If you and your loved ones don’t have diabetes, count yourself among the lucky ones. Well, it isn’t really all the luck of the genetic lottery; there are things that can be done, to decrease the chance that you’ll get it. If you have it, there are things that can be done to control it and reduce its terrible toll on your body. It is definitely lurking, however, from every nook and cranny; and the present eating situation in the U.S. is not helping.

“The Centers for Disease Control estimates that about 57 million adults age 20 years and older have impaired fasting glucose or impaired glucose tolerance or both.  Most researchers and clinicians think it is reasonable to assume that most people with these conditions would benefit from the interventions tested in the Diabetes Prevention Program.” The Diabetes Prevention Program is a nation-wide research program that has been going on for more than a decade.

They’ve learned lots about putting off diabetes and taking care of those that have it. One of the most fascinating facts that they’ve learned is that of the 1.6 million new cases of diabetes per year, it is possible to prevent the onset of hundreds of thousands of those cases. Some of the research has shown that maintaining weight loss and exercise can prevent the onset of diabetes for more than a decade. It may be longer, but that’s how long they’ve been doing the research. As it turned out in their research, life-style changes were far more successful at warding off diabetes than drugs.

Those of you that read this blog know that my husband, Vic, was diagnosed with type 2 diabetes five years ago ….. on March 9, 2010 it will have been six years ago. What a shock when you’re first diagnosed with diabetes – a wake up call. The end of procrastinating thoughts of losing weight, ‘one day.’ Before the diagnosis there was really no idea that he was even at risk for diabetes.

The fact that he sat most of the day behind the computer monitor/keyboard, never registered – the link between the sedentary lifestyle and the risk of insulin resistance and type 2 diabetes, was not even on the radar.

In those days before diabetes, Vic had insisted that he enjoyed white bread, ice cream, and did not like skim milk.  He had a mixed relationship with whole grain products, not always preferring them to comparable refined white flour products. He believed that (white) rice was healthy and therefore, almost a free food – a 2-cup serving was common.

How did he lick diabetes?

Motivation was high – knowledge of diabetes was too stark to ignore. Visions of amputations and the resulting decreased quality of life, a very close fellow professor who had already had a kidney transplant, others who had lost their eye sight, and my explanations of the impact of the disease on heart disease and stroke, all contributed to his desire to take control back from the disease at whatever cost.

We were not going to get into the trap of thinking that all there was to it was to avoid eating lots of sugar.. Fortunately for Vic, I had learned years earlier, that what is so devastating for persons with diabetes, is their accelerated very high risk of cardiovascular disease. Diabetes was just not a good option – he decided to give it his best. He set out to learn about the necessary lifestyle changes needed order to take control back from diabetes. That spelled exercise, diet revision, blood checking and follow-up.

I kid him about his starting weight – if he ate more than usual, he would not get on the scale, because he did not want to risk seeing it over the 200 mark (some kind of personal Waterloo, I guess). He lost 15% of his body weight within 4 months (30 pounds).  He recounted this saga a couple of months ago in a guest blog.

It hasn’t been a snap for him to keep it off, but whenever it starts climbing he doggedly brings it back down,. Over the past eight months, he has been tracking his weight and weight goals on his iPod Touch App, Weightbot.   He is averaging about 164 pounds lately, having achieved the goal of getting down to 165 in Sept from 172 in April.  Since 165 is the center of an array of ups and downs, He has adjusted his goal to be 163.  I like it that he looked at where he was and adjusted his goal. He recognizes that you never arrive and stay there without effort.  He sees that he can achieve the old goal of 165 more reliably by going for a new goal of 163. The measurement App and record keeping seems to comfort his psychometrician soul. (A psychometrician is a statistician/psychologist who studies measurement and evaluation of tests, measures, and the research done with them. They know all about the variability, reliability, and validity of measurements). I have to admit, it’s pretty cool and motivating to see the months of jiggidy jaggity graphs shown on his Weightbot, ultimately moving down. Every time that we go out to eat at a restaurant or to someone’s home, there’s inevitably an alarming upward blip in the chart. Restaurant food is loaded with salt, fat, and sugar, and most people we visit serve pretty small vegetable portions (Vic calls them “vegetables as garnish”) and inevitable quantities of well-salted meat. It means that there’ll be days to get it back to where he’s headed. It might actually help others to see how a sharp rise is only temporary if you don’t throw in the towel, when that discouraging uptick appears on the scale.

The goal was to exercise 45 minutes on the treadmill 4 days per week and two days at the gym doing strength-building exercises. Side note: he used to have severe back problems, which are far better now that he does regular exercise.

As related to diet, in the beginning we focused on a few big changes. We wanted the food to be delicious, because it’s more difficult to feel deprived if you’re filling yourself with ample delicious meals. We knew that avoiding deprivation was a long-term goal, but in the short term we made a few sweeping changes.

1. Because he needed to lose weight, he had to increase vegetable intake. I knew that he would not last very long on a new eating style if he were hungry. So we increased the volume of vegetables. We immediately ended his morning glass of fruit juice – we changed it for vegetable juice, ‘cause he enjoys juice with breakfast.
2. We stopped eating all white flour and white rice. Since then he has embraced whole grains – it’s now his true preference.
3. We decreased meat, cheese, and snack foods (like chips, crackers, candy and ice cream).

That’s where we started.

I think that the motivation is a critical component of success in a massive life style change.  Because eating Mediterranean style is different from the way most everyone else eats, it’s challenging. But if you’re motivated, toward health (motivated not to become a victim of heart disease, general cardiovascular disease, diabetes, cancer, arthritis, Alzheimer’s disease, overweight and obesity, and so on.) This eating style can make a real difference. It is really worth the effort.

It’s interesting, to me from a nutritionist’s standpoint. I could offer the nutrition advice, but the motivation had to come from within him. I believe from my past experience in counseling overweight and obese patients, that some people were clearly motivated, to take responsibility for their health – they succeed in their goals. Others somehow wanted me to do it for them. I remember the sense of failure that I suffered when I could not help them recognize that they needed to accept the responsibility for their own eating. Some would ask to be able to call me, 24-7. I said, yes; but it didn’t help. I felt so bad for them – but I couldn’t do it for them. A person needs to be willing to say ‘no’ to themselves sometimes.

It is true that it really helps to have the social support; someone who cares about your quest, your goals, your health, and your needs. If your family, significant other/s, are fighting you or sabotaging your efforts it’s really difficult. Can you enlist their support? Can you ask that they have their ice cream, cookies, chips, cake, fries, burgers, pizza and so on, out of your home, if ice cream and the other foods are deadly for you? It needs to be a long-term change. Most of us have long-term comfort foods that will call to us for years. Victor still loves ice cream. Sometimes I buy Dryers or Breyers slow churned (or double churned) no-sugar added with half the fat – it’s actually creamy and good. It’s still not a health food, but at 90 or 100 calories per ½ cup, it’s far better than the Ben and Jerry’s and Haagen-Dazs 280 calories per ½ cup. The point is that he doesn’t eat ice cream every day, but to say ‘yes’ sometimes old-favorites in controlled portions works out better, than never.

Lastly, I want to point out that the longer you do it, the more you will develop new ways of thinking about food. Some of it is habit and some is the way the brain is ‘wired’. It takes time – be patient with yourself – at the same time stay motivated not to give up if something doesn’t work the first time you try. Dedicate yourself to the new lifestyle – new habits.

Keep working to find new foods that fit into your new eating plan and enjoyable ways to keep moving. There’s a really big payoff for avoiding diabetes and its resulting disabilities.

One of the things Vic has going for him is that he does not refuse vegetables; that’s an understatement, he likes vegetables and has an adventurous palate. Trying something new with vegetables was not and is not a difficult problem for him. So I’m not too worried that tonight’s experiment will not be eaten – Flavorful Roasted Asparagus.