First Mile Care Earns CDC “Full Plus” Recognition for DPP
By Karl Ronn, First Mile Care CEO and Founder
We’re honored to share that First Mile Care has been awarded “Full Plus Recognition” from the Centers for Disease Control (CDC) for our National Diabetes Prevention Program (DPP) lifestyle change program. This designation is reserved for programs that meet CDC standards for delivering a quality, evidence-based program that achieves retention thresholds.
As a critical member of the national effort to prevent diabetes, First Mile Care already achieved “Full Recognition” status in 2021. The new “Full Plus” status means that the sustained success of our lifestyle change program has earned us five years of CDC recognition moving forward.
“It is programs like First Mile Care that are turning the tide in the fight against the epidemic of type 2 diabetes,” wrote Miriam T. Bell, team lead of the National Diabetes Prevention Recognition Program at the CDC, in a letter announcing the designation. “It is immensely gratifying to see the science of diabetes prevention being implemented to improve the public’s health. Thank you for your commitment to reducing the preventable burden of diabetes in the U.S.”
An important benefit of Full Recognition status is eligibility for enrollment in Medicare as a Medicare Diabetes Prevention Program (MDPP) supplier. As a CDC-recognized in-person organization that has already achieved Full Recognition status, First Mile Care is able to bill Medicare for in-person DPP services provided to eligible beneficiaries.
To achieve this CDC distinction, the First Mile Care team had to meet stringent requirements in a number of categories:
- Lifestyle curriculum content
- Staffing and training
- Intervention duration and intensity (frequency of sessions over one year)
- Minimum percentages for session attendance over the year
- Documentation of body weight
- Documentation of physical activity minutes
- Average weight loss of a minimum of 5% of starting body weight across all participants in the year-long cohort
First Mile Care already teams with health care providers in the greater metropolitan areas of Houston, Detroit, Ann Arbor, Syracuse, and San Francisco. We’re also expanding into Chicago and Central California. More than 600 people enrolled in the First Mile Care DPP in 2022, and our goal for 2023 is at least 1,000 participants. (See testimonials on our website from a few of our successful graduates.)
Health systems and community-based physician practices interested in offering First Mile Care DPP to their patients should contact us for more information.
To learn more about how you can benefit from the First Mile Care Diabetes Prevention Program, take the prediabetes risk test and get started today!
3 Deep Breathing Techniques for Managing Stress
By Gray Jessiman, First Mile Care DPP Coach
Breathwork or active breathing has become a popular component of wellness programs in the last few years because of its many health benefits. Like meditation, active breathing can reduce stress and anxiety, promote better sleep, and improve symptoms of depression. Breathwork can be a useful technique for people with prediabetes who are trying to lose weight to address their glucose (blood sugar) levels.
In the First Mile Care Diabetes Prevention Program (DPP), our coaches counsel participants on stress management as a component of a healthy lifestyle. Stress increases inflammation, the foundation for almost all chronic diseases. The relationship between stress and weight loss is important to understand. When the body is experiencing stress or anxiety, the stress releases hormones that cause the body to elevate blood sugar, store fat, and have a more difficult time burning fuel for energy.
When you are in a stress-producing situation, the sympathetic mode of your nervous system takes over, releasing adrenaline and causing your heart rate to race and your blood pressure to rise. As you experience this acute “fight or flight” mode, your appetite may be temporarily suppressed. But if the stress becomes chronic, it causes a release of cortisol which may affect your appetite and could create food cravings.
Moreover, just the mere fact that you are stressed will elevate your blood sugar. Therefore, the more time you spend being stressed, the more time your glucose level remains high, which becomes a health issue over time. Learning coping mechanisms, identifying the connection between your moods and your snack cravings and adopting good sleep hygiene to bring down your stress level, are all key to maintaining normal blood sugar. You may not be able to change the stress-provoking situation, but you can change the way you react to it.
One mechanism for better managing your emotional state is controlled breathing. Many types of breathing involve long exhales, which slow the heart rate and help to relax a person. This kind of breathing affects the parasympathetic mode of your nervous system, also known as the “rest and digest” mode. During this time, blood pressure goes down, heart rate slows, and stress hormones decrease.
“Breathe, breathe in the air …”
Specific breathing exercises are used for therapeutic purposes including relaxation and improving well-being. Exercises may include changing the breathing depth, such as deep or shallow breathing. It can include changing breathing rate, i.e., how quickly or how long it is done. Additional breathing exercises include changing the way air is inhaled, either through the mouth or the nostrils, and other components of breathing that control different body parts, such as relaxing or contracting the stomach.
Andrew Huberman of the Huberman Lab has shown the science behind various types of breathing. Box breathing, cyclic sighing, and cyclic hyperventilation are three types of breathing that can help you to reduce stress and feel more balanced and grounded in your everyday life. The first two are easy to do and do not require supervision.
- Box breathing is a simple inhale, a pause, and an exhale. You inhale for three to four breaths, pause for three to four breaths, and exhale for three to four breaths. As the name implies, it is a simple method and can be easily implemented.
- Cyclic sighing works very quickly in real time. Cyclic Sighing is one big long inhale through the nose, followed by a short, sharp inhale, and then a slow exhale through the mouth. This type of breathing balances the carbon dioxide in the body and has been shown to be the most effective in reducing stress.
- Cyclic hyperventilation has a similar effect to cyclic sighing, but the initial breathing is a very active breathing that increases adrenaline and epinephrine and activates the autonomic arousal state of the nervous system. When you do this, you have more carbon dioxide in your blood and are in a slightly hyperventilated state. You may experience a tingly sensation and feel a little agitated, but the end result after this type of breathwork is a feeling of calm.
However, it’s important to be aware that this type of breathing exercise is best done under the supervision of an experienced facilitator, as you could experience dream-like images. Some people have even reported that this type of intensive circular breathing helps them explore their unconscious mind and heal from trauma.
If you’re participating in the First Mile Care Diabetes Prevention Program and are interested in using breathwork to help improve your emotional balance and well-being, try exploring these breathing techniques. Experiment with box breathing first, and then move to cyclic sighing, and track how they help you to relax and reduce your stress levels. “Take a deep breath” is a simple but effective piece of advice that is easily practiced at any stage of life.
To learn more about how you can benefit from the First Mile Care Diabetes Prevention Program, take the prediabetes risk test and get started today!
Developing Healthy Snacking Habits
By Barbara Martinez-Benavides, First Mile Care DPP Coach
America is a nation of snackers. According to Statista research published in January 2023, around half of the U.S. population says snacking serves as a meal replacement both at home and at work. Our long periods at home during the COVID-19 pandemic led to explosive growth in the sales of processed snacks like cookies, chips, popcorn, and pretzels. Luckily, as the pandemic has waned, consumers are now showing a growing interest in healthier types of snacks.
There isn’t a hard-and-fast rule about snacking that applies to everyone. How much you snack depends on your individual biology and lifestyle. One thing that is important across people, though, is to stay curious on why you feel you need to snack throughout the day. In the First Mile Care Diabetes Prevention Program (DPP), our coaches ask: What’s triggering your snack cravings?
Ask yourself these questions:
- Could I feel hungry because I’m not getting enough quality sleep?
- Did I recently change my diet? Am I eating mindfully?
- Do my meals include all the macronutrients my body needs? Am I getting the right amount of filling foods such as fiber and whole grains?
- Am I drinking enough water, especially if I’ve been exercising?
- Do I have really long days that are making me tired?
- What’s my mood? Am I feeling stressed, bored, lonely, or sad?
“If I’m preparing for an important work-related call, I notice that I want to reach for a snack,” said Jeff Millhouse, who completed the First Mile Care program in Texas. “I ask myself: ‘Am I truly hungry, or anxious, or perhaps not hydrated enough?’ Sometimes just having a glass of water will suffice. I realize I associate food with relieving boredom or providing a sense of comfort.”
Mike Kowis is also a successful graduate of the First Mile Care DPP. “When I sit down in the evenings to watch TV, I used to have a snack like popcorn or ice cream. After our discussion of triggers and habits in a First Mile Care session with Coach Sandra Huskey, I realized that I eat at night because it’s just what I do as a routine, triggered by turning on my favorite talk show. So I have learned to stop myself from opening the refrigerator or cupboard and instead ask myself, am I really hungry?”
Heck, you might even think you’re hungry because you were subconsciously influenced by a TV commercial!
Food, glorious food!
If true hunger really is the reason you’re craving a snack, go for something nutritious, like vegetables, fruits, nuts, or seeds, rather than bombarding your body with a large meal or, heaven forbid, heavily processed chips and cookies with empty calories.
When you’re deciding on a snack, bio-individuality plays a huge role here again. What have you been eating throughout the day? What are you doing the rest of the day — jogging or binging TV?
Here are some low-calorie yet filling foods that work well as healthy snacks: carrots, celery with salsa, cottage cheese, cucumbers, dill pickles, a hard-boiled egg, Greek yogurt, or roasted vegetables (e.g., broccoli and cauliflower cooked with olive oil spray).
I recommend including at least two food groups as part of your snack, for a more satisfying experience and to help you feel full for longer. For example, plain yogurt with berries, apple with almond butter, carrots or celery with hummus, a rice cake with guacamole, or a square of dark chocolate with an apple, are quick snack options.
“I’m a night owl and sometimes snack late at night, but now I eat carrots and celery at Coach Taylor Winkel’s suggestion,” said Olidia Thomas, who participated in the First Mile Care DPP in Michigan.
If you want to get more creative with your snacks, check out these linked recipes: blueberry bites, chia pudding, fruit ice cream, crispy chickpeas, kale chips, and veggie trio salad.
Mike Kowis added, “If I want something salty and crunchy, I might substitute a raw carrot stick and sprinkle on a tiny amount of salt. I’m still getting that salty taste that I crave, but am also eating a healthy snack with vitamins instead of the empty calories in popcorn. It might sound weird to substitute carrots for popcorn, but it works for me!”
Now for the bad news …
If you’re trying to lose weight or just get healthy even when weight isn’t an issue, there are several common snacks that aren’t as healthy as you might think, and could even stall your progress towards weight loss (if that’s your goal).
Nuts. The high protein and fiber content of nuts make them a satisfying snack, but quantity and quality really matter. Nuts are already high in fats and calories, and then oftentimes have added flavors, oils, and salts which pack on more calories. If you nibble on the right portion, nuts make a great snack option, but it’s easy to over-indulge.
Smoothies. The healthiness of a smoothie depends on the ingredients you put in it. Some people add up to five different fruits, plus honey, plus toppings. If you make the smoothie yourself and keep it simple — one fruit, some greens, water, etc.) — it can be a healthy and filling snack option. Beware, though, that if you buy a smoothie, it could have even more calories than a milkshake. Check out First Mile Care Coach Sandra Huskey’s article on hydration with tips for creating healthier, satisfying smoothies.
Veggie chips. Just because the name is “veggie” doesn’t make them healthy. They don’t have fiber, so they won’t keep you full for long periods of time. They usually contain similar ingredients to regular potato chips — oil, sodium, preservatives, and other additives — so they are still high in calories.
As a general rule of thumb when it comes to snacks, be wary of misleading labeling. Some snacks labeled as “healthy,” “keto,” and “low carb” may indeed be good options, but many processed foods are disguised as healthy by buzzy marketing terms like “gluten free,” “low fat,” or — in the case of chips — “baked.”
Closing advice
I recommend keeping at least two healthy snack options available and ready at home, work, and in the car. If snack meal prep at home is an option for you, that is a great way to set up yourself for success. When you do your food shopping, make sure you have at least one healthy snack on your grocery list, and ideally, in an individual or “personal” size so you’re not tempted to overeat when you open the packaging. It’s even possible nowadays to find healthy snacks like fruit, nuts, and salads in gas station markets — but always read nutrition labels carefully to avoid high calorie snacks. (You’ll find advice on interpreting nutrition labels in this article.)
First Mile Care DPP participant Al Cisneros offers this insight. “I’ve become attuned to where empty calories are placed on shelves. If I go into a convenience store, there are doughnuts nearby, or candy by the cash register. Instead of giving into sugar cravings, I walk a couple of aisles back and find a healthier snack like unsalted nuts or celery sticks.”
My final takeaway when it comes to snacking is an easy one, and usually costs nothing — always, always drink water before snacking. Not only will you know if it is indeed true hunger that you’re experiencing and not thirst, but the water will help fill you up so you may eat less of the snack.
To learn more about how you can benefit from the First Mile Care Diabetes Prevention Program, take the prediabetes risk test and get started today!
Q&A With DPP Participant: Healthy Eating Habits for Disease Prevention
By Juliana Ronn, First Mile Care Director of Operations
Deborah Wilson joined the year-long First Mile Care Diabetes Prevention Program in April 2022. She agreed to talk about why she joined, the results she has seen, and her tips for leading a healthier lifestyle. Deborah is a retired 58-year-old living in Detroit, Michigan who spent her career working with special needs children.
1) What was your biggest health-related problem before joining the First Mile Care Diabetes Prevention Program?
My weight had been fluctuating up and down for about a year and a half. Since I’m vegetarian, I found it difficult to figure out how to eat. I confided in my doctor, Dr. Sarala Vunnam at Henry Ford Health Systems, and told her I needed to see a nutritionist. That’s when she told me about First Mile Care. I didn’t want my health to go from bad to worse and I didn’t want to go on a “diet.” I wanted professional help with lifestyle change to figure out what was right for me.
2) Now that you’re finishing the program, how do you feel about your eating habits?
Along with being vegetarian, one of my biggest challenges was a lack of appetite. I would go all day not eating because I didn’t have a big appetite. Coach Gray Jessiman encouraged me to take pictures of when I was able to eat a balanced meal so that it would motivate me to eat. For meals, I make my plate bright with pretty colors and that motivated me the most. I make sure vegetables take up half the plate to make the times I do eat big meals really count, to provide the energy I need. When I don’t feel like eating, I make a smoothie because I know that will satisfy me. It was all about finding ways to eat that worked for me.
I love to snack on nuts but can unknowingly eat a whole bag in one sitting. Becoming aware of correct portion sizes by preparing snacks in containers was a really helpful tip from Coach Gray. I even use a smaller plate when I’m fixing meals to avoid overeating, so I’m much more conscious about how I prepare my plate overall.
3) Did you know what prediabetes was before First Mile Care?
Yes, I had first-hand experience with type 2 diabetes as my father went into a diabetic coma and never came out. So I was quite aware of what diabetes was all about and that has made me very adamant about monitoring my own health. While I don’t exactly know if I had a prediabetes diagnosis before joining the program, I knew I was at risk for diabetes due to my family history, so I needed to learn how to maintain a healthy weight and avoid developing bad habits. It wasn’t that I was overweight, I just wasn’t at a weight that was comfortable for me and I knew what I wanted for myself because I’d seen my father pass away.
4) What measurable changes have you seen since completing the program?
I joined the program at 159 lbs. My tests showed that everything was fine but my whole life I had been 20 lbs lighter and I had noticed post-menopausal weight gain. With my familial experience with type 2 diabetes, I didn’t feel comfortable at that weight and knew I needed a change.
Now that I’m finishing the program, I’m between 147 and 150 lbs which I am very happy with. I’m still working on getting to 139 lbs, but when I went to check-in with Dr. Vunnam this year, all of my tests came back great! So, yes, through changing my diet and reducing my weight, I feel successful in preventing diabetes.
5) What did you most enjoy about the First Mile Care program?
I liked working with Coach Gray because she understood me and she was great at personalizing the program for me. It was helpful to have one-to-one support to get her input on food labels and she provided recommendations if I should buy a product or not. If I needed extra help, she had lots of ideas and recipes to try but I never felt any pressure. She let me make my own choices. It all boiled down to figuring out a way for me to eat food that would align with my goals and she helped me figure it out.
6) What role did your coach play in your success?
Coach Gray really customized the program for me, my goals, and my health situation. In 2009, I received a diagnosis for a rare muscle disease that kept me in a wheelchair for several years. It’s a disease only 1% of the population has so, in terms of a solution, the doctors don’t know how to treat me. Through determination and the support of my family, I’ve been able to move without a cane or a walker for a few years now. My muscle disease aside, I also experience hip pain at times.
Being able to understand my triggers is what has kept me out of the wheelchair. Now that I’ve mastered my eating, including movement in my lifestyle is key. If I go on a walk, I make sure to listen to my body and take short breaks. Before the pandemic, I was going to the gym once or twice a week and my goal was to try to walk 10,000 steps daily. Now, I spend hours gardening and I’m getting 7,000 or 8,000 steps every day just through growing tomatoes (I have 15 different types!), green beans, strawberries, peas, watermelon, cantaloupe, squash, cucumbers, bell peppers, and lemon peppers.
Coach Gray knows my challenges and was the one who told me that, with my disease, I should be careful about eating too many tomatoes or bell peppers. That was something I didn’t know but I’m a tomato lover! I am so determined this won’t just be a year-long program but a full, permanent lifestyle change for me. It was just those little personal things that my coach recommended that have made all the difference for me in being able to sustain my new habits.
7) Was it helpful to have people in the same geographic area as you embarking on lifestyle change?
Yes! The majority of my group was based around the east side of Detroit, and in our weekly discussions it was helpful to chat about which local stores people could find different ingredients, like monk fruit, and being able to strategize with your group about where to find specific ingredients or produce. It helped us to relate to each other by providing another level of support.
8) Did you find a food journal or another type of tool to be helpful?
I kept a food journal in the beginning and then stopped once I had developed the eating habits that worked for me. Right now, I’m on a salmon kick where I’ll eat salmon, corn, and broccoli for about a month straight, and journaling helped to build that habit. We also built action plans about eating and exercising that I try to follow when I can. However, because of my physical challenges, sometimes I’m in too much pain to walk so I just have to listen to my body and do what feels right.
9) Did you learn something that was surprising from the program?
I learned that walking 10 minutes after you eat is a good way to burn more sugar. Coach Gray also recommended eating my food, waiting, and then drinking water after eating, to avoid slowing my digestive system. Lastly, I’m very good at reading food labels now and learning that if you can’t pronounce it, don’t eat it!
10) Do you think you’ll be able to maintain these habits after the program?
Absolutely. The only challenge has been learning how to eat out at restaurants. I know what to order but sometimes the meals will come with sides where I don’t know the ingredients or the calorie count. I learned that my solution is to just eat around it.
Everything I learned from First Mile Care I live by and I tell people about it. Sure, sometimes I’ll have my cheat days but I’m much more aware of a lot of my habits. I do tell a lot of people about what I’ve learned because when I teach other people, it sticks with me. I’m very adamant about keeping my weight down and now it’s a lifestyle, so it will be very natural to maintain these habits.
To learn more about how you can benefit from the First Mile Care Diabetes Prevention Program, take the prediabetes risk test and get started today!
Get on Your Feet! 8 Tips for Breaking the Deadly Link Between Sitting and Prediabetes
By Sandra Huskey, First Mile Care DPP Coach
There is mounting research connecting sedentary lifestyles to an increased risk of diabetes, dementia, and heart disease as people age. Some experts have even referred to sitting as the new smoking — it has the potential to be that deadly!
According to the Centers for Disease Control and Prevention (CDC), more than one out of every three adults in the U.S. has prediabetes, and nearly half of adults have high blood pressure — conditions aggravated by long hours of physical inactivity. Luckily, simple movement and exercise can help mitigate the negative health effects associated with extended durations of sitting.
In the First Mile Care Diabetes Prevention Program (DPP), coaches advise participants to get at least 150 minutes of moderate-intensity physical activity each week. Coaches recommend you keep track of how much time you spend sitting still each day, for a few days, to have a baseline number for comparison. You will probably be surprised to find that even when you get 150 minutes of activity a week, you spend an awful lot of time sitting still — especially if you have a desk job.
Check out these tips if you’re trying to build habits to incorporate movement breaks.
1. Find a fitness activity you like. Try going for a walk outside, 5-minute yoga, or even a dance break (like this BeeGees one or this Elvis one). Be honest with yourself about your enjoyment level of the activity. You’ll find an excuse to stay sitting down if you’re trying to avoid the movement you have planned!
2. Break it up. Sometimes it’s easier to find small chunks of time throughout the day than one giant period of time. The DPP recommends two minutes of movement for every 30 minutes. Researchers at Columbia University Medical Center recently published a study in the journal Medicine & Science in Sports & Exercise that showed even a five-minute walk every half-hour can help control blood sugar and undo a lot of the risks incurred by sitting for long periods.
3. Create times to move. Taking a movement break might not come naturally in your busy life. You may need to set a timer to remind yourself to stand up and walk around every half-hour until it becomes a habit.
4. Invest in a treadmill or standing desk. On the days that inclement weather doesn’t allow an outside walk or life becomes too busy to disconnect, a treadmill can help maintain your habits. Some people have set up their desks around a treadmill to encourage walking while working and taking meetings. In that way, you don’t have to choose between productivity and your health. There are even space-saving under-desk treadmills and walking pads, too. If you must remain seated at a desk, try sitting on an exercise ball which allows some bouncing movement.
5. Take a stretching break. If the cold, heat, or humidity isn’t in your favor or you’re not feeling up to your usual movement, try taking a stretch break. Stretch breaks will help reduce muscle tension and increase blood circulation. Static muscles will fatigue easily and stretching will help you become comfortable (and make tasks less difficult)!
6. Multi-task. Too many items to cross off your to-do list? See if you can combine your errands with movement. For example, if you live within walking distance, step out on foot to the grocery store or post office. Hold standing or walking conference calls with co-workers, or make a rule that you’ll only allow yourself to phone a family member while you’re on your feet. Create a new habit of always walking in place during the opening credits of your favorite TV show, or during a comedian’s opening monologue. If you use public transportation, stand instead of grabbing a seat, at least for a few stops.
7. Make it engaging. Turn up the music or your favorite podcast during activities. You’re more likely to build and maintain a new habit if it’s coupled with something that you already look forward to doing, and listening to energizing music can help you move faster without realizing it. If you’re into video gaming, a virtual reality (VR) headset may get you on your feet and moving around as your mind is tricked into entering immersive simulated environments.
8. Build in a healthy reward. There’s no better way to encourage a habit than positive reinforcement when you achieve a goal. Maybe there’s a movie or TV show you’ve been wanting to watch or a special purchase you’ve put off. After incorporating movement breaks in your day, a reward is definitely earned!
Take the advice of Gloria Estefan — get on your feet! Get up, stand up, and take some action to promote healthy aging.
To learn more about how you can benefit from the First Mile Care Diabetes Prevention Program, take the prediabetes risk test and get started today!
What’s the Best Trendy Diet Program? (Hint: It’s the One That Works for You)
By Taylor Winkel, First Mile Care DPP Coach and Registered Dietitian
Did you know that the word “diet” comes from the Greek word “diaita,” which means “way of life”? Diet can mean both habitual nourishment, what you normally eat and drink, as well as an eating regimen specifically designed to promote weight loss.
In the First Mile Care Diabetes Prevention Program (DPP), our coaches emphasize eating for healthy aging. We teach that diet, weight loss, and healthy eating are connected, but not interchangeable. Weight loss is a natural side effect to ongoing lifestyle change that involves healthy eating and exercise, but it takes time to achieve.
It’s very common that our DPP participants ask coaches: What’s the best diet? Do you recommend the [Atkins, DASH, IMF, Keto, Nordic, Paleo, Pritikin, Whole30, Zone, etc.] diet? Which one do you think will work for me?
What I tell my group participants is, diets are not one-size-fits-all and there is no magic formula to weight loss. What works successfully for one person may be challenging for someone else. Some popular diets may help you to drop weight in the short term, but aren’t healthy overall and are so restrictive that they become impossible to maintain. The best diet, therefore, is the one that works for you in the long term and promotes sustainable healthy habits.
Fads versus facts
U.S. News & World Report recently announced its annual ratings of popular diets. An expert panel analyzed and ranked 24 diets across several categories. The list examines diets that have some basis in science and avoids some of the more wacky diets and TikTok trends. For the sixth year in a row, the Mediterranean diet came out on top.
The Mediterranean diet is really a style of eating rather than a restrictive diet, focused on simple, plant-based cooking — good quality fruits and vegetables, whole grains, beans and seeds, a few nuts, and olive oil as the preferred fat over butter. Fish is emphasized rather than red meat, while eggs, dairy, poultry, sugar, and refined foods are eaten less than in the traditional Western diet. An important lifestyle part of the diet is eating mindfully and socializing with friends and family over meals.
Denial is a commonality among many of the diets in the U.S. News rankings. That can be their downfall as restriction generally does not work over time. The more complicated and restrictive a diet, the harder it becomes to keep to it. Who wants to live a life in perpetual denial? When you’re fixated on weight loss, you’re more likely to develop an unhealthy relationship with food. Instead, focus on adding only quality calories and ingredients to promote wellness.
Here are a few key points that First Mile Care coaches recommend:
- Eat well-balanced meals of unprocessed whole foods. Non-starchy vegetables should account for about 50% of your plate, lean protein foods for about 25%, and the remaining 25% of carb foods like starchy vegetables or whole grains or fruit.
- When possible, cook at home so you can control ingredients, calorie quality, and portions.
- Read nutrition labels so you know what you’re eating and serving sizes.
- Keep hydrated with water and not sugary drinks.
In addition, a healthy lifestyle includes exercising daily (at least 150 minutes of moderate activity per week), getting adequate, high quality sleep, and managing stress.
Check out the U.S. News & World Report rankings to see their expert evaluations of popular diets, including meal plans, food lists, and tips.
You may also want to watch the webinar about “Deconstructing Popular Diets” on our blog.
To learn more about how you can benefit from the First Mile Care Diabetes Prevention Program, take the prediabetes risk test and get started today!
Q&A With DPP Participant: Becoming Accountable for Lifestyle Change
By Juliana Ronn, First Mile Care Director of Operations
Patricia “Pat” Bagozzi joined the year-long First Mile Care Diabetes Prevention Program (DPP) in May 2022. Pat is a retired 70-year-old widowed grandmother of four living in Westland, Michigan, a suburb of Detroit. She spent 35 years as a claims representative with the AAA Auto Club of Michigan, so knows something about the importance of listening carefully to other people’s problems.
Pat, you’re now about three-quarters of the way through the First Mile Care DPP. What results have you seen so far?
- Normal A1C. My blood sugar is in the normal range again! When my doctor tested my A1C level four months into the program, it was in the normal range at 5.7. One year earlier, it was at 6.0 so indicated prediabetes.
- Healthy weight. I’ve lost 46 pounds and feel fantastic! I’m pretty much at my goal weight now and am feeling good about myself. And it’s not been hard. I put on three pounds over the holidays yet was able to lose it fairly quickly in the new year.
- Healthy girth. I have dropped two clothing sizes. I always used to buy loose flowing tops to cover my upper body. Now I can wear skinny jeans and fitted sweaters and pants with zippers instead of elastic waists! I am so confident about keeping the weight off that I’ve given away my old clothes or had the more expensive items tailored.
What made you join the First Mile Care Diabetes Prevention Program? Did you have a diagnosis of prediabetes?
I didn’t know specifically that I had “prediabetes” although my doctors at Henry Ford Health Systems warned me about losing the extra weight around my midriff and lowering my cholesterol and A1C. My previous doctor told me I had certain markers I needed to get under control, although she also knew my family situation with my husband’s illness, and told me not to try to take on too many changes at once. While a member of my family has gestational diabetes, I was never really too concerned about developing type 2, but as a former smoker, I knew I was at risk for heart disease.
After my husband passed away, I knew it was time for a big lifestyle change. I spent years putting other people first. I was always busy but I wasn’t really focused on myself. I took care of my husband, my work, my kids, and my grandkids. So when that phone call came from a First Mile Care representative, asking to send me information on the Diabetes Prevention Program, I knew it was time to take care of me and put my needs first — for the first time in decades.
I had already quit smoking and drinking, but I was sitting a lot and doing a lot of mindless eating, so I kept putting on weight, ballooning to as much as 200 at one point. After I had knee replacement surgery in the fall of 2020, I could start walking more, which really has helped in losing weight.
What type of weight loss or lifestyle change programs have you tried in the past?
I tried Weight Watchers but I found their points system confusing. It also costs a bit, and people seem to have to go to it for years. I don’t want to deny myself anything. I want to be able to eat what I want when I go out with friends, and not be one of those people who brings my own dish or asks other people to adjust what they’re serving to accommodate me.
Why do you think the First Mile Care program is working for you when others haven’t?
What the First Mile Care program does is make ME accountable for what I put in my mouth and for the healthy food that I eat and for the type of exercise I get. But nothing is off limits and nothing is mandated – apart from getting 150 minutes of exercise a week. Coach Taylor Winkel told me to pick something to do in terms of activity, my choice as to what, just as long as I got the minimum time in. The program has also given me the incentive to read nutrition labels and make sure that everything that goes in my mouth has a purpose. I allow myself to eat what I want, but pay attention to quantity and nutrition, so I’m more satisfied at the end of the day.
What are some changes you have made as a result of what you’ve learned in your DPP classes?
I faithfully read food labels and note the calories, servings sizes, and portions to prepare healthy meals. What’s the amount of added sugar, does it have whole wheat, is it processed? Honestly, I couldn’t believe the amount of food that I was eating before I started the DPP! I used to love eating potatoes and starches that turn into sugar. I’m surprised that I didn’t weigh more than I did, because it was nothing to me to eat a whole big bag of chips in one sitting. While I may eat some chips now, it’s a small package, not a whole bag.
I continue food journaling to track what I eat and drink. I use a watch with a health tracker to record my activity and remind me to move occasionally. I also use the MyFitnessPal app on my phone for gauging and tracking calories. I monitor my water intake, as that’s super-important. I always look at menus online now before I eat in a restaurant with friends, so I can make a conscious decision about what I eat and how much. I’ll only eat half of what I order, have a few chips, have a glass of water, and take the rest home.
What do you enjoy most about the First Mile Care program?
There are a couple of things — education and camaraderie. This program offers one-on-one individual advice. You make the decisions. You set your goals and action plans. You figure out with the coach, through education and trial and error, what works for you as an individual, which may be different from what works for other people. I also enjoy the program for the sense of camaraderie I’ve built with the other people in my group. That’s what I’ll really miss once I’ve finished the program — and hope I can stay in touch with some of the folks. We really do talk about our issues. We give suggestions to one another to work around our challenges.
How is the DPP group dynamic?
There are a couple of things — education and camaraderie. This program offers one-on-one individual advice. You make the decisions. You set your goals and action plans. You figure out with the coach, through education and trial and error, what works for you as an individual, which may be different from what works for other people. I also enjoy the program for the sense of camaraderie I’ve built with the other people in my group. That’s what I’ll really miss once I’ve finished the program — and hope I can stay in touch with some of the folks. We really do talk about our issues. We give suggestions to one another to work around our challenges.
What role has your coach played in your success?
First Mile Care has given me the tools and information to understand healthy options, and to help guide me to make the right choices for me and develop behaviors that promote wellness. Each person is different, so it’s all about finding the right balance of what works for the individual. It’s really helpful that Coach Taylor is a foodie and a registered dietician (RD). She really knows her stuff and has educated us on getting healthy amounts of fruits and vegetables in our diets, and explained what different nutrients do in your body. She turned me onto eating Greek yogurt and helped me adjust my bread consumption. She has helped me to understand that if I’m not hitting the goal I’m striving for, I need to adjust the type and amount of food I’m eating, and to vary the kind of exercise.
Do you expect to maintain the progress you have made in changing your lifestyle?
Absolutely! I’ll never go back to the way I was, mindlessly eating and never getting any exercise. I’m positive about that. I’m a determined person. That’s my personality. Monitoring what I eat, eating healthily, and exercising has become a habit, just like putting on a safety belt when I get in a car.
My main exercise is walking and using exercise bands. I started using them to strengthen my knee after surgery, but now also use them for stretching and arm curls. They’re easy to take with me if I’m away from home. My walking routine lapsed recently when my dog had surgery and it was really rainy outside. Even one week of not walking makes a difference. Now I’m trying to work more weights into my daily routine, and I might sign up with a gym to be able to do water aerobics and other classes in the future.
What advice do you give to people asking you about joining a lifestyle intervention program like First Mile Care?
This program is a whole change of mindset and something that becomes your habit. You have to have the “will to wanna” make a change. But once you see results, you can’t get enough of it. It has really been a metamorphosis for me — I’m like a butterfly! At 70, I can’t wait for my grandkids to come over to the house and I can go-go-go with them. I’m thankful for it every day and speak about it everywhere I go. It’s a beautiful thing.
To learn more about how you can benefit from the First Mile Care Diabetes Prevention Program, take the prediabetes risk test and get started today!
6 Fitness Trends Growing in Popularity in 2023
By Shavon LeBlanc, First Mile Care DPP Coach
Ask ten people about their new year’s resolutions, and you’ll hear “exercise more” or “eat healthier” or “get in shape” from nine of them. The new year is an opportunity to evaluate how you can make improvements. Taking care of these interconnected areas of nutrition, exercising, sleeping, mental stimulation, and mood are necessary for holistic wellness.
Our coaches help participants in the First Mile Care Diabetes Prevention Program (DPP) to implement lifestyle change goal-setting and adjust their action plans throughout the year. Your fitness goals don’t need to be epic feats of Olympic caliber. Even a little shift in how you move throughout your day — as little as five minutes every half-hour — can produce health benefits, according to a recent Columbia University Medical Center study.
Here are six fitness-promoting trends that will continue to grow in popularity in 2023.
1. Wearable technology
Wearable technology will be more affordable, smaller in size, and further linked to more online applications. They’ll include more real-time biometric measurements such as heart rate monitoring, pulse oximetry (blood oxygen reading), stress level monitoring, counting of steps, and monitoring sleep quality.
2. Outdoor workouts
As a result of the pandemic, exercising outside has become an even more popular fitness option. More communities will continue investing in the health of their residents by expanding or building parks and outdoor fitness areas to encourage walking, playing, and living.
Exercising outside is accessible to everyone, improves social interaction, and offers a natural antidepressant as social interactions are built through the camaraderie that occurs in group outdoor activities. Running teams, group walks, fun runs, and obstacle courses are increasing in popularity.
It’s also important to note that the more we encourage outdoor activities and movement, we’ll also reduce a population that sits too much. Sitting is now considered as dangerous to our heart health as smoking! Walking can be a great way to overcome a sedentary lifestyle.
3. Online virtual workouts
Prior to 2020, home workouts like Peloton and The Mirror were beginning to gain popularity due to their “anytime” accessibility. Since the pandemic, the sales of home workout machines have skyrocketed as well as their online application and programming. Virtual reality workouts take exercise to another level of fun as someone can literally jump into the action, making fitness engaging and reducing boredom.
Preventing a sedentary lifestyle is one of the major benefits of home/virtual/online workouts. If you work from home, you can always take a break throughout your day to participate in a fitness activity. You can also partner with friends (or soon make new friends) via online communities that promote accountability.
4. Functional fitness
Older adults should make movement a priority to improve their mental and physical health as well as promote healthy aging. The effects of many chronic illnesses such as obesity, type 2 diabetes, arthritis, and heart disease can be reduced with consistent moderate physical activity on most days of the week. First Mile Care coaches follow the CDC’s guidelines for the DPP, and recommend a minimum of 150 minutes of moderate exercise a week.
More baby boomers are investing in physical fitness to increase their independence. Functional fitness emphasizes building strength in major muscle groups. It’s about building strength and flexibility so that activities of daily living are completed with ease. The focus is on cardiovascular exercise to lower risk of heart disease and stimulate mental health; strength training to lower risk of arthritis and to build bone strength to reduce hip/knee fractures; and flexibility to stimulate and improve mental health and to improve mobility.
5. Nutrition
People are spending more time learning how to prepare healthy meals at home and are trying to eat less processed food. They are considering plant-based and alternative meat options and are investing into growing their own foods.
As we seek to lower the risk of chronic illness and disease, there has been a growing interest in the last few years in integrating nutrition education into fitness facilities. In the past, fitness and nutrition operated independently, but now facilities are partnering with dieticians and nutritionists to share their knowledge with their members.
In 2023, we’ll also continue to see increased adoption of online applications like MyFitnessPal and Noom, which highlight the connection between eating habits, weight loss, behavioral influences, and health.
6. Medicine and fitness
Collaborative care of physical fitness, rest, mindfulness, nutrition, and prevention as lifestyle modifications will continue to be important in improving the health of our society and lowering the risk of diseases . Many chronic conditions, which place an economic burden on our society, can be remedied with lifestyle changes rather than requiring medication. The physicians of the future will better integrate fitness, wellness, and nutrition as a staple in their practices, emphasizing lifestyle modifications before drug therapies.
The best way to improve your physical, mental, and emotional health is to simply start moving, try new things, find what you love, and keep at it. Here’s a list of 15 suggestions that only take a few minutes each. Your First Mile Care coach and classmates are here to help you stay on track, along with your family, friends, and co-workers.
To learn more about how you can benefit from the First Mile Care Diabetes Prevention Program, take the prediabetes risk test and get started today!
First Mile Care Expands Diabetes Prevention Program Footprint to High-Risk Populations in California’s Central Valley
By Karl Ronn, First Mile Care CEO and Founder
I’m pleased to share that First Mile Care is in the process of rolling out our highly successful Diabetes Prevention Program (DPP) within California’s Central Valley. In partnership with a national health plan, we’re initially targeting populations showing a high incidence of prediabetes and type 2 diabetes — specifically, Fresno, Sacramento, and surrounding counties.
What’s more, the First Mile Care Diabetes Prevention Program is now accessible for the first time to physicians who accept patients covered by a Covered California™ health plan. The California Covered exchange makes private health insurance coverage available to eligible individuals and small businesses at federally subsidized rates. The DPP is also covered nationally by Medicare and under California Medicaid.
The best option for addressing type 2 diabetes is to stop it from developing in the first place. According to the Centers for Disease Control (CDC), 38% of the U.S. adult population has prediabetes, putting them on track to develop type 2 diabetes and its associated deadly chronic conditions such as heart disease and stroke.
Local medical experts say the epidemic is even greater in the Central Valley, where nearly half of the adult population of Fresno County, for example, has either prediabetes or type 2 diabetes. In Madera County, approximately 14% of residents are diagnosed with type 2 diabetes compared to a 9% state average. Yet eight out of ten people don’t even know they have prediabetes, or how easily they can reverse the condition through small incremental habit changes.
First Mile Care has achieved CDC Full Recognition for our DPP, a designation given only to programs that have successfully delivered a quality, evidence-based program that meets all of the standards of the National Diabetes Prevention Program. The year-long lifestyle change program is clinically proven to reduce risk of developing type 2 diabetes by 58% (and 71% for age 60-plus).
Our community focus
First Mile Care takes the burden off physicians and health care systems by acting as a complementary extension of a physician’s practice to deliver diabetes prevention classes. In partnership with physicians, we recruit and activate participants based on their ZIP code to develop critical mass for establishing in-person DPP group classes. We secure community-based locations close to participants’ homes to emphasize a shared neighborhood experience which promotes lasting lifestyle changes.
At First Mile Care, we strive to address social determinants of health and health equity by becoming one with the community. We recruit experienced local coaches, certify them in the DPP, and help them tailor sessions appropriately to reflect local activities, amenities, culture, foods, languages, and weather. Coaches recognize the micro-challenges people face in their daily lives and are in a position to make personalized recommendations on healthy practices to create small, sustainable habit changes.
We are already partnering with health care providers in the greater metropolitan areas of Houston, Detroit, Ann Arbor, Syracuse, and San Francisco. We enrolled more than 600 people in the DPP in 2022, and aim to enroll at least 1,000 participants in 2023. Please read testimonials on our website from a few of our successful graduates.
Health systems and community-based physician practices interested in offering the DPP to their patients should contact us for more information.
To learn more about how you can benefit from the First Mile Care Diabetes Prevention Program, take the prediabetes risk test and get started today!
15 Things You Can Do in Under 15 Minutes to Boost Wellness in the New Year
By La Tonya Allen-Brown, First Mile Care DPP Coach
As the new year begins, you can probably use some suggestions for replacing the bad or lazy behaviors you may have developed over the past three years of pandemic living with some new healthier habits that can lead you to a vigorous and (hopefully) happier and longer life.
“I don’t have time to …” — exercise, cook, read, meditate, take your pick — is an easy excuse. The thing is, there are many tiny adjustments you can make to your daily life that require little time or effort but, over time, can have a big positive cumulative impact.
Here are 15 suggestions for activities that take less than 15 minutes — sometimes much less. You probably won’t do them all, and not every day, but pick and choose what could work for you.
Physical wellness
1. Stand up and stretch at least every half-hour — and remain standing for 5-15 minutes, whether in a meeting, watching TV, or folding laundry.
2. Walk 15 minutes twice a day, hitting at least 150 minutes each week as advised in the First Mile Care Diabetes Prevention Program.
3. Lift weights or use resistance bands to build strength through repetitions.
4. Apply sunscreen of SPF 30 even on overcast days, as per the recommendation of the American Academy of Dermatology.
Healthy eating
5. Fix a snack like chopped veggies with a healthy dip to keep on hand instead of eating chips.
6. Infuse a pitcher of water with chopped fruit and/or herbs to have in the fridge to drink instead of sugary sodas. (You’ll save money, too!)
7. Keep a food journal to track what and how much you consume to reveal the patterns of eating and drinking and the link to your moods.
Mental acuity
8. Do a puzzle (crossword, sudoku, Wordle, jigsaw, etc. ) to sharpen your analytical skills.
9. Use an app to teach yourself a new skill, like a one-word–a-day new language.
10. Read a book or listen to an audiobook to flex your ability to concentrate.
11. Check your blood pressure regularly with an at-home monitor, as high BP can be linked to various health issues including cognitive decline.
Emotional well-being
12. Take a quick “do not disturb” break for a nap or meditation.
13. Set a time limit on checking social media accounts to limit negative input and doomscrolling.
14. Phone (not text) a loved one as it can relieve stress, reduce loneliness, and accentuate positive thoughts — for both of you.
15. Choose one thing on your to-do list to work on each day; the progress will make you feel better even if the finish line is a long way off.
When you’re trying to swap out habits, qualified guidance and peer support are invaluable to maintaining your motivation to reach your goals and to avoid lapses into old behavioral patterns and practices. Ask your doctor if you qualify for a Diabetes Prevention Program with certified DPP coaches in your neighborhood.
To learn more about how you can benefit from the First Mile Care Diabetes Prevention Program, take the prediabetes risk test and get started today!