Tips from a Diabetes Practice

My patients are the ones who inspire many of the newsletter topics. If it is on their minds there is a good chance that you may be thinking about these topics as well. This weeks patient education sessions were informative and several patients were focused on “belly fat and stress eating.” Let me share the points of interest I offered to them. Hopefully this information can help you get started on a path to improved health and self satisfaction.

1. What is belly fat? I keep reading about it; and why is it related to increasing my diabetes risk? My whole family is built the same way. We carry our weight in our stomachs not the hips, thighs or rear. When I gain weight it all goes to my stomach. Many of you who have diabetes may be familiar with this question, and most of you are built the very same way. The ‘apple shape’ is the body type which is definitely more at risk for diabetes. This fat is labeled central obesity or intra-abdominal fat. The central fat is more “metabolically active” which means it contains more capillaries. Fat is now considered an organ with multiple functions. Fat cells will release free fatty acids (broken down from fat), which then travel through the increased capillary networks and continue to the liver and pancreas. Floating free fatty acids increase insulin resistance and fatty liver disease, which are all related to type 2 diabetes. Not only does belly fat increase insulin resistance (insulin can not open cell doors to carry glucose inside, and instead glucose broken down from food sits in the bloodstream creating cellular damage), but it may also reduce the amounts of insulin made in the pancreas. The free fatty acids may interfere with the beta cells of the pancreas where insulin is made.

   Bottom line – Your body shape is part of your genetics and you have little control of where your extra fat will be stored. The good news is if we eat healthy with smaller portions and exercise aerobically you will shed pounds all over your body – including the belly fat. There is no such thing as “spot reduction” and hundreds of sit ups will not reduce belly fat. It will increase the abdominal muscles under the fat so when you shed those pounds you will notice stronger, tighter stomach muscles!

    

2. I know most people lose their appetite when they are upset, anxious or stressed but I binge and eat out of emotion. Then I feel guilty and that makes me eat even more! How can I start to quit this behavior which makes me gain weight, feel awful, and mess with my blood sugars? First of all, you should realize that you are not alone and many people are “emotional eaters”. The best way to deal with this situation is to visit with a counselor, social worker, or psychologist and find out what your emotional triggers are and why they continue to haunt you. This behavior has probably been a coping mechanism for years even before you had diabetes. Here are tips for you to use in the short term; but remember – you may need professional assistance.

   Bottom line – Try to differentiate between hunger and appetite – especially in times of emotion – whether they are happy or sad times. Real hunger is a true physical sensation that alerts your body to the need for food. Signs and symptoms can be a pit in your stomach, growling sounds or rumbling. Appetite is more a mental thing which can come from your mind or emotion. Remember, when you have diabetes you should never get to the point of real hunger which can be a sign of hypoglycemia. Be aware of what causes you to binge and write it down. Food diaries are helpful to see patterns as well as quantities of food being consumed. Be honest about the amounts you are eating. Look for triggers that make you binge and have alternatives ready – instead of grabbing chips or crackers, think about fresh vegetables that are already cut up; binging on vegetables which are a “free food” is fine. Eat on a schedule and never skip meals. Pre-package foods in a portion size so if you grab – you grab small. Skipping meals always creates a situation for overeating in the end, especially when you are anxious or stressed. Try not to have trigger foods in the house and if you do, have them in miniature sizes. Inhaling 3 full size chocolate bars is far worse then grabbing 3 chocolate kisses. Buy treat foods in single size servings, which may be more expensive, but may save you in the end. Freeze snacks which may be difficult to chew or bite when you want to grab; you may decide to just skip them if you have to wait until they defrost. Look for 100 calorie snacks if you have to. Learn different coping mechanisms and remember the first 2 bites are what you actually taste. Always chew slowly, but especially when you are upset. Instead of relying on food for comfort think about a warm bath, a cool swim, lighting candles, meditating, reading, deep breathing, listening to soothing music, watching a movie, going for a drive, chewing sugar free gum or anything you can think of to diffuse the stress in the moment. Document all the information and make an appointment with a professional who can help you learn to substitute a healthy behavior instead of grabbing food.

Stress can affect people in different ways, but most of us try to remedy the situation by using food as a solution. Think first about overeating and your diabetes will thank you. Good luck!

NOTE: Consult your Doctor first to make sure my recommendations fit your special health needs.