Maintaining Healthy Habits After Completing the DPP

By Juliana Ronn, First Mile Care Director of Operations

Katherine Dowling finished the year-long First Mile Care Diabetes Prevention Program (DPP) in early 2021. She is happy with the improvements she has made in her A1C level and weight loss, and agreed to share how she is preventing regression and maintaining her healthy lifestyle.

Katherine is a 75-year-old retired kindergarten teacher who lives with her husband of 52 years north of Houston in Conroe, Texas. She joined the Diabetes Prevention Program offered by First Mile Care in the beginning of 2020, at the recommendation of her physician, Dr. David S. Cos of Physicians’ Group of The Woodlands (part of Privia Medical Group).

By her own admission, Katherine has “probably tried every harebrained scheme for losing weight in my lifetime,” losing 20 pounds at least five times in her adult life, by her estimation. Each time she has gained it back as soon as she returns to what she calls “Katherine habits” of making unhealthy choices and eating too much and too often. At one point, she even served as a Weight Watchers leader for a couple of years between the births of her two sons, but gave that up as she felt uncomfortable doing it once she started regaining weight.

Katherine has inherited hypertension and has been on blood pressure medication for many years, although her cholesterol levels have always been in the normal range. But her doctor watched her weight fluctuations over the years and warned about her climbing A1C number. She said he explained its link to type 2 diabetes, and that “it’s what you eat and how much you move, but you don’t have to develop it. You can take care of this. You’ve got to get more active and you’ve got to lose weight.”

She said she knew she was in a “danger zone” when her A1C hit 5.9, but she wasn’t really familiar with the exact term “prediabetes” until she received a letter from her doctor inviting her to join the First Mile Care Diabetes Prevention Program, at no cost to her.

A neighborhood focus

Initially, the First Mile Care DPP classes were held in-person at a CVS pharmacy in The Woodlands, just a mile from Katherine’s home. “If you have to drive a long distance to go to a meeting, that’s going to be a recipe for deciding not to go sometimes. But if it’s close, that’s do-able. First Mile offers classes close to where people are. I think that’s helpful,” she said.

When COVID-19 hit, classes switched to Zoom. “Our group was less than 10 people, and became very congenial and comfortable with each other. Our coach, Karalyn Cass, did an extraordinary job of reaching out for an update from each person at each meeting. So we got to know and encourage each other, and to share suggestions of tactics and foods and parks to walk that we were each trying.”

Katherine added, “I probably helped other people because I don’t think there’s a single vegetable I won’t eat,” whereas some of the men in her class were vegetable-averse.  “I’m just excited to learn things about food that I didn’t know, like how to cook eggplant that a friend brings me from his garden so that it tastes yummy.”  It was rewarding for her to see other class members start to enjoy produce with her encouragement.

“We had one member who lost 100 pounds in our class! Even though we were not actually in a room together, I looked forward to class just so I could visit with my friends in the First Mile Care program. And all of us living in the same area to share recommendations seemed to me to be quite important,” she said.

Takeaway lessons

One of the biggest lessons Katherine took away from the DPP is that “you’re in charge of what you put in your mouth. And if you do the wrong thing, then you’re going to pay for it. That’s just a given.”  

The lessons in the First Mile Care DPP program were simple enough for Katherine’s classmates to understand and talk about in the moment. She learned to look at food labels in a new way, paying more attention to sugar content. “Whoever is doing the grocery shopping should be studying that, especially if you’re buying something that is pre-made. It’s a way to keep yourself on the straight and narrow with the program.”

One of the reasons Katherine believes the First Mile Care program works for her is its emphasis on behavioral change.  “Coach Karalyn was an incredible coach, very positive and knowledgeable. There were several places in the program where we talked about behavioral change, which was a major focus for her and exactly what I needed to hear.” Katherine learned to identify her eating triggers, dealing with sugar cravings and learning to eat her snack popcorn very slowly and mindfully.

Katherine liked the steady, constant pace of the class, with weight loss happening over time. “Quick weight loss is not appropriate for anybody’s body, in my opinion. I should know, I’ve done it many times. But the First Mile Care DPP really worked because it was slow and steady. And I believe that was exactly what I needed. That and the behavioral change that Coach Karalyn was so good at explaining. I felt like those two things were the best help for me.”

As a self-described perfectionist, Katherine used to be hard on herself for gaining weight, and became easily discouraged. The First Mile Care program has taught her to have a growth mindset and view lifestyle change in incremental steps. If she gains weight one week, she needs to persist and have the confidence she will succeed in keeping her goals.

Katherine said, “First Mile Care really focuses on your success in making slow and steady progress. I’ll still go out to dinner and I’ll still eat something I’m not supposed to have, but I get right back to work. That’s something I’ve learned that First Mile has helped me with achieving.”

She added, “One of the things I learned from Coach Karalyn is to give yourself a bit of grace. I think that’s something I need to have in front of me all the time. One of these days I am going to cross-stitch it on a pillow I’ll see each morning as I leave the bedroom. It’s really been a wonderful lesson for me to remember from this class.”

Weight loss and lower A1C

In the final meeting at the end of the program, Katherine learned she had lost 13.3% of her body weight over the course of the year, a statistic she had never been given in past weight loss attempts.  Nine months after finishing the program, she has kept her 20 pounds off. Her A1C stands at 5.0, down from 5.9, delighting her doctor. She gave away all the clothes that no longer fit after taking in the waistbands where possible. She is confident she will not need them again and uses how her clothes fit as a cue to pay more attention to her eating and activity levels.

“Your friends notice when you’ve lost 20 pounds in a year. Everybody asks me, how did you do it? I’ll say, Well, I was in a program that my doctor encouraged me to do. There are lots of diets out there. But the First Mile Care Diabetes Prevention Program really worked for me because it’s not just a diet. And all the lessons were helpful. You learned to look at the information in a different way.”

Maintaining change

The food journaling and daily weigh-ins that Katherine began under First Mile Care continue to be successful tactics for maintaining change, as she is an organized person and likes to see things tracked and written down. “I still record everything I eat. That was not something that was brand new to me, but I started again when I joined First Mile Care.” She would send her coach her weight and activity minutes by every Thursday even when classes no longer met on a weekly basis.

Katherine now allows her weight to fluctuate by three pounds, depending on how much she has eaten or if she drank wine with a meal. “The scale is my friend. I put that number on the diary that I use for eating. I see the number and say, well, I need to eat more salad or be careful to drink more water today. I look at breakfast, I look at lunch, and say, what can I have for dinner that’s not going to upset the applecart? I know pretty well now what not to do. But I forgive myself for my occasional lapses and I just get back to work.”

Katherine exercises more than in the past, but does not play any organized sport. She tries to swim laps for up to 30 minutes at her local YMCA twice a week.  She also walks with her dog for a mile in the morning on average, leaving her house before sunrise to avoid exercising in Texas heat and humidity.

“I will be very surprised if I can’t sustain the behaviors that I’ve learned because this is the longest I’ve gone without going back to old eating habits. And I think that’s wonderful! I’m very excited about it. First Mile Care is a good program and I hope that it will get even more popular, because it has certainly helped me.”

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 Tips for Navigating the Grocery Store

By Kathy Gregory, First Mile Care DPP Coach

At First Mile Care, we place a great deal of emphasis in our National Diabetes Prevention Program (DPP) classes on the planning and preparation of healthy meals. That starts in the grocery store, where you learn to make more conscious purchases.  

As part of the First Mile Care “Diabetes Prevention in Action” webinar series, I played tour guide in my local supermarket. Due to COVID-19 restrictions, my classes couldn’t all go to the market together, so I brought the market to participants via Zoom.  

We know that making action plans, whether it’s for exercise, eating, managing stress, or sleeping, helps you to be more successful in meeting your goals. I recommend you try different stores and test a variety of brands to find the healthiest choices available that you enjoy which are also within your budget. 

Here are my 10 tips for navigating your grocery store.

 

1. Keep to your list. By planning your menus in advance, it’s easier to buy only the items that you need rather than giving into temptation and making spontaneous purchases of items that perhaps you shouldn’t eat. In addition to keeping on track, you may also save money by not over-buying .

 

2. Shop on the edges. Stay on the perimeter of the grocery store as much as you can because that’s generally where most of the whole, fresh foods are found.  Processed foods satisfy your taste buds momentarily but are not nutritiously dense, which means your body will be asking for more food within a few hours. 

 

3. Balance your shopping cart. A healthy plate should be about 50% fruits and vegetables, and your cart should reflect that. When you get to the checkout line, at least half — if not more — of your grocery cart should be filled with fresh, whole foods and in a rainbow of colors and varieties.

 

4. Buy seasonal produce. When you’re planning your menus, do a quick internet search every month to see what’s in season. In general, in-season produce should be cheaper because it’s more plentiful. And by shopping for what’s in season, you may be inspired to experiment with new recipes for fruits and vegetables that you haven’t tried before.

 

5. Consult the experts. The Environmental Working Group (EWG) issues consumer guides to shopping for produce that are useful to bookmark on your smartphone and consult before selecting produce. The EWG Dirty Dozen of fruits and vegetables have the highest levels of pesticide residue. There is a companion list, the Clean 15, with the lowest pesticide residue.

 

6. Read labels. The rule of thumb for labels is five ingredients or less, if possible. They should be words that you recognize instead of dyes, fillers, preservatives, and chemicals. Obviously, you also want to look at levels of sugars, salts, fats, carbohydrates, and calories. Some First Mile Care participants find it helpful to use a smartphone app called Lose It! to read barcodes and get label information.

 

7. Choose proteins wisely.  If you’re going to splurge, do it in the meats section — it’s really an investment in your health. Chicken, turkey, beef — whatever animal protein you eat, make sure it’s a lean cut and preferably grass-fed, as many conventional farm meats and cuts are from animals that have been fed antibiotics and hormones. But not all protein is animal-based; you can get plant-based proteins in many vegetables, as well as beans, nuts, and seeds. 

 

8. Question product placement. Companies pay for eye-level product placement. If you look at the higher and lower shelves, you may find worthwhile brands to compare with the better-known names on the middle shelves. And bending and stretching can be part of your workout!

 

9. Make your life easier. The key to starting a new good habit is making it easy for yourself. And if something that holds you back is the effort involved chopping fruits and vegetables as part of your meal prep, buy pre-cut items. It’s easy to find bags of pre-cut carrots, onions, and herbs, along with pre-mixed salad greens and fruit salads. Buying a cooked rotisserie chicken in your market to de-bone at home can be a great time-saver and ensure you’re getting lean protein in your meals.

 

10. Make food shopping part of your activity routine.  When I go to the market, I dress in my exercise gear and wear comfortable sports shoes. I take water to stay hydrated. I make sure I’ve eaten before I go, so I don’t make impulse purchases because I’m hungry. And because I’m following a list, I walk more briskly and efficiently. I might even do a loop around the store before I begin shopping to get in extra steps.

 

In addition to the produce and meat sections I discussed above, I also visited the dairy section to talk about butter, milk, and yogurt. And I ventured into the inner aisles to look at salad dressings, oils, pastas and pasta sauces, broths, breads, granola, and even chips and peanut butter. 

 

Watch the video below and join me as I walk around my local supermarket. There are occasional video jumps and sputtering due to WiFi connection hiccups inside the store. Please note that if I make recommendations on certain products by name, this is strictly my opinion only. Neither First Mile Care nor I have any relationship with those brands. I hope you’ll find my “tour” useful and that you can apply my shopping tips the next time you go to the market.

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: My Success with the First Mile Care Program

By Juliana Ronn, First Mile Care Director of Operations

Jeannie Lawson recently completed the year-long First Mile Care Diabetes Prevention Program (DPP). She agreed to talk about why she joined, the results she has seen, and her tips for leading a healthier lifestyle.

1. Don’t keep us in suspense. What results have you seen from the First Mile Care Diabetes Prevention Program?

First Mile Care is helping me to lead an active, vital life that makes me happy. I like to travel, especially overseas, and I have to be in pretty good shape for that. Traveling is important to me, and it’s what I want to continue to do until I absolutely can’t — and I want that to be a long time from now. I’ve learned some good healthy strategies through the First Mile Care program which will support me in my long-term travel goals.

Besides my general feeling of good health and well-being, I’ve seen several measurable benefits: 

  • My blood sugar level in my recent A1C test was 5.6, in the average range. This has been consistent since I joined First Mile Care. I’ve been able to stop taking cholesterol medication as my cholesterol level is now in the normal range.
  • I’ve lost — and kept off — 12 to 14 pounds, depending on the day. I have not lost as much weight as some people in my group, but I didn’t have as much to lose at the start of the program. 
  • I’ve lost inches. I now consistently wear a medium instead of a large. I’ve dropped at least one numerical clothing size and sometimes two, depending on the item. 

2. Tell us a little about yourself. What were your health challenges before joining First Mile Care?

I’m a retired educator — high school English and later, head librarian.  I live in The Woodlands, Texas, on the northern outskirts of Houston. I’m 74 years old. Over the past several years, I have gradually lost weight through a variety of efforts, but it was not having a positive impact on my blood glucose. My doctor became concerned that I was in the prediabetes range, and it wasn’t improving despite my weight loss. I was also taking medication to control both blood pressure and cholesterol.

3. Did you know what prediabetes was before your doctor diagnosed you?

While diabetes doesn’t run in my family, I do have an in-law who is a type 1 diabetic, so I have been very aware of the disease.  For years, every time we looked at the numbers, my doctor, Thimos (Tim) Paschalis of Physicians’ Group of The Woodlands, told me I was in the range for prediabetes. But I like carbs and love sweets, and wasn’t really motivated enough to do anything about it. 

4. Before joining First Mile Care, had you tried other lifestyle change or weight loss programs?

I had joined Weight Watchers in the past. It’s a good program, but I needed more structure than it offered me. I wasn’t very consistent. And some of the diet programs that require you to buy food can get very expensive. I also joined a gym and, later on, the YMCA. Since I was not someone who has ever particularly liked to exercise, I was just kind of plodding along. 

5. How did you hear about First Mile Care?

One day I received a letter from Dr. Paschalis introducing First Mile Care and the Diabetes Prevention Program. I contacted the physician assistant Lindsay Domangue, whom I’ve also known for several years, and she told me it was a great program and they’d recommended me for it. I thought about it for a while before committing, because I’m a methodical person and don’t just jump into anything. And it’s been so easy! It’s also amazing that it’s available at no charge to me.  I’m really grateful that they sent that original letter inviting me to join the program!

6. What do you like about the First Mile Care program? Why do you think it has worked for you?

The group encouragement and accountability was critical to me, and the valuable coach instruction and advice. We talked a lot about learning to read food labels. I used to track points in Weight Watchers, but now I track the calories and am shocked at the high calorie and fat content in most fast foods. It has made me very conscious of what I put in my mouth and has changed how I do my grocery shopping. Now when I am in the store, I use a smartphone app called Lose It!, which reads the barcode and tells me the label information. It helps me with tracking what I consume and deciding if I really want to buy that food item with high calorie or carbohydrate or salt count.

Tracking food intake, calories, and activity helps me stay on track and recover when I slip up. I’ve learned it doesn’t work to think you can eat crazy and then exercise like crazy, as what you eat is more important for losing weight than the exercise alone. It’s better not to eat crazy in the first place. I also learned that First Mile Care recommends getting a minimum of 150 minutes of activity each week. I knew movement was important, but it helps me to have a baseline number to hit. 

I used to not pay attention to what I ate when I traveled, but I travel a lot. And I’m very social, so I often dine out with friends. I might lose weight but then gain it back when I was socializing or traveling. Now, I’ve developed the habit of tracking calories and making healthy choices as a result of the First Mile Care program. I have the confidence that I can continue making healthy choices even when I’m eating away from home. It’s become a behavioral pattern.

For example, I was able to spend a week during the summer 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 because of eating desserts or not taking a morning walk. And then when I got home, I’d think, “Oh well, I’ve blown it.” But now, 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.

7. First Mile Care emphasizes neighborhood-based DPP groups. Did you find this helpful?

It was really important for me to participate in a group for motivation. In this program, because we were meeting every week and I knew that I would be speaking about my week, I always came prepared, and so did everybody else. We felt accountable to each other to take the program seriously. The sharing of their challenges helped me. It sometimes became pretty personal. A couple of the people in my group lost family members so we supported each other through those trying times.

Knowing we were from the same geographical area helped us become comfortable with each other. We were all in the same boat with our prediabetes and were united in wanting to improve our health. We knew the same restaurants and neighborhood places and could make recommendations to each other for where to buy certain items and how to fix healthy snacks. Even though we had to do Zoom meetings because of COVID-19 restrictions, I felt as if people were in the same room with me. We were able to meet in person a few times outside and also met with some of the other First Mile Care DPP groups. 

8. What role has your coach played in your success?

Coach Karalyn Cass was fabulous. I can’t say enough good things about her. She was approachable, knowledgeable, and very positive. Like any coach, she had a definite plan for each meeting which started and ended on time. She directed our conversations so everyone could share and be heard but not feel rushed. She added strategies and offered instructions at the end of our time together. I know she really listened because she would refer back to comments people had made in previous sessions. It was also helpful that she was a part of the local community, as she knew the places we walked, and how the weather was affecting our activities. That gave a personal touch which made people feel comfortable. Our group would have been dysfunctional without her facilitation. 

9. What kind of behavioral or habit changes have you made as a result of the First Mile Care DPP?

One of my weaknesses is sweet things. So I’ve learned in the DPP that when I go shopping, I just do not pick up cookies or other sweets. When I made Christmas cookies last year, I kept them at my neighbor’s house to remove the temptation. Instead, I keep fruit in my refrigerator for when I’m craving something sweet.

I have also become aware that one of my triggers for snacking is to sit for long periods of time. I can easily sit in my chair all evening, reading or watching TV and snacking. So I asked my children to chip in together to give me an Apple Watch for my combination birthday and Mother’s Day gift. I love it because it prompts me to get up every half-hour, and it’s kind of a competition because I want to see the circles close on the activity tracker. I would probably never have asked for the watch or used a digital tracker if not for what I learned through First Mile Care.

We also talked quite a bit about what Coach Karalyn called “sleep hygiene” and how it is connected to weight control and good health. So now I try to get ready for bed earlier and quiet myself so that I can go to sleep more easily.

10. Now that your year-long DPP course has finished, how are you sustaining the changes you’ve made?

The year I spent in the First Mile Care Diabetes Prevention Program has really built up my confidence. The material provided throughout the program has been invaluable to me. I have saved everything in a notebook and go back and refer to it. You can diet all you want to, but unless you learn some strategies to continue the changes you make, you slide right back as soon as you leave the program or stop the diet. Well, I’m not going to slide back! I know that I can make healthy lifestyle changes and continue them.  

One of the things I’ve learned from First Mile Care is that doing something with a group really helps keep me motivated. So now I have a small walking group. It’s just a few ladies walking almost daily inside our local mall when the weather is hot, or along The Woodlands waterway when it’s cooler. It’s been a great companion group to my First Mile Care class. I also do Zumba, chair yoga for seniors, and have even started weight classes at the Y.  First Mile has taught me to appreciate the value of the group.

I am so happy about — and thankful for — the health that I have. A lot of my friends have had surgeries and other kinds of health problems. I want to remain vital. And I think that First Mile Care has played a big role in my journey to good health and my ability to stay healthy.

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!


CEO Karl Ronn on Improving the Human Condition at University of Toledo

The University of Toledo virtual Town Hall Series is aimed at sharing the stories of outstanding alumni. This series spotlights graduates from the College of Engineering who are excelling in their careers and carrying out the mission of The University of Toledo to improve the human condition.

Since graduating from UToledo with a degree in Chemical Engineering, Karl has been a serial entrepreneur, innovator, and creator of multiple billion-dollar businesses. Learn about his experiences that led to success with renowned products such as Pampers, Swiffer, Febreze, and Mr. Clean Magic Eraser.

 


Getting a Rainbow of Produce in Your Diet

By Jenny Fowler, First Mile Care DPP Coach

In the First Mile Care Diabetes Prevention Program (DPP), we frequently discuss diet. But the DPP is not a dieting program. When we talk about “diet” we mean nutrition. While modest weight loss (a minimum of  5%) and modest activity (at least 150 minutes per week) are core goals of the year-long program, the DPP focuses on good nutrition and healthy eating, not dieting. The goal is lifestyle change. We want participants to learn to make healthy, sustainable choices in relation to nutrition and fitness that will prevent or reverse chronic health conditions like prediabetes.

Your body needs both macronutrients and micronutrients to function. The body’s systems (e.g. digestive system, immune system, etc.) rely on nutrients and will use your body’s nutrient reserves if not getting enough from your diet. Nutritionally speaking, you want to eat a varied diet and the more variety, the better.  Whole, unprocessed foods have a unique variety of nutrients that you need for optimal health.

Variety for vitamins

Your aim is to ensure that every meal has the ideal balance of about 50% fruit and/or vegetables, 25% starches, and 25% protein. It’s also essential to include some fats in the form of nuts, olives, avocados, coconut oil, and olive oil.  A balance of macronutrients (proteins, carbs, fat) is obvious when looking at your plate, but in terms of micronutrients, you want to include multiple fruits and vegetables in your meal plan.

Different colors of fruit and vegetables are your clue to different compositions of vitamins and minerals. For example, vitamin A can be found in orange foods such as butternut squash and carrots, while a good source of vitamin K is dark, leafy greens like kale. On the other hand, while grains have some variety of nutrient composition, they are all high in the B vitamins so you don’t need to pay as much attention to grain variety.

Eating organically

To evolve your meals seasonally, try to shop at your local farmers market where you’ll be introduced to new fruits and vegetables as time passes. But whether at the farmers market or in a supermarket, consider buying some of your produce organic if you can. Conventionally grown foods can have pesticide residue that may cause inflammation, allergies, and lead to chronic health issues.

The Environmental Working Group (EWG) issues consumer guides to shopping for produce that are useful to bookmark on your smartphone and consult before selecting produce. The EWG Dirty DozenTM of fruits and vegetables have the highest levels of pesticide residue. The Dirty Dozen list for 2021 includes strawberries; spinach; kale, collard and mustard greens; nectarine; apples; grapes; cherries; peaches; pears; bell and hot peppers; celery; and tomatoes. These frequently make the list year after year. For that reason, the EWG recommends you try to buy these items organically grown whenever possible.

There is a companion list, the Clean 15TM, with the lowest pesticide residue. In 2021 this list includes avocados; sweet corn; pineapple; onions; papaya; frozen sweet peas; eggplant; asparagus; broccoli; cabbage; kiwi; cauliflower; mushrooms; honeydew melon; and cantaloupe. 

Look to the rainbow

There’s really no downside nutritionally to eating an ultra-varied diet. However, if you’re a single person shopping for one, there may be a financial downside since eating a variety of foods means buying a variety of ingredients. You may choose to eat meals on repeat simply to avoid wasting food or having to spend too much time on meal prep. If so, the main thing is to make sure you’re getting different colors in your diet like red apples, orange carrots, yellow bell peppers, dark green kale, and blueberries. Whether you change your menu every day or eat the same meal three days running, make your plate as colorful as possible. 

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!


Changing My Habits to Lose Weight and Stay Healthy

By Jeff Millhouse, First Mile Care DPP Participant

This month, I’ll complete the year-long Diabetes Prevention Program (DPP) offered through First Mile Care. Throughout the course of the program, I have become aware of habits and behavioral triggers that I now know I must change permanently in order to stay healthy. Luckily, my DPP coach, Kathy Gregory, has given me the tools and techniques I need in order to maintain my healthy behaviors and not backslide into old bad habits.

I’m in my early 60s and live in The Woodlands, Texas. My main health problem over the years has been fluctuating weight. I’m active, but my eating habits were not always healthy and like many people, I gained weight as I grew older. In the last dozen years, I went through two different weight loss programs that were available through my workplace.  While I achieved my overall wellness and weight loss goals within those programs, they weren’t as structured nor as intimate as the First Mile Care program and the behaviors and results just didn’t “stick.”  I used the My Fitness Pal app or another fitness tracker and would lose a few pounds, and then gain it back after those programs ended. Up, down. Keeping my weight consistently within my target range has been a real struggle. 

I have always been physically active.  Lately, however, I have come to accept that I can’t exercise at the level of intensity or duration that I did when I was in my 40s and 50s.  I still try to do some stretching, body weight exercises, and light weight training in the garage when it’s not too hot or humid. I ride a bike occasionally and take lots of walks with my wife and our dog, as we’re lucky to live in an area with good paths and trees. 

Shock and awe

In June 2020, I was surprised to get a letter from my physician, Dr. John Walker of Highland Woods Health, providing his endorsement for the First Mile Care Diabetes Prevention Program and recommending I join it.  I put that letter aside but received another one two weeks later.  I thought “OK. He’s trying to get my attention now.”  

There isn’t any history of diabetes in my family and I hadn’t thought I was at risk for it. I was overweight and I knew the doctor was monitoring my blood glucose level during my annual physical exam, but he had not previously called attention to it and I was never prescribed any medication to manage it. However, after reading up a little on prediabetes and looking at my blood test results from my last few physicals, I could understand why he was suggesting the First Mile DPP program to me at this time. 

My doctor made the connection between my weight, my blood glucose test history, and my overall health. I realized that my eating habits were not only making me look heavy and feel uncomfortable, but the extra weight was putting my overall health and life at risk. Since I trust Dr. Walker’s advice, I decided to join the program, especially since it was offered at no cost to me. 

So, after a very welcoming introductory call with Coach Kathy, I leaned into the program and began to see results within days. After a couple of weeks, my wife Aimee also joined my same DPP group. She liked the results I was getting and the changes I was making. And since diabetes does run in her family, the desire to take action was even more compelling for her.

Within about four months of joining First Mile Care, I had dropped nearly 20 pounds, as once I got into the routine, it was easy. Since then, my focus has been on sustaining that weight loss. Despite holidays and vacations, I’ve managed to keep off the inches and 15 to 20 pounds. I feel confident enough in my ability to maintain my weight loss that I’ve given away half my suits that no longer fit, and other extra-large clothing that was hanging on me after I lost all that weight. Now I wear a large and sometimes even a medium size.

But even better is how I look and feel. Not only do my clothes fit better, but my knees don’t hurt from carrying that extra weight. And when I had my annual physical just a couple of months into the program, my doctor said my glucose level was already back in the normal range. Seeing the results show up in the blood work was really gratifying, as that was something I couldn’t see or judge on my own.

Spotting triggers

I feel the First Mile Care Diabetes Prevention Program works for me because it’s a pragmatic package of methods and support techniques that I can sustain by myself. Even if I go a bit off-course one weekend and see the results on the scale, I know how to course-correct within a couple of days by sticking to my 1,700 daily calories and remembering the other principles I learned. I can still enjoy my favorite foods and reward myself occasionally. I don’t feel restricted by the program. I have choices. The emphasis on meal planning in this program, which Coach Kathy has returned to again and again, is really key to my success.

Obviously, I’m grateful that my wife has been on this journey with me. One of the things we discovered is that we used to eat large meals in the evening, not because we were hungry but as a way to spend quality family time together  — truly, a “comfort food” habit.  I had a very long drive to and from work, so I would snack after breakfast during my morning commute, and snack throughout the day. On my drive home, I’d have nuts or cheese. And then when I arrived home, my wife would have prepared a big meal for us to enjoy together, just as we did when our son was still at home. The First Mile Care program has made us mindful that our dining habits were born of natural family practices and triggers that don’t really apply to our lifestyle any more. So now we’d rather have our “comfort” meal together at breakfast and only something light for dinner in the evening. 

In addition to family time, I’ve identified stress and boredom as triggers for me. If I’m preparing for an important work-related call, I notice that I want to reach for a snack. I ask myself: “Am I reaching for food because I’m truly hungry, or because I’m anxious or perhaps not hydrated enough?” Sometimes just having a glass of water will suffice. I ask the same questions in the evening, when I’m watching TV and craving a snack. I review my daily calories and sometimes I allow myself a snack, but just as often, I realize I associate food with relieving boredom or providing a sense of comfort.

Learning from others

I’ve enjoyed the group aspect of the First Mile Care counseling sessions. Coach Kathy is very practiced at getting people to join the discussion and share their experiences.  Even the group members that are generally quiet are still engaged and they will often share things they have tried that other participants had mentioned in prior weeks. It has been important to acknowledge each other’s successes, however each person defines his or her own success measures, and even if they are small.

For example, when we discussed the importance of reading labels in a meeting, a member of the group shared how he was in the habit of stopping to buy a supersized cup of iced tea on his way to work. But then he realized it wasn’t the caffeine so much as the high sugar content that was keeping him going through the day, and he decided to quit. As I listened to him share his story, it reminded me of how I would occasionally swallow a couple of glasses of sweet tea at lunch, or grab a Coke at the fountain machine in the company cafeteria.

Beyond those examples, his story made me rethink the multi-day juice cleanses I used to do on a regular basis to help maintain my weight. These were high quality “juicing” products, yet when I looked at the labels on several of the juices, I was shocked at the added sugar. This occurred with both the juice cleanse bundles as well as a “healthy” juice I bought at a local vegetarian restaurant we support. I haven’t done a juice cleanse since!  I’ve also changed the type of yogurt I buy, and look more closely at the sugars in cereals and packaged products. My wife and I try to buy whole foods and fix our own meals to better avoid the added sugars and salts in packaged or prepared foods.

Why DPP works for me

The reason that the First Mile Care Diabetes Prevention Program has been successful in helping me adjust my lifestyle is that it isn’t just a program where you’re counting steps or calories or competing for points. Food tracking or journaling is important, just as it was when I was in Weight Watchers and the other fitness program I did. That’s easy for me as I’m a very analytical, data-driven person.

What has been distinctively different this time 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 — which can either enable progress or hinder it. It’s about learning to determine your triggers for eating or drinking too much or imbibing the wrong foods or not getting exercise. It’s about learning to manage stress and developing good sleep hygiene. It’s about learning how to make smart choices when you’re not at home or in control of the food that’s around you, so that you don’t fall back on old behaviors. 

The Diabetes Prevention Program is not about going on a diet to lose weight — as the name says, it’s about preventing disease. Losing weight is a part of it, but it’s not the only goal. The goal is incremental lifestyle change, and that is a goal I intend to keep.

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!

13 Nutritionists Reveal How to Stop Stress Eating

“When you experience acute, temporary stress, it suppresses your appetite temporarily. But if the stress is chronic and ongoing, it causes a release of cortisol which, in turn, affects your appetite and causes you to want to eat even if you’re not really hungry. Your body is programmed to want more food when you’re experiencing ongoing stress and high levels of adrenaline.

So, you’re feeling stressed out, and you want to eat even though you’re not especially hungry. Do you crunch on a celery stalk? Probably not. Your body wants extra glucose for quick energy to deal with the adrenaline boost. And so you automatically veer toward foods high in fat and sugar and quick carbohydrates. There’s a reason we call those “comfort foods,” as they help dampen that stress response.

You need to figure out how to calm yourself with stress-relieving activities, which aren’t the same for everyone. Typical stress-relieving activities include reading, writing/journaling, being in nature, talking to a friend, meditating/deep breathing, doing a puzzle, physical activity, music, photography, coloring, mindful eating, flower-arranging, knitting, etc. Be careful about screens and electronics, as they may engage the brain in such a way that it triggers stress or excitement.

Create a list of your top stress-busting activities. Keep your list somewhere you’ll see it, like on your fridge or mirror, and decorate it or use colored paper or stickers to make it “pop.” The next time you reach for the freezer door handle, looking for that comforting tub of ice cream, you’ll see the list of activities instead. And be sure to move the list around, so that you don’t get so accustomed to seeing it that you become blind to it.”

 

Read the full article here


The Cure for the Summertime Blues

Most people prefer to exercise outdoors because they enjoy fresh air and feel more energized. Being outside offers an opportunity to be in nature and can lower stress levels — an easy “cure for the summertime blues.”  It may also turn into a social experience due to the possibility of seeing friends or neighbors. You’ll be more likely to stick to your fitness routine if you enjoy it more.

Read the full article from First Mile Care DPP Coach Sandra Huskey via Thrive Global.


Exercising in the Summer Heat and Humidity

By Sandra Huskey, First Mile Care DPP Coach

An important component of the National 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.

Most people prefer to exercise outdoors because they enjoy fresh air and feel more energized. Being outside offers an opportunity to be in nature and can lower stress levels. It may also turn into a social experience due to the possibility of seeing friends or neighbors. You’ll be more likely to stick to your fitness routine if you enjoy it more.

But your enjoyment of outdoor activities may be affected by inclement weather. Any day has the possibility of being labeled too hot, too cold, too wet, too muddy, too rainy, too humid, too sunny, etc.  If you wait for the perfect day and the most ideal weather or temperature, you may never get outside to exercise! Learning to adapt to all kinds of  weather will help you to keep on track with your fitness goals.

Here comes the sun … and the humidity

Summer comes around every year and we know that it’s going to be hot! Keep in mind that when it comes to exercising in the heat, the best way to adjust to it is to consistently exercise in it. Our bodies are very adaptable.  As your core temperature heats up, your brain will tell your body to perspire in order to cool itself down. Over time, your body will become more efficient and begin sweating more quickly in response to your exercise. 

If you’re like me, you may live in an area where you also have to deal with high levels of humidity, which can literally take your breath away.  Oftentimes, you may think you’re out of shape because of the breathless sensation you experience when exercising in high humidity. Humidity prevents the sweat from evaporating so the perspiration stays put on your body, making you feel hotter.  Also, the humid air is saturated with moisture, making it harder to breathe.  As the body tries to cool itself down, it makes the lungs work harder so your respiration rate increases, which in turn speeds up your heart rate.  When this begins to happen, you may feel out of breath. This is the time you need to SLOW DOWN and take a longer rest break —  and drink water!

Follow these tips to learn to enjoy exercising outside in the summer:

1. Dress for the weather.  In the summertime, choose sports clothing and  socks  in lightweight, breathable fabrics made from synthetic materials such as acrylic and polyester because they have sweat/moisture-wicking and anti-chafing properties. Cotton T-shirts and socks can get wet, heavy, and squishy.

2. Wear a lightweight, moisture-wicking, breathable or vented hat to help block harmful rays from your head and face, which also helps keep sweat from rolling into your eyes.

3. Wear sunglasses to protect your eyes.

4. Wear sunscreen above SPF 15 to protect your skin.

5. Run early in the morning or later in the day when the temperatures are cooler and the sun isn’t as hot.

6. Carry water with you or know where there are water fountains along the way.

And a few more recommendations, regardless of weather:

7. After you exercise, you should replenish your body with water (or an electrolyte) to compensate for any increase in sweating. Coconut water is a healthy hydration choice because it is low in natural sugar and also contains electrolytes that the body needs, such as sodium, potassium, calcium, and magnesium.

8. No matter what the outside temperature is, you need the right footwear. I recommend going to a local sport store for assistance in proper fitting. Don’t pick a shoe merely because of the style, color or the brand;  it needs to be right for the physiologics of your foot and the way your foot strikes the ground when you walk.

9. Also, always be aware of your surroundings. If you choose to wear earbuds or headphones to listen to music or a podcast while running, keep the volume low so you can hear what’s happening in the environment around you.

Summertime blues

If you ever feel overwhelmed by heat and humidity, be sure to move inside or to a cool, shady place to rest and drink water.

If you start to experience dizziness, headache, vomiting, confusion, excessive sweating or lack of sweating, rapid heartbeat or muscle cramping, lie down and elevate your feet and apply a cool towel if possible. Call 911 if your symptoms don’t improve.  

The good news is, the body generally adjusts to hot and humid temperatures in approximately two weeks. However, certain medications can make you more susceptible to heat-related stress, so it’s best to consult your doctor before beginning any new outdoor fitness routine.

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!