY • CATCHING HUNGER EARLY LEADS TO HEALTHIER CHOICES • EMOTIONAL EATING GENERALLY LEADS TO EATING UNHEALTHY FOODS • DIABETES TRIGGERS: • HYPER AND HYPOGLYCEMIA CONFUSE THE HUNGER SCALE • EATING JUST IN CASE OF A LOW, EATING ON SCHEDULE BECAUSE WE WERE TAUGHT TO • LONELINESS, BOREDOM, ANGER, STRESS, ANXIETY, DEPRESSION • WATCH FOR ENVIRONMENTAL/EMOTIONAL TRIGGERS SO WHAT DOES HUNGER FEEL LIKE? PHYSICAL HUNGER HYPOGLYCEMIA/HYPERGLYCEMIA • GROWLING, GRUMBLING STOMACH • SWEATY, NUMB, DIZZY (HYPO) • EMPTY, HOLLOW • THIRSTY, FREQUENT URINATION (HYPER) • TROUBLE CONCENTRATING • TROUBLE CONCENTRATING • DIFFICULTY MAKING DECISIONS • DIFFICULTY MAKING DECISIONS • SHAKY • SHAKY • HEADACHE/LIGHT-HEADED • HEADACHE • IRRITABLE, CRANKY • IRRITABLE, CRANKY, SLEEPY DO A SCAN • PAUSE: • BODY • PHYSICAL SENSATIONS • IS MY BLOOD SUGAR LOW? • TREATING A LOW CORRECTLY • IS MY BLOOD SUGAR HIGH? • MIND • THOUGHTS • HEART • EMOTIONS TIME-TESTED TIPS • EAT PLANTS • DON’T RUSH GROCERY SHOPPING, MAKE A LIST • LOOK FOR DIFFERENT STYLES OF THE SAME FOOD • TRY SOMETHING NEW ONCE A WEEK • ADD VEGGIES TO SOUPS AND STEWS • GRILL OR ROAST VEGGIES • AT LEAST 3 SERVINGS OF DAIRY • KEEP LOW CARB SNACKS ON HAND; LOTS OF FRESH VEGGIES • TRY TO GO THREE HOURS IN BETWEEN MEALS OR SNACKS APPROACH CARE WITH CURIOUSITY • BLOOD GLUCOSE TESTING • AN OPPORTUNITY TO LEARN • FEARLESS BG MONITOR LOG EXERCISE • EVERY LITTLE BIT COUNTS • EXERCISE CAN LOWER BLOOD SUGAR FOR UP TO 24 HOURS POST EXERCISE • IMPROVES “METABOLICALLY ACTIVE TISSUE” • INSULIN IS BETTER UTILIZED IN MUSCLE VS FAT • EXERCISE AFTER LIGHT MEAL OR SNACK • THINK OF IT AS MEDICINE (I CAN AFFORD A GYM MEMBERSHIP!) MEAL PLANNING • BALANCE • VARIETY • MODERATION EAT WHAT YOU LOVE • DING DONGS • MY FRIEND’S CRACKERS • LINDT CHOCOLATES • LUCKY CHARMS The Secret of Success in Life is to eat what you like and the let the food fight it out inside -Mark Twain People who love to eat are always the best people -Julia Child Food is an important part of a balanced diet -Fran Lebowitz NOURISH YOURSELF • SMALL CHANGES • BLOOD GLUCOSE LOG • VARIETY, BALANCE, MODERATION • OVERALL HEALTH • PERSONAL HEALTH • NEW FOODS • TASTY FOOD • HEALTHY ALTERNATIVES • HOW DOES FOOD MAKE YOU FEEL AFTERWARDS? MINDFUL MEDICATION USE • WHY DO I NEED MEDS? • WHEN DO I TAKE THEM? WHY AT THAT TIME? • WHAT DO I TAKE? • HOW DOES THE MED WORK? WHAT DID I LEARN? • I BLEW IT. I OVERATE. • WHY? • I WAS AT THAT ONE RESTAURANT • WHEN/WHERE? • MONTHLY LUNCH WITH THE LADIES • WHAT? • I ATE A SALAD THAT I DIDN’T WANT FIRST BECAUSE EVERYONE ELSE WAS. THEN I NEEDED DESSERT • HOW/HOW MUCH? • I GOT WRAPPED UP IN THE STORY KATE WAS TELLING, IT WAS SO CRAZY I FORGOT I WAS PUTTING FOOD IN MY MOUTH SO WHAT’S THE PLAN? • GOAL SETTING • COACHING INSTEAD OF COUNSELING • LISTEN MORE TALK LESS • AVOID “QUEGGESTIONS” (LAURIE BEEBE, MS RD LD) • BEING HEALTHY = • BODY • MIND • HEART • SPIRIT What you deny or ignore, you DELAY. What you accept and face, you CONQUER www.livelifehappy.com