Health Topics 

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Diabetes

Type 2 Diabetes Every year 1.4 million Americans are diagnosed with diabetes, a condition that results from too much sugar in the blood. It's usually related to being overweight, so getting to a healthy weight is the critical first step to fighting or even reversing the disease.

The most common form of diabetes is type 2, which causes your body not to use insulin properly. This is called insulin resistance. Your pancreas makes extra insulin, but eventually it isn't able to make enough to keep your blood sugar at normal levels. But there are things you can do to decrease your risk.

Fight Back with Healthful Foods.
"Foods like white bread, rice and sugary snacks digest quickly and raise your blood sugar in a short period of time," says David Castrilli, M.D., internal medicine physician at CHI Memorial Internal Medicine Associates -Chattanooga. "Choosing foods low in simple sugars and high in other nutrients - like fruits, vegetables, dairy products, whole grain breads and lean proteins - help insulin do its job and remove sugar out of the blood vessels."

Make Moving a Must Do.
The American Diabetes Association recommends 30 minutes of moderate-to vigorous exercise at least five days a week or a total of 150 minutes. Moderate intensity means you can talk, but not sing, through your workout or activity. If you're just getting started, begin with 10 minutes a day and increase a few minutes each week.

Don't Be Afraid to Ask for Help.
If you're concerned about your weight or your risk for developing diabetes, your doctor probably is too. Your doctor, a registered dietician or diabetes educator can answer your questions. They can also help you set realistic weight loss goals (if needed), and show you ways to get to your healthy weight - and stay there.

"Everyone needs to be aware of their blood sugar levels, and the simple blood test for diabetes is usually covered by insurance," says Dr. Castrilli. "The sooner you know about a pre-diabetes or diabetes diagnosis, the sooner you can make lifestyle changes that can reverse the condition in its early stages and improve your health overall."

Could you have diabetes and not know it?
The initial symptoms of diabetes or pre-diabetes can be subtle - so subtle that you might not even notice them. If you're experiencing one or more of these symptoms, talk to your doctor.

  • Excessive thirst
  • Using the bathroom more frequently, especially at night
  • Increased irritability
  • Blurry vision
  • Feeling exhausted, even after sleeping all night
  • Slow or non-healing wounds
  • Recurring yeast infections

Healthy Diet Principles

Many of us our familiar with counting calories, but we miss thinking about macronutrients which are the three main categories of food.

It’s important to get a balance of protein, carbohydrates, and fats. Our bodies need each of these to function.  In the typical American diet, we gravitate towards eating fast food and snacks which contain high amounts of fats and carbs - and not always good fats and carbs. We need to consider proportions of food rather than what seems healthy based on a nutrition label.

Serving sizes are based on weight and how active you are.  It’s helpful to talk with your physician or a nutritionist to find out serving sizes that fit your lifestyle.  I like to use some of the Zone diet principles for guidance which is geared toward an active lifestyle.

Balanced diet

About one-third of your meal should be protein. I like eating more plant protein than animal because of cardiovascular benefits. Legumes are a great source. These are a good source of fiber, protein, zinc, iron, and b vitamins. Examples include chickpeas, lentils, and beans.

The next third of your meal should consist of healthy fats. Fats are important for energy and brain health. They cushion our organs and have other important roles. Fats from plants are the healthiest. Avocado, olive oil, nuts, seeds, fish are good sources.

Carbs should make up 30-40% of our meal. While carbohydrates fuel our body, some help maintain our energy more than others. I won’t get into the nitty gritty of different forms of carbs, but the short version is most carbohydrates should come from colorful vegetables and fruits. Vegetables are the ideal because they generally contain less sugar than fruit.

Eating healthy doesn’t have to be expensive. A good guideline to follow is shopping on the perimeter - though skipping the bakery, of course - helps keep you on track.

My veggie super stars 

  • Beets – They do come with a warning because they contain a higher sugar content, but they are nitrate rich which improves blood flow and naturally lowers blood pressure.
  • Bell peppers – These are easy to add in to several kinds of dishes or eat raw. They are valuable source of nutrients and antioxidants.
  • Zucchini - Zoodles are all the rage!  Zucchini is low in sugar, high in fiber and electrolytes.
  • Cabbage – It’s an unsung hero, and great for the immune system which helps with acute and chronic illness.
  • Exercise
As far as exercise goes, we often think that getting healthy means getting back on that treadmill. While cardio is good for us, research shows that strength training is also important.

Lifting weights is amazing for bone health and weight loss or just maintaining a healthy weight.  It also improves blood sugar levels and may improve cognitive function.  You can use weight resistance bands, dumb bells, or your own body weight.  Weight training twice a week helps mix up your workout routine, and helps you see results faster.  Weights don’t make you bulky, and you don’t have to be a power lifter. To learn how to lift weights, it’s helpful to find someone who knows proper technique like a personal trainer.     

- Jacqueline Gentry, M.D.

Preventing High Blood Pressure with Diet 

Hypertension, commonly known as high blood pressure, is a major risk factor for heart disease. The American Heart Association recommends your blood pressure be less than 130/80. Why does your blood pressure matter? High blood pressure gradually increases the pressure of blood flowing through all the arteries in your body, damaging or narrowing your arteries and ultimately limiting blood flow. Uncontrolled hypertension weakens your brain’s blood vessels, causing them to rupture or leak. This commonly known as a stroke. Hypertension can also cause damage to your kidneys and the delicate blood vessels in your eyes that lead to bleeding, blurred vision or even a loss of vision! 

Although some people are genetically inclined to have high blood pressure even when they are eating well, most will benefit greatly from following a diet that’s low in sodium. DASH (Dietary Approaches to Stop Hypertension) is an eating plan that emphasizes eating more fruits, vegetables and low-fat dairy products while limiting foods high in cholesterol, saturated fat and trans fats. Instead of fatty red meat or process foods, choose whole grain breads, poultry, fish and nuts to keep you satisfied.   

The standard DASH Diet recommends consuming up to 2,300 mg of salt per day. The lower sodium DASH diet allows for 1,500mg of salt per day. 

Consistent, Manageable Changes
It’s difficult for anyone to make a drastic overhaul to their way of eating. I recommend picking one new thing to change in your diet at a time. Once you get that down, pick another small change from the DASH plan. It’s better to make lifestyle changes slowly than start a crash diet that you quit because it’s too hard. A good place to start is by cutting down your salt intake (not just how much salt you are put on your food but counting the salt in the food you are already eating). Other options include eating more fruits and veggies (four to five servings a day) or substituting whole wheat for white flour breads. 

Diet and Exercise Make a Difference 
Following DASH can lower your systolic blood pressure (the top number of your blood pressure) by 8 to 14 points. Heavy drinkers who cut back to moderate drinking can also lower systolic blood pressure (the top number of your blood pressure) by two to four points and diastolic blood pressure (the bottom number of your blood pressure) by one to two points. Moderate drinking is one drink a day for women and two drinks a day for men. A drink is five ounces of wine, 1.5 ounces of 80-proof distilled spirits, or 12 ounces of beer.  

Changing your diet and limiting alcohol consumption can also lead to weight loss, which in turn can help lower your blood pressure. If you’re overweight or obese, every 20 pounds you lose you could drop your systolic pressure by five to 20 points. Lastly, exercise can lower your blood pressure, dropping your systolic blood pressure by four to nine points if you exercise for at least 30 minutes each day. 

It’s worth mentioning again that properly controlled blood pressure contributes to a healthy life by reducing your risk of strokes, heart attacks, kidney failure and other conditions. Following a healthful diet that’s low in sodium is a great place to start. But if these changes aren’t making a difference in keeping your blood pressure under control, your next move is to talk with your doctor about blood pressure medication. 

- Sarah Baker, M.D. 



Video Library

Dr. David Castrilli discusses cholesterol, exercise and healthy eating.

Dr. Jacqueline Gentry shares tips for eating healthy and exercising to achieve optimal health.

Dr. David Castrilli discusses tips for managing type 2 diabetes.

Dr. David Castrilli shares tips managing type 2 diabetes in the summer months. 

Dr. Baker discusses the flu vaccine.