December and Prediabetes: Celebrating your cultural traditions and your health

December is a month packed with meaningful observances and traditions. Do you celebrate Solstice, Christmas, Hanukkah, Kwanzaa, Boxing Day, or New Year’s Eve? My practice serves patients from diverse cultural and religious backgrounds who enjoy a wide variety of wonderful celebratory customs and practices throughout the month. Nearly all of these festivities involve gathering with friends and loved ones…and feasting. That last bit can be a challenge for my patients with prediabetes.

Make Joy Happen

Dreading temptation or deprivation is no fun, so I like to remind my patients that these holidays are occasions for joy. We gather together to share warmth, enjoy each other’s company, offset the season’s long nights and chilly days. Food is a part of this, but it’s not the only part.

There’s so much more to look forward to this time of year. Spending time with family, honoring your spiritual or cultural heritage, planning fun activities like goofy gift exchanges or walking to see holiday light displays — these are also important and fulfilling.

Here are a few suggestions for celebrating both your cultural traditions and your healthy new lifestyle this month.

  • Get in the spirit 

    Remember that the most important thing about the holidays is to spend time enjoying the spirit of fellowship. Practice actively focusing on the positive.

  • Embrace your traditions

    Reclaim cultural practices that support your diabetes prevention efforts. A lot of sound and beneficial culinary wisdom gets lost in the hustle of modern living. Seek out nourishment that fulfills both your desire to observe beloved traditions and the healthful changes you’re making in your everyday life.

  • Share your delight

    If you’ve discovered healthful new recipes, amazing hiking trails, fun classes — by all means share them with your friends and family. You might inspire new traditions that generations to come will cherish. Spread the joy.

  • Reach out

    Don’t struggle in silence and don’t beat yourself up. If you overeat one day, it’s okay. Try to eat better and exercise the next day. Utilize your support network. Be kind to others, but also remember to be kind to yourself.

  • Take a bow 

    Celebrate the progress you made this year. You’ve made the decision to set goals and change your behavior for the better, and that’s fantastic! Acknowledge your accomplishments and step into the new year empowered.


Six Tips for Managing Prediabetes and Surviving the Holiday Season

By Irazema Garcia - First Mile Care, DPP coach

The holidays are upon us. With that comes chilly weather, happy memories, and joyous get-togethers. What can also come with the holiday season? Stress, guilt, overeating, and more stress. Although, the holiday season can uproot anyone’s life, it is important to not let this time of year derail you from your successes. Instead, brainstorm ways to incorporate the holidays into your new lifestyle.

Here are six things to keep in mind during this time of year:

  1. Organize a non-food get together: Although the festivities this time of year can usually revolve around platters and platters of food, suggest meeting with friends and loved ones to exchange gifts in a non-food setting.  Coordinate a session at a local ice-skating rink or schedule to meet for a holiday-themed play or ballet (hello Nutcracker!). You can enjoy everyone’s company and well wishes just as much while doing an activity than while munching on food. Who knows — a new tradition may even be born.

  2. Stress less, smile more: The holiday season may bring an uptick of stress to many.  Whether it be scheduling multiple parties into an already busy month, or the unusually high traffic that comes with holiday shopping — several situations can make stress levels soar higher than normal in the winter months. The mere fact that you are stressed will elevate glucose levels in the blood (not to mention increase stress eating).

    Therefore, the more time you spend being stressed, the more time your glucose level remains high. Bringing down the stress level as much as possible is crucial to maintaining normal blood sugar. You may not be able to change the situation, but you can change the way you react to it. Try to remember the positives that come with the season, not the negatives – whether it be seeing family members who live far away or participating in once-a-year traditions. Find what you appreciate about them and rejoice in them.

  3. Value what you have accomplished: As the year comes to a close it is not uncommon to look back at the past year and take inventory. Acknowledge the hurdles that have been overcome. Remember to keep harmful thoughts at bay by flipping them to more positive thoughts that will help you reach goals. Rather than saying “I didn’t lose enough weight this year”, remind yourself of (and celebrate) the FIVE pounds that were lost (and remain off). Instead of falling into the gloom and doom mindset of thinking all the extra events will derail your success, carefully map out ways to incorporate the habits you have learned this year into the holiday season. During this time of celebration, celebrate the little things that have happened. Without those little successes, bigger achievement would be nonexistent.

  4. Routine, routine, routine: As tasks and invitations begin to mound, be mindful to keep the routine you have built going strong. Continue to commit to your morning walk or after-work gym session. By staying on top of your physical activity you will have more energy, better endurance and improve your mood — all helpful this time of year.

    Ensure you are giving yourself time for self-care and watching out for your health. There are 168 hours in a week. Finding ways to fit in 30 minutes of movement and eight hours of adequate sleep will still leave most people with enough time to dedicate to holiday activities. Remind yourself of what is important and plan ahead if need be to ensure you stick to your routine.

  5. Savor the friendship: This time of year can get hectic and overwhelming. Do not let it get the best of you. Remind yourself why you are attending all of these social gatherings. The reason there are multiple invitations to holiday parties and various gifts to buy is because you have built a social support system that cares about you. Relish in that  — even when it gets stressful. Be thankful for those people in your life. Being around loved ones can strengthen your desire to make permanent lifestyle changes (you want to be there for them, you want to be able to enjoy them). It may also be a good time to ask for more support (or even offer support) as you implement your lifestyle changes. Every person who celebrates with you, is a potential supportive partner.  Don’t be afraid to share with them what you have learned and how they can support you.

  6. Enjoy and move on: So you indulged in the festivities more than you anticipated (third slice of pie sound familiar?). Now what? Well, move on. You cannot go back in time. So why beat yourself up over a decision you made hours, or even minutes ago? Instead of dwelling on the past focus on what you can do differently next time. Ask yourself what led you to this and what can you do to avoid it in the future? Did you forgo your after-dinner walk because you were enjoying the conversation with your aunt? Invite her to walk the neighborhood with you to see the holiday lights. Were you tempted by the desserts piled in front of you? If you know this will occur, opt to sit somewhere else at the next party or serve yourself a small sliver instead of a complete slice and walk away. Perhaps you loaded your plate with foods you were not expecting to see. Maybe it means bringing a dish or two that you know will make you feel better about eating to the next get together. And do not discount what you can do after the fact either. Concentrate on the rest of the week. It may mean figuring in an extra workout session or foregoing the leftover stuffing tomorrow. The main thing is to chug along and focus on what is ahead of you. One meal does not make or break you. Realistically speaking if you consume three meals a day, one meal is 0.00091324% of your total yearly meals.  Do not let 0.00091324% derail the success you have had thus far. Use it as a learning experience.

Remember to cherish and partake in the spirit of the holidays. If you approach this time of year with the same dedication and zeal as the rest of the year, you and your new habits will be able to get through this unfazed.


Community: The Key to Preventing Diabetes at Scale

By Daphne Li, First Mile Care, Chief Operating Officer

DPP shows that supportive day-to-day human interactions and a sense of a community are key drivers of effective treatment and sustained behavior modification.

Breakthrough advancements in gene editing, personalized fitness tracking, and AI are the kind of technological marvels that fuel great optimism for the future of health. But, even as we digitize our world with wonderous gadgets and hyperconnected services, burdensome chronic diseases such as diabetes continue to spread unchecked. 84 million— or almost one in three people in the United States—has been diagnosed with prediabetes and is on a dangerous path toward developing type 2 diabetes and heart disease. That percentage is both staggering and sobering.

So, if technology has advanced so much, why are we in this predicament? Well, it turns out that human behavioral patterns account for the greatest impact on early death in the United States. People making poor health decisions in isolation is an enormous and growing problem. The scientifically proven solution to chronic disease lies not in checking our apps, but in establishing meaningful connection with others.

Shifting Counterproductive Health Patterns

As illustrated in Michael Pollan’s popular Netflix series Cooked, technological advancement sometimes generates counterproductive impacts on human health. After World War II, the US began using innovations created to feed the troops (industrialized mass production, processed foods with long shelf-lives, frozen dinners, etc.) to feed American families. Within a couple of generations, technologies to improve food availability, convenience, and flavor-enhancement shifted our consumption habits drastically — and not necessarily to our benefit.

As a population, the US became larger, more sedentary, and less healthy. Did you know that simply commuting past fast food restaurants on your way to work increases the statistical probability that you’ll have a higher body-mass index (BMI) than your peers? It’s evident that the choices available in in your community matter.

Diabetes prevention is a distinctly human issue that requires a distinctly human approach. And the most powerful catalyst for change is found in our local communities. Software can help eliminate unhealthy habits, but it turns out that people need community support to sustain their new habits over time. To reverse the tide and curb the incidence of expensive chronic diseases like type 2 diabetes, we must find ways to take proven programs like the Diabetes Prevention Program (DPP)— originally developed by the CDC—and scale them nationally.

DPP

Since 2010, DPP has helped 200,000 people delay or avoid developing type 2 diabetes by providing intensive individual counseling and motivational support on effective diet, exercise, and behavior modification. As a result, DPP reduced program participants’ risk of developing diabetes by an impressive 58 percent. For every 10 people with prediabetes who completed the DPP program, the majority either slowed or halted their progression toward type 2 diabetes. Unfortunately, the number of DPP program participants to date constitutes a mere drop in the prediabetes bucket.

By scaling DPP across the US, we can move the health of our nation in a positive direction because we know that interpersonal, evidence-based lifestyle change programs reduce risk of type 2 diabetes and improve overall health. Technology is absolutely part of the equation, but human connection and effective face-to-face community care and support are the critical factors. In effecting lasting lifestyle changes.

Doctors, too, play an important role in reversing chronic disease, first by diagnosing the condition and then by recommending programs where they can monitor progress. Modern technology can help them do both with greater precision and efficiency, but the physician-patient relationship is central to long-term nationwide success. DPP shows that when the medical community can call on supportive coaches who provide day-to-day human interaction and a sense of a community, sustained behavior modification is possible in the majority of cases.

Bottom line: people have the greatest impact on other people. Embracing this truth has proven efficacy in preventing diabetes and associated chronic diseases. We’re building First Mile Care with these findings in mind. Technology definitely informs our approach and processes, but we know that when it comes to human health, community is essential to effecting lasting lifestyle changes.


Lifestyle Change: 5 Reasons to Join a Class

By Irazema Garcia, First Mile Care Coach

Ever tried doing something new by yourself only to give up a few weeks later? Was it overwhelming? Not as fun as you hoped? Confusing? It can be tough to make changes.

Often, years or even decades worth of habits have to be examined and faced to make a lifestyle change or acquire a new skillset. New routines have to be tested. The inability to self-gauge progress — to know what needs to happen, or when — can prove to be frustrating and disappointing. It’s daunting to go it alone without feedback or support.

Addressing this challenge is one of the central tenets of the Diabetes Prevention Program (DPP), where lifestyle change is accessibly applied and reinforced with personalized coaching and neighborhood-based cohorts that foster a sense of community.

Joining a group or class to enter a new phase clears a lot of obstacles — and has other benefits. Not only do you meet interesting new people with similar goals, but the group environment also serves as a base of support when the going gets tough. Here are five reasons to make lifestyle changes with the support of others:

  • Social Support: Having support can prove to be beneficial. Studies have shown that having social support leads to better adherence of diet and exercise routines. Social support also improves self-perception (when it comes to adhering to diet and fitness routines). Finding a group that understands and supports you through the challenges that come with changing an ingrained routine can prove to be helpful. Knowing there is someone to talk to or go for a walk with who is going through the same challenges can help you (and them) stay on track. Having someone there pushing you to take more steps in a day or remind you how much you have accomplished can be the key to staying on track. And providing that same support to others can further strengthen your own resolve.

  • Accountability: The group environment can also help with accountability — especially with weight loss. First Mile Care participants have noted that they find themselves sticking to their new lifestyle choices when they have a coach and a group who will want to know what they ate or how much they moved. Having a group who is waiting to celebrate accomplishments makes people want to stay the course and hit their goals.

  • Shared Ideas: Group classes promote sharing concepts and ideas. They serve as a wellspring for life-enhancing inspiration. Groups of individuals travelling on a parallel journey develop a joint understanding of what it takes to achieve goals, and sharing that understanding can help solidify needed changes in routine.

  • Resources: Just like learning about the area’s best dry cleaner from a neighbor, gathering relevant local information is easily accomplished when you are part of a group. — interesting new recipes, details on fun fitness classes, insights on the best farmer’s markets, the list goes on and on. The most reliable resources abound because you’re all locals and understand your neighborhoods.

  • Motivation: Seeing others hit their goals can serve to reignite your own motivation. Even when you are struggling or feel overwhelmed by everything life has thrown at you lately, sharing in someone else’s success fuels your own journey. You see others make it through the week (and live to tell about it!), so why can’t you? Hitting rough patches oftentimes derails people pursuing goals. But if you’re in a group with someone who has crossed that bridge (proverbial or not), it can keep you on track. You inner need to succeed can fuel you to try new things and push yourself to accomplish what you set out to accomplish.

Visit First Mile Care for more information on DPP, lifestyle change, and chronic disease prevention.


When the Who is You

By Irazema Garcia, First Mile Care Coach

Who is at risk for diabetes? It is estimated 84 million American adults have prediabetes and nine of out of ten do not even know they have it. With staggering numbers like those, it is hard to contemplate not knowing someone with prediabetes. Yet how often do you hear someone talking about it? And how often do you stop and wonder if you are one of those 84 million?

People with no family history of diabetes can still be at risk for prediabetes. Even when your blood glucose or HbA1c reading is not in the diabetes range, you can still be susceptible to developing it.

Traditionally, risk markers will include indicators such as family history or a record of gestational diabetes. However, there are also lifestyle factors that indicate higher risk for prediabetes and diabetes — especially if the lifestyle includes little to no physical activity or regular stress. Diabetes prevention needs to be discussed.

Diabetes can be prevented, and prediabetes can be reversed. It takes time and effort, but it can be done — with DPP.

DPP

Making small changes to counterproductive long-term habits can decrease the chances of developing diabetes. Whether it is expending more time being active, learning to better cope with stress, or eating more nourishing foods, lifestyle changes can reap big results. In fact, the National Institutes of Health Diabetes Prevention Program (DPP) study “showed that participants in the DPP Lifestyle Change Program lowered their chances of developing type 2 diabetes by 58 percent.”

The first step is acknowledging there is an issue. Coming to terms with the fact that you may be at risk is important: Chances are you won’t modify your behavior without first realizing changes are needed.

And without changes, the disease will move forward whether or not you acknowledge it — just as it has for millions of your peers and neighbors.

Dealing with prediabetes

Here are some steps you can take to see if it’s you who has prediabetes:

  • Assess risk. Speaking to a primary care provider is a great way to see if you are at risk for developing prediabetes. In the meantime, you can also take the CDC’s prediabetes test to gauge your odds.

  • Acknowledge and accept. If you are at high risk, acknowledge it. Acceptance does not mean surrender — it simply means you’re aware your risk is high for prediabetes. Come to terms with your diagnosis and take steps towards reversing it — you can halt its progression.

  • Find resources. “Why me?” and “Now What?” are common responses to a prediabetes diagnosis. Seeking out valid resources and information will ease your concerns and answer many questions about prediabetes.

  • Get support. You do not have to do this alone. Even modest lifestyle changes can be hard to make on your own. Joining a group filled with like-minded individuals who are trying to create new habits is a great way to find and give support. Among other benefits, Diabetes Prevention Programs (DPP) like First Mile Care typically offer informational sessions and coaching in a group setting to support your progress.


Your Body’s Canary in a Coal Mine

By Irazema Garcia, First Mile Care Coach

One in three. Those are the odds that you’re the one of the 84 million Americans who falls into the prediabetes range. That’s one out of every three adults in the U.S. And 90% of those “ones” don’t even know they have prediabetes.

The good news is that a prediabetes diagnosis is like a canary in a coal mine. It’s a warning that conditions within your body are unsafe, but it doesn’t mean you’re doomed to develop diabetes. Prediabetes can be reversed via DPP.

What It Means to Have Prediabetes?

Prediabetes is diagnosed when the body’s blood sugar (glucose) is higher than normal, but not high enough to be considered within the diabetic range. It’s a stage where action needs to be taken. With proper lifestyle changes, delay — and even prevention — of diabetes is possible.

You may have heard the condition referred to by other terms, including “high blood sugar” or “elevated blood sugar.” But by any name, if no changes are made, people with prediabetes run the risk of developing type 2 diabetes in as little as five years.

Who’s at Risk?

Although anyone can be at risk for prediabetes, the Centers for Disease Control (CDC) has determined there is a higher risk for those who:

  • Are overweight

  • Over the age of 45

  • Have a parent or sibling with type 2 diabetes

  • Exercise less than three times a week

  • Gave birth to a baby weighing more than 9 pounds

  • Had gestational diabetes.

Prediabetes Call to Action

Simply put, preventing diabetes can prevent other diseases. Diabetes increases the risk of developing other health conditions including heart disease, hypertension (high blood pressure), neuropathy, and kidney disease. Those living with diabetes face a host of complications including oral health issues like gum disease, eye diseases such as glaucoma, skin disorders like candida, and sexual disfunction, to name a few. Preventing diabetes can, in turn, prevent these conditions from developing.

The sooner action is taken, the easier it may be to prevent a diabetes diagnosis. Making small lifestyle adjustments to address prediabetes is far simpler than managing diabetes and its attendant health complications.

The necessary changes may be minimal and can be painlessly interwoven into daily life. For example, something as inconsequential as walking briskly for 20 minutes day can make a huge impact in diabetes prevention. Lowering stress and making sound nutritional choices can be done in a similarly incremental fashion — with big payoffs. In fact, one study showed that a 5% reduction of body weight (8 pounds for someone who weighs 160) correlated with an enormous cut in diabetes risk.

What’s next?

You do not have to be one of the 84 million Americans with prediabetes. No matter how small the changes may seem, being proactive can reap big rewards in preventing diabetes. The sooner a lifestyle change is implemented, the sooner the disease can be reversed. DPP works! And making small, sustainable changes before the onset of diabetes will definitely create a better quality of life.


This physician gets a leg up on diabetes prevention referral

“As an internist and private practice owner in San Francisco, Mark Savant, MD, knows that technology is essential to advancing medicine and helping patients. He just needed to find the right organization to help. It was an introduction from one of his patients to a Silicon Valley-based preventive chronic care company that would change the way Dr. Savant identified and enrolled patients with prediabetes into a diabetes prevention program (DPP).” Read more from the American Medical Association >


Silent, Sweeping, Stoppable

By Dr. Mark Savant, Internal Medicine Practitioner

I’m not an alarmist kind of guy, but I do believe in being proactive. Millions of Americans are developing a dangerous disease and many of them don’t know it. That’s the bad news. The good news is that its progression — once considered inevitable — can be halted or even reversed.

Patients predisposed to or diagnosed with prediabetes are not automatically destined to become diabetic.

Details on diabetes

There is no cure for diabetes, the chronic condition marked by high levels of blood sugar (aka glucose). Basically, it’s a metabolic disorder that occurs when your body stops appropriately using insulin, the hormone produced by the pancreas to regulate blood glucose and assist in breaking down fats and proteins for energy. Early symptoms can be hard to spot and are often masked among ordinary stresses of modern life.

Untreated diabetes is no joke. It results in damage to all parts of the cardiovascular system. Long-term complications include vision impairment, nervous system problems, and even kidney damage, heart disease, surgical amputation, and stroke. Type 2 diabetes (aka diabetes mellitus type 2) is the most common form of the disease. Diabetes is also often the first in a progression of other chronic conditions, such as coronary heart disease. So it is important to stop diabetes before it happens.

Prevention is better than cure

Prediabetes is a condition where you have a higher blood glucose level than normal, but not high enough to be type 2 diabetes. People who develop type 2 diabetes usually have prediabetes first.

The Centers for Disease Control (CDC) estimates that there are over 84 million Americans who have prediabetes — that’s one in every three adults — and that would be considered an epidemic. In my own practice, I’ve seen the numbers rise even over just the past few years. Anywhere from 30 to 50 percent of my patients have prediabetes.

There are many factors that lead to prediabetes, including:

•       genetics (a predisposition that runs in the family)

•       being overweight

•       having high blood pressure

•       not getting enough exercise

You can’t change your genetic makeup, but other predisposition factors can be addressed to reverse prediabetes and prevent the onset of type 2 diabetes.

So why is there an epidemic?

Prediabetes generally develops from lifestyle behaviors adopted over a long period of time. The best course for reversal is to adjust that lifestyle and change those behaviors. But that’s also a long-term proposition. You can’t take a 10-day course of imaginary anti-prediabetes tablets and fix the problem. You have to lose weight, improve diet, and get enough exercise — and sustain that new lifestyle in perpetuity.

That such a common-sense prescription for health may sound very daunting to a lot of people is indicative of the source of the problem. The behavioral issues driving this epidemic undoubtedly stem from cultural changes associated with the pace of contemporary life. It shouldn’t be so difficult to eat well and exercise moderately for a third of the country — but it really is. This is reflected in the surge in metabolic disease incidence. Diabetes was a rare disease 100 years ago (pretty rare even 50 years ago). Now it’s everywhere.

DPP = real and lasting change with First Mile Care

Diabetes prevention programs (DPP) are evidence-based and effective iterations of the methodology for addressing prediabetes developed by the Centers for Disease Control (CDC). Using a combination of techniques focusing on lifestyle management, stress mitigation, diet and nutritional coaching, and community support — it helps people prevent diabetes before it even starts. DPP has proven to be very successful. In fact, the DPP is even more successful than prescribing medication such as Metformin, which is the world’s most widely used anti-diabetic drug.

One of the keys to its success is that people respond to other people. In-person coaching and the community involvement aspect of the program separate it from the host of failed diets and fad exercise regimens that simply aren’t sustainable for most folks.

That’s where First Mile Care comes in.

The greatest barrier to better prediabetes treatment from a doctor’s perspective is that need for the human touch. I’m only one person and I’m already counseling my patients about better diet and exercise when I see them — but I see them only once a month, if I’m lucky. I don’t have the same ability that First Mile Care does to reach into my patient’s local community and work with them face-to-face each week. That’s what it takes — weekly support and reinforcement to create new, healthy habits. By working with First Mile Care in this way, they become an extension of my practice and my care team. Constant reinforcement really removes barriers to effective treatment. When I prescribe DPP, I know that my patient is going to be getting access to a lot more resources from First Mile Care than I could personally provide or than they could ever find themselves.

When you have an in-person coach and the friendship and support of other people with prediabetes, it makes a huge impact in helping a person sustain positive changes in their lives — and it’s actually kind of fun.

Convenience is key

When it comes to combatting prediabetes, I can’t do it alone — and my patients shouldn’t have to either. That’s where First Mile Care bridges the gap.

First Mile Care leverages the power and convenience of our on-demand culture with an affordable, scalable, and sustainable platform to bring DPP to anyone at risk of diabetes. First Mile Care fosters community-based, peer-to-peer connections that provide individuals with the support system and guidance they need — and they do it in the settings where people actually make lifestyle choices. It’s focus on convenience, strategic support, personal connection, and sustainable lifestyle enhancement makes DPP convenient and enjoyable. So it sets patients up for success.

And it’s setting doctors up to help stop prediabetes in its tracks.


DPP: Ditching Diets to Achieve Greater Self-Awareness

By Jenny Fowler, First Mile Care Coach
Three Areas to Practice Greater Awareness

When patients are prescribed the diabetes prevention program (DPP), they often mistakenly think they’re being put on a diet. Most people hear the word “diet” and immediately shut down. Diets frequently summon negative thoughts: “punishment,” “deprivation,” “tried before,” “failed,” “didn’t work for me,” or even “why bother?”

Well, good news! The Diabetes Prevention Program is not a diet. DPP is a commitment to small, incremental lifestyle changes that can ultimately reverse a prediabetic state. You don’t have to develop type 2 diabetes, and DPP is an evidence-backed methodology to restore healthy metabolic function in your body and achieve “food enlightenment.” It all starts with greater awareness of…

Your Own habits

Identifying triggers is an essential part of putting together a sustainable food program. Trigger examples include stress, lack of sleep, your exercise routine, missing nutrients, and a variety of other factors. These can contribute to how, when, and why you eat certain foods and how they make you feel. Often we resort to making undesirable food choices because of lack of planning or stress. By intentionally mapping out your day or even your week, you will become better equipped to handle some of the factors that create unhealthy habits. For example, if you know that your work schedule is often unpredictable, leaving you with little time for cooking or a reliance on heavily processed meals, try meal prepping.

Meal prepping does not require chef-level skills or hours of kitchen labor, but allowing yourself to take advantage of nutritious pre-chopped veggies or pre-cooked proteins can make a huge difference when you’ve had a long and stressful day. Be realistic about what you have time for. Eating healthy doesn’t mean that everything has to be made from scratch in your home!

Cutting corners can help eliminate unhealthy choices and is absolutely okay, and in fact, encouraged in DPP. Be realistic about what you have time for and what may be causing you additional stress. Putting a helpful structure in place and planning ahead can almost always ward off a trip through the drive-thru.

How You Feel  

There is no such thing as a one-size-fits-all meal plan. What works for some will not work for everyone. This is where your own personal power of observation becomes incredibly important. Mindlessly tracking what you eat and logging it into an app or food journal is pointless on its own.  In the Diabetes Prevention Program, you can try tracking your food to observe correlations that might exist between how you feel and certain foods, quantities, or times you may have eaten. For example, if you tend to not feel well on Tuesday evenings, maybe there’s an element of your taco Tuesday tradition that’s not working for your body. Be aware of when you don’t feel well and think back to what the source may be. Identify patterns in your behavior that could be contributing to your lack of well-being.

There’s no substitute for investigating your own habits and your body’s response. The best method for determining your optimal diet is through observation — personal trial and error. Ask yourself – is my food doing all it can for me? Does my food serve as the proper fuel I need for my day? And do I feel well?

What’s in Your Food

Unfortunately, much of how we consume comes from our attraction to packaging or marketing language and advertising. And even if we dig deeper, most people only flip over the package to check the calories. BUT, calories are not the only thing you should take into consideration when purchasing food. In fact, low-fat or reduced-fat and fat-free items can often have more sugar in them. And it is important to understand that sugar is not synonymous with sweet.

There are many items – ones you may associate with the savory spectrum – that are loaded with sugar. Fat helps you feel satiated and provides flavor in most foods, so when removing fat from processed items, sugar (and sodium) are often increased to fill the taste gap. Be mindful of what makes up the low-fat foods you do purchase. The American Heart Association recommends 25g of sugar or less per day for women and 37g for men. You may be surprised to know that close to that amount (or more) can be found in your morning yogurt.

Beyond sugar, it’s important to be aware of the recommended serving size and other elements such as sodium and fiber. In the Diabetes Prevention Program, you can form the habit of checking nutrition labels for the actual serving sizes.  It is easy to accidentally eat large portions in prepackaged foods. Find out what’s really inside your food by checking the recommended amounts of nutrient intake per day per portion. There’s often more than one portion in the package.

Moral of the DPP Story?

DPP is not about the latest fad diet, protein powder, or Instagram-famous supplements. It’s about becoming more aware of the foods you eat and what they do for you. It’s developing the presence of mind to be honest about what works for you and how that fits into your life. The purpose of DPP is to set you up for “food enlightenment” success and trigger greater self-awareness in every part of your day.


Health2047 Spin-Off Focuses on Prediabetes Coaching

Health2047 Inc., a Silicon Valley-based innovation company founded by the American Medical Association (AMA), has spun out its second startup, First Mile Care, a preventive chronic care company focused on prediabetes. Health2047 previously launched Akiri, a San Francisco-based company developing a blockchain-based network-as-a-service platform for the healthcare industry. First Mile Care seeks to scale up CDC’s proven National Diabetes Prevention Program. Read more >