Healthy Tips – November/December 2020

Topics This Issue:


Creative Winter Exercise: Ideas from a Diabetes Star

Terri Woodrow knows a thing or two about self-care while living with diabetes. As one of PacMed’s doctor-nominated “Diabetes Stars,” Terri made time for us in her busy schedule, as a (now-virtual) para-educator, to share how she’s adjusted her health routine for COVID times.

When the weather’s nice, get out and about

“I’m fortunate to live close to an urban park area, so when the weather’s nice I’ll go for a 30- or 40-minute walk. It’s always nice to get outside in the fresh air, especially during the wintertime.”

Revisit past activities, try new ones

“One love of mine is aerobics. I used to teach it back in the day. I gradually switched from aerobics to running. When I couldn’t run anymore, I tried swimming and other low-impact activities, but was never consistent with them. Recently, I rediscovered aerobics. I found an instructor (Jenny McClendon, a licensed physical therapist) on YouTube. She has a love of teaching seniors and beginners in hopes they know it’s never too late to start an exercise program. It’s perfect for me, now that I’m 65. I’ve also done line dancing a few times a week and resistance training with elastic bands. If it’s something you love, you’re apt to stick with it.”

Find a pace that’s right for you–and keep going

“Along with diabetes I’ve had a few other health issues, like back and shoulder problems, so I’m not able to go all out anymore. I’ve learned through my PacMed doctor and diabetes educator how important regular exercise is to my ongoing health. So, I find the pace that’s right for me and keep rolling.”

Start with the tools you have–but start

“You don’t have to belong to a gym or buy fancy equipment to exercise. Resistance bands are a good, affordable investment. For light weights you can use water bottles filled with dried beans or soup cans. One YouTube video shows you can get in a complete workout just using a chair!”

Mental health affects diabetes, too

“I’ve learned that added stress can cause glucose levels to spike. When COVID-19 hit, and then the riots started, my numbers went up. I’ve learned to limit my news intake, be gentle on myself, stay positive and find things to look forward to. It’s funny, now I get compliments on being so optimistic!

“One thing I’m looking forward to is a three-week driving tour of Yellowstone and the Grand Tetons with a friend. We had to cancel the trip this year because of COVID, but we’re determined to do it next year. I love the planning and anticipation… it’s almost as fun as the actual trip!”

PacMed is nationally recognized for providing high-quality diabetes care. We help patients manage their diabetes through education, classes and support. Learn more about diabetes care at www.PacMed.org/Diabetes.

Back to Top


Diabetes: From diagnosis to successful self-care


Have a new diagnosis of diabetes? Or perhaps you recognize that your diabetes could be managed better? Self-care for diabetes can be overwhelming. It requires new knowledge, ongoing attention and a new mindset to keep moving forward.

So do you move from feeling stuck to finding success? How do you wrap your mind around this diagnosis?

Learn everything you can.

Your doctor and care team will guide your care and can point you to classes and support groups. A great resource to utilize first is the American Diabetes Association website.

Ask your care team to help you understand diabetes. Ask lots of questions! Here’s a brief introduction:

Insulin, a hormone in our bodies, keeps our blood glucose (sugars in the blood) at a healthy level. Diabetes is a condition where there is a lack of insulin or the insulin isn’t working well, and so, too much glucose collects in the blood. In Type 1 diabetes, the body cannot create insulin. Type 1 diabetes typically occurs earlier in life and is best managed by an endocrinologist. In Type 2 diabetes, the body develops a relative lack of or resistance to insulin. This usually occurs later in life and can be due to many things, including genetics and lifestyle factors.

Commit to success.

Diabetes is controlled with medications, by monitoring your blood sugars and by making lifestyle changes in diet, exercise and weight management.

It’s easier to be motivated when you understand the value of making lifestyle changes. These all play a role in keeping you healthy and your diabetes under control:

  • Losing weight (decreasing excess body mass and fat cells) allows your body to regulate blood sugar more efficiently.
  • Eating healthier and reducing your intake of carbohydrates and refined sugars decreases the amount of blood sugar the body must regulate.
  • Increasing cardiovascular exercise burns calories and increases the body’s metabolism, empowering it to use up any excess sugar that might turn into fat tissue.

It’s not easy, but these lifestyle changes become more manageable and natural once you realize they will not only result in better blood sugar control, but also help prevent many other health conditions, leading to a healthier and happier you.

Partner with your primary care provider.

  1. Keep a log of what you eat and your activities. A daily log helps your doctor and diabetes educators to cater their advice to your particular situation. For example, if you tell your doctor that you eat pasta five times per week, he or she can make specific recommendations as to how much pasta or the type of pasta you should be eating.
  2. Ask about other care you might need. Your providers might suggest vaccines, annual eye and dental exams, foot care—all important for preventing and monitoring complications from diabetes.
  3. Know the danger signs of low blood sugar (hypoglycemia). Signs may include shaking, lightheadedness, nausea and sweating. Work with your doctor to create a plan for what you will do in this situation. Finally, make sure you understand the plan—don’t hesitate to say it’s not clear and ask questions!

PacMed encourages our patients to take an active role in their care by doing some research, being disciplined with their medications and lifestyle, and asking questions when needed.

You may learn more about PacMed diabetes care, nutrition classes and other resources at www.PacMed.org/Diabetes. To find a primary care provider to guide this care, visit Lynnwood providers at www.PacMed.org/Lynnwood

Back to Top


Reimagine holidays and celebrations


If the holiday gatherings and family celebrations we cherish are disrupted, how will we handle the long, dark season ahead? As we all work together to slow and turn the outbreak of COVID-19, we may find some silver linings: More meaningful holidays. Deeper connections. More time to slow down and reflect.

PacMed therapist Eun Ku and the Living Well Alliance team share ideas for how a pandemic winter can be an opportunity to create the holidays we’ve always wanted—as well as birthdays and other missed gatherings.

Connect more deeply, outward

Reimagine the pandemic as an opportunity to avoid the “holiday rush” and instead connect with others. You might call Grandma on Sunday, spend time journaling on Wednesday and write a holiday letter on Saturday. You can also deliver gifts to friends’ doorsteps and say “hi!” from a distance.

With birthdays, a group video gathering might be a fun choice—but there are other options! Plan ahead and make a one-on-one date for virtual tea and conversation with a friend. Make sure you both have tea and cookies at the ready. A good, old-fashioned greeting card is a wonderful thing to receive in the mail, especially with a newsy letter, photo or loving note tucked inside.

Is a friend celebrating an anniversary? Choose a simple but fun menu, draw up a complete grocery list and share it with your friend’s household. Shop separately (no contact, pick-up groceries work well!), and then turn on Teams, Zoom or Facetime in your kitchen and cook together. A good screen and speakers are helpful. This works great with stir-frys and other fast meals. Have a glass of wine ready for when you sit down to dine together!

Connect more deeply, inward

Set side time for yourself. To manage the mental health impacts of isolation, choose healthy, self-soothing behaviors. You might try yoga, breathing exercises, contemplation, reading poetry aloud or meditation.

If you have experienced a loss from COVID, the slower and more contemplative pace of winter may open up new space to grieve. Use these quieter months to reflect on the past year, loved ones and the changes that have taken place. If the feelings that come up seem too powerful to handle on your own, it can help to work with a mental health professional to process them.

Get creative and stay active

If you love holiday outings, engage the family in a virtual trip-planning adventure. Research the places you want to travel to in the future, when safety allows. Or take a short drive to treat your brain to beautiful winter scenery or holiday lights—on homes or at a display like Stanwood’s Lights of Christmas. Another fun idea: Pretend you’re spending your holiday abroad and explore recipes from cuisines around the world.

It’s healthy to keep moving! If you enjoy decorations, add more ornaments or lights throughout the house. Change your front door decoration for New Year’s, the first day of snow, Valentine’s Day... Mix up your décor by painting a wall, rearranging furniture or putting up new artwork or photos. Take regular walks or search out some new spots for winter activities you love—like a hidden sledding hill or an open-air ice rink where you can maintain social distance.

You can learn more about therapist Eun Ku, LICSW, CMHS, EMMHS, and our other behavioral medicine providers at www.PacMed.org/BehavioralMedicine. All behavioral medicine visits are currently taking place via phone or virtual session. To schedule an appointment, please call 1.206.621.4045.

Back to Top


NUTRITION CORNER: 6 healthy holiday tips


As we approach a unique holiday season this year, taking care of your health continues to be important. Delicious, holiday foods bring us comfort and an opportunity to reimagine and invent traditions. Here are six reminders for health in the coming weeks.

  1. Focus on family and friends. With the pandemic and the holidays upon us, continue to put family and friends first. Instead of trying to re-create your normal extravagant meals for just a few people, try out some new recipes. Explore different traditions that you can share virtually. Social interaction can comfort us in similar ways to food by increasing our feel-good hormones. However, with social interaction, that emotional reward can last longer and be more satisfying.
  2. Experiment with cooking alternatives. Aim to reduce the amount of saturated fat and refined sugars you use for traditional recipes and incorporate healthy alternatives like natural sugars, fiber and unsaturated fats. For example, use olive oil instead of butter in a cake or casserole recipe. Or substitute natural sugars from fruits like apple or banana for added sugars in your favorite recipe. Try these other healthy-ingredient swaps.
  3. Eat slowly and savor every bite. Start every meal with gratitude about something you hold dear and, as you eat, appreciate the flavors of each bite. Eating slowly prevents overeating by allowing us to listen to our bodies’ hunger and fullness cues.
  4. Be mindful of portions. Take note of which items and how much of each is on your plate, especially in a meal with lots of food options. A good strategy for portion control is to mentally divide your plate:
    • ¼ Select lean proteins such as poultry or fish to make up a quarter of the plate—or about the size of a deck of cards.
    • ¼ Fuel up on complex carbohydrates such as whole-grain pastas, brown rice and vegetables like potatoes, corn, peas and squash. Portion these to fit in another quarter of the plate. Fiber from the complex carbs delays how fast blood glucose levels rise in the blood, which is especially important for those with type 2 diabetes.
    • ½ Savor a variety of non-starchy vegetables such as dark green leafy vegetables, broccoli, carrots, cauliflower and celery. These should fill up to one half of your plate, are loaded with vitamins and fiber and don’t affect blood sugars as much.
    Oregon Health and Science University offers this heart-healthy plate visual to help you visualize portions!
  5. Drink in moderation. Limit alcohol consumption to one drink per day for woman and two drinks per day for men. Focus instead on staying hydrated with these fun alternatives to water or a mocktail.
  6. Stay active. Continue any type of daily movement over the holidays to better your physical and mental health. Try an online yoga, Pilates or weights workout class, or check your local trail guide for winter-friendly hikes. See also the “Creative Winter Exercise” article in this newsletter.

Written by Christy Goff, MS, RDN, CD, and Diego Manjarrez, Bastyr dietetic intern during PacMed nutrition rotation.

Back to Top


Mint-Chocolate Meringue Cookies


This healthier, low-calorie cookie has some star ingredients such as protein-rich egg whites and antioxidant-loaded cocoa powder, and they’re easy to make. Enjoy during a festive video lunch or a special gathering within your household.

Makes 60 small cookies, about 12 servings. Total time, 45 minutes.

Ingredients:

3 egg whites
⅛ teaspoon cream of tartar
⅔ cup granulated sugar
¼ cup unsweetened cocoa powder, sifted
¼ teaspoon mint extract
⅓ cup mini chocolate chips or finely chopped bittersweet chocolate

Directions:

Preheat oven to 300 degrees. Line two baking sheets with parchment paper. With an electric mixer, beat egg whites and cream of tartar until soft peaks form. Gradually add sugar, 1 tablespoon at a time. Add cocoa powder and beat until the mixture becomes glossy. Add mint extract. With a spatula, gently fold in chips. Place mixture in a pastry bag* fitted with a ½- or ¾-inch tip. Pipe 1-inch rounds onto prepared baking sheets, leaving 1 to 2 inches between cookies. With damp fingertips, press down any peaks. Bake for 25 to 30 minutes, rotating pans halfway through baking. Place baking sheets on a cooling rack for 10 minutes before peeling cookies off the parchment.

*If a pastry bag isn’t available, spoon mixture into a zip-top bag and snip a ½-inch hole in the bottom corner of the bag. Batter can also be dropped with a tablespoon onto the baking sheet.

Nutritional information for 5 meringues:
Calories: 65 Total fat: 0g Cholesterol: 0mg Sodium: 56mg Carbohydrates: 13g Dietary Fiber: 1g Sugars: 12g Protein: 4g

Recipe from the American Cancer Society.

Back to Top


A successful Wellness Symposium—and virtual, too!


The Living Well Alliance’s annual, one-of-a-kind wellness symposium for Puget Sound–area wellness coordinators was a booming success this past October. We thank our participants for their willingness to engage virtually, and for their thoughtful and creative contributions to our discussion. We hope our program is helping you to promote and grow your workplace wellness program.