Signs you may become diabetic

A patient of mine who is over 100 pounds overweight for her height had a few blood tests abnormalities that suggest the progression to diabetes may be occurring. Her fasting blood sugar was above 100 ( hers was 150).

Fasting insulin level was 36 ( normal is less than 24). This means her body is pumping out more insulin due to resistance to insulin from overweight. This is also reflected in the high fasting blood sugar. The body is not able to metabolize the sugar in the diet

The treatment for this is to lose weight and make better food choices. High fiber in the diet will help slow down the absorption of sugar into the blood and may help decrease the blood sugar after a meal

Less processed foods is important, since they convert to blood sugar rapidly and are low in fiber as well.

The third abnormality that is seen in patients who have trouble with insulin and blood sugar is elevated liver enzymes since the body converts sugar into fat in the liver. The fat surrounds the liver, and causes inflammation around the liver as well. It can be corrected with weight loss and the good choices mentioned above

Eating fresh fruits and vegetables, and whole grains are a great way to get more fiber into the diet. Try to stick to the number of calories a day that is recommended for weight control or 500 calories less a day if you want to lose weight

500 calories less a day can be achieved by decreasing intake of sugary foods, processed foods such as buns, breads, sweet desserts.



Ways to lose weight without dieting

Web MD has some useful tips on weighs (ways) to lose weight without dieting


Portion Control

Using a smaller plate

Green tea

Getting a good night sleep

Eating more vegetables

Having soup before a main meal

Choosing whole grains

Cutting back on sugar intake

Limiting alcohol intake

pausing between bites when eating

Splitting an entrée when eating out or have an appetizer as a main course

How to build a healthy meal


how to build a healthy meal

Make half your plate fruits and vegetables. They are a great source of nutrients, unlike many processed foods where nutrients may have been removed. They are also low in calories and fat.

Add lean protein from nuts, eggs, dairy ( fat free or 1% milk), legumes and whole grains- 

Avoid extra fat and saturated fat. Saturated fats contribute to heart disease, stroke, and other inflammatory conditions in the body such as leaky gut and autoimmune diseases.

Take your time to eat- it takes twenty minutes for your stomach to tell your brain it is full, so savor the food, eat it slowly.

Choosing a smaller plate will give the appearance of a larger meal and can help you with portion control and limiting overeating.

Try to eat more meals at home- so you have a better idea of what you are eating. Many restaurants add extra fat, salt and sugar to their foods to give them taste.

Choose healthier options at home or eating out- choose grilled and baked instead of fried food. 


Constipation is one of the most common intestinal problems in children.  It is a symptom that signals something is wrong. It is not a disease.  Most constipation is not caused by a serious medical disease.

The cause of most constipation has no sign of injury, infection or blood abnormality to explain the very real symptoms. Children need help from their parents and sometimes from a health care professional, to prevent or manage constipation.

Constipation can be defined as the passage of painful stools or a reduction in the frequency of stools.  An important feature in this definition is the perception of pain or difficulty in passing stool, regardless of frequency. The experience of pain when going to the bathroom can lead to avoidance of having a bowel movement.

It is not correct to assume that a bowel movement every day is normal. There really is no right number of bowel movements. In general, 2 or less normal bowel movements a week may be a sign of constipation.

Constipation is generally caused by a change in diet and fluid intake, or by avoidance of bowel movements because of pain such as anal irritation or small tears in the skin or rashes. Other factors such as change in daily routine, stressful events or postponing using the toilet when the urge to have a bowel movement can play a role in a painful bowel movement.

There are a number of ways to help avoid constipation- such as paying attention to what you eat and drink and getting exercise.

Certain foods can contribute to constipation and should be avoided such as: High fat foods, high sugar foods, processed foods such as instant mashed potatoes, macaroni and cheese.  Food that have little or no fiber such as ice cream, milk, dairy, cheese and snacks like chips and pizza can be a contributing factor in constipation.

Eat more fiber.  Add fiber to the diet. Fiber helps form soft, bulky stool.  It is found in many fruits, whole grains, and vegetables. Be sure to add fiber a little at a time, so the body can get used to it.

Drink more liquids- water is best, sugar drinks are the worst.  Drinking sugar drinks, without fiber, fills your body with calories without fiber.

Exercising helps the digestive system to stay active and healthy. A walk for 20 minutes a day can help or you can break it up into two ten minute sessions.

It is important  to allow enough time to have a bowel movement and not to ignore the urge to have a bowel movement. Waiting only makes constipation worse.

Sports Nutrition and the Athlete

My intern who is a swimmer athlete eats for breakfast whole wheat bread with peanut butter

For lunch she has a sandwich such as turkey, with lettuce, cheese on whole wheat bread. Her dessert is an apple.

After school she wont eat anything heavy if she has a practice at 3 pm. However, if she has a later practice- she will eat:

salad with dressing, Greek yogurt.

After practice she had chocolate milk and dinner which comprised pasta with tomato sauce.

The above illustrates good eating habits for the following reasons:

Her diet is high in carbohydrates early in the day which she needs for energy to swim.

She is getting good sources of protein from nuts, meat and cheese which represent a good variety.

After exercise, she is replenishing her protein and energy stores.

The athlete such as her should have a diet of 20% protein, 60% complex carbohydrates and 20% as fat.

In between swimming sessions is described as a challenge because often she is at meets in places that are not at home. Choosing foods that are optimal for energy and performance requires planning and effort.



What is the healthiest way to lose weight without crash diets?


What is the healthiest way to lose weight without crash diets?

Behavior modification to healthy choices, good decision making and increased activity is the healthiest way. Moderation, variety, balance, portion control. It has to be a program you can follow that allows you to eat the foods you enjoy in moderation. There is no one food you can not have. Try lean proteins, whole grains ,fresh fruits and vegetables, and poly and monounsaturated foods