Exercise with Type 1 Diabetes – by Ginger Vieira
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If you or a loved one has Type 1 Diabetes, you’ll know that exercise can be especially frustrating…
- If you don’t do it, you risk weight gain and eventual insulin resistance.
- If you do it, you risk dangerous hypos, or perhaps hypers if you took off your pump or skipped a bolus.
Unfortunately, the popular medical advice is “well, just do your best”.
Ginger Vieira is Type 1 Diabetic, and writes with 20+ experience of managing her diabetes while being a keen exerciser. As T1D folks out there will also know, comorbidities are very common; in her case, fibromyalgia was the biggest additional blow to her ability to exercise, along with an underactive thyroid. So when it comes to dealing with the practical nuts and bolts of things, she (while herself observing she’s not a doctor, let alone your doctor) has a lot more practical knowledge than an endocrinologist (without diabetes) behind a desk.
Speaking of nuts and bolts, this book isn’t a pep talk.
It has a bit of that in, but most of it is really practical information, e.g: using fasted exercise (4 hours from last meal+bolus) to prevent hypos, counterintuitive as that may seem—the key is that timing a workout for when you have the least amount of fast-acting insulin in your body means your body can’t easily use your blood sugars for energy, and draws from your fat reserves instead… Win/Win!
That’s just one quick tip because this is a 1-minute review, but Vieira gives:
- whole chapters, with example datasets (real numbers)
- tech-specific advice, e.g. pump, injection, etc
- insulin-specific advice, e.g. fast vs slow, and adjustments to each in the context of exercise
- timing advice re meal/bolus/exercise for different insulins and techs
- blood-sugar management advice for different exercise types (aerobic/anaerobic, sprint/endurance, etc)
…and lots more that we don’t have room to mention here
Basically… If you or a loved one has T1D, we really recommend this book!
Order a copy of “Exercise with Type 1 Diabetes” from Amazon today!
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Antioxidant Matcha Snack Bars
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The antioxidants in this come not just from the matcha, but also the cacao nibs and chocolate, as well as lots of nutrients from the hazelnuts and cashews. If you’re allergic to nuts, we’ll give you substitutions that will change the nutritional profile (and flavor), but still work perfectly well and be healthy too.
You will need
For the base:
- ⅔ cup roasted hazelnuts (if allergic, substitute dessicated coconut)
- ⅔ cup chopped dates
For the main part:
- 1 cup raw cashews (if allergic, substitute raw coconut, chopped)
- ½ cup almond milk (or your preferred milk of any kind)
- ½ cup cacao nibs
- 2 tbsp lime juice
- 1 tbsp matcha powder
- 1 tbsp maple syrup (omit if you don’t care for sweetness)
For the topping (optional):
- 2oz dark chocolate, melted (and if you like, tempered—but this isn’t necessary; it’ll just make it glossier if you do)
- Spare cacao nibs, chopped nuts, or anything else you might want on there
Method
(we suggest you read everything at least once before doing anything)
1) Blend the base ingredients in a food processor until it has a coarse sticky texture, but isn’t yet a paste or dough.
2) Line a cake pan with baking paper and spread the base mix on the base; press it down to compact it a little and ensure it is flat. If there’s room, put this in the freezer while you do the next bit. If not, the fridge will suffice.
3) Blend the main part ingredients apart from the cacao nibs, until smooth. Stir in the cacao nibs with a spoon.
4) Spread the main part evenly over the base, and allow everything you’ve built (in this recipe, not in life in general) to chill in the fridge for at least 4 hours.
5) Cut it into blocks of the size and shape you want to eat them, and (if adding the optional topping) separate the blocks slightly from each other, before drizzling with the chocolate topping. Put it back in the fridge to cool this too; an hour should be sufficient.
6) Serve!
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Which Tea Is Best, By Science?
- Which Plant Milk?
- Why You Should Diversify Your Nuts!
- Cashew Nuts vs Coconut – Which is Healthier?
- Cacao vs Carob – Which is Healthier?
Take care!
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The Sweet Truth About Diabetes
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There’s A Lot Of Confusion About Diabetes!
For those readers who are not diabetic, nor have a loved one who is diabetic, nor any other pressing reason to know these things, first a quick 101 rundown of some things to understand the rest of today’s main feature:
- Blood sugar levels: how much sugar is in the blood, measured in mg/dL or mmol/L
- Hyperglycemia or “hyper” for short: too much sugar in the blood
- Hypoglycemia or “hypo” for short: too little sugar in the blood
- Insulin: a hormone that acts as a gatekeeper to allow sugar to pass, or not pass, into various parts of the body
- Type 1 diabetes (sometimes capitalized, and/or abbreviated to “T1D”) is an autoimmune disorder that prevents the pancreas from being able to supply the body with insulin. This means that taking insulin consistently is necessary for life.
- Type 2 diabetes is a matter of insulin resistance. The pancreas produces plenty of insulin, but the body has become desensitized to it, so it doesn’t work properly. Taking extra insulin may sometimes be necessary, but for many people, it can be controlled by means of a careful diet and other lifestyle factors.
With that in mind, on to some very popular myths…
Diabetes is caused by having too much sugar
While sugar is not exactly a health food, it’s not the villain of this story either.
- Type 1 diabetes has a genetic basis, triggered by epigenetic factors unrelated to sugar.
- Type 2 diabetes comes from a cluster of risk factors which, together, can cause a person to go through pre-diabetes and acquire type 2 diabetes.
- Those risk factors include:
- A genetic predisposition
- A large waist circumference
- (this is more relevant than BMI or body fat percentage)
- High blood pressure
- A sedentary lifestyle
- Age (the risk starts rising at 35, rises sharply at 45, and continues upwards with increasing age)
- Those risk factors include:
Read more: Risk Factors for Type 2 Diabetes
Diabetics can’t have sugar
While it’s true that diabetics must be careful about sugar (and carbs in general), it’s not to say that they can’t have them… just: be mindful and intentional about it.
- Type 1 diabetics will need to carb-count in order to take the appropriate insulin bolus. Otherwise, too little insulin will result in hyperglycemia, or too much insulin will result in hypoglycemia.
- Type 2 diabetics will often be able to manage their blood sugar levels with diet alone, and slow-release carbs will make this easier.
In either case, having quick release sugars will increase blood sugar levels (what a surprise), and sometimes (such as when experiencing a hypo), that’s what’s needed.
Also, when it comes to sugar, a word on fruit:
Not all fruits are equal, and some fruits can help maintain stable blood sugar levels! Read all about it:
Fruit Intake to Prevent and Control Hypertension and Diabetes
Artificial sweeteners are must-haves for diabetics
Whereas sugar is a known quantity to the careful diabetic, some artificial sweeteners can impact insulin sensitivity, causing blood sugars to behave in unexpected ways. See for example:
The Impact of Artificial Sweeteners on Body Weight Control and Glucose Homeostasis
If a diabetic person is hyper, they should exercise to bring their blood sugar levels down
Be careful with this!
- In the case of type 2 diabetes, it may (or may not) help, as the extra sugar may be used up.
- Type 1 diabetes, however, has a crucial difference. Because the pancreas isn’t making insulin, a hyper (above a certain level, anyway) means more insulin is needed. Exercising could do more harm than good, as unlike in type 2 diabetes, the body has no way to use that extra sugar, without the insulin to facilitate it. Exercising will just pump the syrupy hyperglycemic blood around the body, potentially causing damage as it goes (all without actually being able to use it).
There are other ways this can be managed that are outside of the scope of this newsletter, but “be careful” is rarely a bad approach.
Read more, from the American Diabetes Association:
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Dates vs Banana – Which is Healthier?
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Our Verdict
When comparing dates to banana, we picked the dates.
Why?
It was close, and bananas do have some strengths too! We pitted these two against each other as they’re both sweet fruits often used as a sweetening and consistency-altering ingredient in desserts and sweet snacks, so if you’re making a choice between them, here are the things to consider:
In terms of macros, dates have more than 3x the fiber, more than 2x the protein, and a little over 3x the carbs. You may be wondering how this adds up in terms of glycemic index: dates have the lower GI. So, we pick dates, here, for that reason and overall nutritional density too.
When it comes to vitamins, bananas have their moment, albeit barely: dates have more of vitamins B1, B3, B5, and K, while bananas have more of vitamins A, B6, C, E, and choline, making for a marginal victory for bananas in this category.
Looking at minerals next, however, it’s quite a different story: dates have more calcium, copper, iron, magnesium, phosphorus, potassium, selenium, and zinc, while bananas are not higher in any mineral. No, not even potassium, for which they are famous—dates have nearly 2x more potassium than bananas.
Adding up these sections makes for a clear win for dates in general!
Enjoy either/both, but dates are the more nutritious snack/ingredient.
Want to learn more?
You might like to read:
From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?
Take care!
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Egg Whites vs Whole Eggs – Which is Healthier?
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Our Verdict
When comparing egg whites to whole eggs, we picked the whole eggs.
Why?
Egg whites are mostly protein. Egg yolks are mostly fat, with some protein.
However, fat ≠ bad, and the yolk is also where the choline is stored, which itself (as well as its benefits for your brain) will tend to reduce fat storage in the body.
Furthermore, the yolk contains an assortment of vitamins, minerals, and essential amino acids. After all, the yolk is there specifically to contain everything needed to turn a cluster of cells into a small bird.
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How much time should you spend sitting versus standing? New research reveals the perfect mix for optimal health
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People have a pretty intuitive sense of what is healthy – standing is better than sitting, exercise is great for overall health and getting good sleep is imperative.
However, if exercise in the evening may disrupt our sleep, or make us feel the need to be more sedentary to recover, a key question emerges – what is the best way to balance our 24 hours to optimise our health?
Our research attempted to answer this for risk factors for heart disease, stroke and diabetes. We found the optimal amount of sleep was 8.3 hours, while for light activity and moderate to vigorous activity, it was best to get 2.2 hours each.
Finding the right balance
Current health guidelines recommend you stick to a sensible regime of moderate-to vigorous-intensity physical activity 2.5–5 hours per week.
However mounting evidence now suggests how you spend your day can have meaningful ramifications for your health. In addition to moderate-to vigorous-intensity physical activity, this means the time you spend sitting, standing, doing light physical activity (such as walking around your house or office) and sleeping.
Our research looked at more than 2,000 adults who wore body sensors that could interpret their physical behaviours, for seven days. This gave us a sense of how they spent their average 24 hours.
At the start of the study participants had their waist circumference, blood sugar and insulin sensitivity measured. The body sensor and assessment data was matched and analysed then tested against health risk markers — such as a heart disease and stroke risk score — to create a model.
Using this model, we fed through thousands of permutations of 24 hours and found the ones with the estimated lowest associations with heart disease risk and blood-glucose levels. This created many optimal mixes of sitting, standing, light and moderate intensity activity.
When we looked at waist circumference, blood sugar, insulin sensitivity and a heart disease and stroke risk score, we noted differing optimal time zones. Where those zones mutually overlapped was ascribed the optimal zone for heart disease and diabetes risk.
You’re doing more physical activity than you think
We found light-intensity physical activity (defined as walking less than 100 steps per minute) – such as walking to the water cooler, the bathroom, or strolling casually with friends – had strong associations with glucose control, and especially in people with type 2 diabetes. This light-intensity physical activity is likely accumulated intermittently throughout the day rather than being a purposeful bout of light exercise.
Our experimental evidence shows that interrupting our sitting regularly with light-physical activity (such as taking a 3–5 minute walk every hour) can improve our metabolism, especially so after lunch.
While the moderate-to-vigorous physical activity time might seem a quite high, at more than 2 hours a day, we defined it as more than 100 steps per minute. This equates to a brisk walk.
It should be noted that these findings are preliminary. This is the first study of heart disease and diabetes risk and the “optimal” 24 hours, and the results will need further confirmation with longer prospective studies.
The data is also cross-sectional. This means that the estimates of time use are correlated with the disease risk factors, meaning it’s unclear whether how participants spent their time influences their risk factors or whether those risk factors influence how someone spends their time.
Australia’s adult physical activity guidelines need updating
Australia’s physical activity guidelines currently only recommend exercise intensity and time. A new set of guidelines are being developed to incorporate 24-hour movement. Soon Australians will be able to use these guidelines to examine their 24 hours and understand where they can make improvements.
While our new research can inform the upcoming guidelines, we should keep in mind that the recommendations are like a north star: something to head towards to improve your health. In principle this means reducing sitting time where possible, increasing standing and light-intensity physical activity, increasing more vigorous intensity physical activity, and aiming for a healthy sleep of 7.5–9 hours per night.
Beneficial changes could come in the form of reducing screen time in the evening or opting for an active commute over driving commute, or prioritising an earlier bed time over watching television in the evening.
It’s also important to acknowledge these are recommendations for an able adult. We all have different considerations, and above all, movement should be fun.
Christian Brakenridge, Postdoctoral research fellow at Swinburne University Centre for Urban Transitions, Swinburne University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Healing Trauma – by Dr. Peter Levine
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Dr. Levine’s better-selling book about trauma, Waking The Tiger, laid the foundations for this one, but the reason we’re skipping straight into Healing Trauma, is that while the former book is more about the ideas that led him to what he currently believes is the best approach to healing trauma, this book is the one that explains how to actually do it.
The core thesis is that trauma is a natural, transient response, and is not inherently pathological, but that it can become so if not allowed to do its thing.
This book outlines exercises, trademarked as “somatic experiencing”, which allow the body to go through the physiological processes it needs to, to facilitate healing. If you buy the physical book, there is also an audio CD, which this reviewer has not listened to and cannot comment on, but the exercises are clearly described in the book in any case.
The physical aspects of the exercises are similar to the principles of progressive relaxation, while the mental aspects of the exercises are about re-experiencing trauma in a safer fashion, in small doses.
Any kind of dealing with trauma is not going to be comfortable, so this book is not an enjoyable read.
As for how useful the exercises are, your mileage may vary. Like many books about trauma, the expectation is that once upon a time you were in a situation that was unsafe, and now you are safe. If that describes your trauma, you will get the most out of this. However, if your trauma is unrelated to your personal safety, or if it is about your personal safety but the threat still remains extant, then a lot of this may not help and may even make things worse.
In terms of discussing sexual trauma specifically, it was probably not a good choice to favorably quote Woody Allen, and little things like that may be quite jarring for a lot of readers.
Bottom line: if your trauma is PTSD of the kind “you faced an existential threat and now it is gone”, then chances are that this book can help you a lot. If your trauma is different, then your mileage may vary widely on this one.
Click here to check out Healing Trauma, if it seems right for you!
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