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Tests You Should Have if You Have Diabetes*

By Kathy Sinkin, RN, CDE

If you have diabetes, you know how much stress it can cause in day-to-day living. You need to take your medications, eat carefully, test your blood sugar, make time for physical activity, and both schedule and keep doctor appointments. In addition to managing your own care, there are specific tests and procedures that your health care provider should perform on a regular basis. According to the American Diabetes Association, these include:

  • A1c test. This blood test should be done at least twice a year, or more frequently if you have uncontrolled diabetes. It measures what your blood sugar levels have been for the last two to three months. Most people should aim for an A1c of less than 7%. Some people have a higher number, but your health care provider will discuss your target number
  • Kidney tests. Your doctor will collect a urine specimen once a year and test for protein in your urine called albumin. In addition, your blood will be tested to see how well your kidneys are functioning.
  • Eye exam. Your doctor will order an eye exam yearly from a specialist. A dilated eye exam will determine if diabetes has affected the blood vessels in your eyes, among other things.
  • Foot exams. You should check your feet every day, but your doctor should check your feet at each visit to look for sores, calluses, infection, loss of sensation, pulses and reflexes. Take your shoes and socks off while you’re waiting in the office.
  • Cholesterol. Your health care provider should check your cholesterol profile every 5 years, or more often if you are taking cholesterol medicine.
  • Blood Pressure. This should be checked at every visit.

These tests should be performed to avoid or delay any complications from diabetes. You should ask for a copy of all tests performed, which you can save in a folder, as part of your medical history

For more information, please go to: Standards of Care | American Diabetes Association

professional.diabetes.org/content/clinical-practice-recommendations

Kathy Sinkin is a Registered Nurse and Certified Diabetes Educator with Cornell Cooperative Extension of Suffolk County’s Family Health and Wellness Program. She can be reached at kas239@cornell.edu

Snack time

By Kim Mendel, RD CDN

When you hear the word snack, do you think of healthy foods or chips and sweets? Does the thought of snacks make you feel like you shouldn’t be snacking, or that snacks are just for kids? Snacking can actually be beneficial to most people.

Examples of good snacks include low fat cheese sticks, wheat crackers, nuts and seeds (such as almonds, walnuts, sunflower seeds), fruit with Greek yogurt, and rice cakes with avocado. Carrots, peppers, cucumbers, or any veggie you like can be dipped in low-fat cream cheese or hummus or can be eaten plain with a squeeze of lemon.

Snacking can be used to help control blood sugar, curb your appetite, prevent over-eating at the next meal, and even to help increase your daily vegetable intake. When you are practicing weight maintenance or reducing your caloric intake, make sure your snack contains no more than 100 calories. If you are counting carbohydrates, try to keep your snack to one carb serving (or 15 grams of carbs).

Remember……we are all individuals with a variety of nutrient needs. Speak to a dietitian or diabetes educator to get a better understanding of your daily caloric needs. Snacks are part of a healthy lifestyle and help you with your weight goals (weight loss, weight management and, for some, weight gain).

Kim Mendel is a Registered Dietician and Diabetes Educator with Cornell Cooperative Extension of Suffolk County’s Family Health and Wellness Program. She can be reached at km432@cornell.edu

Cooking with Millet (Part 3 of Whole Grain Series)

By Donna Moodie, RD CDN CDE

Millet is another quick-cooking whole grain that is actually a seed harvested from grasses that grow in Asia and Africa. Millet has a nutty flavor and a fluffy light texture, and it can be used in place of rice, another grain, or a starchy vegetable in a meal. Millet can even be used in breakfast porridge. Millet is gluten-free, and can be eaten by people with celiac disease, gluten-intolerance, or wheat allergy.

Millet can be purchased pearled or hulled. The hulled variety is the closest to the natural grain, and still contains plenty of fiber along with important nutrients like magnesium, phosphorus, and manganese. Millet contains 41 grams of total carbohydrate and 2.3 grams of fiber per 1 cup cooked serving. A word of caution: millet is considered a goitrogen. You have to be careful not to consume large quantities of millet because it may suppress thyroid function and/or lead to hypothyroidism. Overall, however, millet is a nutrient-packed grain that can be included as part of a healthy diet.

An easy way to enjoy millet is to cook it according to package directions. The ratio is usually 1/3 cup of uncooked millet to 1 cup of liquid (for a side dish or salad) or 1/3 cup uncooked millet with 1 ¼ cups liquid (for porridge). Millet is usually simmered for about 20-25 minutes. A good way to try millet is as breakfast porridge with low fat milk or nut milk, and with chopped or dried fruits and nuts.

Enjoy adding millet to your diet. Be adventurous in trying different whole grains and adding them to your healthy eating plan.

If you want to learn more about whole grains and the different types of grains that can be eaten, The Oldways Whole Grains Council, is a good place to start. Find it on the internet at wholegrainscouncil.org. Good health and bon appetit!

**this article was not intended to take the place of medical advice, if you have concerns, contact your doctor

Donna Moodie is a Registered Dietician and Certified Diabetes Educator with Cornell Cooperative Extension of Suffolk County’s Family Health and Wellness Program. She can be reached at dm258@cornell.edu

Local Eating Resources


By Jessica A. Schreck, RD CDN

Local Eating Resources

I often search the web for local farms and markets in order to eat seasonally and locally. The Long Island Farm Bureau is an excellent resource. There are so many reasons to support local agriculture, other than the nutritional benefits of eating food picked at peak harvest. Many of you may see the “Grown on LI” logo at local farm stands, an initiative of the LIFB to promote local eating.

This website includes delicious and healthy recipes, as well as gardening tips. It also has an “ask a farmer” section. The website informs you of the availability of farms, stands, and markets in your area. While there isn’t much winter produce to choose from, there are local oyster, dairy, and poultry farms that you can patronize. Be sure to check out the “Did You Know” section which has some insightful facts about Long Island agriculture.

DID YOU KNOW?

Long Island has more than 60% of the greenhouse and nursery production in New York State.

Long Island has more than 30,000 acres of agricultural production, one-half of which is preserved and protected.

New York ranked third in the nation (behind California and Washington) in grape production for wine and juice.

New York ranked fourth in the U.S. in sweet corn and pumpkin production in 2007. 

Source www.LIFB.com

Jessica Schreck is a Registered Dietitian and Family Health Educator with Cornell Cooperative Extension of Suffolk County’s Family Health and Wellness Program. She can be reached at 631-727-7850 ext. 342 or at jas945@cornell.edu

THAT’S WHAT FRIENDS ARE FOR

By Maxine Roeper Cohen, M.S.

For most of us, friendship is important. Research has shown how social isolation can lead to poor health. Spending time with friends, a spouse or significant other, or a group of friends is linked to good health. In fact, the concept of quantity in social interactions has been studied closely. In a huge study published in January of 2016 in the Proceedings of the National Academy of Sciences, researchers at the University of North Carolina at Chapel Hill confirmed that beginning in adolescence, more social interactions predicted less hypertension (high blood pressure), less inflammation, lower rates of obesity, and other signs of bad health as people aged. This study had 15,000 subjects, ranging in age from adolescents to the elderly. 

This does not prove that social interactions cause changes in health. Interestingly, when the researchers looked at the quality of the social interactions, it was found that quality does predict health outcomes more accurately than the quantitative measure. The level of support from family members, friends, and significant others is important. In many respects, it is probably better for your health to have a few really good friends than a large number of Facebook or more superficial friends or acquaintances.  

When you have good relationships with family and friends, your health can be positively affected. However, when you have strained relationships with family or friends, there can be adverse effects on your health. So, from health point of view, strive for positive, supportive relationships with friends, family, and significant others. Ending a difficult relationship, as hard as that can be, might keep you from developing high blood pressure or putting on weight. Simply stated, it might be wise to say good-bye to a demanding or high maintenance friendship or relationship. Paraphrasing a popular song, look for friends who are there for you “in good times, in bad times. That’s what friends are for.”

Maxine Roeper Cohen is a Parent Educator with Cornell Cooperative Extension of Suffolk County’s Family Health and Wellness Program. She can be reached at mc333@cornell.edu.

Kids Need to Move More

By Kerri Kreh Reda, M.P.H.

Getting and keeping kids moving is important due to the many benefits physical activity provides such as helping to prevent chronic disease, heart disease, and diabetes. Engaging in physical activity also promotes flexibility, better sleep, stress management, and weight management. Additionally, children’s school performance may be enhanced.

In December of 2016, the National Physical Activity Plan Alliance released the 2016 U.S. Report Card on Physical Activity for Children and Youth. This report found that American children are not doing very well when it comes to engaging in physical activity. Only 21.6 % of children ages 6-19 years meet U.S. Physical Activity Guidelines. In addition, approximately 63% of children exceed the Sedentary Behavior Guidelines.

Below are links to some resources that will help you promote physical activity and encourage the children in your lives to move more.

Full report on Physical Activity for Children and Youth:

http://www.physicalactivityplan.org/projects/reportcard.html

U.S. Physical Activity Guidelines for Children and Youth

https://www.cdc.gov/healthyschools/physicalactivity/guidelines.htm

“Raising Healthy Children: Family Fitness”

http://edis.ifas.ufl.edu/pdffiles/FY/FY114300.pdf

“Spring Forward with Fun, Healthy Physical Activities for the Whole Family”

https://www.nhlbi.nih.gov/health/educational/wecan/downloads/matte23.pdf

Kerri Kreh Reda, M.P.H., is a Human Development Specialist with Cornell Cooperative Extension of Suffolk County’s Family Health and Wellness Program. She can be reached at 631-727-7850 ext. 330 or at kkr5@cornell.edu.

Your Child’s Protein Needs: How much is enough?

Rachel Lippmann-Turner, MS, RD

It is meal-time and you do your best to provide your child with healthy foods from all food groups.  Your little one signals that he is done eating, and is ready to move on to the next activity.  You notice that all the food is gobbled up except the chicken.  Your mind wanders back to previous meals, thinking you notice a pattern.  You ask yourself, “Is he getting enough protein?”

Protein provides the building blocks for growth and development.  It is responsible for making enzymes and hormones which regulate many of the body’s functions.  Animal sources include meat, seafood, eggs, and dairy (milk, cheese, and yogurt).  Non-animal or plant-based sources include soy and soy products, nuts and seeds, legumes (chick peas, lentils and beans) and grains like quinoa and oats.  The 2015 Dietary Guidelines recommend the following protein intake:

                          1-3 years old: 13 grams of protein per day

                          4-8 years old: 13-19 grams of protein per day

                          9-13 years old: 19-34 grams of protein per day

                          14-18 years old (female): up to 46 grams of protein per day

                          14-18 years old (male): up to 52 grams of protein per day

Keep in mind that there are about 7 grams of protein in once ounce of meat.  An easy way to estimate this is to visualize the size of a deck of cards. This size is equivalent to about 3 ounces of meat.  An egg contains about 1 ounce of protein. You can also read food labels for the protein amount.  Be sure to look at the serving size to ensure adequate calculation.  Visit https://www.choosemyplate.gov/ for more information on serving sizes of protein and all the food groups.  This may help to put your mind at ease, knowing that you are meeting your child’s daily nutritional needs for protein. 

For more information on the 2015 Dietary Guidelines click on the link below:

https://health.gov/dietaryguidelines/2015/guidelines/appendix-2/

Rachel is a Registered Dietitian and the Nutrition Educator for Cornell Cooperative Extension of Suffolk County’s Family Health and Wellness Program’s Parent Toddler Nutrition Program. She can be reached at ral326@cornell.edu

 

Serving Size versus Portion Size…..Is There a Difference?

By Kim Mendel, RD CDN

These two terms are often used interchangeably, but they are different and should be treated as such. Learning the difference between these terms can help us to eat more healthfully, as many of us struggle with weight management and diabetes.

Portion size is the amount of food we decide to eat as a snack or a meal. The portion we choose to eat can be less than or more than the actual serving size.

Serving size is stated on the nutrition fact label on food packages. It is determined by the FDA (Food and Drug Administration) and the USDA (United States Department of Agriculture). The FDA sets what is called a RACC (Reference Amounts Customarily Consumed). These standards were gathered from consumer surveys of people’s eating behavior from the 1970’s, 1980’s and early 1990’s in order to create what we know today as serving sizes. They are currently under review in order to adapt to today’s population. Americans have been consuming larger amounts of food throughout the decades. We should be consuming smaller portion sizes to maintain a balanced and healthy diet.

Here are some tips to think about when reading a food label: Is there more than one serving per package? How many calories? How much and what types of fat? How much sodium? With multiple servings per package, you will need to multiply the amount you have eaten by the number of servings in the package. For example, a label on a box of crackers says there are 18 crackers per serving and there are 5 servings per package. If you consume the entire package, you are consuming 5 times the amount of calories, fat and sodium. If you reduce your portion size and decide to consume 8-10 crackers, then you are clearly consuming less than the serving size and therefore considerably fewer calories, and less fat and sodium!

The next time you eat chips or cookies, and you eat the entire bag, remember…you decided on the portion size, but you ate the entire number of servings!

Kim Mendel is a Registered Dietician and Diabetes Educator with Cornell Cooperative Extension of Suffolk County’s Family Health and Wellness Program. She can be reached at km432@cornell.edu

Talking to kids about sex – why it’s important

By Kerri Kreh Reda, M.P.H.

If you have young children, you may not think it’s time to teach them about sex, but by age three children have already received many messages about sexuality. When you are expecting your baby, “Is it a boy or a girl?” is one of the first questions asked. Then we tend to dress our infant in pink or blue and buy trucks or dolls, depending on the gender. Our children identify with the parent of the same gender and often imitate the behaviors of that parent. As children grow older, they have access to outside influences such as the media and peers. As a parent, you should commit to having ongoing talks about sex, and this conversation should start early on.

Sexual development, which is part of human development, begins at birth. Sexual development includes physical changes that occur as children grow, as well as the knowledge they gain, the beliefs they form, and the behaviors they show. Children’s sexual development is influenced by their age, what they’ve been exposed to, and what they are taught.

It is essential that children have guidance in this area. Research shows that a lack of proper education and guidance can lead to high risk behaviors such as early sexual activity, teenage pregnancy, sexual abuse, and sexually transmitted infections. Currently:

  • The U.S. has the highest rate of adolescent pregnancy among developed countries.
  • Only one-third of adolescents engaging in intercourse use any form of birth control.
  • One million teenagers become pregnant each year, and 1 in 10 adolescent girls becomes pregnant before age 20.
  • The highest rate of increase in sexually transmitted infections is among adolescents.
  • An estimated 1 in 4 girls and 1 in 10 boys are sexually abused during childhood. Ten  percent of all victims are less than 6 years of age. More than 70% of these cases involve persons known by the child, such as a step-parent, babysitter, or other family member.

Early and open communication about sexuality with your child:

  • Develops a dialogue of trust
  • Allows you to share family values
  • Provides your child with accurate information
  • Helps your child build effective decision making skills
  • Counteracts negative and exploitative sexual messages in the media

When parents provide children with information about sex and sexuality that is both accurate and age-appropriate, they take a huge step towards making sure their children grow up safe, healthy, and comfortable with their bodies.

Resource:

Sexuality and Your Child ages 3-7 (University of Missouri-Columbia Extension)

http://extension.missouri.edu/explorepdf/hesguide/humanrel/gh6002.pdf

Kerri Kreh Reda, M.P.H., is a Human Development Specialist with Cornell Cooperative Extension of Suffolk County’s Family Health and Wellness Program. She can be reached at 631-727-7850 ext. 330 or at kkr5@cornell.edu.

Heart Health

By Amy O’Shea

February is National Heart Month. According to the Centers for Disease Control (CDC), heart disease is still the leading cause of death in America, accounting for one in four deaths each year. The CDC also reports the shocking news that about half of the American population has at least one of three major risk factors for heart disease: high blood pressure, high LDL cholesterol, and smoking. Other risk factors include obesity or being overweight, diabetes, physical inactivity, poor diet, and excessive alcohol consumption. It is possible to prevent many of the risks associated with heart disease through diet and physical activity. Here are some heart-healthy tips to keep your heart beating strong:

  • Eat whole grains. These complex carbohydrates are packed with nutrients and fiber. Fiber has been linked to reducing the risk of heart disease, cancer, and diabetes. Limit added sugars and refined starches.
  • Eat plenty of fruits and vegetables. Try to fill half of your plate with fruits and veggies at each meal as they are packed with vitamins, minerals, antioxidants, and fiber.
  • Eat less saturated fats, trans fats, and cholesterol. Replace solid fats like butter with healthy oils (e.g. canola or olive oil) that are predominantly unsaturated. Choose leaner proteins like chicken, turkey, fish, and eggs. Choose lower-fat dairy products. Limit your consumption of fast foods.
  • Consume omega-3 fats. Omega-3’s have an anti-inflammatory effect and may lower cholesterol levels. They can be found in the following foods: fatty fish (salmon, sardines, tuna, and mackerel), avocado, walnuts, flax seeds, and omega-3 eggs.
  • Eat less salt and high sodium foods. Try salt free seasonings and herbs to add flavor to meals. Limit your intake of very salty foods such as fast foods and processed/ pre-packaged foods.
  • Make time for exercise. The American Heart Association recommends at least 150 minutes of moderate exercise per week, or 75 minutes of vigorous exercise per week, or a combination of both.
  • Stop smoking. https://www.cdc.gov/tobacco/campaign/tips/quit-smoking

Amy O’Shea is a Dietetic Intern with Long Island University, C.W. Post and Volunteer with Cornell Cooperative Extension of Suffolk County’s Family Health and Wellness Program

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