Guidelines to Power Napping

By Karalyn Cass, First Mile Care DPP Coach and Program Coordinator

Many people are not fully aware of the important role that sleep plays in maintaining a healthy weight. In the First Mile Care Diabetes Prevention Program (DPP), coaches emphasize the basics of good sleep hygiene. As I explained in an earlier article and webinar on sleep habits, sleep is closely connected to both weight gain and loss, as well as how your body reacts to insulin, the hormone that controls your blood sugar. 

Your body repairs, recovers, and restores many functions during sleep that influence how much energy you have during the day. Sleep affects two hormones — ghrelin, which tells your body when you need to eat, and leptin, which tells your body that you’re full. When you’re sleep-deprived, your body will end up with too little leptin and too much ghrelin. Your brain will tell your body to stop burning calories and that you need to eat. You’ll feel hungry even when you don’t really need food. 

The general recommendation for a healthy amount of  sleep is 7-9 hours a night. Sometimes, though, you can use a brief period of sleep during the daytime to re-energize the body. Napping can help with drowsiness, relaxation, mood improvement, better concentration, a sharper memory, and creativity — hence the nickname “power nap.” 

In some countries, especially ones with hotter climates, napping is part of the traditional culture. (Noel Coward wrote an entire patter song about it.) While nap rooms have become a popular benefit in some larger companies for employees working odd hours, for most people with an 8-5 job, “siesta time” is a luxury to indulge on weekends, during vacations, and after big holiday meals.

Forty winks

It’s best to avoid frequent or excessive napping. The ideal nap is a short one in which you fall asleep quickly and wake feeling refreshed. 

  • Timing is everything: Napping before 3pm will take advantage of your natural sleep-wake cycle and be less likely to interfere with nighttime sleep. 
  • Keep it cozy: There are people who can nap anywhere, but a quiet, comfortable place will contribute to drowsiness.
  • Make it quick: Avoid napping for more than 10 to 20 minutes — set an alarm to avoid falling into deep sleep. Some power nappers can sleep as little as five minutes and still feel a benefit. Anything longer may hinder the five stages of sleep and leave you feeling groggy.

If you’re getting the recommended amount of sleep each night, you probably won’t need a nap on a regular basis. For people with erratic work schedules or who know they will be temporarily losing sleep (e.g., taking an early or late flight, vacation, etc.), a nap is helpful to recoup those lost zzzzzz. But naps aren’t for everyone, as some people find it easy to glide into a quick midday siesta while for others, it’s challenging to enter and leave a state of unconsciousness. And napping is not a long-term solution for people who suffer chronic insomnia.

Getting your shut-eye

An occasional nap of 10-20 minutes is not bad for your health. If you are sick, you may need to nap to aid your recovery, and for longer periods. Babies and young children also take long naps to give their body time to develop.

But if you’re an adult and need frequent naps, poor sleep at night is most likely the root cause. Consider frequent napping as a warning sign and reflect on what you can do to improve your sleep in terms of quality as well as quantity. 

Paying attention to your sleep patterns and trying to establish good sleep hygiene is key. Here are a few things to consider:

  • Scheduling: Establish a consistent sleep schedule that ensures the recommended amount of sleep, even on weekends.
  • Relaxation: Create a relaxing sleep environment: bed, pillow, temperature, etc. Reserve your time in bed for sleep and sex only, and avoid eating, working, or other activities. 
  • Movement: Get the recommended amount of exercise during the day. Physical activity can reduce stress and settle your mind, helping you to fall asleep faster and improve sleep quality.
  • Limitations: Avoid the following in the evening hours before bedtime:
    • Large meals
    • Large amount of fluids
    • Caffeine in coffee, teas, sodas, and chocolate
    • Alcohol
    • Use of electronics less than 30 minutes prior to bedtime

If you’re getting the recommended 7-9 hours of sleep each night yet are still feeling sleepy during your normal day, that could be an indicator of a hidden health problem. A recent study published by the American Heart Association found a link between older adults who napped and a higher risk of high blood pressure and stroke. Yet, experts recognize that the nap itself may not be the problem, but a symptom of poor nighttime sleep or other health factors. Make sure to talk to your physician about any underlying health issues that could be interfering with your sleep.

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!


10 Steps to Healthy Aging

By Gray Jessiman, First Mile Care DPP Coach

September is designated National Healthy Aging Month in the U.S. to encourage healthy lifestyle behaviors among older adults. It’s also about raising awareness of the prevention and management of chronic health conditions like high cholesterol, high blood pressure, and obesity, which are often linked to the development of prediabetes and heart disease.

According to the Centers for Disease Control (CDC), more than one in three American adults have prediabetes, but 80 percent are unaware of the condition and the risk it poses for developing into type 2 diabetes. Compared to 2025, by the year 2060, U.S. rates of type 2 diabetes are expected to jump by nearly 40%, per a study published in the Journal of the American College of Cardiology in August. 

Luckily, prediabetes is reversible, so you have the chance to take control of your health by improving your eating habits, becoming more physically active, and lowering your blood sugar levels to avoid becoming a statistic.

The best time to prevent type 2 diabetes is NOW. If your doctor says that your blood sugar is in the range for prediabetes, or that you have other risk factors based on family history, consider the diagnosis as an early warning sign — like an indicator light on your car dashboard. The First Mile Care Diabetes Prevention Program (DPP) teaches participants with prediabetes to make small adjustments in habits that add up to sustainable, healthy lifestyle change in eating, activity, sleep, and stress management. You have time to fix this! 

The glass is half-full

The idea of Healthy Aging Month gained traction in the early 1990s when the first members of the Boomer Generation began turning 50. It spread the message that it is possible to celebrate life and the positive aspects of growing older by adopting a healthier lifestyle at any age. It encourages people to focus on their physical and mental health and take precautions to help them mature gracefully. 

It’s often been a challenge the last few years to look on the brighter side of life events. The world has sometimes seemed to be spinning out of control. And as you age, your physical and mental health as well as dietary and social needs, may change over time. But your life is still within your control. You can take charge of your physical and mental well-being by incorporating habits around exercise, healthy food, and adequate sleep. You’ll find it’s possible to age healthfully and gracefully and see the glass as half-full instead of empty.

Here are 10 habits you can start today to reduce your risk for diabetes and related chronic illnesses and to improve your ability to stay healthy into old age. 

  1. Be proactive about prevention. It’s important to have annual physical exams and regular checkups by your physician —  and don’t skip your eyes and teeth. Your health insurance may entitle you to proactive healthcare screenings, tests, and immunizations based on your age and gender. Your doctor may recommend tracking important health indicators at home with tools and smartphone apps, such as a continuous blood glucose monitor for learning how food affects the body, or an arm or wrist band for checking blood pressure range.
  2. Manage stress levels. Chronic stress can be associated with fatigue and depression, which can cause people to become less active and lead more sedentary lives. Stress can also interfere with sleep and increase your appetite, so it’s critical that you find ways to de-stress regularly. Stress-relieving activities should be calming and leave you feeling more grounded afterwards. Finding what works best for you to reduce and manage stress can play a crucial role in healthy aging.
  3. Practice good sleep hygiene. Your body restores many functions during sleep that play a role in how much energy you have. Sleep enhances mood, reasoning, problem-solving abilities, coping mechanisms, attention to detail, and memory. It also affects two hormones that tell you when you’re hungry and when you’re full, so it has a strong effect on weight loss (and gain). You want both the right quantity of sleep — at least seven hours — as well as good-quality sleep, so practice a healthy bedtime routine. Regular physical activity is a foundational element of sleep hygiene, as research shows that exercising can help you fall asleep faster and improve sleep quality.
  4. Eat in moderation. Using food as “medicine” is key for promoting a healthy and vibrant lifestyle. First Mile Care recommends a diet high in fruits and vegetables, with the ideal meal about 50% produce, 25% starches and fibers, and 25% protein, along with some fats essential to brain health and satiety (e.g., nuts, seeds, avocados, coconut or olive oil, etc.). It’s important to balance the recommended amount of each food group with daily recommended calories, which varies with age, sex, and physical activity level. As you age, you may need fewer calories, and can learn to eat mindfully and manage calorie intake through portion control, meal timing, and healthy food swaps. The National Institute on Aging offers dietary guidelines for older adults on its site, Healthy Eating As You Age
  5. Choose liquid refreshment wisely. Hydration becomes even more important as you age. Instead of sugar-sweetened drinks, consume water, sparkling water, tea, or coffee. Fruit and herbs add flavor that turns plain water into something special. Alcohol should be taken in moderation; ideally, no more than one drink per day. You can also make your own delicious smoothies at home with healthy ingredients.
  6. Get on your feet. Exercise actually slows down the process of aging. It is not only good for physical fitness, it also stimulates the growth of new brain cells, releases endorphins that boost your confidence, and improves sleep quality. The First Mile Care DPP says adults should aim for at least 150 minutes of moderate-intensity physical activity each week to help maintain a healthy weight and lower blood pressure, cholesterol, and sugar levels. Make your physical activity something you truly enjoy doing, alone or with a friend — swimming, cycling, dancing, running, yoga, walking, dancing, etc. Every step counts when it comes to reducing diabetes risk and maintaining a healthy heart. Recent research shows that walking for even two minutes after a meal can make a world of difference.
  7. Practice strength and resistance training. Muscles atrophy or shrink as part of the aging process, resulting in poor leg strength and balance that are a common cause of falls in older adults. Strength training is about maintaining muscle mass by building strength progressively through movement repetition and increased resistance through weight lifting. It can change your body composition by decreasing body fat and increasing coordination, power, and metabolism. Practicing strength training two times a week with either resistance bands or weights helps build strong bones and muscle, and improves balance and coordination, which is especially critical as you age.
  8. Stimulate your brain. As you age, your brain shrinks in size, slows down, and becomes less adaptable to change. Therefore, you need to exercise your brain regularly just as you stretch other muscles. This can include reading, writing, art, music, skills, crafts, languages, and all types of brain teasers, puzzles, and games — whatever involves concentration, analysis, problem solving, and memory.
  9. Maintain social connections. Remaining active and engaged with others is a gift to yourself. The emotional support you receive from being part of a network — friends, family, church, alumni groups, volunteer organizations — is part of the bigger picture in helping to keep your mind and body well. Human support eases stress when times get tough, as was reinforced during the last few years of COVID-enforced isolation and separation.
  10. Keeping a positive outlook.  The power of positive thinking shouldn’t be underestimated. The Journals of Gerontology: Series B published research that being pessimistic about growing old can become a self-fulfilling prophecy, leading to a faster deterioration in both overall health and wellbeing. The reverse can also be true. Technology puts pressure today on emotional well-being; increased screen time can affect sleep quality as well as mental health. Setting limits for your tech devices can reduce your exposure to negative news and influences, and therefore the risk of creating anxiety, stress, and depression.

You’re as old as you feel, the saying goes. By developing the right lifestyle habits, you’re going to look and feel younger, no matter your age.

“I am so thankful for the health that I have,” said Jeannie Lawson, a Houston-area septuagenarian who completed the First Mile Care DPP in 2021. “A lot of my friends have had surgeries and other kinds of health problems. First Mile Care has played a big role in my journey to good health and my ability to stay healthy. It is helping me to lead an active, vital life that makes me happy.”

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!


Considering Calories

By Taylor Winkel, First Mile Care DPP Coach and Registered Dietician

Calories, calories, calories. People sometimes obsess over them. A calorie is a unit of energy in food and drink. We use calories to describe or measure how much energy your body could get from eating or drinking something. When you consume more calories than you expend in energy, your body stores the excess as body fat, which can result in weight gain over time. 

When someone talks about following a diet and counting calories to lose weight, the first thing that comes to mind is sustainability. Most trendy diets are attractive because they offer a short-term fix, yet weeks or months later the weight returns because adopting a diet of too few calories and too many rules is not practical and sustainable in the long term. This is why the First Mile Care Diabetes Prevention Program (DPP) emphasizes identifying behavioral triggers to make small, incremental changes to eating, physical activity, and other healthy habits that result in lifestyle improvements. 

The DPP promotes eating for health, not for short-term weight loss. First Mile Care coaches encourage participants to keep food journals to become more self-aware of eating habits. The DPP curriculum includes guidance on how to reduce calorie intake by controlling portion sizes and frequency of eating, and by swapping healthier foods for unhealthy items.

In addition to what you eat and drink, effective stress management, ample shut-eye, and regular exercise all play a role in lowering blood sugar and blood pressure levels, which can reverse prediabetes and reduce the risk of heart disease, along with other health benefits.

The calorie-energy connection

The ideal number of calories varies for each person. The Academy of Nutrition and Dietetics recommends calorie needs for adult women range from 1,600 to 2,200 per day, while for men it’s 2,000 to 3,200 per day. A person who rarely exercises and has a sedentary lifestyle would likely be at the lower range of calorie needs, whereas a very active person might be at the higher end. 

The factors that determine how many calories an individual adult needs is based on total daily energy expenditure (TDEE), or the number of calories you burn throughout a 24-hour period from all the types of physical activity your body does to keep you alive, from brain functions to exercise. 

TDEE reflects a combination of four calculations:

1) Basal metabolic rate (BMR) is the minimum number of calories your body needs to survive at rest, including breathing, organ function, and other body processes. BMR can change from person to person based on sex, height and weight.

2) Exercise activity thermogenesis (EAT) is the amount of energy needed for intentional activity or planned exercise that exert effort, such as running, lifting weights, swimming, cycling, etc.

3) Non-exercise activity thermogenesis (NEAT) is any energy required when not intentionally exercising. This can be doing chores around the house, cooking, cleaning, or pacing on the phone.

4) Thermic effect of food (TEF) is the energy required by the body to digest and absorb foods, and changes depending on what you eat.

To put it simply, sex, height, weight, activity level, and even the things you eat can affect the amount of energy or calories you burn, and ultimately need to survive. A professional athlete and a breastfeeding mother have vastly different caloric intake requirements than an office worker, as they expend energy differently. 

Al Cisneros, who successfully completed the DPP in the Houston area, said, “The First Mile Care program doesn’t require me to give up anything, only to get enough exercise to offset my caloric intake. I’ve found food journaling to be extremely helpful, and have continued to practice it even after the required period ended. I now realize there are so many easy forms of movement that burn calories and count towards my fitness goals.”

The dangers of not enough calories

We’re usually concerned with avoiding the consumption of too many calories. But what happens when you don’t get enough?

When you eat enough and have extra calories, specifically from carbohydrates, your body preserves glucose and stores it into the liver and muscles as glycogen so it can be utilized at a later time. Similarly, when you eat fat in excess, your body stores that in your adipose tissue.

If you do not eat enough, your body will start to slow down its metabolism so it can conserve energy, while also trying to make its own energy. To make your own energy (gluconeogenesis), your body will first pull that glycogen from liver and muscle stores in order to fulfill energy needs. Eventually, when the body is low on glucose or glycogen, fat tissues get broken down and the body makes energy from them. 

If your body goes through this process over and over and does not have enough fuel to power it, it not only slows down metabolism as described above, but it may lead to things such as nutrient deficiencies, mental fatigue, gallstones, etc. Basically, if you don’t eat enough calories, your body doesn’t convert enough energy and then goes into starvation or survival mode. 

Paying attention to your hunger cues

DPP is about becoming more aware of the foods you eat and what they do for you, rather than the latest fad diet, protein powder, or Instagram-famous supplements. If you’re fixated on weight loss, rather than on adding quality ingredients and calories to promote wellness, you’re more likely to indulge in disordered eating and develop an unhealthy relationship with food. 

One of the best ways to know if you are — or are not — eating enough calories is by getting in touch with your hunger and fullness cues. When you start to feel weak, shaky, sluggish, irritable, constantly hungry, experience frequent headaches or brain fog, or are struggling to sleep at night — these might be signs you are not eating enough.  And those are only short-term effects. If you restrict yourself too much for too long, you might notice hair loss, anemia, bone loss, and many other health complications. 

Good health results from consistent behaviors. Weight loss is a natural side effect of eating for health. Making lifestyle changes that endure can be a slow process, but a rewarding one that pays big dividends.

“As a result of the First Mile Care program, I’ve developed the habit of tracking calories and making healthy choices even when I’m eating away from home,” said Houston-area resident Jeannie Lawson. “It’s become a behavioral pattern and is always in the back of my mind. Tracking food intake, calories, and activity helps me stay on track and recover when I slip up. I know the choices I am making and how to reconcile them.”

Estimating your calorie needs

It’s always a good idea to talk with your primary care physician or meet with a dietitian one-on-one who can accurately assess your calorie needs. There are also online tools that can provide an estimate. The MyPlate Plan from the U.S. Department of Agriculture (USDA) bases estimates on height, weight, age, sex, and activity level. The Body Weight Planner from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) considers the same factors and is a bit more comprehensive.

Jeff Millhouse has also completed the First Mile Care DPP. He said, “Food tracking is important, just as it was in the other fitness programs I did. What is distinctively different is that the First Mile Care program takes a more holistic view about addressing the many intertwined factors that affect your physical health and mental well-being. It’s about learning how to make smart choices so that you don’t fall back on old behaviors.”

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!


Tempting Your Tastebuds with Herbs and Spices

By Jenny Fowler, First Mile Care DPP Coach

The First Mile Care Diabetes Prevention Program (DPP) teaches participants to make small adjustments in habits that add up to sustainable, healthy lifestyle change in eating, activity, sleep, and stress management.

While the DPP does not label foods or behaviors as “good” or “bad,” we recommend eating a diet high in fruits and vegetables. The ideal balance of a meal is about 50% produce, 25% starches and fibers, and 25% protein. It’s also essential to include some fats in the form of nuts, seeds, avocados, coconut oil, and olive oils, as they help you to feel satisfied.

Throughout the year-long DPP course developed by the Centers for Disease Control (CDC), we encourage participants to try new recipes, explore restaurants, and discover new ways to prepare food. In fact, one of the benefits of the First Mile Care DPP is our emphasis on sharing neighborhood-centric information with other participants in the group, who all live in the same ZIP codes as their coach. 

A diet focused on produce doesn’t have to be simple or plain.  Most Asian cuisines emphasize vegetables, yet their combinations of herbs and spices make for interesting flavor profiles. Experimenting with herbs and spices can jazz up your meal and even your beverages.

What’s the difference?

The dictionary definition distinguishing herbs from spices is that herbs are leafy things (e.g., basil, tarragon, thyme, cilantro, etc.) and spices are whole or ground seeds (e.g., coriander, cumin, anise etc.). But the division between leaves and seeds can be a bit messy.

Quite a few spices, like cardamom, cumin, and tumeric, come from plants that are botanically herbs — seed-producing plants that die down at the end of a growing season. Ginger (from a root) and garlic (a bulb) can generally be found in the spice aisle when in their powdered form, as can saffron (from a flower stigma) and clove (from a flower bud) which, like cinnamon bark, comes from a tree. And in the case of a number of plants, both leaves and seeds are used in culinary creations. The main thing is that, whatever their origin, they all add variety to the taste of your cooking.

Whether it’s an herb or a spice or simply something everyone thinks of as a spice, it’s important to remember that freshness really, really matters. People often say they don’t like a spice or don’t see its value, but that’s because they’ve tasted old dried stuff that sat in a kitchen cabinet for years.

When organizing your spice cabinet, keep these tips in mind:

  • Write the purchase date on the jar cap or put a label on the bag. In this way, you’ll keep track of the age and know exactly how long that paprika has been on the shelf.
  • Ground spices lose flavor more quickly than whole spices. As a general rule, whole spices can last up to four years, ground spices up to three years, dried herbs three years, spice blends two years, and fresh spices only a week or so. While it’s more convenient to buy them pre-ground, you’ll get more flavor over a longer period, and more benefits from the essential oils, if you buy them whole and grind them as you use them — similar to coffee beans. 
  • Before using any spice or herb in a jar, take a deep whiff. The sell-by date is not enough for judging freshness. If the aroma isn’t pungent, the taste (and health benefits) won’t be, either. Time to toss it.

Here are just a few herbs and spices that I like to use in meals. You can also experiment with infusing fresh herbs like basil and lavender in water for a tasty, sugar-free drink.

Herbs

Basil/mint. Many of the most popular culinary herbs are from the same mint family: anise hyssop, basil, lavender, lemon balm, oregano, rosemary, sage, savory, summer savory, sweet marjoram, and thyme. Basil contains antioxidants, vitamins and minerals, including vitamin A, vitamin K, iron, manganese, and calcium. Fresh or cooked basil is a delicious addition to salads and pasta dishes, and can even be a substitution for mint in a cocktail like a mojito.

Dill. The leaves of dill weed can be added like parsley to potato salad, tzatziki dip, and fish. The seeds are used as a spice to flavor foods like bread and pickles.

Lavender. Another member of the mint family, all lavender is edible, but some types have a higher camphor content so are better suited to soaps and bath products. What’s labeled as “culinary” lavender is a flavorful addition to vinegars, fruit, salads, and poultry dishes. Steep the seeds with black or herbal teas, or add them to ground coffee beans for an extra-soothing cuppa joe. 

Lemon grass. Its distinct citrusy flavor and aroma is a staple in South Asian cooking. It’s widely used in savory dishes and meat, poultry, seafood, and vegetable curries, especially when combined with coconut milk. The stems are also used in teas, pickles, and in flavoring marinades. It promotes digestion and is considered a diuretic.

Oregano. As a member of the mint family, oregano has a minty aroma as well as a peppery bite and can even dress up canned soup. It often appears in Mexican and Spanish dishes as it pairs well with tomatoes, pasta, and olive oil. Oregano has antibacterial properties and has been shown to have antiviral properties for certain viruses. You can get therapeutic amounts from oregano oil.

Rosemary. The rosmarinic acid in this herb is known to help with allergies, nasal congestion, and overall inflammation. Fresh or dried rosemary will flavor oils, vinegars, sauces, meats, soups, and stews.

Sage. Sage is very high in vitamin K, and it contains vital minerals like magnesium, zinc, and copper.

This herb is antimicrobial which may help reduce dental plaque from bacteria in your mouth. Several types of acidic compounds in it act as antioxidants, which has made it a popular traditional ingredient in bedtime infusions.

Tarragon. This aromatic, licorice-scented herb is frequently used in French cuisine as it adds flavor to any meat or vegetable dish as well as soups. You can make your own salad dressings and meat marinades by infusing vinegar with tarragon. It’s a source of vitamins A, B6, and C, and is considered a digestive aid.

Spices

Cardamom. The black and green pods and seeds are widely used in Indian, Middle Eastern and even Swedish cuisine. It’s a core ingredient of popular masala spice mixtures that season meat and vegetable dishes, baked goods, and even chai tea, coffee, mulled wine, hot cider, and eggnog. It has a range of antioxidant, diuretic, and digestive properties that make it a fixture in traditional medicine.

Cayenne Pepper. A dash of this spice adds flavor to soups, stews, scrambled eggs, and hummus. It adds heat to Mexican sauces, Asian curries, and Cajun dishes. A tiny pinch gives a kick to hot cocoa or even lemonade. It offers potential health benefits as an active ingredient is capsaicin, which is thermogenic, meaning it speeds up metabolism. Like other chili peppers, cayenne peppers are especially rich in provitamin A carotenoids and vitamin C.

Cinnamon. Obtained from the inner bark of the cinnamon tree, cinnamon adds flavor not only to candy, pastries, breakfast cereals, and snack foods, but to savory dishes, fruit, and tea as well. It has antioxidant, antibiotic, and anti-inflammatory properties.

Coriander/Cilantro. The seeds of the coriander plant are the coriander spice, while in the U.S. we call its edible plant leaves and stems “cilantro.” It’s a member of the parsley family, related to other lacy-leaved plants such as anise, caraway, chervil, cumin, dill, and fennel, and even vegetables such as carrots, celery, and parsnips. Coriander leaves and seeds are full of vitamin K, and it also acts as a diuretic. The seeds can be roasted, pounded, and included in meat rubs and marinades.

Cumin. A spice from the dried seed of a plant in the parsley family, it’s a staple in spice blends and is used in Mexican, Indian, African, and Asian cuisines. It has calcium, iron, and magnesium, and also contains antioxidants which may be linked to benefits such as promoting digestion.

Paprika. This spice made from dried and ground red peppers is a common ingredient in spice blends and rubs, marinades, sauces, and stews. It adds a touch of color to hummus, waffle fries, deviled eggs, and cauliflower. Like cayenne pepper, it contains capsaicin, shown to have antioxidant properties and a range of health benefits.

Turmeric. A member of the ginseng family, turmeric is a frequent addition to Indian cuisine. In addition to giving mustard and curry their vibrant coloring, it also contains curcumin, known to have powerful anti-inflammatory effects. 

As you can see, there’s no reason you should ever consider your meal boring and tasteless! The MyPlate.gov website of the U.S. Department of Agriculture (USDA) has a wealth of information related to healthy eating, including recipes and meal plans based on the USDA’s Dietary Guidelines for Americans, 2020-2025. 

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!


AMA Health2047 Bullish on Innovation

“…the diabetes prevention program is ‘just remarkably effective. It far outshone the conventional behavior modification like Weight Watchers. It even outperformed diabetes drugs like Metformin.'”

Read the full story from Chicago Medicine (pg.22) >


Walking for Wellness

By Sandra Huskey, First Mile Care DPP Coach

A study published this month in Diabetes Care found that walking 10,000 steps per day can lower the risk of death in people who have trouble regulating their blood sugar. The researchers at the University of Seville examined data from the CDC on 1,700 American adults with prediabetes and diabetes. Walking for 2.5 hours a week can cut your risk of heart disease by 30%, according to Harvard Medical School research.

This isn’t really a surprise to participants in the First Mile Care Diabetes Prevention Program (DPP), who are asked to get a minimum of 150 minutes of moderate activity — which can include walking — per week as an element of the program. If 10,000 steps seems daunting, try taking it in chunks. People trying to start exercising often get caught up in “all or nothing” thinking, but even a few minutes throughout the day in small spurts of activity offers benefits. 

Walking not only burns calories but can strengthen your muscles, flatten your abdomen, lower your blood pressure, relieve stress, and lift your mood as endorphin levels increase. It’s a cardio exercise as it gets your heart rate up, as well as a weight-bearing exercise that engages all of your lower body muscles, plus your core and arms if you swing them lightly from your shoulders. Walking can also help prevent bone loss as you age, since bone is living tissue that, like muscle, grows stronger with exercise, according to the National Institute of Health.

Why walk?

Walking truly is the near-perfect exercise because it doesn’t require training, you can do it anytime — winter or summer, day or night, alone or with a partner or pet — and it’s free.  All you need is a decent pair of shoes that you check regularly for wear and tear to avoid uneven pacing that might lead to falls and hip, ankle, and back pain.

Even a tactic as simple as parking your car at the far end of a garage from the door can add extra steps to your day. If you have a sedentary desk job with a lot of virtual meetings, try using the time before or right after the meeting to take a short walk. If you’re working from home, do a “virtual commute” at the start and end of each day by walking around your house, yard, or neighborhood as if you were commuting to and from work. Walking meetings and phone calls are an easy way to get your steps in, as is using your walk to catch up on podcasts, whether for education or entertainment. 

Here are a few tips for getting more out of your walk.

Take smaller steps at a faster pace: Your walk will become a more challenging cardio workout if you walk faster, and swing your arms accordingly. Shorter strides help build your cadence and increase your speed (and you’ll hit that magic 10,000 marker more quickly).

Vary your route and scenery: If possible, get both flat and hilly terrain into your walk, or take in stairs. Determine multiple routes that help you reach your goal in terms of steps or time, and then vary them daily to keep your walk fresh.

Challenge yourself with intervals: Walk slowly for one minute, then quickly for one minute, and repeat. Or walk in five-minute blocks, where one minute is fast-paced and four are easier.

Keep going: The fewer breaks you take, the longer you’re keeping your heart rate elevated, so keep pacing in place while waiting to cross the street, or while checking out shop windows or the books in your neighborhood Little Free Library.

Aside from the physical benefits, walking gives you “me time” — preferably outdoors in the fresh air — to think, listen to music, catch up with a friend, or just to observe your surroundings and change of seasons in more detail. You may even make new acquaintances in your neighborhood. 

Mike Kowis, who completed the First Mile Care DPP in Houston in 2021, saw the value of tracking his daily steps on his Fitbit. “One of the most rewarding parts of the First Mile Care program was getting together with the other participants and telling them about meeting my goal of walking 10,000 steps every single day. It felt great to be encouraged by people who sincerely cared about my success and were happy for me.”

So start walking!

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!


CHPPR and First Mile Care Partner to Reduce Prediabetes Rates

“The DPP is a year-long, lifestyle change program clinically proven to stop the onset of type 2 diabetes. Less than 5% of Americans with prediabetes have a program within 10 minutes of home. We are committed to making the DPP more accessible by creating a nationwide network of First Mile Care DPP coaches.”

Read the full story from our partners at UT Health here >


Vacation Travel Doesn’t Have to Derail Your Fitness Goals

By Barbara Martinez-Benavides, First Mile Care DPP Coach

Summer is here and with most pandemic restrictions lifted, people are excited about traveling farther afield for vacation. Despite higher costs, there’s probably a driving trip on your horizon this summer and possibly a flight. Traveling is one of the best ways to break out of your routine, recharge your batteries, and create new memories (and jigsaw puzzles!) to share with friends and family — even if the travel destination is only a couple of hours away. 

If you’re trying to change your lifestyle to become healthier, traveling away from home for vacation or business poses risks. Successful lifestyle change involves identifying triggers for unhealthy behaviors and developing new eating and exercise habits. Changing your routine, while a great stress reliever, also means you may sabotage those new habits you’ve been working so diligently to establish. On the plus side, travel provides the opportunity to do different types of exercise and to discover new seasonal foods and healthy brands you might not otherwise know.

A little backsliding during vacation is normal. The important thing is that if you do gain weight during vacation, that you don’t become discouraged. Instead, update your action plan, reset your goals, and continue working towards them. The First Mile Care Diabetes Prevention Program doesn’t label foods or behaviors as “good” or “bad.” What’s key is that you learn to balance your food choices and get enough activity into your daily routine to address your caloric intake to stop or reverse prediabetes.

Whether you’re going on a road trip or hunkering down in your annual vacation cabin, how can you avoid succumbing to temptation and undermining your hard-won achievements?

Location, location, location

It’s easier to control the quantity and quality of your meals if you are fixing them yourself, just as you do at home — and a lot less expensive, too. If you have the option of staying in a motel or rental home with a kitchen, you can more closely approximate the healthy meals you have at home. You can also enjoy checking out what’s available in the local markets.

But not everyone enjoys meal planning. Or perhaps your idea of vacation is to have someone else do the cooking for you? I previously wrote on how to stay on track with your eating goals when dining in restaurants — tips such as deciphering the menu, making substitutions, and rightsizing your meal. 

The “highway to the Danger Zone” of fast food can be found en route to your vacation destination. Airports, train stations, and roadside diners are often the exclusive preserve of fast food, whether familiar chains or Mom ‘n’ Pop stands. But don’t despair; there are healthier choices available depending upon the type of restaurant you choose, as I recently described in an article on fast-food dining

Jeannie Lawson is a Houston-area resident who has completed the First Mile Care Diabetes Prevention Program. “I used to not pay attention to what I ate when I traveled, so I might lose weight but then gain it back while traveling. Now I’ve developed the habit of tracking calories as a result of the First Mile Care program and continue making healthy choices even when I’m eating away from home. For example, I spent a week at a spa hotel in Mexico which has fabulous food. I’ve gone to that hotel several times over the years and have always gained at least five pounds. But after being in the First Mile Care program, even though I didn’t actively track that week, it was always in the back of my mind. I knew the choices I was making and how to reconcile them. This time I only gained one pound — which I easily lost at home.”

Respect the zzzzzz

A change in sleeping habits often accompanies a change in venue. It could be attributed to a different time zone, a strange mattress, eating late, or drinking more alcohol than normal. You may be cramming as many wakeful hours of fun as possible into your limited vacation time. It could be all these things combined!

We all know how sleep affects mood, problem solving, and memory, among other mental impacts. But there is also a strong connection between inadequate sleep and weight gain. Sleep affects two hormones, leptin — which tells your body that you’re full — and ghrelin — which tells you when you’re hungry. A restful seven hours a night is considered the minimum amount of sleep for adults. Resist the temptation when traveling to burn the candle at both ends. Instead, try to maintain good sleep hygiene to reduce the possibility of hauling home extra vacation pounds among your souvenirs.

Keep moving

An important component of the Diabetes Prevention Program (DPP) is getting regular exercise. First Mile Care recommends setting a goal of at least 150 minutes per week of physical activity in a variety of types of exercise.

If you’re doing a driving trip, you’ll obviously be doing a lot of sitting. You’ll want to make regular 10- to 15-minute stops at least every couple of hours to do some stretches and give the driver’s eyes and muscles a break. When you’re the passenger, you can do calf raises or triceps pushes while you ride. 

When you’re traveling away from home for business or pleasure, you might not have access to a gym. Even if you do, spending part of your precious vacation time trapped in a tiny hotel gym is not especially appealing. Probably the easiest way to make sure you get an adequate amount of exercise while on vacation is to walk everywhere you can. It’s a great way to explore a new place or to reacquaint yourself with a place you may already know. You’ll notice more of your surroundings and may discover new shops or sights that are easily missed from a car window. You can also march in place, dance, do wall push-ups, and climb stairs instead of sitting all day. 

One way to fit workouts into your travels is to bring a few packable items of exercise equipment. A flat resistance band weighs little and will fold up. A small exercise ball, when deflated, can be packed into a suitcase. If staying with friends, you can always borrow some canned food or water jugs to use as DIY weights. There are also live or on-demand streaming workouts of varying lengths that don’t require equipment that you can do through a fitness app.

And, of course, many people plan vacations specifically around physical activity despite the summer heat, taking camping, biking, and hiking trips, staying by lakes or rivers for water sports like swimming, paddling, rowing, and waterskiing, or visiting aquatic parks, amusement parks, and resorts that involve outdoor activities. And if you are staying in a resort, there could be walking tours or fun fitness classes (beach volleyball, diving, surfing, or tennis) either offered by the hotel or at a nearby facility. 

Mike Kowis is a Houston-area “graduate” of  the First Mile Care Diabetes Prevention Program. “Once I started the First Mile Care program, I became more mindful of my activity level. My daily steps have become such a habit that even when I was traveling out of town and checked into a hotel late at night, I went outside for a walk just before midnight to make sure I hit my daily goal. Although I tracked my calorie intake for about six months, when my wife and I took a vacation trip to Montana during the summer, I stopped tracking. I did get in a ton of walking so didn’t see any ill effects. I have found that my weight only fluctuates up or down by a couple of pounds because I am keeping up my activity level and eating the same foods. And the MyFitnessPal app for food tracking is there on my phone should I ever need it.”

Guilt-free fun

With simple tweaks, you can get in your minimum activity without feeling that you’re missing out on fun with family and friends. Walking instead of riding, swimming instead of floating, taking the stairs instead of the elevator — any movement is good movement and will help offset your well-deserved vacation meal indulgences

Says Olidia Thomas, a Michigan resident who is currently participating in the First Mile Care program, “When I went on a vacation with friends recently, I packed healthy snacks, cooked in the resort kitchenette, and was more conscious of staying active and eating balanced meals. I found that keeping a food journal is helpful. I still eat the things I love in moderation. I just keep track of the calories and try to stay within the guidelines. Most importantly, I forgive myself when I go off course. Knowing I can fall off the wagon and get back on is important. It’s not the end of the program.”

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!


Superfoods — What’s in a Name?

By Taylor Winkel, First Mile Care DPP Coach and Registered Dietitian

The First Mile Care Diabetes Prevention Program (DPP) teaches participants to eat healthy, well-balanced meals in order to prevent long term complications associated with health problems including — but not limited to — prediabetes and hypertension. 

While well-balanced meals take into account the portioning of fruit, vegetables, protein, and starches/grains, superfoods have become a popular topic in the last decade. How do superfoods fit into the DPP?

Defining the indefinable

A superfood — also known as a power food, or even as a superfruit — is a nutrient-dense food beneficial for health and well-being. The Merriam-Webster dictionary definition is “a food that is rich in compounds (such as antioxidants, fiber, or fatty acids) considered beneficial to a person’s health.”

Typically, a food is considered a superfood when it can offer maximum health benefits for minimal calories. Its benefits should go beyond what its nutritional value is, such as being linked to disease prevention. You will often see superfoods high in vitamins, minerals, antioxidants, fiber, healthy fats, phytochemicals and/or flavonoids — without high fat and sugar content. Berries are considered a superfood because they are packed with antioxidants which help fight disease and defend our cells. 

For example, the current superfood du jour is quinoa, a nutrient-dense seed that has twice as much protein as brown rice. It is a “complete” protein, which means it offers all nine essential amino acids, the building blocks of protein. Quinoa is naturally gluten-free. It is low on the glycemic index, meaning it won’t spike blood sugar. It is high in manganese, copper, phosphorus, and magnesium which together provide support for your bones, collagen, blood sugar control, and sustained energy. It is also high in fiber, folate, and zinc, providing support for the digestive system as well as the brain and immune system. Moreover, quinoa has phytonutrients, providing antioxidant and anti-inflammatory benefits.

By contrast, brown rice is not a complete protein like quinoa, and it is also lower in other minerals. While it is high in manganese and fiber, it has only half as much protein as quinoa. However, brown rice is a good source of selenium which is important for thyroid and immune health. So while quinoa is considered a superfood, brown rice also contributes to a healthy diet. Variety is key to receiving a full spectrum of nutrients.

Buyer beware

Confused that there is no established minimum amount of nutrients or antioxidants in a superfood? That’s OK. Superfoods should be incorporated into a balanced menu when possible, but you don’t need to be hyper-focused on them. If you are “eating the rainbow” and choosing healthy food across all food groups, you are likely eating a healthy diet already. 

Surprisingly, there are not yet official criteria or benchmarks for what constitutes a superfood in the U.S. Unlike claims such as “organic” and “healthy,” the term “superfood” is not regulated by the U.S. Food and Drug Administration (FDA) or U.S. Department of Agriculture (USDA). That means it’s basically defined by consumer food trends driven by smart company marketing. It can be what the companies and manufacturers want it to be. In fact, according to the University of California Davis, the term was first used in 1918 in the United Fruit Company’s strategy to increase banana consumption.

Therefore, when in the grocery store, you’d be wise to remember that the superfood label can be an exercise in corporate branding that often provides an excuse for a higher price — rather like the equally unregulated term “natural.” For that reason, you won’t see superfood on food labels in the European Union without a specific, authorized, associated health benefit.

Here are a few examples of popular foods that could be considered superfoods — they have passionate advocates as well as critics.

  • Fruits: apples, açaí berries, avocado, bananas, blueberries, goji berries, pomegranate (including seeds), tomatoes , watermelon
  • Vegetables: broccoli, Brussels sprouts, kale, seaweed, spinach, sweet potatoes
  • Legumes: chickpeas, lentils, soybeans (including tofu and tempeh)
  • Grains, Seeds & Nuts: buckwheat noodles, oats, quinoa, chia seeds, flax seeds, pistachios, walnuts
  • Herbs: garlic; ginger; green tea; tarragon
  • Animal Protein: eggs, yogurt, halibut, salmon

Though superfoods have a lot to offer and can help you reach optimal nutrition, it isn’t necessary to obsess over them. The key to achieving a healthy diet is variety and moderation, which is why First Mile Care coaches advocate well-balanced meals such as outlined in the USDA MyPlate dietary guide.

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!


Helping patients with prediabetes, one ZIP code at a time

First Mile Care, which is a health platform that is like Uber but for prediabetes, finds ways to deliver timely diabetes prevention in patients’ communities to make changes that stick. Read the full story via the American Medical Association >