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There are Four Types of Diabetes.

The first is called type 1 diabetes which affects some 5 – 10% of the total diabetic population. This condition used to be referred to as either insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Its cause is unknown, but it’s an autoimmune disease in which a person’s body attacks the cells that produce insulin in the organ called the pancreas. Insulin is a hormone that is essential in assisting cells in the blood to accept sugar coming from food. When these cells (beta cells) in the pancreas can no longer produce insulin – it causes an inability of cells to accept the sugar which in turn causing the sugar to increase higher and higher. Type 1 diabetes is most commonly diagnosed before age 20. It’s rarely diagnosed later in life, but it can happen. Individuals who have this type of diabetes have to inject insulin via a syringe for the rest of their life. Individuals with this type of diabetes have to monitor their blood sugar closely every day and follow an active physical activity program. There is no cure, but there is some promising research that may heal these patients.

The second type of diabetes is called pre-diabetes. This condition does not mean that a person is diabetic – it means that it increases your chance of developing this disease, unless immediate action takes place. During this condition the blood sugar exceeds (120 mg/dl) the normal fasting number when fasting. Some individuals may take oral hypoglycemic medications (i.e. Glucophage) temporarily to help bring their blood sugar down. Physical activity (exercise) is essential to all diabetics and is one of the best ways along with a healthy diet to keep blood sugar in a healthy range.

The third type of diabetes and most frequent is called type II. This type affects nearly 90 – 95% of all diabetics. This disease begins with the body’s inability to accept insulin which in touch allows the sugar in the blood to be taken in the cell to get burned for energy. This condition is called insulin resistance. Or similar to type I diabetes, the body may not be produce enough insulin from the pancreas. As with each type of this disease, when blood sugar remains higher than 120 mg/dl at a fasting state, diabetes complications will soon follow. The following races seem to be more susceptible to developing this type of diabetes … Blacks, Latinos, Asians, Native Americans and Pacific islanders and Hawaiians.

The fourth and least common type is called Gestational diabetes. This type can occur during pregnancy. Between 40 – 60% of women with this type of diabetes will develop type II diabetes in a span of 10 years post-partum. The numbers are high, yes, but it is not inevitable that women with gestational diabetes will have diabetes for life.

Check back next week when we discuss diagnostic criteria for each type of diabetes.

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Steve J. Roch Jr., RD, LDN, CFT is a registered and licensed dietitian. He is also a certified personal trainer. Steve is the owner and president of BestRD Wellness, LLC, a company that provides nutrition therapy and wellness services to residents and businesses in the areas of New Orleans and South Louisiana. Steve can be contacted by email at steve@bestrdwellness.com.

For the next few weeks – I want to donate some attention toward this disease. I will lay out a detailed presentation of how to live a ‘normal’ life for those affected. Upcoming blogs will include learning about rates and statistics in the U.S. and Louisiana, what types of diabetes exist, diagnosed criteria, specific test to monitor, prevention tips and nutrition basics of managing this disease. I hope you will obtain a better understanding of this disease and enjoy the information presented. I also look forward to reading your posted feedback.

Diabetes rates:

The prevalence of diabetes is quickly soaring to become one of the top preventable diseases and causes of premature death in the United States. Little over 1.5 million Americans over the age of 20 are diagnosed with diabetes every year. Currently, some 24 million people in the U.S. have diabetes. That’s nearly 8% of our entire population. Diabetes rates are increasing rapidly and expected to double in the next 20-30 years. So, we must act quickly to counter this seemingly grim fate. It’s that important!

National Demographics:

This disease does not discriminate between genders. The numbers are nearly split down the center between men (12 million) and women (11.5 million). Considering age brackets 12.2 million or 23.1% of Americans over the age of 60 have the disease. Almost 11% of Americans over age 20 have the disease. A little under 186,000 children and teens under the age of 20 have the disease.

Louisiana Demographics:

In Louisiana, we fare much worse than other states. Orleans parish has some of the highest rates in the state with 10.6% of its population being diabetic. Following Orleans is Tangipahoa (11.1%); Plaquemines (10.7); St. Charles (10.4%); Jefferson (10.2%); St. Bernard (9.9) and St. Tammany (7.9%) being the home to the lowest prevalence of diabetics in Louisiana. In just ten short years the prevalence of newly diagnosed diabetics in LA has risen from 5.2% in 1997 to 10.1% in 2007. Sadly, our state posts the highest death rate from diabetes in the nation (35.5 per 100,000 population).

Cost of Diabetes (Nationally):

Total costs associated with diabetes have been reported to be a staggering $174 billion (yes that’s with a B) annually. A closer look at the numbers reveals $116 billion goes toward direct medical costs and another $58 billion for indirect costs (disability, work loss, premature mortality). Considering related factors such as gestational diabetes, pre-diabetes and undiagnosed diabetes, the cost rises to an eye twitching $218 billion annually. In 2006, total costs related to diabetes in Louisiana were approximately $2,431,000,000.

Check back next week when we define the various types of diabetes. For more information about diabetes rates in Louisiana, check out the Louisiana Diabetes Control Program (DPCP) Website here .

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Steve J. Roch Jr., RD, LDN, CFT is a registered and licensed dietitian. He is also a certified personal trainer. Steve is the owner and president of BestRD Wellness, LLC, a company that provides nutrition therapy and wellness services to residents and businesses in the areas of New Orleans and South Louisiana. Steve can be contacted by email at steve@bestrdwellness.com.

Spring is finally here, the cold weather is gone and Easter is this Sunday. I was thinking…this year, why not put a new twist on an old tradition – let’s think about nutrition and health in our celebration.  Not sure how?!? Here are some suggestions to facilitate change in the way we celebrate Easter:

Fill each basket with healthy items i.e. sugar-free chewing gum, sugar-free Life Savers, sugar-free suckers and carrots – cuts the sugar and calories

Use colored plastic Easter eggs for scavenger hunts – using real boiled eggs can put the little one’s at risk of food illness – when eating real eggs don’t let them sit at room temperatures for more than 2 hours

Avoid all-you-can eat buffets on Easter Sunday; opt for restaurants that offer a la carte menu items – this will help eliminate adding extra calories to your meal

Try giving kids non-edible items in their baskets such as Easter erasers, stickers, pencils, tattoos, coloring books and toys (Hot Wheels for boys and dolls for girls) instead of traditional high calorie sweets.

Limit egg consumption around this holiday – one regular egg has 210mg of Cholesterol – it is recommended to eat only 300mg of Cholesterol per day – choose brands like Christopher eggs and Eggland’s Best – these brands have less cholesterol/Saturated (unhealthy) fat and added omega fats + vitamins for heart heath in their eggs.

Add a little physical to your holiday gatherings – hide physical activity games in the plastic eggs i.e. Hop like the Easter bunny to find the next egg or try egg toss contests and spoon egg races or take the family out to see the Chris Owens Easter parade in the French Quarter which starts at 1pm or check-out the Easter on the Avenue on St. Charles at 12:15pm.  The Parade will start at Emeril’s Delmonico Restaurant and make its way around Lee Circle, then up Cadiz Street where it turns around and returns to the restaurant.

Freeze fruit and offer natural sugar/sugar-free drinks instead of giving the children candy – the sweeter fruits work best i.e. papaya, berries, grapes/grape juice, sugar free Hawaiian punch mix

If you must go for the traditional sweets – go for Elmer’s dark chocolate heavenly hash and Gold brick eggs – you can also buy Hershey’s dark chocolate bars and melt them into a fondue bowl – dip strawberries, marshmallows, pretzels, and nuts in to make a yummy dessert

For more information on healthy Easter recipes and meal ideas, visit the EatingWell Magazine.

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Steve J. Roch Jr., RD, LDN, CFT is a registered and licensed dietitian. He is also a certified personal trainer. Steve is the owner and president of BestRD Wellness, LLC, a company that provides nutrition therapy and wellness services to residents and businesses in the areas of New Orleans and South Louisiana. Steve can be contacted by email at steve@bestrdwellness.com.

Have you heard the news? The Registered Dietitian is the Food and Nutrition Expert! That’s right. Many people believe only doctors can give answers to their nutrition questions. The truth is that medical doctors are in fact a solid source for getting your health questions answered, but the best source for nutrition information is from a Registered Dietitian (RD). A RD will collect vital information from you in a nutrition assessment. Then create a specific and individualized nutrition program based on research and sound science designed just for you.

Many of you might have never heard of us before but rather seeked out the advice of ‘Nutritionists’ for nutrition counseling – beware! In Louisiana, an individual may only promote themselves as a Nutritionist if they are also a RD or vice versa. Self-proclaimed Nutritionists do not hold the necessary credentials nor have they undergone the training or posses the knowledge to provide you with safe and accurate nutrition recommendations.

I’ve been involved with health and wellness for over 15 years and during that time personally witnessed many ‘self proclaimed nutrition experts’ give clients (you) diseases/illness specific nutrition advice that is dangerous and potentially harmful! The truth is…following dietary instructions from non-licensed individuals can drastically increase your chances of injury or sickness for you and your family. Just because someone eats or looks like a Greek statue does not mean they can tell you how to eat for your specific health conditions.

The most frequent offenders of non-licensed people you have to be most careful of are: multi-level marketers, health food store salespersons, personal trainers, former bodybuilders, some allied health professionals and friends and neighbors who may all be good intentioned, but misinformed about the science of nutrition and how it can affect our body. Now, before I get blasted with your comments for picking on these folks – let me say that some helpful health information may be collected from the aforementioned population. They may promote non-specific nutrition information to you such as: following the food guide pyramid, eat your fruits and vegetables, and tips on cutting calories which will help you lose weight, etc.

However, the moment they give you a specific diet i.e. eating program to lower your cholesterol – it’s illegal! According to the Louisiana Board of Examiners in Dietetics and Nutrition which is the credentialing agency for RDs and watch dog for nutrition fraud in our state – it’s illegal for any person’s other than a Licensed Dietitian/Nutritionist (LDN), Medical Doctor, Dentist, Osteopath, Registered Nurse, Pharmacist or Chiropractor to give out specific dietary instructions to treat an illness.

You may be asking yourself – why is the RD the food and nutrition expert? Good question. The American Dietetic Association Commission on Dietetic Registration (ADA-CDR) has worked with major colleges and universities throughout America to set up educational guidelines for RDs. A high school graduate interested in becoming a RD must complete 3 steps –

1) Enroll in a 4-5 year dietetic program in an accredited university which classes include: medical nutrition therapy, cultural nutrition and counseling, nutrition assessment, organic and biochemistry, healthy cooking/food technology as well as many other medical and science based courses;

2) Complete a 1200 hour (~12 month) dietetic internship program from an approved college;

3) Pass a national exam from the ADA CDR.

Additionally, we must complete 75 hours of continuing education every five years to stay up-to-date. So, as you can see, we do not only take a weekend course in nutrition. Every RD makes a commitment to the pursuit of lifelong learning to help to provide their clients with reliable scientific nutrition information. So, when you are looking for help with your eating habits – make an appointment with a RD/LDN!

For more reading on how to report someone who is giving out illegal or dangerous nutrition information, check out the Louisiana Board of Examiners in Dietetics and Nutrition Website.

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Steve J. Roch Jr., RD, LDN, CFT is a registered and licensed dietitian. He is also a certified personal trainer. Steve is the owner and president of BestRD Wellness, LLC, a company that provides nutrition therapy and wellness services to residents and businesses in the areas of New Orleans and South Louisiana. Steve can be contacted by email at steve@bestrdwellness.com.

There’s been quite a bit of talking about fruits and vegetables this week.  Lauren gave us some pointers on how to select fruits and vegetables and Alison shared a recipe to get your kids to eat more vegetables with their meals.  I wanted to wrap up the week by providing you with 20 easy ways to add fruits and vegetables to your diet. Although, we’ve all heard the saying get 5-A-Day…according to the Centers for Disease Control, only 20% of the US population meets the recommended 5-A-Day (5 servings of fruits and veggies per day).

Fruits and vegetables come in many shapes, sizes, varieties and tastes. Many of us shun the idea of 5-A-Day, because we have this build in phobia that we acquired somewhere in our lives that fruits and vegetables ‘esp. vegetables’ taste bad. It does not have to be this way. Fruits and veggies are what we make them to be. They can be mouth watering and irresistible or they can taste like a lump of clay in our mouth – it’s all in the preparation.

If you just chomp down on a raw eggplant – no that’s not too appealing. However, if you stuff it with a trio of seafood, bread crumb’s and spices – we love it. Many clients I’ve counseled over the years had never tasted or experimented with uncommon fruits and veggies in our area. Some examples include: papaya, horned melon, kale, sprouts, kiwi, parsnips, lentils or garbanzo beans (chickpeas) and varieties of lettuce (butterhead, arugula or watercress). Another fear of my clients is not knowing how much to eat. We’ll get to what counts as a portion in a couple of weeks.

Provided below are tips that offer you ideas on how to get more fruits and vegetables into your daily meal planning. If you put a little thought into getting 5-A-Day – it’s very possible to meet your objective.

20 Ways to Get More Fruits And Vegetables In Your Diet

1. Grab an apple, orange, bag of grapes as you walk out the door and much on during your morning commute.

2. Before eating that fried shrimp Po-boy for lunch – order a house/green salad when dinning out.

3. Choose a ready-to-eat fruit cup instead of chips, candy bar or unhealthy sweets.

4. Add some veggies such as mushrooms (Red Hill local brand at Rouses), tomatoes, onions, green peppers, squash, zucchini to the grill when planning a BBQ.

5. Dip a few bananas into liquid dark chocolate (50 – 60% cocoa) and freeze for a couple of hours – kids love these.

6. Make a vegetable pizza for the family – load it up with carrots, bell peppers, tomatoes, olives, onions and other favorite veggies.

7. Add Louisiana blueberries, blackberries or raspberries to pep up your morning breakfast cereal.

8. Try a meatless dish for dinner – examples include: roasted veggie lasagna, broccoli and tofu stir fry, veggie fajitas, replace angel hair spaghetti with spaghetti squash marinara or red beans and rice w/o the sausage.

9. Pack a small bag of dried apricots, apples, prunes, pineapples, and cranberries for a healthy snack.

10. Substitutions – use veggies instead of original ingredients i.e.: spaghetti squash for wheat spaghetti, mashed cauliflower for mashed potatoes, eggplants instead of veal parmesan.

11. Stop by and get a smoothie from Smoothie King for a snack – ask to double your fruit (strawberry) on drinks like the Caribbean way and Muscle Punch – but ask to wash the fruit to avoid too much sugar

12. Visit a Mediterranean restaurant – Acropolis on Vets in Metairie is a favorite of mine – order dishes like Hummus – which is made from chickpeas, Baba Ganoush – made from eggplant, Greek Salad – made with tons of veggies, or Spanakopita – made with spinach

13. Add some canned ‘no sugar added’ fruit cocktail to Jello and feed the family

14. Marinate some veggies of your choice and a dash of Tony Chachere’s (low sodium of course) or some of Chef Paul’s Magic seasoing and water overnight – I recommend using carrots, cucumber, bell pepper, celery and/or okra

15. Throw in some pears, mango, plums or grapefruit to take your ordinary vanilla yogurt blossom with flavor and nutrition

16. If cooking at home – try a traditional old style Italian side – wrap prosciutto around asparagus, sprinkle a little black pepper and extra virgin olive oil (first press) and bake for about 20 minutes – you can also wrap prosciutto around cantaloupe or honeydew melon or both for a nice appetizer

17. For a healthy dessert – slice some fresh or canned peaches, fresh or canned cherries, fresh kiwi or raisins on angle food or sponge cake

18. Participate with your children in community sponsored gardens – you take home and eat – nothing beats local. If you child’s school does not participate in this concept – volunteer with the school to start one

19. If dining out or eating at home – make it a Mexican night – choose guacamole, salad, salsa, tacos stuffed with veggies, gazpacho soup

20. Add some baked sweet potatoes or pumpkin with a little margarine and cinnamon to your pork or chicken meal as a healthy side

For more tips about how to create a successful home garden or to participate in community based gardening visit the LSU Agricultural Centers Website. For recipes, check out the CDC Fruit and Vegetable More Matters.

I also encourage ya’ll to go buy a fruit and vegetable cookbook – Vegetarian Times and Cooking Light are recommended – and start trying some new foods or put a new face on an fruit or veggie that you’ve tried before, but did not prefer. Remember that you’ll never know if you like something if you don’t try it (at least once or twice).

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Steve J. Roch Jr., RD, LDN, CFT is a registered and licensed dietitian. He is also a certified personal trainer. Steve is the owner and president of BestRD Wellness, LLC, a company that provides nutrition therapy and wellness services to residents and businesses in the areas of New Orleans and South Louisiana. Steve can be contacted by email at steve@bestrdwellness.com.

March is not only known for its designation as ‘National Nutrition Month March’ – it also brings awareness to another very important issue facing our society ‘Colorectal cancer’. Dating back to 1999, the U.S. Senate overwhelmingly agreed that more attention should be focused on this preventable disease. They took a vote and identified March as National Colorectal Cancer Awareness month.

Cancer is the second leading cause of death of all Americans. Colorectal cancer (AKA Colon cancer) as its name implies is a type of cancer that may affect either or both the rectum or the colon. It ranks second among all cancer victims in both genders nationally. Colon cancer may cause polyps or abnormal growths which can grow anywhere within the colon walls. Symptoms are sometimes asymptomatic meaning you do not know anything is wrong. Recognizable symptoms include … losing weight and without a reason; change in bowel habits (constipation or diarrhea); blood in or on fecal matter (stool); or pains, aches, or cramps in your stomach that are persistently present.

In our state, 53 to 57 people out of every 100,000 are diagnosed with this easily preventable disease. Unfortunately, of those who are diagnosed 19 to 21 people will lose their life. Most people are diagnosed in their early 50’s. The incidence of new diagnosed cases increases drastically after age 50. Early detection by way of screening plays a critical role in reaching successful outcomes. In fact, it is estimated by the Centers of Disease Control (CDC) that if people age 50 and older would undergo a routine screening – just that one measure would prevent 60% of deaths. Doctors may use one of three tests to exam a patient’s risk: 1) High-Sensitivity FOBT (Stool Test) which is recommended once a year; 2) Flexible Sigmoidoscopy which is recommended once every five years and/or 3) Colonoscopy which is recommend once every ten years. Other tests may also be performed.

There are several non-controllable and controllable risk factors that increase someone’s risk of developing this disease. Below is a list to help identify the two.

Non-Controllable

• A personal or family history of colorectal cancer or colorectal polyps
• A genetic syndrome such as familial adenomatous polyposis or – hereditary non-polyposis colorectal cancer (Lunch syndrome)
• Inflammatory bowel disease (including ulcerative colitis and Crohn’s disease)

Controllable

• Inconsistent physical activity
• A low-fiber and high-fat diet
• Overweight and obesity
• Alcohol consumption
• Tobacco use
• Low fruit and vegetable intake

10 Tips to Help Reduce Your Risk

1. Know your genetic (family) history – ask yourself has anyone in your family ever had this disease

2. Aim for the recommended 38 grams of Fiber per day (found in fruits, vegetables, and whole grains) – search for foods labels that contain … whole wheat, brown rice, oatmeal, bulgur (cracked wheat), popcorn, buckwheat, millet, quinoa, amaranth and sorghum

3. Eat at least 5 servings of fruits and vegetables every day at a minimum – include the bright color ones (orange, red and yellow) – also the dark colored greens contain many disease fighters called antioxidants

4. Limit consumption of refined and processed grains such as white flour products, rice and baked goods

5. Decrease the amount of unhealthy fat (Saturated and Trans) in your diet from foods such as red meat – one tip is to trim all the fat off of the meat – it’s also recommended to limit consumption of processed meats

6. Replace meat with fatty fish (tuna, salmon, mackerel, halibut, lake trout {not Lake Pontchartrain fish}, sea bass, sardines and shellfish) 1-3 times per week

7. Maintain a healthy body weight

8. Try to achieve some cardiovascular activity daily i.e. walking around your neighborhood or riding a bike

9. Drink alcohol responsibly – drink only the recommended servings – 1 serving for women and 2 for men (serving size 1oz hard whisky (80 proof or greater); 5oz wine; 12oz beer)

10. If you use tobacco – QUIT

For more information check out the Colorectal Cancer Team at Our Lady of Our Lake and Mary Bird Perkins Hospitals located in Baton Rouge and the Cancer Research and Prevention Foundation.

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Steve J. Roch Jr., RD, LDN, CFT is a registered and licensed dietitian. He is also a certified personal trainer. Steve is the owner and president of BestRD Wellness, LLC, a company that provides nutrition therapy and wellness services to residents and businesses in the areas of New Orleans and South Louisiana. Steve can be contacted by email at steve@bestrdwellness.com.