“In March 2022, my doctor told me that my blood work was showing that I was prediabetic and recommended that I sign up for a class to learn how to not become a Type 2 Diabetic. As a then 68 year old, I knew that diabetes ran in my family and that my physiological make up made me an ideal candidate to be a diabetic. I searched the web and found the Eat Smart, Move More, Prevent Diabetes online class and started attending in April 2022.
When I started attending my A1C was 6.4 and my weight was 227 pounds. Through attending classes and doing what our wonderful instructor told us could help, at the end of the program, I weighed 203 pounds (and still am losing weight), got my A1C down to 5.7, and am now swimming a 1/2 mile a day. I am eating healthy and watching my sugar intake. I can honestly say that I have never felt as good as I do today and my lifestyle of a good diet, daily exercise, and taking care of myself is the best it has ever been. The classes I attended weekly and then monthly are the reason why all this has happened to me. Today, I am not only healthier than every before, but as I spend time with my three grandchildren, when I take them out for ice cream, I make sure to get the non sugar ice cream!”
About a month ago, I broke my toe. It’s the big toe, and arguably the most important since it’s responsible for balance. I went from engaging in over 500 minutes of physical activity a week to maybe 100 minutes, severely restricted by my injury and a walking boot. Pre-injury, I enjoyed daily movement consisting of interval-based cardio and weightlifting, running, and walking. I was aiming for a few weightlifting milestones and training for a 10k.
Not only did I have a great movement routine that brought me joy and was a part of my social life, I had great balance in my nutrition. I planned out different meals every week, fitting in a few times to eat out with friends or family; I knew how many groceries to purchase; I never had to wonder what I would eat for dinner or if I would have time to cook, since I prepared most of my meals and snacks for the week over the weekend. All of a sudden, everything changed and my routine no longer worked for me.
At my initial appointment, my healthcare provider informed me that I would be in a boot for 6-8 weeks. If everything heals properly, I am looking at another 10-12 weeks to full recovery. For me, that means 6-8 weeks with no cardio, only some heavily modified bodyweight workouts, and some upper body weightlifting. This is movement, but not nearly what I was accustomed to. After I am cleared to wear a regular shoe instead of a boot, I will be able to do more, like stationary biking. This is good progress of course, but not the high-intensity, functional cardio movements that were once a part of my routine.
Adjusting to a New Routine Post-Injury
A month in, I have a decent handle on my new physical activity routine, but I am still struggling with my nutrition. It took about 2 weeks for my appetite to “align” with my decreased activity levels. I knew I did not need the same portions to fuel my body since I was not expending the same amount of energy daily. My hunger and satiety cues did not align, and for a week after my injury, I was eating as I had been. Knowing this was not sustainable, I decided to make some changes.
Overall, I eat smaller meals and try to include a high-quality protein source at breakfast, lunch, and dinner. Since it is much more difficult to gauge how much food I need, I buy more shelf-stable foods, like canned tuna and canned fruit stored in water. This way, I do not waste food if I do not eat it in one week. Rather than preparing everything for the week over the weekend, I prepare a couple days’ worth of lunches and dinners at a time, and I make my breakfast every morning. I pay much more attention to my hunger and satiety cues. Once I feel just a little bit full, I stop eating. I store leftovers for my next meal, partial meal, or snack. If I do not finish my breakfast, I pack it with my lunch to have at work later in the morning. These strategies help me feel adequately fueled and not over-fueled while I learn to better recognize and honor my hunger and satiety cues.
Our routines change based on life events, natural aging, sickness, or injury. It’s not easy to adjust to these changes or establish new routines. Acknowledging what you can control in these scenarios is important because you cannot control everything–even if you wish you could. For example, I cannot control my recovery speed, because my bones can only grow so fast. But, I can take ownership of my new routine, adjust my physical activity, and make healthy nutrition choices as I recover.
If you experience an injury or setback, give yourself grace and time to find an alternative routine. Start slow and don’t push yourself to do activities at the level you might have done in the past. Don’t forget to be kind to yourself and allow your body time to regain strength and stamina. You may need more recovery time and that is OK. This mindset will allow you to lead a balanced life under your unique circumstances.
*This blog post was authored by Dr. Carolyn Dunn and edited by Casey Collins
We may think of negative body image as something that mostly impacts young people. As someone in their 60s who has experienced decades of society telling me what my body should look like I know that negative body image can continue well after youth has faded. I did think, however, that at some point in our lives, we would relax and understand that our bodies are just fine the way they are. As long as you are healthy, let your body just be that—YOUR body. Several recent experiences proved to me that negative body image is alive and well in older adults.
My mother-in-law who is 88 and incredibly fit, not just for 88 but for any age, has dementia. She recently transitioned to an assisted living facility. One evening while helping her shower she said without hesitation “I know you are looking at me and think I am fat!” Even at 88 with dementia, she is still concerned about a made-up body image ideal. Since spending more time visiting this facility, I noticed my mother-in-law was not the only resident with these ideas. Another resident who is 90 was talking with a friend and discussing what she should and should not eat that night because “I need to lose a few pounds.” Yet another resident commented that “Sarah is thin but she could be really skinny if she didn’t eat all of her meals.” A new resident in her 90s was struggling to eat and had finally eaten a roll. When an encouraging nurse asked if she wanted another roll she said no because she should not eat too much bread.
Even in an era where body positivity is more popular than in my youth—or the youth of 80 and 90-year-olds—we continue to be barraged by media images of unattainable and unhealthy thinness. My hope is that someday whole-body health will win over society’s outdated idea that thinness equates to health. Perhaps the younger generations embracing body positivity will be less burdened over their lifespan by these antiquated ideas. The sooner we realize that the body we have should not be judged by unhealthy standards controlled by media hype the better.
Changing your inner monologue about your own body image can be complicated. Here are some thoughts that may help.
Appreciate what your body can do.
Think of all the miraculous things that your body can do physically. Walk, jump. Play with your children or grandchildren.
Avoid comparisons to others or your younger self.
No two bodies are alike. Your body is unique, comparing it to anyone else’s just sets you up for negative thoughts. Also, our bodies change as we grow older, and it is normal to not look like you did 5, 10, or 20 years ago.
Focus on the positive.
Instead of looking in the mirror and only noticing what you think are your negative traits, focus on the positive aspects of your body. If you wouldn’t say it to your friends, don’t say it to yourself. Treat your body like your best friend!
Think about your positive traits that are not physical.
Chances are when someone describes you, they don’t only list physical traits. In fact, they probably don’t list physical traits at all. They may say you are funny, smart, a good friend, a mother, a father, or any number of things that have nothing to do with your body.
Evaluate your relationships.
This is a tough one but a necessary one. If you have a friend or family member who is constantly saying negative things about their body, your body, or other people’s bodies, evaluate how you can distance yourself from this person. At least distance yourself from the talk. I have a relative who is constantly talking about her aging body and asking questions like “Why is this happening to me?” “I used to be so skinny and now I have a fat stomach.” I simply remove myself from the conversation or quickly change the subject to something non-body or food related.
* If you need further help or if negative body image is controlling your thoughts, please seek professional help as you need. The National Eating Disorders Association can provide resources.
Food fads come and go. However, a hot trend from several years ago is still going strong. Kale. There is a reason for that. Kale, a leafy green has the potential to improve your overall diet in several ways. It is high in fiber and low in calories, and a diet high in leafy greens can decrease the development of chronic disease. Leafy greens can also help with inflammation, something that is the root of many chronic illnesses. Lucky for us, kale is available year-round and can be found in most grocery stores. It is a versatile green and can be eaten in salads or cooked.
A pro tip for eating kale raw is to macerate it. This is a very simple process. Cut away the large stem all the way up the leaf and cut the leaf into narrow strips. Massage the kale with a bit of olive oil for 5-10 minutes. This softens the kale and makes for a much better salad.
Recently, there has been a lot of buzz around Intermittent Fasting and its effect on weight loss. But does this really help us lose weight?
What is Intermittent Fasting?
Before we dig into this topic, let’s first define what is meant by Intermittent Fasting. Intermittent Fasting, also called Time Restricted Eating, refers to an eating pattern that involves fasting, or not eating, for a period of time each day or week. According to the Mayo Clinic, some popular types of Intermittent Fasting include:
Alternate-day fasting. Eat a normal diet one day and either fast entirely or have one small meal (less than 500 calories) the next day.
5:2 fasting. Eat a normal diet five days a week and fast two days a week.
Daily time-restricted fasting. Eat normally but only within an eight-hour window each day. For example, skip breakfast but eat lunch around noon and dinner by 8 p.m.
If we look at how metabolism works in the body, it would make sense that Intermittent Fasting could be beneficial. When we eat food, it is broken down into sugar in the blood that our cells use for energy. Insulin is the hormone that enables the sugar to leave our bloodstream and enter our cells to be used by the body for energy. If our cells don’t use all of the sugar from the food that we eat, then this gets stored in our bodies as fat. The more fat cells our bodies have, the less efficiently our insulin can work to lower our blood sugar, leading to insulin resistance. Higher blood sugar can also cause inflammation. Insulin resistance and inflammation are highly linked to increased risk for chronic diseases such as diabetes, high cholesterol, hypertension, and obesity.
It is thought that the mechanism for Intermittent Fasting producing weight loss is that during the period of fasting, insulin is lowered causing the fat cells to release their stored sugar to be used as energy by the body, which can result in weight loss.
What does the research say?
One research study looked at two groups that both reduced their daily calories by 25%. One group incorporated Intermittent Fasting and ate all of their calories in an 8-hour window, while the other group ate the same amount of calories without a time restriction. At the end of the 12-month study, both groups lost similar amounts of weight and there were no differences between the groups related to weight loss. Both groups also had similar improvements in blood pressure, lipids, blood glucose levels and other risk factors.
What does this mean for us?
For most of us (excluding those who have diabetes, eating disorders, are pregnant or breastfeeding, or require food with medications), Intermittent Fasting does appear to be a safe strategy for modest weight loss. When used as intended, it limits the time window for eating and therefore can reduce the number of calories that we eat during the day.
There is a major pro and major con of Intermittent Fasting.
Pro
By limiting the amount of time that we are eating, it sets a natural stopping point for eating each night, which can greatly reduce nighttime boredom snacking, which is a challenge for many of us.
Con
If we use our eating window as a license to eat as much as possible during that window, it can produce the opposite results. It is still important to practice mindful eating and refer to our own calorie needs even while Intermittent Fasting.
Perimenopause and menopause have had their challenges for me, including weight gain despite no change in diet or exercise. In addition, a baseline bone density scan performed last summer revealed lower than normal bone density in my hips. Needless to say, I became very motivated to lose weight, especially abdominal fat, and prevent further bone loss. My physician recommended 5+ days of weight-bearing exercise per week as well as minor nutrition adjustments for bone health.
Around this same time, I saw Dr. Dunn’s review of the book “The Whole Body Reset” by Stephen Perrine. This book is targeted to those in mid-life and beyond and focuses on consuming an adequate amount of protein at each meal throughout the day. I changed my eating habits to incorporate the recommendations in the book and was surprised to notice that my urge for a mid-morning and post-dinner snack disappeared. I also began to slowly increase the amount of weight-bearing exercise I performed each week. Gradually, I began to lose weight. Hooray! Unfortunately, however, I hit a plateau prior to reaching my goal weight.
One of the key tenants of our programs is tracking so I decided to try a calorie counter app to see if I could move past my weight loss plateau. Below are the pros and cons I experienced when using the calorie counter app:
Pros
Knowing the total number of calories consumed per day
Increased awareness of how activity affects the total daily calorie budget
Pinpointing my afternoon snack as the likely result of my weight loss plateau
The convenience of logging foods and activity
Cons
Focusing on calories to the point of obsession
Exercising for the sole purpose of increasing daily calorie allotment
Guessing at the caloric content of home cooked meals
Consuming an evening snack simply because I had more calories available for the day
The app provided me with very beneficial information, especially regarding the caloric content of my afternoon snack, and helped me move past my weight loss plateau. However, due to my newfound obsession with calories and exercise, I deleted the app from my phone. Instead, I am opting to focus on consuming an adequate amount of protein throughout the day, being mindful of the caloric content of my afternoon snack, making sure half of my dinner plate contains vegetables, and making sure I am getting regular weight-bearing exercise. It took some time and effort to figure out what works for me and is sustainable long-term. Have you found what works for you?
I naturally clench my jaw when I’m working or concentrating but a few years ago, I started to notice regular jaw tension and attributed it to higher stress levels–I guess a global pandemic will do that. I got a cheap drugstore night guard to protect my teeth at night but that wasn’t going to address the underlying issue of managing my stress.
Stress management is really important for our overall health and I’ll be honest, I don’t always strike the right balance. I think it is fair to say that most of us probably don’t always strike the right balance to feel a complete sense of contentment.
So, what helps me manage stress? Moving my body really helps, but I’m not always motivated to do heart-pumping movements. When I’m in the office that isn’t always practical or feasible. I have found that stretching during the workday (in a desk/computer setting) can be a really helpful way to reset my body and mind. I usually stretch my back, shoulders, and legs. I never considered stretching my face until I checked out a book from my local library called Chair Yoga by Kristin McGee. I was flipping through the book and found a section on face exercises. They may help ease eye strain and jaw tension plus they just feel nice.
Face Exercises:
Start by sitting in a relaxed position. This whole routine should take around 10 to 12 minutes.
Up/Down with Eyes: Look up and down with your eyes 12 times. Focus on moving your eyes only. When finished rest for a few seconds with eyes closed.
Side-to-Sides with Eyes: Look left and right with just the eyes 12 times. When finished rest for a few seconds with eyes closed.
Eye Circles: Circle the eyes around 6 times clockwise, then 6 times counterclockwise.
Close/Opens: Close your eyes for 10 seconds, then open your eyes as wide as you can. Repeat 6 times.
Diagonals: Start by looking up to the left at a diagonal, then down to the right at a diagonal. Focus on moving your eyes only. Perform 12 times of upper left to lower right movements and then switch to the upper right and lower left corner for 12 times.
Head Back Downward Gaze: Tilt your head back and then gaze down at the tip of your nose. Hold for 5 to 8 breaths.
Fishy Face: Suck in the cheeks and pucker the lips. Hold for 3 seconds and then release. Repeat 10 times.
Open Wide: Open your mouth as wide as you can and hold for 2 seconds before releasing. Repeat 10 times.
Lower Jaw over Top Teeth: Take the lower jaw and lift it over your top teeth. Your lips can stay together. Hold for 15 seconds. You will stretch the entire underside of the jaw and the neck. Repeat 3 times.
Side-to-Sides with Lower Jaw: Let your lower jaw relax and release from the top jaw, and then try moving it from side to side. Repeat 10 times.
Gummy Lips: Curl your top lip up toward your nose, hold for 3 seconds, and then release. This is not a scrunched face. Repeat 10 times.
Wide Smiles: Smile as wide as you possibly can, stretching the entire mouth and holding for 3 seconds before relaxing. Repeat 10 times.
According to the Physical Activity Guidelines for Americans, adults should get at least 150 minutes of moderate to intense physical activity per week. For some of us, that means hitting the gym for 30 minutes a day to “knock it out” before work or maybe going on a moderate-intensity walk. Although doing this might check the box of hitting your weekly physical activity goal, a new study has shown that it is also important to move throughout the day. Many of us, after that morning walk or gym session, go to work and sit for 8-10 hours just to come home and sit some more.
A study was published last year by the American College of Sports Medicine that showed it is important to our cardiometabolic health to move throughout the day. Cardiometabolic health describes a combination of multiple risk factors that include blood sugar, BMI (Body Mass Index), cholesterol levels, blood pressure, and cardiovascular disease.
Study Highlights
The study tracked participants during their regular week. At the conclusion of the study, participants were classified into four groups: active couch potatoes, sedentary light movers, sedentary exercisers, and movers. All participants achieved their 150 minutes of physical activity per week goal. People in the active couch potato group, although sufficiently active, were still sedentary for over 10 hours per day. This group had the highest sedentary time and the lowest amount of cumulative activity time. At the other extreme, movers had less sedentary time and accomplished more movement throughout the day. The study found that this increase in movement throughout the day and decrease in sedentary time greatly improved participants’ cardiometabolic markers.
What does that mean for us? Keep up those daily walks, but remember to keep moving all day long. It is essential to take breaks from our sedentary actions to move our bodies.
Easy ways to incorporate movement into your day to decrease your sedentary time:
Take a 10-minute movement breaks every hour.
Take short walks throughout the day. Even around the office or in the parking lot.
Get a workout buddy for accountability and fun! It will be easier to take breaks if you have someone helping you remember to move.
Take time to stretch! Even at your desk, here are some easy stretches to do, or maybe take time for chair yoga.
Choose some bodyweight exercises to increase your resistance training throughout the week. If you do a couple of exercises per hour, it really adds up!
Okay, the title sounds a little extreme. I didn’t give up sugar ENTIRELY. I’m no martyr! But I cut way back on my sugar consumption and my life changed in ways I did not expect. And now I want to share my lessons learned with anyone who will listen.
In a recent conversation with a friend, I compared my eating habits to that of a child left alone in a candy store. I have been eating SO much sugar for the past year. How did I get here? Well, let’s rewind. What happened one year ago? I got pregnant! A very happy time indeed but the first 6 months of becoming a parent rock your world in ways that you never see coming. I quickly learned that breastfeeding makes you incredibly hungry—all the time. Meal prepping went out the window and I was basically in survival mode, eating the most convenient and easy-to-prepare foods, which often meant junk food and processed food. My sweet tooth reared its ugly head. I justified all of this to myself because “Hey! I’m a breastfeeding mom and I need the extra calories.” And it was admittedly doing nothing to my waistline, so I figured no harm, no foul. Other than feeling like a hypocrite to the participants that I teach, I didn’t think anything bad was happening.
I’ve struggled with insomnia for many years prior to having a child, but do you know how frustrating it is to be dead exhausted from keeping an infant alive and happy all day, and still not be able to fall asleep at night? It all came to a head a few weeks ago, after three nights in a row of particularly awful episodes of insomnia. I ran through all the options I had left: Sleep aid? Only if I want to stop breastfeeding. Therapy? I’d love to, but with daycare, it doesn’t currently fit into our budget. Exercise? I’ve been doing that! What about my diet? Could I start eating better—give up sugar?? Gasp. I was desperate enough to try anything.
So, the next morning I cut off my fountain of sugar. Cold turkey. Just like that. I gifted my Trader Joe’s chocolate-covered raisins and peanut butter cups to some friends. I put my giant chocolate bar on the top shelf of a cabinet, out of reach. I turned down an invitation to go out for frozen yogurt. I started preparing savory oatmeal (topped with leftover stir-fried veggies, don’t knock it until you’ve tried it) instead of sweet oatmeal (topped with brown sugar and pecans). I snacked on cheese, nuts, and fruit instead of whatever junk food I could lay my hands on. I ate strawberries for dessert.
Here comes the unexpected side effect...
That first night, I slept for seven hours straight and I woke up feeling like a new person. After 6 months of complete sleep deprivation, I didn’t know that it was possible to feel this good. I wondered if placebo affect was at play – I wanted this no-sugar experiment to work, so I convinced myself that that it did. But you know who had no idea that I dramatically changed my diet, and slept through the night for the first time in his almost six months of life? That’s right—my sweet baby. He went from waking up two, sometimes three times in the night to feed to sleeping for seven blissful, consecutive hours. On day four I just couldn’t believe the stark difference in our sleep quality and decided to put things to the test. I reverted back to my old ways and guess who woke up twice that night, upset, hungry, and insatiable? You guessed it—my baby regressed back to his wakeful sleep cycles and drank milk like there was no tomorrow.
As you can imagine, I hopped back onto the no-sugar bandwagon pretty quickly. And I’m not going to lie, it is really hard. Not to mention the added layer of how addictive sugar is. I have had to change my whole way of thinking. Once we get started down a path of excessive consumption, it can be immensely difficult to reverse it. I know in time it will get easier to not eat so much sugar. My taste buds and my brain will adapt. I will eventually stop breastfeeding! And of course, I’m highly motivated to continue this new trend of good sleep for both myself and my baby.
Here is what I’m doing to help myself ride the wave of my sugar cravings:
Eat a solid and balanced breakfast – Keeps my blood sugar levels more normal and my stomach full, so I’m less likely to feel extreme hunger swings later in the day. Lately, this has been the savory oatmeal I mentioned, with added flax seed meal, or scrambled eggs with shredded zucchini, beans, and a slice of whole wheat toast.
Replace sweets with fruit – Right now clementines seem to be hitting the spot. And they’re starting to taste sweeter the more distance I get from chocolate.
Stay hydrated – I’m sure this is not new information for most people – often when we think we’re hungry we are actually thirsty. Breastfeeding also makes you super thirsty, making it extra important to keep a water bottle handy.
Chew minty (sugar-free) gum between meals – Sometimes I think I just need to be chewing something. This helps satisfy that need.
Brush my teeth – Similar to what the gum provides, getting that fresh minty feeling in my mouth feels good! And then I don’t want to ruin it with a snack I’m probably not hungry for.
Sip on warm, herbal tea – I find the fruity teas from Celestial Seasonings are especially helpful! They taste a little sweet but have no added sugars (real or artificial) and it hits the spot in the evening when I want a sweet dessert. In the summer I plan to make larger batches of iced tea from this same brand.
Keep junk food out of the house – If you’ve ever been in one of my classes you can say it with me: “If it’s not there, you can’t eat it!” I’m really feeling this one right now.
Practice mindfulness – In my moments of intense cravings, I ask myself if eating said sugary item is worth losing sleep over. So far, the answer has been no. I value my (and my baby’s) sleep way too much.
There’s a difference between knowing the right choices to make for our health, and actually making those healthy choices. I think sometimes what it takes to make that important change is having something at stake that is bigger than us. A prediabetes or diabetes diagnosis, a difficult financial situation, and the health and well-being (and sleep quality) of our children. The list goes on. We all have valid reasons to work on our health, but sometimes it takes a triggering event to wake us up and actually make those necessary lifestyle changes.
If you have never tried farro, this is a great way to start. Farro gives this salad a wonderful texture. You can, however, use another grain you may have on hand such as brown rice, barley, or bulgur. This recipe uses roasted carrots and zucchini. However, you can use any roasted vegetable or even leftover roasted vegetables. It makes a beautiful dish for a buffet or to take to a shared meal.
Tip: Cook the farro to yield about 4 cups cooked. This is about 1½ cups of dry farro. Try cooking the farro using the pasta method. Rinse uncooked farro and add to a large pot. Add water to cover the farro plus about 3 or 4 inches. This is more water than the faro will absorb. Cook for about 45 to 55 minutes, or until tender. Then drain as you would pasta.
Serves: 8 Serving size: 1/8 of recipe Prep time: 15 minutes Cook time: 45 minutes Total time: 60 minutes
Ingredients
Roasted Vegetables
1 pound carrots
2 small or 1 large zucchini
1 tablespoon olive oil
1/2 teaspoon kosher salt
12 teaspoon pepper
Farro Salad
4 cups cooked farro (see above for cooking method)
2 tablespoons olive oil
3 large carrots, shredded (about 1 ½ cups)
3 celery stalks, diced
1/4 teaspoon salt
Pinch red pepper flakes
1 15-ounce can cannellini beans (or another white bean), drained and rinsed well
1/2 cup prunes, cut into small strips (about 8 prunes)
Juice and zest of 2 lemons
Directions
Preheat oven to 375 degrees.
Slice carrots and zucchini on a diagonal into 1/4-inch slices.
Place on a sheet pan. Toss with olive oil, salt, and pepper.
Roast for 45 minutes, tossing halfway through.
Cook farro according to package directions to yield 4 cups of cooked grain.
Heat the remaining olive oil in a large sauté pan. Add the carrots and celery when the oil is hot and cook for 10 minutes or until the vegetables are tender. Add a few tablespoons of water if needed.
Add salt and red pepper flakes. Stir to combine.
Add the cooked faro, beans, prunes, lemon zest, and lemon juice to the pan. Stir to combine and heat through.
Place the faro mixture in a large bowl or mound onto a platter.
