What is Diabetes?

Diabetes is a group of diseases that affect how your body uses blood sugar, or glucose. Normally, the pancreas releases insulin to help your body store and use the sugar and fat from the food you eat. However, when the pancreas produces very little or no insulin, or when the body doesn’t respond appropriately to insulin, diabetes can occur. Glucose is vital to your health because it’s an important source of energy for the cells that make up your muscles and tissues. It’s also your brain’s main source of fuel. If you have diabetes, no matter which type, it means that you have too much glucose in your blood, which can lead to serious health problems. Chronic diabetes conditions include Type 1 diabetes and Type 2 diabetes. Potentially reversible diabetes conditions include pre-diabetes, which occurs when your blood sugar levels are higher than normal but not high enough to be considered diabetes. Another is gestational diabetes, which occurs during pregnancy but may resolve after the baby is delivered. For someone without diabetes, a fasting blood sugar on awakening should be under 100 mg/dl. Before-meal normal sugars are 70–99 mg/dl. Speak with your doctor to learn more and always go for annual physical exams/blood work to keep on top of your levels.

A key component to managing diabetes, regardless of which condition you have, is to maintain a healthy weight through a healthy diet and exercise program. Studies show that following a “diabetes diet,” rich in nutrients & low in fat and calories, is best. This generally consists of eating more fruits, vegetables, and whole grains while cutting down on animal products, refined carbohydrates, and sweets. Speak with a registered dietitian to help create a meal plan that will work specifically for your needs. In addition, everyone needs regular aerobic exercise. Exercise lowers your blood sugar level by moving sugar into your cells where it’s used for energy. Speak with your physician about the appropriate exercise regimen for you.

By Gina Stallone


Kids and Concussions

Each year, approximately 30-45 million children & adolescents between the ages of 6-18 participate in organized sports. The young brain is especially susceptible to concussions. In fact, sports-related concussions account for more than half of all emergency room visits by children ages 8-13. Despite that large ratio, experts say that certain terms have minimized the serious nature of the injury. These terms, which are used to describe a hit, include “ding” or “bell ringer” and should be replaced by the actual medical term, mild traumatic brain injury.

Virtually no sport is free of concussion hazard. A concussion is caused by a direct or indirect blow to the head. Contrary to popular belief, you don’t have to lose consciousness to sustain a concussion. Approximately 90% of concussions involve no loss of consciousness or only a brief disruption of mental alertness. You don’t even have to hit your head — a whiplash injury can cause one. Recognizing concussion symptoms in children can be more complicated than in adults, since a child may not be capable of articulating certain symptoms of a concussion, such as feeling “in a fog” or vertigo. Other symptoms, including irritability, may be mistakenly interpreted as a behavioral issue rather than a sign of a brain injury. Some competitive young athletes are so eager to get back on the playing field that they deny having any symptoms, or they downplay their symptoms, in order to get back in the game. Others may exaggerate their symptoms to avoid returning to school. It’s best to err on the side of caution and take all reported symptoms seriously. Find a balance between returning too soon and sitting out too long is an important part of the plan for optimal recovery.


by Gina Stallone




Go Further with Food


March is National Nutrition Month. The Academy of Nutrition and Dietetics developed this in 1973, with the first theme being “Invest in Yourself – Buy Nutrition.” Its primary focus is on the importance of making informed food choices and developing sound eating & exercise habits. This year the theme is “Go Further with Food.” With the New Year’s resolutions and holidays behind us, this month is the perfect time to re-focus our health needs and kick-start our health goals.

Eating right doesn’t have to be complicated! Start making simple changes to your daily diet & you will see some big results. Here are some simple tips to get started:

  • Eliminate processed foods
  • Minimize saturated & trans fats, sodium, and added sugar
  • Eat lean meats, poultry & fish
  • Consume a lot of vegetables in a rainbow of colors!

You want to eat what you love, but be smart! Always keep everything in moderation. Smart food choices will help guide you on the path to a healthier, longer life.

VO2Max Test

VO2 max is a measure of your maximum aerobic capacity. As your aerobic fitness increases, your VO2 max increases. This is an important aspect of running performance and for endurance athletes, as it will help determine the athlete’s level of fitness.

VO2 max specifically refers to the maximum amount of oxygen that an individual can take in and use during intense or maximal exercise. It is measured as “milliliters of oxygen used in one minute per kilogram of body weight” (ml/kg/min).

Establishing a baseline VO2 max is critical for any endurance training program. Once you determine an athlete’s VO2 max, you can then design a program using various endurance training methods, and test their progress with subsequent max tests. Beginner runners can improve their VO2 max simply by logging more miles however, more experienced runners will need to do harder workouts in order to boost their VO2 max. It is possible to increase VO2 max by regularly performing exercises that challenge the cardiovascular system. This is done by increasing endurance training volume and intensity over time. Full-body rhythmic movements which include running, cycling, swimming and rowing are all effective ways to do this. It’s also important to be sure and provide variety to the types of endurance training being done so as to continue challenging the body.

The Bruce Treadmill Test is common test done to estimate VO2 max using a formula and an athlete’s ability to exercise on a treadmill as the workload is increased. The Bruce Protocol is a maximal exercise test where the athlete works to complete exhaustion as the treadmill speed and incline is increased every three minutes. The length of time on the treadmill is the test score and can be used to estimate the VO2 max value. During the test, heart rate, blood pressure, and ratings of perceived exertion are often also collected.

The Bruce treadmill test is a maximal exercise tolerance test, it is not something to be done without a physician’s clearance and expert supervision. In an untrained individual or an athlete with an underlying heart condition, exercising to a maximal effort can lead to injury or potential heart events. While performing the treadmill stress test, clinicians will monitor the patient’s vital signs continuously and stop the test at any sign of trouble. For an athlete, an experienced technician should monitor heart rate and rhythm throughout the testing. Be sure that your testing facilitator has the appropriate clinical expertise and has conducted such tests many times before you step on the treadmill for your own testing. Since this is a maximal exercise test, it should not be performed without a physician’s approval and without reasonable safety accommodations and supervision.





By Gina Stallone

Get in the Know

A heart attack strikes someone about every 43 seconds. The most common symptom is chest pain or discomfort but there are many other signs & symptoms that can occur. Many movies portray a person clutching their chest and immediately dropping to the floor but it doesn’t always happen to quickly in real life. In fact, people often do not realize they are even having a heart attack at all! Research has shown that people often equate the symptoms they are experiencing with acid reflux, gas pains, the flu, or normal aging.

It’s important to mention that if you or someone you know is experiencing any of these symptoms seek immediate medical attention. Aside from the chest pains & discomfort, the following symptoms can also occur: pain or discomfort in one or both arms, back, neck, jaw, or stomach; shortness of breath with or without chest discomfort; breaking out in a cold sweat, nausea, lightheadedness; uncomfortable pressure, squeezing, fullness, or pain in the center of your chest or upper back.

Heart disease is the number one killer of women but it is preventable. Schedule an appointment with your physician to learn about your personal risk. You can also quit smoking, which will cut your risk of coronary heart disease by 50 percent. Another simple tip is to start an exercise regimen. Just walking 30 minutes a day can lower your risk for heart attack and stroke. Lastly, you can modify your diet and make changes for a healthier, longer life.


Reference: www.heart.org

The Skinny on Saturated Fats


Everyone knows that there are good & bad fats. How bad are the “bad fats” and how can they be avoided?

Saturated, or “bad,” fats are high in LDL cholesterol. They are simple fat molecules that have no double bonds between carbon molecules because they are saturated with hydrogen molecules. They are also typically solid at room temperature.

Saturated fats can occur naturally in many foods, with the majority coming from animals such as meat & dairy products. Additionally, many baked goods & fried foods contain high levels of saturated fats. The American Heart Association recommends aiming for a diet containing 5-6% saturated fats. This means, if you are consuming 2,000 calories per day 120 will be saturated fats, or 13g.  It is important to choose unsaturated fats rather than saturated fats and trans fats since unsaturated fats can reduce your risk of heart disease and improve “good” (HDL) cholesterol levels.

Focus on a nutrient-dense diet filled with fruits, vegetables, whole grains, low-fat dairy products, poultry, fish, and nuts. Always choose lean meats & poultry without skin. Cut back on foods containing saturated fat including, but not limited to:

  • desserts and baked goods, such as cakes, cookies, donuts, pastries, and croissants
  • many cheeses and foods containing cheese, such as pizza
  • sausages, hot dogs, bacon, and ribs
  • ice cream and other dairy desserts
  • fried potatoes (French fries) – if fried in a saturated fat or hydrogenated oil
  • regular ground beef and cuts of meat with visible fat
  • fried chicken and other chicken dishes with the skin
  • whole milk and full-fat dairy foods


Choose foods higher in unsaturated fat and lower in saturated fat as part of your healthy eating style. Here are some tips:

  • Use oil-based dressings and spreads on foods instead of butter, stick margarine, or cream cheese.
  • Drink fat-free (skim) or low-fat (1%) milk instead of reduced-fat (2%) or whole milk.
  • Buy lean cuts of meat instead of fatty meats or choose these foods less often.
  • Add low-fat cheese to homemade pizza, pasta, and mixed dishes.
  • In recipes, use low-fat plain yogurt instead of cream or sour cream


By Gina Stallone




In the Zone

We all know by now that exercise is important, regardless of your goal. Whether you are trying to build muscle, lose weight, or just get healthier, exercise is the way to go. How do you know if you’re doing enough…or too much?! Calculate your heart rate!

First, you want to take your resting heart rate. This is the number of times your heart beats per minute while at rest. You can test this out in the morning after you’ve had a good night’s sleep & before you get out of bed. For children 10 & older and adults (including seniors), the average resting heart rate is 60-100 beats per minute. For well-trained athletes, the average is 40-60 beats per minute.

Next, you want to get your maximum heart rate. This is the maximum number of times your heart should beat per minute during exercise. The basic way to calculate your maximum heart rate is to subtract your age from 220. For example, if you’re 45 years old, subtract 45 from 220 to get a maximum heart rate of 175.  Heart rate during moderately intense activities is about 50-69% of your maximum heart rate, whereas heart rate during hard physical activity is about 70% to less than 90% of the maximum heart rate. Below is a chart from the American Heart Association:


Age Target HR Zone 50-85% Average Maximum Heart Rate, 100%
20 years 100-170 beats per minute 200 beats per minute
30 years 95-162 beats per minute 190 beats per minute
35 years 93-157 beats per minute 185 beats per minute
40 years 90-153 beats per minute 180 beats per minute
45 years 88-149 beats per minute 175 beats per minute
50 years 85-145 beats per minute 170 beats per minute
55 years 83-140 beats per minute 165 beats per minute
60 years 80-136 beats per minute 160 beats per minute
65 years 78-132 beats per minute 155 beats per minute
70 years 75-128 beats per minute 150 beats per minute


It’s important to note that there are a few high blood pressure medications that will lower the maximum heart rate and thus, the target zone rate. If you’re taking any such medication, contact your physician to find out if you should aim for a lower target heart rate. During the first few weeks of working out, aim for the lower range of your target zone (50 percent) and gradually build up to the higher range (85 percent). After six months or more, you may be able to exercise comfortably at up to 85 percent of your maximum heart rate. If you have a heart condition or you’re in cardiac rehab, talk to a healthcare professional about what exercises you can engage in, what your target heart rate should be, and whether or not you need to be monitored during physical activity.  This will also help you to choose the types of physical activity that are appropriate for your current fitness level and health goals, because some activities are safer than others.


by Gina Stallone

I Love Chocolate!

Its’ Valentine’s Day! Many people demonstrate their affection by buying their partner  flowers and chocolate. While delicious, this can be a day filled with a ton of extra calories! Luckily, you can still quell your sweet tooth.  It’s okay to eat chocolate and not feel guilty, as long as you consume the right type of chocolate.


Not all chocolate is created equal, and it is important to select dark chocolate high in cacao instead of processed chocolate filled with sugar. Dark chocolate has many health benefits and is rich in fiber, iron, magnesium, and copper.

First, dark chocolate is filled with antioxidants, especially flavonoids and polyphenols. The higher the cacao content in dark chocolate, the higher the percentage of antioxidants. The flavonoids have been shown to have cancer fighting properties, to have a positive effect on heart health, and to improve focus and memory. The polyphenols may be involved in cholesterol control and may improve the blood pressure and fasting blood sugar of diabetics.

When purchasing dark chocolate, choose brands that are minimally processed, have a cacao content of 70 percent at a minimum, ones that originate from organic or fairly traded cacao beans. Additionally, read the labels to avoid buying bars with hydrogenated oils, palm oil, and/or coconut oil. Choose dark chocolate made with cocoa butter instead. Additionally, while dark chocolate is much lower in sugar than conventional chocolate, choose brands made with stevia if you are diabetic or do not want to consume the sugar. Another thing to make note of is whether the chocolate is made with soy lecithins, which can be a potential allergen for some people.

So this Valentine’s Day, indulge your sweet tooth with dark chocolate and make your heart even happier!




What is Leaky Gut?

According to the National Institute of Health, 60-70 million people in the United States are affected by digestive diseases. This includes irritable bowel syndrome (IBS), constipation, inflammatory bowel disease (IBD), gallstones, and reflux, among others. The condition and function of the GI tract is important for our overall health and well-being. Research shows that stress, lack of physical activity, processed foods, and chemicals affect the gastrointestinal tract (GI tract) and contribute to an increased incidence of disease.

The food we ingest gets broken down, and the nutrients are absorbed in the small intestines before entering the bloodstream. The balance of gut micro-organisms, the mucosal lining, and the integrity of the tight junctions, which are located in the epithelial lining of the small intestines, all contribute to the proper digestion and absorption of food. The lining of the small intestines is semi-permeable and normally allows nutrients to be absorbed, while also acting as a barrier to prevent toxins, microbes, and large food particles from entering our internal system. Additionally, the lining contains a substance called secretory IgA (SIgA), which is an immunoglobulin that binds to bacteria, toxins, viruses, fungal spores and antigens, and it prevents them from crossing the epithelial barrier and entering the bloodstream. Next, the lining is made up of tiny openings called tight junctions, which are responsible for determining what is allowed to pass from the intestine into the bloodstream. They allow vital nutrients into the blood stream while keeping large undigested food particles and disease causing compounds out of the systemic circulation.

Leaky gut, also known as intestinal hyperpermeability, occurs when the toxic byproducts and undigested proteins in the GI tract are absorbed into the bloodstream and cause inflammation. When SIgA is decreased, fewer pathogens are eliminated, and the altered microbiota in the small intestine leads to dysbiosis, which is a change in the balance of the microorganisms. Other causes of dysbiosis are physical stress, mental stress, infections, chemicals, alcohol, antibiotics, corticosteroids, birth control pills, and dietary factors, such as gluten. Additionally, an overgrowth of yeast can also damage the mucosal barrier and increase the permeability of the intestine so that undigested particles are absorbed. Yeast also releases toxins and enzymes which can further increase intestinal permeability.  In summary, any condition that may cause inflammation, such as medications, infections, trauma, or a range of diseases including cancer, may result in hyperpermeability.

As a result of this dysbiosis, there is a malfunction of the tight junctions and a breakdown of the gut barrier. The tight junctions open too wide and become more permeable, allowing unwanted toxins and other particles to “leak” into the bloodstream overwhelming the liver and causing potential allergies.  There is an inflammatory response with toxins moving from inside the gut to outside the gut due to lipopolysaccharides (LPS), which are molecules on the surface of gram negative bacteria. These molecules cause inflammation outside the gut by activating the cytokines, which are substances that signal the activation of the immune system.

Some of the symptoms of leaky gut include fatigue, fevers, poor tolerance to exercise, memory issues, food sensitivities, thyroid dysfunction, inflammatory skin conditions, nutrient malabsorption, bloating, abdominal issues, fevers of unknown origin, and issues with concentration. Very often, leaky gut can lead to diseases and conditions and can be underlying factors in ADD, psoriasis, irritable bowel syndrome, malnutrition, food allergies and intolerances, autism, celiac disease, depression, inflammatory bowel disease, eczema, acne, dermatitis, rheumatoid arthritis, and chronic fatigue syndrome.

In order to repair leaky gut. A “6R” approach is often used: 1. Remove 2. Reduce 3. Restore 4. Replace 5. Reinoculate 6. Repair.  First, it is important to remove whatever is irritating and damaging the GI tract, such as NSAIDS, alcohol, allergenic foods, and pathogens. After removing these irritants, proper motility needs to be restored. Insoluble fiber can be used to restore the appropriate bowel transit time to make sure food is moving through the GI tract at an acceptable rate. Next, digestive enzymes need to be replaced to aid in digestion and stimulate the body’s own enzyme production. Afterwards, the GI tract needs to be reinoculated with friendly bacteria by taking probiotics to rebalance the microflora. Lastly, the mucosal lining should be repaired with specific supplements, such as L-glutamine, zinc, essential fatty acids, N-acetyl glucosamine, aloe vera, glycerrhiza, beta carotene, vitamins A, C, an E, and others.

Leaky gut is not a disease, but it is a real condition that needs to be addressed. It is a gray area in the medical field because it is result of some other condition rather than a diagnosis by itself. If you are experiencing GI symptoms without an etiology, it is certainly worth investigating. The gut could be your answer to a healthier, happier existence.

by Denise Groothuis MS RD CPT


Lower Your Cholesterol to Keep Your Heart Healthy

Your lipid profile includes both cholesterol and triglycerides, and high blood lipid levels put you at risk for cardiovascular disease. In fact, every 1% reduction in cholesterol reduces your cardiovascular disease by 2%. Our bodies make cholesterol, and we consume cholesterol from animal foods.

The goal is to have your total cholesterol less than 200 mg/dL, and it is important to remember than anything over 240 mg/dL is considered high. Cholesterol is made up of HDL (high density lipoproteins), also known as “good cholesterol” and LDL (low density lipoproteins), also known as “bad cholesterol.” The goal for optimal heart heath is an HDL higher than 60 mg/dL and an  LDL less than 100 mg/dL. It also is important to make sure your triglycerides are well controlled and strive for less than 150 mg/dL. High triglycerides are often the result of a high carbohydrate diet, physical inactivity, smoking, excess alcohol, and obesity.

Diet and lifestyle change can improve your lipid profile. Regular physical activity has been shown to increase HDL, and weight loss has been linked to a 10% decreased risk of high lipids. Avoid trans fats and reduce saturated fat by limiting red meat, butter, eggs, cream, and tropical oils to further improve your numbers.