I hate when my patients use the word “cheated” like they are confessing to me that they did something awful when they ate a piece of pizza or cake. I just got back from vacation recently and I promise you that I did not eat perfectly! That is what has inspired this particular post. Does it have to be about food? No. It can be about anything in which you have slipped from where you would like to be:

• Maybe you were doing a great job testing your blood sugars 4-5 times a day and all of a sudden you have slipped down to 2-3 or even less.
• Maybe you were remembering to take all of your medications at the appropriate times but recently have forgotten here or there.
• Maybe you were exercising every day just even for a few minutes but have become a little lax and let a week slip by.

If any of those pertain to you it is not too late. Today is the day to start again!! One of the truest things I heard one of my weight loss participants once say is that she would find herself eating badly at the start of the day and then it would spiral and keep going through the weekend. I am sure we have all felt that way at one time. That can be very discouraging and you can almost feel trapped in that downward spin but know that you are in control and that you don’t even have to wait until tomorrow to revert back to your healthier ways- you can start right now the very minute you finish reading this blog. Get up and go for your walk, test your blood sugar, take your medications, make the next food choice a healthy one. You have the power and it will feel good!! Remember how you feel when you are making the positive choices for your body, for your health. And remember how you feel when you don’t.

As we approach fall and the start of a new school year, remember how it felt when you were the one heading back. You would pick that special first day of school outfit and have the whole year to look forward to not knowing what amazing events would occur and what wonderful memories would be made. This can be your “new” time also much like how everyone resets at the New Year. Don’t wait until then. Enjoy these last few weeks of summer as we head into fall and choose to be the healthiest version of yourself!

Your “just for today” challenge is just that- start fresh today!

Who likes planning meals? I definitely do not! Especially if you are trying to eat healthy. Often it can feel like you are eating the same things over and over because you are afraid to branch out to try anything new for fear that you will get off your healthy eating path. Do not be afraid! I am going to give you a simple guide to planning meals/snacks to help you get the right food groups and hopefully help take the stress out of planning meals. The goal will be meals that will maintain blood sugar levels vs spike them high above target.

Breakfast- if you do not eat breakfast- start today! This is the most important meal to get your body’s metabolism going.

• eggs (with some veggies for an extra plus), toast, maybe some bacon or sausage
• banana and peanut butter
• protein infused cereal (Special K protein is one example)
• smoothie (click here for a recipe I make most mornings)
• greek yogurt with some berries and nuts
• cottage cheese with some fruit and nuts
• pancake/waffle with eggs
• oatmeal with some nuts/spoon of PB

Lunch- this is a toughie simply because if you are on the road during the day like me you do not have access to a microwave- so soup or leftovers are out (unless you like it cold), or fridge- ice packs will work for a few hours. So if you have the option to pack/have whatever you like then the same idea as dinner listed below applies. If you have to select from a fast food here are some of the best I have researched- most of which I eat if I am in a pinch

• Panera- Mediterranean chicken flatbread with apple as side (click here to access Panera’s nutrition info for additional menu items)
• Wendys- chili with side salad (click here for Wendy’s nutrition info)
• Subway- 6 inch turkey, chicken or ham with as many veggies as you want! Load them up!! If you add dressing and cheese or go with a fried chicken or sweet teriyaki option then you are looking at added calories/carbs. (click here for Subway’s nutrition info)
• Chipotle- any of their bowls with light rice-you’ll save the carb with no wrap (click here for Chipotle’s nutrition info)
• Otherwise I tend to pack: veggies, hummus, string cheese, almonds, a piece of fruit, chicken, or yogurt
• *Note I am always looking for new lunch ideas for the road so if you have any please leave in the comments!!

Dinner- the magic formula for all meals is a healthy carb/lean protein/healthy fat. So pick 1 from each category mix it up and have fun!! Don’t forget to throw in veggies too!

• healthy carb options: sweet potatoes, brown rice, quinoa, whole wheat pasta, squash, corn, whole wheat/grain bread, whole wheat pitas
• lean protein: chicken, lean beef, turkey, fish, shrimp, beans, eggs (who doesn’t love breakfast for dinner?)
• healthy fat: many of your protein sources are going to contain healthy fats but you could also add an olive oil based dressing (balsamic vinaigrette) or an avocado
• some veggie options: salad, green beans, broccoli, asparagus, sautéed peppers and onions, or even try roasted cauliflower (break off pieces, sprinkle with olive oil, salt, and pepper, bake at 400 for 20 mins)

Snacks- these can make or break your day simply because if you are snacking it is usually because you are hungry at a non meal time and if you didn’t plan ahead you might end up making a bad/spontaneous choice at a vending machine. Always keep a healthy snack on you or in your desk.

• Fruit and nuts
• Lara bars (I eat a Blueberry muffin one almost every day)
• Cheese stick (with or without fruit, nuts, or crackers)
• Greek Yogurt
• Quest bars (I mentioned these once before and will probably mention again. I LOVE these!!)
• Popcorn with some spray butter and some parmesan cheese (for protein)
• Unlimited veggies and hummus

Your “just for today” challenge is to select one of the healthier snack options to enjoy as a snack today

Protein is essential part of our diet. It is used to build muscle and tissues. Protein is also as essential in blood sugar management. When protein is consumed at the same time as carb, it will help to slow the absorption of the carb so that the increase in the blood sugar will not be as dramatic. A perfect example: if you ate just a banana, the result would be a very quick rise in your blood sugar as a banana is pure carb. That immediate influx of sugar often reminds me of something like a nuclear plant from a cartoon where the red lights are going off and the sirens are blaring for emergency. When sugar flows into your blood stream that rapidly, I imagine the brain, similar to the cartoon nuclear plant, trying to relay to your pancreas: send out all available insulin. For those with Type 2, the body will release all remaining insulin making cells (remember those with Type 1 no longer have the cells to make their own insulin). If you have enough of these “red alerts” then eventually those insulin producing cells will die off out of exhaustion. Note: of course it is more medical than this however this is something I have come up with as an easy way to explain to my patients how eating carb alone can burn out their insulin producing cells faster.

Now let’s say you take that same banana and pair it with my all time favorite food- peanut butter (yum). Immediately, the body process is altered. The peanut butter which is a protein (and a fat) will help to slow down the carb rush into your blood stream. Therefore no red flashing lights and no sirens blaring. Just a nice subtle notification to your insulin producing cells to please release some insulin as there is some carb entering the system. Remember my goal here is to help you maintain good numbers thus achieving your A1C goal of under 7. One way big way you can do that is my learning how to eat properly. Making this one adjustment will help immensely- pair every carb you eat with a protein source. I must note here that the EXCEPTION to this is if you are experiencing a low blood sugar (less than 70)- this is when you ABSOLUTELY want that quick rush and only quick fast acting carb (juice, regular pop, glucose tablets, etc.).

With all that being said here is a list of some protein sources:

• Meat (beef, chicken, turkey, pork, etc.)
• Fish
• Dairy (eggs, milk, yogurt, cheese, cottage cheese)
• Tofu
• Beans/Legumes
• Nuts
• Protein additives (whey, soy, pea, milk- can be found in protein bars, powders, cereal)

My next blog will be all about helping you to meal plan with this idea in mind!

Your “just for today” challenge is to do your best to try so that every carb you eat is paired with a protein source.

Picture this- an inner tube floating down the river with 10 of your friends on it. All of a sudden someone else jumps in and throws one of your friends off, then another, and another. All of a sudden there are only 3 of your friends left out of 10- and that is no fun! This is very similar to the scene playing out in your body. The inner tubes are your red blood cells (see picture above) which float around your body carrying oxygen molecules (you and your friends). When your blood sugars run high, excess sugar molecules (the people who kicked your friends off) see the red blood cells carrying the oxygen and decide they want a free ride too so they jump on and kick off your oxygen molecules. So why does this all matter? Well your A1C (also called hemoglobin A1C or HbA1C) is a measure of the amount of sugar stuck to your red blood cells. And the higher the A1C, the less oxygen that is riding your red blood cells being delivered to the cells in your toes, fingers, eyes, brain, etc. Overtime, if your A1C remains high, then those cells will begin to die due to lack of oxygen and this is where the complications of diabetes come from. Therefore, if you are able to maintain an A1C under 7 then that means that your cells are getting the appropriate amount of oxygen and your risk for complications is lower and THAT is my goal for you!!

When I worked at Children’s Hospital of Pittsburgh diabetes center, I used to describe A1C to my pediatric patients as another type of report card. So for those of you who haven’t received a report card in many, many years- it is back! The reason I compare your A1C to a report card is simply because it is an average of your blood sugars over a 3 month period of time. Meaning that having one or two individual high blood sugar readings from finger testing will not shoot your A1C up. It is many high readings over many days/weeks. But be encouraged because you can begin to make an immediate change that can quickly bring your A1C back to the American Diabetes Association’s target of less than 7.

Below is a chart showing A1C values (measured in %) and the matching average blood sugar value so that you have an idea of where you are measuring.

• 6%= average blood sugar 126
• 7%= average blood sugar 154
• 8%= average blood sugar 183
• 9%= average blood sugar 212
• 10%= average blood sugar 240
• 11%= average blood sugar 269
• 12%= average blood sugar 298

Your “just for today” challenge is an easy one- if you do not know what your last A1C was then call your doctor office and find out. If it is higher than 7 do not worry and know that starting today you can work to improve your numbers so that your next one will be better!