Diabetes is a serious, chronic illness. While experts continue to learn more about diabetes, the number of people that have the disease is increasing at an alarming rate. It’s known that genetics play an important part in the development of diabetes, particularly Type 2 diabetes. In addition, a significant portion of diabetes management is carried out by the person who has it and/or his family, making diabetes, in essence, a “family” disease.
On the positive side, taking care of yourself by making healthy diabetes-related choices and encouraging your at-risk family members to do the same may also improve their well-being. Indeed, sharing your lifestyle goals with your loved ones holds benefits for everyone.
This is the first in a series of articles that will address the importance of making healthy lifestyle choices for both you and your family. How can you make good-for-you eating a family affair?
Genetics…and environment
A diagnosis of diabetes has an enormous impact on you and those around you. The importance of managing food, physical activity, medication, and blood glucose monitoring with everyday life may seem overwhelming at first. The support of your family is key; in fact, it’s been said, “It’s hard to do diabetes alone.” Because genetics influences the likelihood of developing diabetes, particularly Type 2 diabetes, your family members may also benefit from following your lead and making healthier choices as well.
But genes alone are not enough to determine who will develop diabetes; a person’s environment also plays a part.
In most cases of Type 1 diabetes (a condition in which the pancreas stops producing insulin), a person must inherit risk factors from both parents to develop the disease. But most people who are at risk don’t get Type 1 diabetes, so research into environmental factors is important and ongoing. Nutritionally, the only known link at this time between diet and Type 1 diabetes is that Type 1 diabetes is less common in people who were breast-fed as infants and in those who first ate solid foods at later ages.
In Type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin. It has a stronger link to family history than Type 1, but lifestyle also influences its development. Being overweight – particularly having excessive abdominal fat – and not exercising regularly raises one’s risk of developing Type 2 diabetes. Because family members often have similar eating and exercise habits, obesity tends to run in families. So children of parents with Type 2 diabetes who model poor health habits are at increased risk for the condition not just because of genetics but also because of unhealthy habits that have been established over the years.
The good news is that a healthy lifestyle can delay and perhaps prevent Type 2 diabetes, even if the tendency is in the family genes. Exercising regularly and choosing healthful foods is good for both the person with diabetes and his family members. You cannot change your family history, but you can take smart steps to lower the risks for yourself and those around you.
Health begins at home
It’s not always easy to make lifestyle changes and to bring your family on board with your new behaviors. One helpful resource for establishing good health at home is the Y (also known as the YMCA). The Y has been a leader in promoting wholesome living by encouraging families to build the Five Pillars that support a healthy home: eat healthy, play every day, get together, go outside, and sleep well. Although not specifically aimed at diabetes self-management, these pillars and quick tips provide a great starting point for overall good family health:
• Eat healthy by aiming for five servings of fruits and vegetables every day. Choose your drinks with care, and cut out drinks with added sugar. H2O (yes, good old water) is the way to go! Check the Nutrition Facts panel on the labels of foods you buy, noting calories, carbohydrate, fat, and sodium. Control your portions so you’re not consuming more calories than you burn. One quick tip is to use smaller plates, such as salad plates, to make your meals appear larger and more satisfying. If anyone wants seconds, serve additional helpings of fruits and vegetables.
• Play every day by including 60 minutes of physical activity in each day, whether it be using a hula hoop, throwing a Frisbee, or walking the dog. At least three days each week, try for 20 additional minutes of more vigorous activity such as kicking a soccer ball or riding a bike. Entering a community fun run or a walkathon as a family can give you extra motivation to get moving.
• Get together by making the most of the time you spend with your family. As the Y notes, strong relationships are the cornerstone of health and well-being. You may need to plan for one-to-one time with each family member, whether it’s a date night or just spending time sharing thoughts and feelings while doing household chores. Turning off the TV is one way to improve your family time together.
• Go outside to reap the mental and physical benefits of being around nature. While planned activities are important, unstructured playtime outdoors also benefits children and their development, particularly in the areas of curiosity, creativity, and stress reduction. Regular contact with nature is beneficial for adults as well.
• Sleeping well is probably one of the most overlooked components of good health. Doctors recommend 10—12 hours of sleep per day for children between the ages of 5—12 and even more for younger children. For adults, the benefits of adequate sleep include improved immune function, metabolism, mood, memory, and learning. Getting plenty of rest may play a role in preventing heart disease and other chronic conditions such as diabetes.
For more information on the Five Pillars, access the Y Web site at www.ymca.net/healthy-family-home.
Healthful eating for diabetes
People with diabetes do not need special foods; in fact, the foods you eat to stay healthy with diabetes are good for your entire family. A healthy eating plan has the following characteristics:
• It’s controlled in carbohydrate (sugars and starches).
• It contains high-fiber grains, beans, fruits, and vegetables.
• It emphasizes smaller portions of meat and protein foods.
• It is low in fats and sweets.
Eating a variety of foods is important as well. A good place to start is with a healthy daily meal plan for teenagers and adults that includes at least the following:
• 2 to 3 servings of nonstarchy vegetables
• 2 servings of fruit
• 6 servings of grains, beans, and starchy vegetables
• 2 servings of low-fat or fat-free milk
• About 6 ounces of meat or meat substitutes
• Small amounts of fats and sugars
These are only general guidelines. The actual amount of food you need depends on the number of calories and grams of carbohydrate you need, which is determined by your sex, size, age, and activity level. A registered dietitian who specializes in diabetes nutrition can help you design a healthy meal plan that’s right for you and can be modified to satisfy the needs of the rest of your family.
The American Diabetes Association has developed a free resource called MyFoodAdvisor. It has features that allow you to track the carbohydrate, fat, calories, and other nutrients you eat each day, substitute healthier alternatives in recipes, and explore over 5,000 different foods. MyFoodAdvisor can help you create shopping lists based on your meal plan so you’ll make the most of your time and money. You can even save the meals and recipes you and your family especially enjoy to a personal recipe box.
For more information about MyFoodAdvisor, go to the ADA Web site, www.diabetes.org, and click on “Food & Fitness.”
The US Department of Agriculture resource ChooseMyPlate is not diabetes specific, but it is rich in information about healthy eating at home. It includes resources for weight management, a “SuperTracker” tool that can help you plan, analyze, and track your diet and physical activity, as well as healthy eating tips for the entire family.
For more information about ChooseMyPlate, check out the Web site www.choosemyplate.gov.
Garnering family support
Ideally, your family will unite around the kitchen table, support your diabetes self-management efforts, and benefit from eating meals based on your diabetes meal plan. If your family is accustomed to eating high-carbohydrate, high-fat foods, it may be a challenge to shift to a new way of eating. Having a family discussion about ways to support the person with diabetes who needs to limit those foods is a good place to begin accepting “the new normal.” It’s very isolating for the person with diabetes to eat a salad while others are having French fries, but everyone can get healthier by eating more raw, steamed, or lightly sautéed vegetables and fewer fried ones. Check out these tips for getting your family on board with healthful eating.
Experts say that families reap enormous emotional and health benefits when they eat meals together regularly. Family communication improves, and the behavior of children is better overall. Dining without the distractions of cell phones and television makes mealtime a great time to be together, connect, and share. Children who eat at least three meals a week with their family are more likely to be at a healthy weight and to choose nutritious foods over empty calories.
It may take a bit of effort to eat together in the hectic world of work and after-school activities, but it is effort well-spent. Make family mealtimes a priority, and use your healthy diabetes meal plan as the basis for instilling good eating habits that will last your family for a lifetime.