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 >

Making Healthier Choices in Fast-Food Restaurants

By Barbara Martinez-Benavides, First Mile Care DPP Coach

Most people will find themselves occasionally pulling into a restaurant drive-through lane on the way home from work, or perhaps when on a road trip. The hustle and bustle of everyday life tempts us to rely on convenience. In a 2013–2016 survey, more than one-third of U.S. adults said they consumed fast food on a given day.

Recognizing this fact of life, First Mile Care Diabetes Prevention Program (DPP) coaches guide participants on how to maintain healthy eating habits when fixing a healthy meal at home isn’t possible or requires too much time. “Healthy fast food” may sound like a contradiction in terms, but that’s not the case. Even in fast-food restaurants, it’s possible to find healthier items on the menu.

Everyone has their favorite indulgences. The goal of First Mile Care is to help participants make lifestyle changes that stick for the long term, without having to deny yourself the things you love. Learning to make healthier swaps when eating out can give your body the nutrients it needs, while avoiding the things that could sidetrack your progress toward prediabetes intervention.

Planning for temptation

Have you ever sat near someone on an airplane who brought aboard McDonald’s French fries? It’s hard not to begin fantasizing about their golden crispy deliciousness, despite being aware of their levels of fat, salt, sugar, and additives

The smell and appearance of fast food can influence you to order something you wouldn’t otherwise have considered eating. The reason for this is what we think of as “junk food” is highly processed and designed to be addictive —as well as ultra-pleasing to your taste buds and olfactory system. It lights up the pleasure centers of your brain to keep you coming back for more. This makes craving processed foods a very real thing.

The way to combat temptation is to take a few minutes to review the menu before you enter the restaurant, decide what to order, and follow through. Many restaurants list the calories, saturated fat, trans fat, sodium, carbohydrates, and other nutrients in their offerings. If you can’t find it, ask an employee for a copy of the nutritional information. If the description reads like a chemistry project, move on to something — or somewhere — else.

Here are some other tips to keep in mind when you dine in a fast-food restaurant.

  1. Choose wisely. Many fast-food restaurants now offer vegetables, soups, and salads —  but avoid adding crackers, croutons, bread, grated cheese, bacon bits, and creamy dressings.  If you load toppings, it may defeat the purpose of making the “healthier choice” in the first place. Choose plain vegetables (grilled or steamed, no butter), a baked potato instead of fried, and fruit for dessert. Make sure that toppings are on the side so you can control what, and how much, is included. 
  2. Rethink liquids. Sweet drinks (including tea and natural drinks like lemonade) and milkshakes are calorie bombs that make it easy to swallow hundreds of calories without realizing it. Skip the sugary sodas and opt for plain water, sparkling water, infused water, unsweetened tea, or water with lemon juice.
  3. Don’t upsize your meal. Choose the smaller size when ordering a combo meal. Paying a few cents more to get a much larger portion may seem like a great deal, but it will add a lot of fat, calories, and sodium. And, probably, you will eat more than your hunger requires. Usually when people are served more food, they eat more, instead of eating mindfully and listening to their body’s hunger signals.
  4. Leave some food on the plate. You don’t have to finish everything on your plate. When you feel satisfied —  but not necessarily full — you can stop eating. You might be able to get a to-go container, although fast food does not always age well.

Making meals happier

There are many options when it comes to eating at a fast-food restaurant. Here’s what to look for and what to pass up at each of the most common types of establishments.

Hamburger restaurants

Best Options: plain single grilled burger (if possible without a bun, with a lettuce wrap, no ketchup/mayonnaise), grilled chicken, veggie burger, salads (lettuce, tomato, cucumber, no cheese), extra lettuce, tomatoes and onions, baked potatoes, mustard, pickles

Limit/Avoid: extra cheese, mayonnaise, ketchup, special sauces, French fries, breaded or fried meat or fish, bacon, heavy dressings, chicken nuggets and strips, onion rings, chili, milkshakes 


Fried chicken restaurants

Best Options: skinless unbreaded grilled chicken breast, salad (tomato, lettuce, cucumber), baked potato

Limit/Avoid: fried chicken, extra crispy teriyaki wings or fried chicken chunks, chicken and biscuits, Caesar salad, coleslaw, French fries, onion rings, mashed potatoes with gravy, extra sauces, ketchup


Sandwich restaurants

Best Options: lean regular or junior sized meats (such as roast beef, chicken breast, lean ham), whole grain breads, vegetables, mustard, vinegar, olive oil

Limit/Avoid: fatty meats, tuna salad, bacon, meatballs, cheese, mayonnaise, special dressings (eg. buffalo), white bread, croissants, crackers, chips, cookies


Mexican restaurants

Best Options: lean grilled meats (fajitas), fish or shrimp, vegetable burritos, vegetables, beans, corn tortilla, guacamole, salsa, pico de gallo

Limit/Avoid: crispy toppings or wraps, street corn, refried beans, sour cream, extra cheese, chips and queso


Italian restaurants

Best Options: thin crust pizza with less cheese and more vegetables, antipasti with vegetables, pasta (whole wheat if possible) with tomato sauce and vegetables, grilled lean meats, tomato-based soup, balsamic vinegar/olive oil as dressing

Limit/Avoid: thick or buttery crust pizza, meat lover’s pizza, stuffed-crust pizza, extra cheese, garlic bread, meaty antipasti, meat lasagna, caprese salad, mozzarella sticks, cream or butter-based sauces (eg. alfredo), tiramisu


Asian restaurants

Best Options: lean meat, vegetables (broiled, steamed or sautéed), edamame, cucumber salad, low-sodium soy sauce

Limit/Avoid: anything fried or crispy, tempura, fried rice, peanut sauce, sweet and sour sauce, regular soy sauce, fortune cookies, sugary drinks


Fast food is convenient, inexpensive, and tasty, but it is also packed with fats, sodium, dyes, preservatives, and sugar — all things that could raise your risk of obesity, diabetes, high blood pressure, heart disease, and stroke.

However, you don’t need to cut fast food completely out of your life. Learning to enjoy things in moderation through healthy swaps is key to lifestyle change and maintaining a healthy life balance.

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: Changing My Relationship With Food

By Juliana Ronn, First Mile Care Director of Operations

Olidia Thomas is a 72-year-old widow who lives in Ypsilanti, Michigan, with her two youngest granddaughters. She spent 45 years as a healthcare manager at the University of Michigan in Ann Arbor before her retirement. She has been in the year-long First Mile Care Diabetes Prevention Program (DPP) for seven months.

1. Olidia, Were you concerned about prediabetes before joining the First Mile Care Diabetes Prevention Program?

Minimally. I had heard the term at my job and knew about prediabetes monitoring but didn’t really think it applied to me. Nobody ever does, right? There isn’t a history of diabetes in my family, although hypertension is common. I take medication for high blood pressure.

My physician, Dr. William Chavey of Emmaus Health Partners, did talk to me for a couple of years about my need to lose weight. He was concerned that my blood glucose put me in the prediabetes range. I have some friends who have type 2 diabetes and must take shots or pills, and I certainly didn’t want to let myself get to that point. So, when I got a letter from Coach Taylor Winkel of First Mile Care saying that Dr. Chavey had recommended me as a candidate for the diabetes prevention program, I was ready to try it.


2. Have you tried any weight loss or lifestyle change programs in the past? 

Oh sure, I have paid memberships in several weight loss programs and gyms in the past. I’ve gained weight and lost it and gained it all back again. I wasn’t consistent with any of it and would get discouraged and give up. For example, Weight Watchers didn’t work for me as I had to deny myself too many of the things I really liked. I tried to game the system by starving myself just before the weigh-ins. The thing was, I was focused solely on the short-term goal of losing pounds rather than on making the long-term behavioral changes that would result in weight loss.

3. You’ve been in the First Mile Care DPP for about seven months. What results have you seen so far?

Yes, I’ve already lasted longer in First Mile Care DPP than in any other program I’ve tried. And that’s because I’ve made a firm commitment to myself to stay on course. In addition, the changes are fairly easy to make, and I can see the effects. My doctor was really impressed with my progress at my checkup.

  • I feel better. I don’t feel sluggish. That’s a significant improvement for me.
  • My A1C has fallen from 5.7 two years ago to 5.2. My doctor said it’s now “better than normal” and no longer in the range for prediabetes.
  • I’ve lost 32 pounds so far. My long-term goal is to lose about 90 pounds, even though I may not be able to lose all that by the time I finish the First Mile Care program in the fall. Instead, I’m focusing on achieving short-term goals of 20 pounds, and then will reset my goals. My doctor says this is my lowest weight in four years.
  • I can feel the change in my clothes, especially on my bottom half. My clothes feel loose and comfortable. A belt that used to be so tight I couldn’t wear it, is now loose enough that I use the second notch from the end. 


4. Why do you think the First Mile Care program is working for you when others haven’t?

I have a positive mindset and commitment to the program. I follow the suggestions that my coach makes. It’s not just about denying myself food but about setting goals, looking at what I eat, counting calories, increasing water intake, increasing fruits and vegetables, looking at portion sizes, and getting more exercise. 

I found that keeping a food journal and tracking my intake is helpful. It’s not onerous to do it. I still eat the things I love, like ham, in moderation. I just keep track of the calories and try to stay within the guidelines. Even 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. Most importantly, I forgive myself when I go off course.

5. What has been the most helpful thing that you’ve learned in the First Mile Care program? 

My entire relationship with food is changing. I used to eat whatever I wanted and as much as I wanted, without thinking about it. Now I eat mindfully. I look at the calorie counts, and especially at the portion sizes. I’m not only eating more fruits and vegetables; I’m adding more variety. I used to eat a lot of fast food, especially pizza, but have cut way back. My whole way of eating is changing!

6. What are some of the specific changes you have made?

Oh, there are so many!

  • Portions and servings. I pay attention to portion size and eat smaller amounts. I even bought little serving trays to use for preparing my weekly meals. 
  • Meal prep. I am trying new ways of preparing my food and recently bought an air fryer. For example, I love fried chicken but now put it on the grill or the air fryer instead of traditional frying. I fixed some sweet potato fries in the air fryer, and they were delicious! Now I’m trying to get used to the taste of olive oil as I know it’s healthier.
  • Shopping. I plan my week’s meals before I go to the store so that I don’t buy things on impulse that aren’t healthy. I avoid buying soda pop and other things, like candy, that I know I’ll find hard to resist if I have them in the house.
  • Nighttime snacking.  I’m a night owl and sometimes snack late at night, but now I eat carrots and celery at Coach Taylor’s suggestion.
  • Restaurant dining. I’m of the generation that doesn’t believe in wasting food. At my coach’s suggestion, I now always ask for a to-go container at the start of the meal and put half my food away. I can still eat at my favorite Olive Garden but split my serving into two meals.
  • Exercise. I was never consistent at exercise, but now I always meet or exceed the recommended minimum of 150 minutes of weekly moderate exercise. I follow YouTube exercise videos for seniors, bought resistance bands for at-home strength training, and just got a FitBit to track my steps and blood pressure. 

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

Coach Taylor is very motivating and encouraging – a real cheerleader when it comes to keeping everyone in the group on track towards their goals. When someone falls off the wagon, so to speak, she encourages us to get on again. She has made suggestions that I hadn’t thought of before, like doing short sprints of exercise during TV commercials. I have stopped watching TV in bed so that it’s easier to get up and move about. She’s made me aware that every little bit of movement counts towards my activity goal. 


8. First Mile Care emphasizes neighborhood-based groups that pull participants from the same ZIP codes. How has being in a group helped you?

The group is helpful both in terms of accountability and motivation. You want to be able to tell people each week about your progress and get bragging rights and congratulations. But it’s also helpful to swap stories about our struggles. I feel less discouraged if I  know that other people also fall behind in meeting their goals, yet can get back on track.

We also share tips and recipes and information on where to go shopping. For example, one of the women in my group suggested juicing, so now I make that into my own tea. I never used to like tea but am trying it as a substitute for soda pop, so my granddaughter and I have boiled apple, lemon, and pineapple peels for tea.

9. How do you expect to maintain the progress you have made in changing your lifestyle?

This is the longest I’ve stuck with a lifestyle change program. Knowing I can fall off the wagon and get back on is important. It’s not the end of the world. It’s not the end of the program. I plan to keep monitoring what I eat, setting up meal plans, eating more vegetables, drinking more water, and getting my minimum 150 minutes a week of exercise. One recommendation in the program is to get your family members involved so that they can support you. I’ve got my grandchildren to remind me that “you said you weren’t going to eat that.” If I ask my granddaughter to buy me a candy bar now, she won’t! 


10. What advice do you have for people who join a lifestyle intervention program like First Mile Care?

You have to be committed. You have to make up your mind that you really want to follow the program, but also recognize that there will be times that you may not be able to stick to it. Set your goals in increments so that you can achieve small successes as you work towards them. Allow yourself to backslide at times. The important thing is that you don’t give up! It’s worth the effort. The finish line is attainable.

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!

Aquatic Fitness Is More Than Just Swimming

By Shavon LeBlanc, First Mile Care DPP Coach

Summer is almost upon us so everybody jump into the pool! Aquatic fitness is an optimal form of exercise; a hidden jewel that is often overlooked. The pressure and resistance of water provide a soothing environment that engages your entire body in building strength and flexibility. 

Why is water a great exercise option? It torches calories! You can burn more calories in an hour-long, high-intensity aquatic class than on the treadmill. Whether you are experiencing joint pain, rehabbing an injury, are pregnant, deconditioned, overweight, or even an athlete — water exercise is an all-inclusive workout that is adaptable to all fitness levels and provides a true fitness challenge.

As part of the First Mile Care Diabetes Prevention Program, coaches encourage participants to engage in a minimum of 150 minutes of moderate physical activity every week to lower the risk of developing type 2 diabetes and other chronic illnesses and diseases. Aquatic classes and swimming are examples of moderate physical exercise that may help participants in reaching the DPP goal of losing 5-7% of starting weight.

Land versus water

When working out on land, there are compound exercises which can target multiple muscle groups at the same time. For example, a squat-to-press movement engages your lower body, core, and upper body within one exercise. 

When working out in the pool, your entire body is targeted, providing a full body workout within one class session. One of the greatest benefits to water-based exercise is that it targets the primary muscles as well as their opposing muscle group. For example, when running in the water, you are getting the benefit of the force of the water targeting both the hamstrings and the quadriceps. When pushing up within the pool, you benefit from targeting the chest muscles, back muscles, and core. 

The buoyancy of water provides the freedom to participate in exercises like squatting and jumping that can be challenging outside of water. This buoyancy also provides the opportunity to increase the intensity of exercise without causing joint pain. Normally, when lifting weights on land, there is a teardown of muscle to build stronger muscle. But the resistance offered by water accomplishes muscle toning without creating joint tension. The force of the water targets your abdominal muscles and builds flexibility, balance, strength, and endurance — all while reducing stress on your joints.

Here are some examples of water-based exercises:

  • Swimming Laps: freestyle, backstroke, breaststroke, butterfly stroke
  • Water walking: walking in patterns, backwards walking, side-to-side walking, single leg balance walking
  • Water running or jogging: water racing, time-based running sequence, wall running, backwards running
  • Water aerobics: integrates exercises such as basketball, bicep curls, boxing, dancing, jumping, lunging, squats, and cross-country skiing

Some people also find they can exercise longer in the pool than on land, due to the cooling effect of water on body temperature.

What you’ll need

Your pool probably provides major gear like water bicycles, treadmills, and elliptical machines. There are several smaller items that you may want to supply yourself if they aren’t otherwise available, such as:

  • Buoyancy belt to assist in floating
  • Foam dumbbells or strap-on wrist or ankle water weights for building resistance
  • Resistance gloves or hand paddles for strength training
  • Kickboard 
  • Fins
  • Goggles or eye mask

However, please don’t use household items like empty water jugs as aqua weights, as they are ineffective and unsafe in the pool.

Developing a routine

When putting together your your aquatic fitness routine, keep in mind the FITT principle

  • Frequency: 3-5 days per week 
  • Intensity: Moderate to Very Intense 
  • Time: 30-45 minutes 
  • Type: swimming laps, aqua stretching, aquatic running or jogging, aqua bicycling, aqua boxing, aquatic boot camp, Aqua Zumba©

For example, First Mile Care participant Katherine Dowling swims laps for up to 30 minutes at her local YMCA twice a week, at the recommendation of her cardiologist. She says, “It’s wonderful to be in the water. Swimming is like a vacation or therapy, as it’s so peaceful and relaxing, and you can think about whatever you want to think about.” 

Aquatic fitness can be enjoyed by everyone. Jump right in; the water’s fine!


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!

Time to step up screening for prediabetes and type 2 diabetes

“And the Diabetes Prevention Program from First Mile Care, a Health2047 spinoff, provides coaching, support and other resources enabling people to live longer and healthier lives.”

Read the full article via the American Medical Association.

Letting Nutrition Labels Guide Your Grocery Shopping

By Kathy Gregory, First Mile Care DPP Coach

Learning to make more nutritious choices in the foods and drinks you consume is key to adopting a healthy lifestyle. As part of the Diabetes Prevention Program (DPP) curriculum, First Mile Care coaches teach participants how to track their intake and become more aware of portion size and the high calorie and highly processed foods to limit. The goal is to increase awareness of how eating smaller portions of higher quality foods as part of a balanced diet can satisfy hunger and improve wellness.

When navigating the grocery store, examine packaging carefully before you decide on a purchase. Generally, the statements on the front of a package are marketing claims, while the back or side has factual information. By checking the nutrition facts label, you can make more informed choices. If you’re trying to lose weight, you’ll be mindful of how many calories you eat, and how many are from sugar and fat. If you have high blood pressure, you’ll look at salt content. It may take a bit longer to do your shopping, but when you pull an item from the cupboard at home, you’ll know it was the best option available.

First Mile Care participant Jeannie Lawson was shocked at the high calorie and fat content listed on labels. “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.”

Servings versus portions

For anyone seeking to monitor their calorie intake or consumption of different proteins and vitamins, the serving sizes listed on nutrition labels can guide you in the right direction. All the nutrient amounts on the label are based on the serving size. The serving size reflects a standard quantity chosen for measurement and is not a specific recommendation of how much you should consume of the item.

It’s easy to misread and misinterpret nutritional labels, and they are not infallibly exact. As per the FDA guidelines, “FDA’s continuing policy since the 1970s assigns the manufacturer the responsibility for assuring the validity of a product label’s stated nutrient values.” What’s more, the average size of some food items, especially produce, is larger today than when the standard serving measurements were developed years ago. Bananas, for example, come from mini to giant sized, and chicken breasts are larger than they used to be.

What can be confusing is that while a serving is what is stated on the package, it may not be the amount that you would normally eat of a particular item — what’s called a portion. Therefore, it’s critical to look at the number of servings in the package. It’s OK to eat more than a serving, as long as you are aware that you are also consuming multiples of calories and nutrients, too.

For example, according to the packaging on a Top Ramen brick of noodles, a serving is just half the brick, even though most people will consume the entire brick as their portion. The label on a can of soup or chili or clam chowder, or a packaged Indian dinner, or boxed pasta, may also say it’s multiple servings, even though the actual quantity that will satisfy you is the entire package.

If you eat two servings, you need to double all the quantities in the nutrition facts. So if a serving has 150 calories but you ate two servings, you actually ate 300 calories. For example, the nutrition label on a package of rice says that a serving is half a cup, but most people would consume more than that amount in a single sitting. If your portion is one cup of rice, that is two of your recommended servings of grains for the day.

Another food item whose serving size is easily misunderstood is breakfast cereal. Most people just eyeball the amount of corn flakes or granola poured into a bowl. If you read the serving size listed on the label, you may find you’re eating double or even triple the serving — as well as the sugar and calories.

The confusion doesn’t end with food. Some beverages, like Gatorade and some brands of kombucha, contain more than one serving in a single small can or bottle.

Achieving balance

Calories provide a measure of how much energy you get from a serving of a food item, and the number of servings you eat determines the number of calories you consume. Balancing the number of calories you eat and drink with the number of calories your body burns through daily activity is a stepping stone to achieving a healthy body weight. Your estimated calorie needs may be higher or lower and vary depending on your age, sex, height, weight, and physical activity level.

As First Mile Care participant Al Cisneros explains, “I never used to look at food labels or packaging. When my wife asked me to pick up bread and butter at the grocery store, I grabbed the first thing I saw. I never considered basing my choices on sodium and fat and carbohydrate levels. My First Mile Care DPP coach, Sandra Huskey, encouraged us to read labels carefully, track calories in our food journals or apps, and make wise decisions based on whether an item is really worth how long it will take to burn off the calories.” 

Labels also show how much a nutrient in a single serving contributes to the percentage of Daily Value (%DV) reference amount of nutrients to consume (or not to exceed) in a recommended daily diet. You can use the %DV figure to gauge how a food’s nutrients stack up and which nutrients to consume more, and which to consume less.

Five ingredients or less

Nutrition labels sometimes seem written in a foreign language. The rule of thumb for labels on healthier food items is five ingredients or less, if possible. You want to see words that you recognize as ingredients instead of the names of dyes, fillers, preservatives, and chemicals. Whole foods like produce, legumes, lean meat, eggs, whole grains, nuts, and seeds generally have fewer ingredients so there’s less uncertainty about what you’re putting in your mouth.

Some nutrients are better in smaller amounts. Many ultra-processed packaged foods include added fat, sugar, salt, and preservatives. Eating too much fat, especially saturated fat or trans fat, cholesterol, added sugars, or sodium can raise your risk of health problems such as heart disease and high blood pressure. On the flip side, there are nutrients such as fiber, vitamins, and minerals that can improve your health and lower your risk of certain health problems. Most Americans don’t get enough dietary fiber, vitamin A, vitamin C, calcium, or iron.

Nutrition labels caused First Mile Care participant Jeff Millhouse to re-evaluate the multi-day juice cleanses he used to do on a regular basis to help maintain his weight. “When I looked at the labels on several of the juices, I was surprised at the added sugar. This occurred with both the juice cleanse bundles and a healthy juice I bought at a local vegetarian restaurant. I’ve also changed the type of yogurt I buy, and look more closely at the sugars in cereals and packaged products.”

Knowledge is power

The First Mile Care Diabetes Prevention Program is centered on developing sustainable healthy changes to diet and fitness, without giving up the foods you enjoy

Nutrition labels pack a lot of useful information into a tiny box. They can guide you to become a smarter grocery shopper (and eater). As First Mile Care participant Katherine Dowling advises, “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.”

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!