Nutrition News You Can Use Sun, 15 May 2005 13:02:08 -0500 Sugar free-but is it carbohydrate free? Thu, 17 Jul 2014 22:25:00 +0000 It's not surprising that the term "sugar free" and "carbohydrate free" are at times misunderstood and used interchangeably. Foods labeled "sugar free" are not sweetened with caloric sweeteners such as sugar, corn syrup, honey, fructose or glucose. "Sugar free" doesn't mean carbohydrate free. Diet soda and "sugar free" jello are examples of products that are truly "sugar free" and carbohydrate free. These products contain no sugar, calories or carbohydrate as they are sweetened with a sugar substitute. A "sugar free" cookie may not contain sugar as a carbohydrate source but flour is a carbohydrate. Yogurts labeled "sugar free" have "no added sugar" however contains fruit and milk which are carbohydrates. This distinction is very important for people with diabetes. Sugar and foods containing sugar are part of a diabetes meal plan. Total carbohydrate intake has the most effect on blood glucose levels. Sugar, starch, fiber and sugar alcohols are all sources of carbohydrate and will raise blood sugar levels. Consuming sugar alcohol will increase blood sugar levels, but not as dramatically as some other carbohydrate sources.

Products labeled "sugar free" or "low carb" often use sugar alcohols to replace sugar. Sugar alcohols are FDA approved lower calorie sweeteners that contain about one-half of the calories other sweeteners contain and generally produce smaller increases in post meal blood sugar. Despite the name, sugar alcohols are not sugar or alcohol. Because sugar alcohols are not well absorbed they can cause a laxative effect and digestive discomfort, especially when larger quantities are consumed. Sugar alcohols are found on the nutrition label under the bold heading of total carbohydrates, and are listed in the ingredient list as sorbitol, mannitol, xylitol, isomalt or hydrogenated starch hydrolysates.

When comparing the nutrition label of a "sugar free" product vs. the regularly sweetened version likely will reveal very similar carbohydrate content and calories. If one consumes "sugar free" cookies with the assumption they are a "free food" or without carbohydrate it will likely result in a rise in blood sugar. Emphasis should be placed on the total amount of carbohydrate more so than the source of carbohydrate.

It's not that sugar alcohols can't sometimes be helpful in reducing the total carbohydrate and calorie content of a product. The bottom line is to remember that total carbohydrate intake is the most important fact on the nutrition label for those with diabetes. Mistakenly, many people think "sugar free" or "no added sugar" products do not raise blood sugar. Whether carbs come from sugar alcohols or other sources of carbohydrate it is important to include them into your overall meal plan. It may be appropriate for some individuals to work with a dietitian or diabetes educator to learn how to use advanced carbohydrate counting to determine whether it would be beneficial to subtract a portion of the fiber and sugar alcohol from the total carbohydrate for a more accurate carbohydrate intake.

You are the Captain of Your Team Thu, 19 Jun 2014 13:54:00 +0000  

If you have found yourself as one of the 29 million Americans who have diabetes it is not uncommon to have a period of adjustment, sometimes even a period of denial. Diabetes affects daily routines at home, school and work. With time and perseverance diabetes management can become a habit and part of your usual routine.

Support in managing your blood glucose is important. Although you will be in charge of your diabetes and day to day decisions are up to you it doesn't mean you have to do it alone. Having a diabetes healthcare team that you trust and feel comfortable with is an important first step. Their job is to work with you to develop a diabetes management plan that works for you. There is no "one size fits all" in diabetes management. Your diabetes care plan should be as individual as you are.

Your diabetes care team may include:

  • Primary care provider - this is often your regular doctor. Depending on the situation your primary care provider may be able to manage all your diabetes needs. All aspects of your diabetes care should be discussed with your primary care provider. Sometimes referral is needed to a diabetes specialist.
  • Endocrinologist- a diabetes specialist doctor. You may choose to see an endocrinologist from the start or may be referred by your primary care doctor.
  • Registered dietitian (RD) - A dietitian can teach you how food affects your blood glucose and help assist in developing a diabetes meal plan and set goals to manage your diabetes.
  • Certified Diabetes Educator (CDE) often a nurse or dietitian; however could be a healthcare providers from other disciplines with advanced diabetes training. A CDE works to empower you with the skills and knowledge necessary to make the behavior changes needed for good diabetes management.
  • Social Worker – A social worker or health psychologist can help with the adjustment and emotional impact of managing diabetes.
  • Pharmacist - A pharmacist can answer any questions or concerns you may have with your diabetes medication or any medications you are prescribed.

Who and when you share your diabetes diagnosis is a personal decision.  Family and friends can be a great support system. In some cases it may be hard for them to understand some of the changes and they may be worried about you. Let the important people in your life know specific ways they can support you and don't be afraid to ask for help.

Don't forget that you are the one in charge of your diabetes self-management plan! A diabetes self-management plan will help manage blood glucose within a target range, decreasing potential complications associated with diabetes. Ultimately, you decide what to eat, when to eat, and if or when to check your blood glucose. The self in diabetes self-management is the most important word! As we know with all facets of life change is inevitable and this is also true with a diabetes plan. If your plan isn't working it is time for a change. Don't be afraid to ask questions and discuss concerns with your healthcare team. You being an active and engaged team player will make their job easier and result in the best outcome for you. Don't sit on the sidelines; be the captain of your team!

Behavior Change: Where Are You Mon, 28 Apr 2014 15:36:00 +0000 Have you heard the phrase "a goal without a plan is just a wish"? This is especially true when it comes to diabetes self- management. Anyone managing diabetes is very well aware of the time and effort required for most people to maintain good diabetes control. The best plan for diabetes management is an individual plan, as no two individuals with diabetes have the same pancreas function any more than they have the same lifestyle or medical history.

There is an important reason we refer to diabetes care as diabetes self-management. Although one's health care provider or diabetes educator prescribes medication and provides education regarding lifestyle changes and skills necessary for diabetes care, the majority of the time individuals with diabetes manage their own condition. It is just not realistic to seek advice from a health care provider every time you eat, check blood glucose levels, take medication, or deal with minor illnesses.

In addition to gaining the knowledge and skills required for diabetes control, behavior change is key for long-term successful diabetes control. James Prochaska's "Stages of Change" model is helpful in understanding why some areas of behavior change come easier than others and helps evaluate one's readiness for change. These stages of change are:

  • Precontemplation - being unaware that change is needed or having no intention of changing
  • Contemplation - aware of benefits of change and plan to change in next 6 months
  • Preparation - taking steps to change in the next 30 days
  • Action - making changes within the last 30 days
  • Maintenance - has successfully made a change within the last 6 months and working on not regressing to past behaviors

Any type of change takes time and often it comes with a step or two forward and few steps back. Give yourself time to move through these stages of change. Trying to identify changes that will lead to the most positive health outcomes is a great place to start. For some this might be cutting out sweetened beverages and for others it might be starting to monitor blood glucose on a regular schedule. "I will try to drink more water and cut out regular soda to help my glucose control, but I just don't know if I can give up my Mountain Dew" is an example of someone in the Contemplation stage of behavior change. This person is aware of the benefits of cutting out Mountain Dew and is thinking about changing this behavior, while realizing how difficult it may be. A statement reflecting the Action stage of behavior change might sound like this: "I am so proud of myself for totally giving up Mountain Dew and only drinking water or other sugar free beverages for the past month." In this example the behavior has actually happened over the last month.

It is difficult to work on too many changes at once so prioritize your goals, starting with those that will have the greatest health impact. Congratulate yourself on those behavior changes that have successfully reached the Maintenance stage.

Visit Your Guide to Diet and Diabetes at for more diabetes resources and for diabetes friendly recipes.

Money Smart Week Mon, 07 Apr 2014 11:47:00 +0000 Money Smart Week is a public awareness campaign to help individuals and families better manage their finances. Annually, 45 states participate in Money Smart Week which was created in 2002 by the Federal Reserve Bank of Chicago. Free educational seminars and activities are planned throughout the week on a variety of topics with a goal of improving consumer financial literacy.

I will be guiding tours this week at local grocery stores called Supermarket Smarts: A Guided Store Tour for Your Wallet and Health. My hope is that consumers will be able to shop smarter and healthier after joining me for a tour of the grocery aisles. In our fast paced lifestyle we sometimes find grocery shopping can be just another necessity that we rush through without always being prepared to get the most for our dollar and our health.

Follow these 10 Tips from the USDA to Stretch your Food Dollar and eat healthier on a budget:

  1. PLAN! Before heading out to the store check to see what you have on hand that can be used in the coming week. Make a list and plan casseroles or stir fries that can stretch the food dollar.
  2. Get the best price- Look online and in the newspaper for weekly grocery ads. Clip coupons and sign-up for the store's loyalty card.
  3. Compare and contrast - Look for "unit prices" on the store shelves to make sure you are getting the best price by comparing different brands and sizes.
  4. Buy in bulk - Larger bulk or family sizes are generally cheaper if you have the freezer or cabinet space.
  5. Buy in season - produce will be more economical and fresher when bought in season.
  6. Convenience cost- going back to basics by preparing more foods yourself will not only save money but improve the nutritional value of the meals as convenience foods are often less healthy.
  7. Easy on your wallet choices - Some foods are good choices all year long. Beans are an excellent source of a low cost protein. Carrots, greens, apples and bananas are good produce choices year round.
  8. Cook once eat later - Cook a batch of your favorite casserole or soup and freeze some for a later time.
  9. Get your creative juices flowing- Use that leftover chicken in a stir-fry or sliced on top of a salad. Throwing away food is like throwing money in the trash!
  10. Eating out - Restaurants can be very expensive! Look for early bird or "2 for 1" specials. Sticking with water as a beverage also saves money.

To find out how to join me for a grocery store tour visit Additional offerings of these workshops and other Money Smart Week educational events will be presented throughout the week of April 5-12.

Look for announcements at your local Extension office or on the Money Smart website at

Resource: USDA

February is American Heart Month Thu, 13 Feb 2014 14:38:00 +0000 One in every four deaths in the United States is attributed to heart disease or stroke, making cardiovascular disease the leading cause of death in this country. According to the Center for Disease Control someone in the U.S. has a heart attack every 34 seconds and each minute someone dies from a heart-related event. Although these statistics are alarming, lifestyle measures can play a significant role in improving health and decreasing risk for cardiovascular disease.

Certain risk factors for cardiovascular disease are not modifiable. Having a family history of heart disease and age are not risk factors we have control over. On the other hand, risk factors such as cholesterol levels, blood pressure, weight, physical activity level, diabetes control and tobacco use are known as modifiable risk factors, which we do have some control of. Having diabetes significantly increases the risk of cardiovascular disease which provides even more incentive to maintain good control over those blood glucose readings!

Knowing your numbers for cholesterol, blood pressure, glucose and weight are important indicators for risk of future heart disease. These numbers are affected by our everyday habits such as food choices and physical activity habits. Eating a heart healthy diet and staying physically active can decrease the risk of cardiovascular disease.

To learn more about how to decrease risk factors for cardiovascular disease join University of Illinois Extension Nutrition and Wellness Educator, Marilyn Csernus, MS, RD for Meals for a Healthy Heart, a series of two sessions designed for anyone interested in preventing or managing heart disease. In each session, participants receive recipes, watch cooking demonstrations, taste foods, and learn about proper diet & physical activity to better care for their health. The Meals for a Healthy Heart program aims to improve your overall well-being and complement the recommendations of your health care provider.

Meals for a Healthy Heart will be offered February 19 and 26, 2014 from 4:30 PM to 6:30 PM at the Boone County Extension office located at 205 Cadillac Court, Unit 3 in Belvidere and again March 13 and 20, 2014 from 5:30 PM to 7:30 PM at the Ogle County Extension office located at 421 W. Pines Road in Oregon. The fee for the two session program is $15 per person and pre-registration is preferred. For more information visit the University of Illinois Extension website at or call the Ogle County Extension Office at (815) 732-2191.

Diabetes Foot Care Tue, 28 Jan 2014 13:53:00 +0000

You may be wondering why I am discussing foot care as part of a nutrition blog. Well, as a certified diabetes educator we help individuals with diabetes manage all aspects of diabetes care, thus diabetes foot care being the topic today. Continue reading to find out how to attend an upcoming presentation on diabetes foot care by local podiatrist, Dr. Brandon Gumbiner.

Routine foot problems can turn into major foot problems for someone with diabetes. Poor blood flow can change the shape of the foot or toes. Often the cause of diabetes foot problems is a result of nerve damage or neuropathy, which can lead to loss of feeling to the foot. Although neuropathy can be painful it can also make it difficult to feel pain and temperature sensation in the feet. This loss of feeling can unfortunately increase the risk of blisters, cuts or burns to the feet. It is important to always check the temperature of bath water prior to stepping into a tub filled with hot water because nerve damage can make it difficult to recognize the water is too hot and potentially result in a burn.

Anyone with diabetes should never work on calluses or corns at home. Leave this to a healthcare provider. Calluses tend to build up quicker on the feet of those with diabetes and can become thick and breakdown leading to open sores or ulcers if not properly trimmed and cared for. Feet can become very dry and cracked, especially lately with the extreme cold. Proper daily foot care is essential to keep feet healthy. The feet also become dry because the nerves that control moisture balance may not be working as well with diabetes. It is important to dry your feet well after a bath or shower and apply a thin layer of an unscented lotion. Do not rub lotion between the toes as this extra moisture can lead to infection.

If a foot ulcer does develop get it treated right away. Treatment will depend on the severity and location of the ulcer. Sometimes a special shoe or brace is needed to protect the ulcer and allow for better healing. Diabetes can cause blood vessels in the foot to narrow and harden leading to poor circulation. Following the advice of your health care provider to keep your blood pressure, cholesterol and glucose levels in check and not smoking can give you some control over improving circulation problems. Following the advice of your healthcare provider regarding physical activity is important as well, especially when treating a diabetes foot problem as no two problems are the same. Just as with a diabetes meal plan, diabetes foot care must be individualized.

To learn more about diabetes foot care join me for the February 5, 2014 Living Well with Diabetes Support Group meeting at the Rock River Center located at 810 South 10th Street in Oregon, IL at 6:30 pm. We are very pleased to have Dr. Brandon Gumbiner as a guest speaker for our upcoming support group meeting. Dr.Gumbiner, a podiatrist in private practice with Katherine Shaw Bethea Hospital will provide an informational talk on diabetes foot care. Anyone managing diabetes or family and caregivers of those with diabetes are welcome to attend.

Happy New Year Fri, 03 Jan 2014 09:58:00 +0000

Every year millions of us make the same New Year's resolutions that we probably made last year and failed to fulfill. Although we have good intentions many resolutions made in the New Year fall by the wayside as we get caught up in the demands of every-day life. Sound familiar? How about taking a different approach to becoming healthier in 2014? Instead of just resolving to "lose weight" or "exercise more" why not map out a game plan of behavior changes to make your goal a sustainable reality?

Improving health likely involves adding more physical activity and eating healthier. It doesn't have to be about deprivation or what we need to give up. Look on the flip side and think of what you can add to your lifestyle. Maybe some of these suggestions will help 2014 start and end on a healthier note:

  1. If you don't know how, learn to cook! It is very difficult to eat healthy without cooking and opening a can or sticking something in the microwave doesn't count.
  2. Start a healthy recipe collection and try a couple of new dishes each week.
  3. Solicit a neighbor, friend or family member interested in becoming healthier to join in your efforts.
  4. Been itching to learn to dance or take a yoga class? No time like the present!
  5. Planning a vacation this year? Why not make it an active vacation with hiking, biking, kayaking or other outdoor adventures?
  6. Pack your lunch for work rather than relying on fast food.
  7. Seek out co-workers interested in improving their health. Keep healthy snack options stocked in the break room such as fresh fruit, light yogurt or string cheese, nuts or whole wheat crackers.
  8. Always have salad "fixings" available. Adding a tossed salad for lunch or dinner is an easy way to help meet the goal of 5 servings daily of fruits and vegetables.
  9. Strive to eat more "whole' foods and less processed foods.
  10. Turn the T.V. off. Research has shown that prolonged sitting increases our risk of mortality! At least get up and walk around during commercial breaks if you do watch T.V.
  11. If you smoke and have attempted to quit without success, seek help from your health care provider. Quitting smoking is a great way to start the New Year and will greatly reduce your health risk.
  12. Drink alcohol in moderation, which is no more than one drink per day for women and no more than two drinks per day for men. In the U.S. one drink is considered 1 ½ ounces of hard liquor, 12 ounces of beer or 5 ounces of wine.
  13. Be adventurous by trying new foods, especially unfamiliar fruits and vegetables.
  14. Maybe try out "Meatless Mondays" to cut back on unhealthy fats.
  15. Develop good sleep habits. Chronic sleep deprivation can have negative health ramifications.
  16. Get moving! Find some type of physical activity that is realistic to do on a regular basis. Walking is sometimes the best for many of us.

Think about choosing a couple of these to start the New Year off in a healthy fashion. Focus on behavior changes that will increase your chances of improving your health in 2014. Small changes sustained over time can reap great health benefits!