Keeping Your Brain Healthy As You Age

By Karalyn Cass, First Mile Care DPP Coach

The goal of the National Diabetes Prevention Program (DPP) is to help participants develop new habits they can sustain in order to lead a healthy lifestyle in the long term and prevent prediabetes. But a healthy lifestyle is not only concerned with physical fitness; it’s also about mental and emotional health.  As part of the First Mile Care “Diabetes Prevention in Action” webinar series, I offered some tips on how to keep your most important organ — your brain — healthy as you age. 

As part of the natural aging process, you experience gradual changes to your body. Your brain ages just like the rest of your body. It shrinks in size, it slows down in speed, it becomes less adaptable to change. Therefore, it’s critical to stretch your brain as well your heart, legs and other muscles.

Most people will continue to have strong memories as they grow older, and their ability to remember will not decline rapidly or substantially. But almost 40% of us will experience some form of memory loss at some point after age 65. A recent study published in JAMA Network Open emphasizes the importance for women, especially, to flex their brain to keep it in good condition. Women in the study showed faster declines in global cognition as they aged, even though memory decline was about the same as for men.

Typical age-associated memory impairment may include your inability to remember details of a conversation or event that took place over a year ago. Sometimes you might have difficulty finding a word at the tip of your tongue, or remembering the name of an acquaintance. That’s normal.  But when your memory loss affects your ability to stick to your normal routine, you’re finding it difficult to learn new things or complete familiar tasks, and people close to you notice changes in your abilities, those could be signs of greater cognitive decline or even dementia that you should discuss with your physician.

The diabetes-dementia link

Researchers in the UK are investigating how people with prediabetes run an elevated risk of cognitive decline. In the study, higher-than-normal blood sugar levels were linked to an increased likelihood of vascular dementia, a common form of non-Alzheimer’s dementia caused by reduced blood flow to the brain. And according to a study report in Diabetes Care, people with diabetes were 60% more likely to develop any form of dementia than people without diabetes.

Knowing that if you are prediabetic, you are at greater risk for cognitive decline, it’s important to do what you can to reverse prediabetes and keep your brain from becoming flabby. Luckily, there are many things you can do to improve your brain health as well as your physical fitness and emotional well-being, which all influence each other.

  • Exercise (aerobic, strength training, balance, flexibility)
  • Healthy eating (especially brain-healthy foods such as berries, fish, green vegetables, and nuts)
  • Social connections
  • Reading and writing
  • Sleep quality and stress management
  • Art, music, and animal therapy
  • Learning new things (crafts, skills, languages, etc.)

Training your brain

Crossword and jigsaw puzzles, card games, word and number games, brain teasers, matching games, video and computer games, drawing, and even coloring books can stimulate your mind and sharpen your brain. The important thing is that they involve concentration, analysis and problem solving, and memory. 

There are many brain teasers and challenges you can find simply by going on YouTube or otherwise searching the internet. A few good sources — both free and paid subscriptions — can be found on the AARP’s Staying Sharp site, Cleveland Clinic’s Healthy Brains site, Lumosity, and Sharp Brains.

Watch the video below for my full presentation on improving brain health and adding quality years to your life.

To learn more about how you can benefit from the First Mile Care Diabetes Prevention Program, take the prediabetes risk test and get started today!

Deconstructing Popular Diets

By Kathy Gregory, First Mile Care DPP Coach

A core component of the National Diabetes Prevention Program (DPP) is learning to eat well and develop new healthy lifestyle habits to reverse prediabetes. As part of the First Mile Care “Diabetes Prevention in Action” webinar series, I looked at the pros, cons, and commonalities of several popular diets.

It’s important to understand that diet, weight loss and healthy eating are linked, but not interchangeable. People invest a lot of time (and money) in searching for a magic weight loss formula, but diets are definitely not one-size-fits-all. If you fail to stick to the guidelines, you may feel guilty and become discouraged, even though we all have different motivational triggers. What is successful for one person may be really challenging for someone else. When you’re fixated on weight loss, rather than on adding quality ingredients and calories to promote wellness, you’re more likely to develop an unhealthy relationship with food. 

Let’s look at five of the most popular diets today.

  • Keto Diet — This diet requires detailed food tracking to adhere to recommended percentages. The focus is on healthy fat for about 75% of your daily calories, 20% protein intake, and no more than 5% carbohydrates. Due to the high fat and protein intake, you may feel fuller for longer. However, because it’s very low in fibrous foods such as fruits, vegetables, and whole grains, it can result in nutrient deficiency and constipation.
  • Paleo Diet — This diet emulates the dietary pattern of our ancestors by emphasizing fresh foods and avoiding processed foods. It promotes the intake of healthy fats, vitamins, and minerals from fresh foods but excludes legumes, dairy, and grains, so some people may not absorb enough fiber, calcium, or vitamin D.
  • Whole30 Diet — An elimination diet that requires you to cut out grains, dairy, legumes, alcohol, and added sugars and sweeteners from your diet for 30 days, mainly to help you identify food sensitivities or allergies. While it does not focus on calorie count, you may miss out on some important nutrients. It can be so restrictive that you may find it difficult to maintain without a medical reason.
  • Intermittent Fasting (IMF) Diet — The 16:8 is the most common IMF diet, where you’re encouraged to eat more fruits, vegetables and other health-promoting foods but only during an eight-hour period, while fasting during the other 16 hours. While it eliminates all-day grazing, it is very restrictive and can lead to bingeing during eating windows. Also, as your body adapts to “starvation” periods, it will begin to burn fewer calories as it senses you may not be getting enough nutrients.
  • Mediterranean Diet — This follows the food traditions of many Mediterranean countries by focusing on olive oil, vegetables, fruits, nuts and seeds, beans, whole grains, and some dairy products. It is low in saturated fats and fairly easy to follow as it is not particularly restrictive, although it requires the availability of fresh ingredients to prepare meals at home.


These diets all advocate eating fresh, whole foods — meaning, foods that are not processed. Whole foods are fruits, vegetables, lean proteins, dairy — not something you buy in a box or package. (Pro tip: When you go to the grocery store, try to spend the majority of time shopping in the perimeters where you’ll find whole foods, or in farmer’s markets to get what’s in season.)

Another commonality among several of these diets is restriction. Yet that can be their downfall as restriction generally does not work over time because we run out of willpower. The more complicated and restrictive a diet, the harder it becomes to adhere to it over time. 

Eating for health

The DPP emphasizes eating for health, not short-term weight loss. But weight loss IS a natural side effect of eating for health; it just takes time to achieve. At First Mile Care, we recommend DPP participants follow these guidelines:

  • Eat whole food – fresh vegetables should be about 50% of your plate, lean protein about 25%, and starchy vegetables or whole grains 25%
  • Cook at home so you can control ingredients, calorie quality, and portion sizes
  • Exercise daily (at least 150 minutes per week)
  • Manage your stress load
  • Get adequate and quality sleep
  • Stay properly hydrated with water and not sugary drinks

Good health results from consistent behaviors. Making lifestyle changes that endure can be a slow process, but a rewarding one that pays big dividends. 

Watch the video below for my full presentation on diets, healthy eating, and their link to diabetes prevention.

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!

Struggling With Sugar Cravings

By Jenny Fowler, First Mile Care DPP Coach

Feeling in control of your food choices is an important step along the road to healthy living. But when it comes to sugar, many of us struggle with temptation or even addiction despite our best efforts to control the craving.

As a certified holistic nutrition consultant and wellness coach, I help participants in the National Diabetes Prevention Program (DPP) determine strategies to control unhealthy eating habits that can lead to prediabetes. One of the most challenging is sugar consumption. I led a discussion on dealing with sugar cravings as part of the First Mile Care “Diabetes Prevention in Action” webinar series.

It’s important to get a handle on sugar cravings to maintain stable energy throughout your day, to help balance blood sugar, and to aid in weight control. Oftentimes, you feel sugar cravings when your blood sugar is imbalanced. If your blood sugar is too low, your body wants a quick fix to bring the sugar back to a more stable level. You may make poor food choices to satisfy that sugar craving, food choices which can negatively affect your weight.

The main reasons for sugar cravings fall into three buckets:

  • Nutrition: Are you getting enough of the three macronutrients each day?  The amino acids in protein build the brain chemicals that stop sugar cravings. What about unrefined carbohydrates, your body’s preferred source of fuel? Do you eat the right amount of healthy fat, which helps keep your blood sugar stable?
  • Habits: Are you craving sugar because you habitually have something sweet as part of a routine or at a certain time of the day? Are you eating regularly (every 3-5 hours) throughout the day to keep your blood sugar stable?
  • Emotions and Location: Are you craving sugar simply because you can see or smell something sweet in physical proximity? Or just know that there are doughnuts in the cupboard and ice cream in the freezer? Or are you under stress, which can cause your blood sugar to peak and crater, throwing your body into a red alert?

When you feel a sugar craving, think about WHY you are experiencing it. It may be because your meal planning doesn’t address the right balance of the three macronutrients. Or you’re in the habit of eating cookies with an afternoon cup of tea. Or you’re experiencing a lot of stress at work.

Once you can figure out your trigger(s) for craving sugar, it’s easier to address those cravings. Instead of just trying to deny your body what it wants, find an alternative activity or substitute routine. In a different webinar, I provided tips on calming activities that can reduce stress and help avoid nervous eating. Oftentimes, if there is not a physical reason for the craving, it will pass if you distract yourself with another activity. 

Of course, if there is a physical reason, make sure you have some tasty but healthy snacks available so you don’t reach for the chocolate. Or perhaps you need to eat the three macronutrients more often, more regularly, in smaller amounts, to avoid the blood sugar highs and lows that lead to sugar cravings. The important thing is to give your body regular, healthy fuel to keep your blood sugar fairly balanced and avoid big swings and crashes. 

Watch my webinar video below for more ideas on how to gain control of your sugar cravings. It does get easier!

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!

Karl Ronn of First Mile Care: “Sleep is also critical to wellness, and something our coaches touch upon in multiple sessions”

Often when we refer to wellness, we assume that we are talking about physical wellbeing. But one can be physically very healthy but still be unwell, emotionally or mentally. What are the steps we can take to cultivate optimal wellness in all areas of our life; to develop Mental, Physical, Emotional, & Spiritual Wellbeing?

As a part of our series about “How We Can Do To Cultivate Our Mental, Physical, Emotional, & Spiritual Wellbeing”, I had the pleasure of interviewing Karl Ronn, founder and CEO of First Mile Care, a Silicon-Valley based preventative chronic care company that develops affordable, scalable, and sustainable solutions to reverse health conditions like prediabetes..

Read more on Thrive Global here >

Everyday Health: TIPPI Type 2 Diabetes

First Mile Care DPP coaches share their tips for preventing and reversing type 2 diabetes with Everyday Health. Read all the tips on TIPPI >


“Exercise reduces the risk of chronic illness, provides weight control, enhances mental health, strengthens bones and muscles, and improves longevity and mental acuity. Be patient and don’t give up, making movement a priority takes practice!”

“I recommend keeping fitness fun. Find a movement you enjoy (such as walking, swimming, gardening – anything that gets you off the couch and moving) and find a friend to exercise with for 30 minutes every day.”

– First Mile Care Coach Shavon LeBlanc


“Maintain a food log to track how you feel after pre-workout meals.”

“Try to eat 2-3 hours prior to exercising, or else eat easily digestible, simple carbs and a smaller portion of protein.”

“If you use protein powders before a workout, educate yourself on reading labels. Note sugars as well as chemicals or dyes.”

– First Mile Care Coach Kathy Gregory


“I recommend making your workouts enjoyable to avoid losing motivation. Make a plan and schedule time for yourself to workout. Within the first month, you should notice improvements in your mood and see visible results in as little as a few weeks!”

– First Mile Care Coach Sandra Huskey


“Try keeping a list of your top stress-relieving activities somewhere visible, like a fridge or a mirror, so you’ll see the list the next time you go to open the freezer door!”

“Practice calming activities (such as reading, being in nature, talking to a friend, music, coloring or physical activity) to reduce stress.”

– First Mile Care Coach Jenny Fowler


“Adopt a “growth mindset.” In her 2007 book, ‘Mindset, The New Psychology of Success’, Carol S. Dweck, Ph.D explains that a “fixed mindset” focuses on failure while a “growth mindset” looks at failure as an opportunity for improvement. Having a “growth mindset” helps you achieve the goals you set for yourself in your diabetes prevention program action plan and empowers you to keep making progress towards sustainable habit changes to reverse diabetes.”

– First Mile Care Coach Bibilola Ladipo-Ajayi

How Health2047 nurtures innovation on medicine’s biggest challenges

To date, Health2047 has helped launch nine new companies. Some of the ideas came from within Health2047 and other ideas were ones people brought to the company. Health2047 was able to help provide expertise and help find capital to help fund the projects.

One example is First Mile Care, a company that has rethought chronic care management. The Centers for Disease Control and Prevention’s (CDC) Diabetes Prevention Program has been shown to reduce the incidence of type 2 diabetes by 58%. But expanding on the idea to reach more people has proved a challenge. First Mile Care is scaling up the prevention platform that includes a physician prescribing the program and conducting the program in the patient’s community. Cohen said the company is now entering a growth phase.

Learn more from the American Medical Association >

Having Fun With Hydration — It’s More Than Just Water

By Sandra Huskey, First Mile Care DPP Coach

When you hear “hydration” you immediately think “water,” right?  Your body is about 60% to 70% water. Water aids digestion, keeps your blood moving, helps your kidneys and bowels work, provides saliva, and regulates body temperature, among other critical functions. It energizes your muscles and joints and reduces fine lines in your face. It wards away headaches and fatigue and keeps you alert. It also helps you to control calorie intake and your weight, because water helps to fill you up.

But hydration goes beyond just drinking water. If you eat fruits and vegetables that are full of water, they make you feel fuller for longer. As part of the ongoing series of “Diabetes Prevention in Action” webinars offered by First Mile Care, I shared my tips for making hydration fun and looked at how to jazz up your water intake and make healthy smoothies.

In the clinically-proven National Diabetes Prevention Program (DPP), coaches emphasize that you need to be mindful of everything that goes into your body — and that includes all liquids. First Mile Care DPP coaches recommend that you keep a food journal to track your intake. We teach DPP participants to read food and nutrition labels carefully as the ingredients of what you eat and drink go towards your calorie, carbohydrate, sugar, fiber and other nutrient counts.

Water, water, everywhere

How much water should you drink? That varies based on your body size and how much you’re exercising and perspiring. In the summer months in Texas where I live, you’re going to want to increase your hydration to a bare minimum of 64 ounces if you’re exercising, but you could aim for 80 ounces.  My tip is to keep full glasses of water around the house, or for some folks, it’s drinking from big containers where they can easily measure their intake.

The important thing about water is to know your sources and look at the labels, as all water is not created equal. Here are a few things to keep in mind.

  • Tap water. Check what minerals your municipality adds to it.
  • Mineral water. It varies by the source, and naturally has different nutrients in it.
  • Bottled water. Some may come from a particular spring, but some come from a water municipality, and even “purified” water may have calcium, chloride, magnesium salts and other additives.
  • Sparkling water. The added carbon dioxide gives it the bubbles. Most sparkling waters like Lacroix are flavored, so check the label for the additives.
  • Club soda or seltzer water. The bartender’s favorite, probably because it has a bit of saltiness, although it’s basically just like sparkling water.
  • Tonic water. Consider it a soda drink and not a water, as it has a lot of added sugar and sodium as well as quinine, which can increase heart rhythm.
  • Sports drinks. Check the additives, as Gatorade, for example, has a lot of added sugar.

You’ll be more inclined to increase your water consumption if it has a pleasant taste. Luckily, it’s easier to turn boring water into a flavored beverage than for Cinderella to turn into a princess. Consider infusing a jug or glass of water with herbs like basil or mint, or lemon or lime quarters, or cucumber slices.

Satisfying smoothies

You can jazz up your water, but sometimes you want something a little more satisfying. For example, I drink smoothies as a snack or to replace electrolytes and lost fluids after a run or other physical activity. And it’s easy to make your own delicious, healthy smoothies! Here are a few of my basic ingredients.

  • Base: plain yogurt, coconut water, low-fat milk, almond milk, oat milk, soy milk
  • Protein: peanut butter, almond butter, cashew butter, pistachio butter
  • Fiber: flaxseed, flax meal, chia seed or even veggies such as spinach
  • Consistency: banana (it has sugar), or a healthy fat like avocado or sweet potato (but remember they are still fats!)
  • Flavor: cinnamon, unsweetened cocoa, ginger, turmeric, vanilla
  • Sweetener: go natural with honey or fruit like blueberries, which are lower in sugar than dates

If you’re just starting out with homemade smoothies, you might want to limit yourself to only a few key ingredients. For example, yogurt, coconut water, peanut butter, and one flavoring.

The good thing about homemade smoothies versus purchased ones is that every ingredient is under your control. Anything you put in it will go towards your nutritional and calorie counts, so always check the labels for the amounts of sugar, sodium, protein and fiber. For example, coconut water has sugar, but it’s natural sugar and the calories are lower than in other drinks. Almond Breeze milk is unsweetened so has no sugar. Yogurt with fruit is higher in sugar and calories, which is why I recommend plain yogurt so you can add your own flavors and better track your nutritional intake.

Watch my webinar video below to learn more of my tips for making hydration fun!

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!

28 Nutritionists & Health Enthusiasts Reveal the #1 Healthiest Food in the World (and Why)

First Mile Care DPP Coach Jenny Fowler shares her opinion on the #1 healthiest food.

“While I’d love to say that there is one magic food that we all could eat every day to keep us in optimal health, I can’t…”

Yes, kale is chock full of nutrients like vitamin A, vitamin K, and calcium. The açaí berry is loaded with antioxidants. Wild salmon is one of the highest sources of omega-3s. But to say that there is 1 food in the whole world that is healthier than all others? It’s just not possible; you need all of these nutrients. And that’s a good thing, because variety in food is not only healthier for us, but it tastes better, too!

So what to do? Eat a variety of cruciferous vegetables (of which kale is one) to help your liver detox, enjoy a variety of berries for their antioxidants, and have some wild fish or hemp, chia, and flax seeds to get your dose of omega-3s. Enjoy the variety of foods the world has to offer to reap the benefits of a variety of nutrients.

Read more on Incredible Edibles >

Resources for Healthy Eating in National Nutrition Month

By Juliana Ronn, First Mile Care Director of Operations

March is National Nutrition Month! It offers an opportunity to revisit some useful articles and information sources with tips for eating well — and healthily.

Good nutrition is a major component of the clinically-proven National Diabetes Prevention Program (DPP) offered by First Mile Care. Our program enables personalized support and guidance at the community level, giving participants access to the coaching, tools, and resources they need to live healthier lives and reverse or prevent chronic health conditions like prediabetes. Approximately 88 million Americans over age 18 have prediabetes, but 84% of them aren’t aware of it.

The DPP was designed by the Centers for Disease Control (CDC) to help people make more informed choices and lasting changes in their lives. While modest weight loss (about 5%) and modest activity (150 minutes per week) are core goals of the program, the DPP also focuses on nutrition and healthy eating, not dieting. The goal is to create realistic eating habits that you can stick with for the long-term, not just short-term meal plans. Participants learn to eat healthier without giving up the foods they love, even when eating out. Small changes, like awareness of portion sizes, can make a big difference.

Here are a “baker’s dozen” of links to articles about nutrition and healthy eating on the First Mile Care blog, in our “Diabetes Prevention in Action” webinar series, and in other online resources to help you on your journey to a sustainable healthy lifestyle.

1. The U.S. Department of Agriculture (USDA) has a robust website with advice on nutrition choices and links to a wealth of resources related to healthy eating, including MyPlate, the USDA food group guide.

2. Coach Irazema Garcia offers her advice on the First Mile Care blog on how to plan and prepare a menu of healthy meals without feeling overwhelmed.

3. The HuffPost has a useful section on food that recently quoted Coach Jenny Fowler in an article about how to avoid confusing serving and portion sizes of many popular foods.

4. Coach Kathy Gregory discusses on Thrive Global how important good nutrition is to your workout performance and results.

5. Yes, the DPP lets you bake desserts and other goodies in a healthy way — just follow Coach Sandra Huskey’s advice. 

6. Have you ever wondered if it’s OK to eat the same foods, day after day? Eat This, Not That! interviewed Coach Jenny Fowler on getting the right blend of stability and variety in your diet.

7. Everyday Health is a blog that is full of consumer-friendly health and wellness content.

8. Coach Irazema Garcia’s recipe for cauliflower makes it a healthy yet still-delicious side dish.

9. Well+Good is a popular lifestyle blog with a lot of tips on healthy eating, including comments from Coach Kathy Gregory on coping with grocery-store shortages.

10. Coach Jenny Fowler provides advice for eating “smart” at holiday meals and other gatherings focused on food. 

11. Keeping a food journal is a useful way to discover how eating habits are connected to your moods, says Coach Karalyn Cass.

12. Learn about the link between your eating habits and mental health in this article on Incredible Edibles that includes Coach Kathy Gregory among the experts offering advice.

13. The Wall Street Journal talks about foods that can help fight stress, anxiety, and depression, while Coach Jenny Fowler offers tips on the First Mile Care blog for breaking the link between stress and eating.

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!

Total Health: Karl Ronn of First Mile Care On How We Can Optimize Our Mental, Physical, Emotional, & Spiritual Wellbeing

First Mile CEO Karl Ronn shares tips on how we can optimize our mental, physical, emotional, & spiritual wellbeing.

“The CDC-backed Diabetes Prevention Program works. The problem is that the DPP isn’t yet reaching millions of people. Everyone wants to tackle these problems digitally because that’s the new technology. At First Mile Care, we are embracing the opposite. We said, let’s be hyper-local, with an in-person, face-to-face program in every ZIP code. Embrace the complexity and find a solution. We are proving that our platform can do that.”

Read more via Authority Magazine >