Tag Archive | Diabetes

Define: “Healthy Eating”

When I see patients in the office we often start discussing “healthy eating,” as if we both are on the same page! However, I follow-up my question by asking “What exactly do you believe is healthy?” The majority of the time, the conversation feels like we are speaking two different languages.

The truth of the matter is, everyone’s definition of “healthy eating” is different!!

Not a difficult choice here!

Not a difficult choice here!

Now, what exactly is “healthy eating” or “eating clean?” How can this be accomplished?

Although eating healthy comes in all shapes and sizes, I personally follow a “Personal Paleo Code” as described by Chris Kresser. This isn’t necessarily the only “eating healthy” lifestyle change that exists, but I do believe that a “Personal Paleo Code” is a good basis for people to start on. I have seen excellent results from friends and patients that adhere to the principles.

A great basis to start on!

A great basis to start on!

I believe that “eating healthy” starts on the premise of removing processed foods, sugar, and grains from someone’s lifestyle.

Removing sugar sweetened beverages is a great start!

Removing sugar sweetened beverages is a great start!

The biggest issue I find when I discuss lifestyle modification is the last part of this lifestyle change – the grains. People look at me dead in the face and say, “Why can’t I have grains?” Well, the short story is that bread, pasta, and any other grain-laden product is easily converted into sugar. Once this process happens (the Krebs Cycle, etc.), the laws of adiposity take hold. Insulin is released from the pancreas to regulate blood sugar. Once insulin is released, sugar is broken down into immediate energy where needed by the body, and into fat stores for the excess. People look at me and say, “Sugar makes us fat?” The simple answer is yes. Insulin is a “fat storage hormone” If our bodies can’t immediately use the energy from food (which is usually the case), we store the sugar as fat. This is the fat most commonly seen stored in our abdomen.

Visceral Fat is the biggest enemy!

Visceral Fat is the biggest enemy!

A few weeks ago I had the pleasure of coming home to Florida, and witnessing my family try and transition to a “healthy eating” lifestyle. I have seen some of the common pitfalls and that I will discuss a few of them in depth.

Juices (yes, even “Naked” smoothies) are a huge pitfall. The best way to tell if the juice is real juice is if you juice it yourself, or you look at the nutritional label to see how much dietary fiber is in the beverage. Most juices will have no dietary fiber – this means the beverage is simply pure sugar water. Avoid all juices unless you can reliably say that they have dietary fiber in them. In theory, fiber slows the digestion of the sugar in the intestinal tract so as to not inundate the pancreas with a huge amount of sugar for processing. Drinking beverages like the ones I described above are the same as, or even slightly worse than drinking a Coca-Cola or Pepsi.

Popular beverage nutritional facts.  Notice the absence of Dietary Fiber!

Popular beverage nutritional facts. Notice the absence of Dietary Fiber!

Processed foods are generally laden with ADDED SUGAR. Check out my previous blog for these pitfalls. Take the time to look at the nutritional label, and if you can’t pronounce the ingredient, you probably shouldn’t eat that item. Companies like to break up the amount of sugar in the ingredients label by using sugar synonyms such as but not limited to:
Brown Rice Syrup, High Fructose Corn Syrup, Cane Sugar, Coconut Sugar (just because it is from a coconut doesn’t make the sugar any better for you), Brown Rice Syrup, Sucrose, etc. This concept is discussed extensively in Robert Lustig’s book “Fat Chance”. My summary of his analysis of all the “Diets” of the 21st century breaks down to this:

All successful lifestyle modifications/diets have one thing in common, they eliminate SUGARS and PROCESSED FOODS from them!!

In general, labels with a laundry list of ingredients are usually processed and composed of unhealthy ingredients. The closer from the earth the item is, the better it is for you.

Since I will be publishing this just before we all gobble down a few pounds of Thanksgiving Turkey here is my method to having a healthy, fun, and fulfilling Holiday!

Number one priority: TURKEY (Probably a pound or two for myself… lol)
Number two priority: Veggies
Number three priority: Everything else

Fill up on meat and veggies before you get into the sugar laden sweets!!

Eat plenty of Turkey and Veggies!

Eat plenty of Turkey and Veggies!

Finally, just because the box says “low fat”, “low sugar”, or “low carb” doesn’t necessarily mean it is good for you. Always read the nutritional labels on the boxes!! “Low fat” typically = loaded with sugar!! “Low carb” or “Low sugar” may mean that the food is packed with fat. Fats can be good or bad (I will discuss this in a future blog), but sugar is responsible for the epidemic of obesity.

As they say, “Eat to live, but don’t live to eat!!”

Redefining “HEALTHY” Snacking!!

I spoke with my mother on the phone yesterday (boy do I love her!! ☺), and she happens to be one of my inspirations to help America combat our food addiction. She was talking to one of her friends, who mentioned that she had just done a colon prep for a colonoscopy. For those of you who don’t know what is required for a colonoscopy, let me sum this up for you: Prior to the procedure, you take a very potent laxative to rid your body of any waste left in your gastrointestinal tract. After drinking this laxative a person can lose up to about 15 pounds of weight, mostly because the person is left extremely dehydrated. After being completely cleaned out, you have a scope inserted into your rectum to inspect for any suspicious lesions. We as physicians recommend you do this once every 10 years after the age of 50 (Based on findings this recommendation can change). If we find any suspicious lesions, we will then biopsy them and determine the etiology of the lesion. This is not a risk free procedure and is not intended for lasting weight loss.

Getting back to the topic, – it seems that everyone in America wants the “Lose Weight Quick” diet. Let me say one thing, there isn’t one. Most fad diets have a person regaining the weight they dropped during the diet within the following week to month after the diet (1). The real trick to losing weight fast and keeping it off is true, unadulterated lifestyle change.

Lifestyle modification can be hard, but if you follow a “Personal Paleo Code” or some other sustainable change this can be done. When I was talking with my mother I knew one thing, she definitely has a sweet tooth and a carb addiction. (If this sounds like something your battling, keep reading!!) I know that out of any modification that I can do for my mother, I need to make sure that she has options for healthy snacks for between meals. In the next few paragraphs I am going to discuss common “healthy snacking” options, as well as truly healthier alternatives for them, which will abide by “Your Personal Paleo Code.” Just because the packaging on foods says it is “heart healthy”, and or “low-fat” does not make the item good for you! I am going to take a look at a salty snack, a sweet snack, and one that is both sweet and salty!!

Salty

Pita chips, potato chips, or any sort of chips:

Bad Example:
Stacy’s Simply Naked Pita chips: Enriched wheat flour (Wheat flour, niacin, reduced iron, thiamin mononitrate, riboflavin, folic acid), Sunflower Oil and/or Canola Oil (High in omega-6 fatty acids and/or trans fat), sea salt, whole wheat flour, and less than 2% of: Organic Cane Sugar (ADDED SUGAR), oat fiber, yeast, malted barley flour, rosemary extract, and ascorbic acid. If you are going to add any flavoring, then add more calories and ingredients.

Stacy's Pita Chips

Stacy’s Pita Chips

Good Substitute:
Original Black Bean Beanitos: Whole black beans (Big improvement from Enriched wheat flour), whole grain long brown rice and/or long grain white rice, pure sunflower and/or safflower oil (See above, good oils are expensive), guar bean gum, sea salt

Original Black Bean Beanitos

Original Black Bean Beanitos

For the person with a Sweet tooth:
Chocolate Chip Cookie or brownie
The Bad Example:
Nestle Tollhouse Chocolate Chip Cookie (one serving): White Flour (Processed), whole raw eggs, unsalted butter, semisweet chocolate, brown sugar, granulated sugar (SUGAR, SUGAR, SUGAR), vanilla extract, salt, and baking soda.
Nutrition Facts

Tollhouse Chocolate Chip Cookie: Happens to be Pinterest's most popular pin!!

Tollhouse Chocolate Chip Cookie: Happens to be Pinterest’s most popular pin!!

Serving Size: 1 Cookie
Amount Per Serving
Calories 147.9
Total Fat 7.8 g
Saturated Fat 4.7 g
Polyunsaturated Fat 0.3 g
Monounsaturated Fat 2.4 g
Cholesterol 24.3 mg
Sodium 101.1 mg
Potassium 60.2 mg
Total Carbohydrate 19.4 g
Dietary Fiber 0.7 g

Sugars 8.8 g
Protein 1.5 g
Vitamin A 4.0 %
Vitamin B-12 0.6 %
Vitamin B-6 0.6 %
Vitamin C 0.0 %
Vitamin D 0.3 %
Vitamin E 1.2 %
Calcium 1.0 %
Copper 4.3 %
Folate 3.8 %
Iron 4.2 %
Magnesium 3.4 %
Manganese 6.8 %
Niacin 2.4 %
Pantothenic Acid 0.9 %
Phosphorus 2.7 %
Riboflavin 3.6 %
Selenium 5.5 %
Thiamin 4.3 %
Zinc 1.6 %
*Based on a 2,000 calorie diet

Let’s be honest with ourselves, no one can eat just one Chocolate Chip COOKIE!!

The Better Substitute:
Chocolate Chip Cookie Dough Quest Bars: Protein Blend (Whey Protein Isolate, Milk Protein Isolate), Isomalto-Oligosaccharides (Prebiotic Fiber), Almonds, Water, Unsweetened Chocolate, Cocoa Butter, Erythritol. Contains Less than 2% of the following: Sea Salt, Stevia (Low calorie Natural Sugar), Natural Flavorings, Sucralose (Small amount of added sugar).

Quest Chocolate Chip Cookie Dough Bar

Quest Chocolate Chip Cookie Dough Bar

Nutrition Facts
Serving Size 1 (60g)
Calories 190
Calories from Fat 70
*Percent Daily Values are based on a 2,000 calorie diet
Amount/Serving
%Daily Value*
Total Fat 8g 12%
Saturated Fat 3g 15%
Trans Fat 0g
Cholesterol 5mg 2%
Sodium 280mg 12%
Vitamin A 0%
Vitamin C 0%
Magnesium 8%
Phosphorus 10%
Amount/Serving
%Daily Value*
Potassium 125mg 4%
Total Carbohydrate 21g 7%
Dietary Fiber 17g 68%
Sugars 1g
Erythritol 1g

Protein 21g
Calcium 10%
Iron 10%
Contains almonds and milk-derived ingredients.
With the pre-biotics and the high dietary fiber the carbohydrates here are virtually all but negated.

Sweet and Salty

Granola Bars:
These items are definitely not part of “Your Personal Paleo Code”, they are usually chock-full of added sugars.
Bad Example:
Kashi Crunchy Granola & Seed Bars, Chocolate Chip Chia: You may think, as many others do, “Oh this bar has CHIA, it must be good for me!” But let’s take a closer look at the ingredients – this bar is loaded with sugar and soy.
Whole Grain Oats, Whole Grain Blend (Whole: Barley, Buckwheat, Hard Red Wheat, Rye, Triticale And Quinoa), Dried Cane Syrup (ADDED SUGAR), Semisweet Chocolate Chips (Dried Cane Syrup, Chocolate Liquor, Cocoa Butter, Soy Lecithin, Vanilla Bean), Expeller Pressed Canola Oil (High in Poly-unsaturated Fatty Acids and possibly contains trans fat), Invert Cane Syrup (ADDED SUGAR), Unmodified Cornstarch (ADDED SUGAR), Chia Seeds (Moderate benefits), Brown Rice Flour, Coconut, Whole Oat Flour, Evaporated Salt, Molasses (MORE SUGAR at least natural source), Vanilla Extract, Sodium Bicarbonate, Soy Lecithin (a lot of problems to be discussed later), Spice Extractives.

Kashi Chocolate Chip Crunchy Chia Granola and Seed Bar

Kashi Chocolate Chip Crunchy Chia Granola and Seed Bar

Good Substitute:
Paleokrunch Bar:
Raw almonds, almond meal, shredded coconut, raw sunflower seeds, raw pumpkin seeds, coconut oil (high in good saturated fats), honey, vanilla extract, and baking soda.

Steve's Paleogoods Original Krunch Bar

Steve’s Paleogoods Original Krunch Bar

Original Krunch Bar

Original Krunch Bar

They also make a Dark chocolate espresso version very similar to this.

Here are some other “HEALTHY” (not really) options that I came across in the store the other day:

Skinnygirl Tasty Nutrition Bar: Looks good for you until...

Skinnygirl Tasty Nutrition Bar: Looks good for you until…

Skinnygirl Tasty Nutrition Bar nutritional information shows the amount of added sugar!

Skinnygirl Tasty Nutrition Bar nutritional information shows the amount of added sugar!

Brown Rice Syrup is another name for added sugar. Organic sugar, even though it is organic is still added sugar. The food industry does a great job at deceiving the public!

My alternative to this bar:

Larabar is a healthy alternative: Blueberry Muffin is not paleo but still very nutritious

Larabar is a healthy alternative: Blueberry Muffin is not paleo but still very nutritious

Nutritional Information for the same Blueberry Muffin Larabar with ingredients:Dates, cashews, unsweetened blueberries, blueberry juice concentrate, lemon juice concentrate, vanilla extract.

Nutritional Information for the same Blueberry Muffin Larabar with ingredients.

This is not exactly a paleo example, but many especially the cherry pie are paleo friendly.

Also, anyone can grab fresh fruit or vegetables for consumption if they need a boost! You would be amazed at how few calories are in some of the vegetables we consume everyday. In one bag of spinach there are roughly 100 calories. I hope you read this mother, I love you ☺!!

My mother and I!

My mother and I!

If anyone has any specific weakness for a certain snack, feel free to e-mail me @ Ronald.Torrance@med.lecom.edu and I will try and find some healthy alternative for you!

Now that you have the alternatives, go throw out those “healthy snacks” and pick up some of my good alternatives!!

Breakfast…No YOLKING around!!

Breakfast, while being the most important meal of the day, is often the most underrated meal of the day! When working on modifying someone’s lifestyle, my first question is, “What is your typical breakfast?” The response that I usually receive often reflects how little time most people have to prepare breakfast in the morning, since many say they either have a cup of coffee or a bowl of cereal.

Although these two options are common, they illustrate extremely unhealthy options for breakfast.

1. A cup of coffee, while not necessarily the worst option, due to the benefits of intermittent fasting leaves most people wanting more. Most commonly after their cup of coffee, I see people picking up something convenient, such as a muffin, bagel, granola bar, or some other carbohydrate laden food item. This adds numerous empty calories plus introducing more added sugars into our “most important meal of the day!”

2. A bowl of cereal, often results in patients consuming excessive amounts of sugar and carbohydrates, without any real nutritional benefits. If the cereal is at least eaten with whole milk, or raw milk, there would be a minor nutritional benefit. However, since our nation is hooked on reduced-fat milk, there isn’t much in it that would necessarily help provide a satisfying breakfast.

Which looks like a better option to you? Powdered eggs or real eggs?

Which looks like a better option to you? Powdered eggs or real eggs?

The lack of quality nutrition in the morning had me thinking on my drive into work the other day. I found myself pressed for time and needed to satisfy my belly. I started looking around and I realized just how difficult getting a good wholesome breakfast can be. Every on the go breakfast restaurant will give you powdered eggs (SEE ABOVE or BELOW) or low-grade bacon, with some high glycemic index carbohydrates (ie: Biscuit, English Muffin, Toast, etc.) to go with these options. By no means is this a wholesome breakfast. When I say wholesome, I mean a breakfast packed full of good fats, proteins, and some complex carbohydrates through vegetables.

Take your pick!

Take your pick!

What I recommend for Breakfast (when time isn’t an issue):

2-3 Slices of good quality bacon: Great source of saturated fat and protein
3-4 organic free range eggs: Great source of Omega-3 Fatty Acids and protein.
-Please eat the yolks (All of the 13 micronutrients in eggs are found here!)
Half of an avocado- High in Monounsaturated Fatty Acids, especially oleic acid (MUFAs), and naturally low in sugar. Helps rid the body of “bad” low-density lipoprotein (LDL)

Fats, especially saturated fats, along with protein, help stabilize blood sugar throughout the day.
If you lead a hectic lifestyle and are on the go in the morning, or can’t make bacon and eggs, here is my advice. Get a dozen organic free-range eggs from the store, and on Sunday night (or any night you have time) put all dozen eggs in boiling water for 10 minutes. This gives you a dozen hard-boiled eggs for consumption throughout the week. These are great for on the go in the morning!! Unsweetened full fat yogurt is another option for the on the go individual. This not only gives you plenty of active cultures for a healthy gut microbiome, but is full of good protein and fat.

Remember as the Abraham Lincoln once said, “In the end, it’s not the years in your life that count. It is the life in your years!

Take the fight to OBESITY!!

A new study conducted by the Bill and Melinda Gate’s foundation has brought the world’s biggest health-related problem to the forefront. Our world as a whole is OBESE, and the latest data shows that although the rate of children becoming obese is slowly declining, the prevalence of this pandemic is still rising. We as physicians have failed the general public. We have given you diet recommendations (ie: low fat and high carb (condoning high sugar diets)) that were based on weak evidence, and made these recommendations the dogma/doctrine for a healthy diet for the past 40+ years.

Double Wide Wheelchair: Our world didn't used to require wheelchairs this size!

Our world didn’t used to require wheelchairs this size!

Africa still only has the need for traditional wheelchairs.

Africa still only has the need for traditional wheelchairs.

I realized this upon reading Gary Taubes’ “Good calories, bad calories.” This book exposes the physicians of the 50’s and 60’s (especially Ancel Keys) for making recommendations on carefully chosen (dare I say “cherry picked”) evidence. For those of you would like to investigate further without reading the book check out the “Seven Countries Study”.

That being said, in our previous posts (PEPSI and DIET), we gave our best recommendations for preventing cardiovascular disease and the improper release of hormones (ie: insulin) with the consumption of diet beverages. This past week I came across a new study that links both diet and regular sodas to obesity. We must continue to reduce our overall added sugar consumption, as well as decrease our consumption of diet beverages. When we drink diet beverages (brain response to artificial sweeteners), the diet beverage triggers an insulin release in the body in order to break down the sugar we ingested. Unfortunately when we consume these artificial sweeteners, insulin is unable to break down the artificial sweeteners the way it does real sugars. This leads to our body craving more real sugar, and often times we don’t feel too well until we consume some convenient sugar product (ie: cookies, pastries, candy bars, etc.) If we replace sugar sweetened and artificially sweetened drinks in our daily routines with water, or some carbonated flavored water (since studies show our bodies may be addicted to the carbonation), I believe we will not only see a decrease in the prevalence of obesity in the world, but we will also see an overall reduction in chronic diseases, such as, metabolic syndrome, diabetes, hypertension, and arthritis.

My recommendations for cooking from scratch and adopting a “NO BREAD” lifestyle will help our country defeat this epidemic that has been taking the world by storm.

Healthy way to start the morning with bacon, eggs, and avocado!

Healthy way to start the morning with bacon, eggs, and avocado!

A healthy lifestyle starts by stocking our pantry the right way. I had the privilege of going on grocery store tour with a preventative cardiologist friend of mine, I noticed that shopping for and preparing nourishing food is extremely difficult in supermarkets dominated by the marketing industry. We put all the wholesome and nutritious foods in the back, so we constantly are walking by less nutritious highly marketed empty calorie items. The term that he used was to shop the periphery of the supermarket and stay away from anything with a shelf life longer than one week.

Make a commitment to yourself today to start living a healthier lifestyle by choosing sustainable, nutrient dense foods, from local markets when available. Eliminating inflammation from your body by avoiding unnatural, heavily processed foods and look the other way from sugar, gluten and grains. By subscribing to my blog today you will be doing exactly that! My future posts will feature healthy dishes to make for the family in addition to the posts I am currently writing!!

Drink green tea; think clearer, lose weight, cure Diabetes? and Alzheimer’s?

Trenta, unsweetened green tea with no water and no ice!

Trenta, unsweetened green tea with no water and no ice!


I walk into my neighborhood Starbucks and I ask for a trenta, unsweetened green tea, with no water and light ice. The barista instantly goes to work making my green tea. This tea is the same tea that I have been drinking for about four years now, however only recently did I learn that this green tea is doing more than just giving me a caffeine high! After reading a few recent clinical studies I realize I might be helping myself lose weight, increasing my cognitive function, decreasing my waist size, helping ward of cancer, decreasing my risk for diabetes, and even decreasing my risk for dental caries as well as bad breath! (1,2) All just by drinking GREEN TEA!!

When we drink green tea we are not only getting somewhere between 25-40mg of caffeine per serving but we are also getting various different catechins and L-theanine. This combination of caffeine and L-theanine according to recent research has a synergistic effect on cognitive function. So if your typical day includes going to Starbucks for a cup of coffee, I recommend switching it up and trying some green tea. I know not everyone is a Starbucks enthusiast, so if you want to go out and buy your own I found some Organic Green Tea at Trader Joe’s that is quite good. This recent study that showed increase in working memory processing from the effects of green tea could be a great way to stave off the effects of aging and the epidemic of Alzheimer’s and dementia. More research needs to be done, but this is a start. (2)

Organic Green Tea from Trader Joe's

organic green tea from Trader Joe’s

Not only does this amazing beverage help with attentiveness and cognition, it also has been shown in recent studies to help decrease abdominal circumference and decrease weight. Green tea helps mobilize fats in the body (through lipolysis), especially the abdominal area for energy production. (3) This increase in fat mobilization allows the body to preferentially utilize the available fat stores for energy. If I use myself as a small case study, I personally saw my waist line go from a 34″ to 32″. However there are multiple other confounding factors that have influenced that reduction (i.e.. Crossfit and increased frequency in running).

Recent studies are also linking this amazingly beneficial beverage to enhanced insulin sensitivity. When a person’s body becomes more sensitive to insulin this allows for less insulin production as a whole. This could be a huge benefit for Type II diabetics. Most commonly Type II Diabetics are insulin resistant. The quick and fast on Diabetes is that about 90% of the country’s diabetics are Type II. Type II Diabetes develops after the body becomes flooded over a long period of time with high levels of glucose. Type II diabetes is primarily considered as multifactorial, however the increased exposure to high levels of glucose will start de-sensitizing your body to insulin. The biggest risk factor for Type II Diabetes is obesity (one study says 58% of DMII patients could have prevented diabetes by lifestyle modification and weight loss). If we can reduce abdominal fat with Green Tea then we can reduce the incidence of diabetes. When glucose is ingested this triggers an insulin response. In people with normal functioning beta cells (Insulin producing cells of the Pancreas) a spike in blood sugar triggers the release of a certain amount of insulin. Once the insulin is triggered it helps aid in breakdown of glucose. When someone becomes insulin resistant, the process of glucose utilization doesn’t work the way that it is described. In type II Diabetics there body and the body’s receptors have become resistant to the insulin. Since we are finding that green tea makes our bodies more sensitive to insulin, this will then reverse the effects of diabetes. If any of the readers have been told they are pre-diabetic or that their hemoglobin A1c is between 5.9-7.0, then I feel that along with cutting down the ingestion of carbohydrates (i.e. breads, pastas, cereals, ADDED SUGARS, pizza, etc.) they should start drinking unsweetened green tea.

In a nut shell I believe that the benefits of consuming green tea are evident. The studies in all the medical journals prove that GREEN TEA is beneficial. So, instead of ordering a Venti Mocha Latte, drink some Green Tea!

Until next time, WITH HEALTH!

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