Ending Type 2 Diabetes One Exercise, Nutrition, and Gardening Class at a Time

Posts Tagged ‘Food Intake’

The Fair Haven Community Health Center Visits the Peabody Museum’s FOOD EXHIBIT!!

In About the Program, Nutrition Class on April 27, 2012 at 4:10 PM

Written by guest blogger Emilie Swenson

“Quien le gustaba el museo hoy?”  (Who liked the museum today?)  I asked in the van on the way back to Fair Haven.  Of my six passengers, everyone raised their hands!   Participants from the Diabetes Prevention and Bright Bodies programs took a field trip last Tuesday, April 17th, to the Big Food exhibit at the Peabody Museum.  Tickets were generously donated by the Peabody Museum for the free entry of 38 patients and five program facilitators. The exhibit explores culture and eating, and focuses on many of the issues that participants learn about through the healthy lifestyle programs they attend through the Fair Haven Community Health Center.  The groups walked through the exhibit with Elizabeth Magenheimer, APRN CNM CDE, who used the exhibit to solidify many of the concepts about healthy eating she teaches in the weekly lifestyle program curriculum.  Participants balked at the amount of food one person consumes in a year—eight whole pizzas, many liters of soda, gallons and gallons of milk, and stacks of boxes full of vegetables.  They took examined nutrition facts and compared snacks, learning more about which snacks are good to eat (given a green light in the exhibit), and those to stay away from (red light)!

One of the main topics that is discussed during the education portion of these programs is how to look for healthy foods, how to make healthier choices, how to understand portion sizes, and how to be active.  This exhibit combined many of these things in interactive ways.  As we walked through, we talked about beverages—looking at the many teaspoons of sugar contained in different beverages—from Coke to Iced Tea to Capri Sun, realizing that water really is the best option!  We also saw how portion sizes have changed throughout the years; many foods like bagels have doubled in size over the past 20 years!  There was a display of a reclining youth, laying in bed, one hand in a bag of chips, and a can of soda beside his bed, remote in hand, TV on.  We talked about what was unhealthy about his behavior, and how we can all make changes.  No Chips, No Soda, and No TV, were all ideas mentioned by the children.

By far the biggest hit of the exhibit was the stationary bike that powered a light – the harder you peddled, the higher up on the wall the light went.  The kids and parents (and even nurse practitioner) tried their hand (or legs) at this activity while a crowd of onlookers cheered them on.  It was a great adventure to visit the Big Food exhibit in the museum and reinforce the concepts they are learning in their healthy lifestyle programs. Thank you to the Peabody Museum for hosting us!


Fresh Direct, US/Mexican Style

In Nutrition Class on March 2, 2012 at 1:29 PM

One of the Diabetes Prevention Program participants, Anna for the purposes of this story, took it upon herself to prepare a distinctly Mexican salad for one of our nutrition class cooking demos this week. When collecting her receipt for the ingredients, I faintly balked. It was hand-written in pencil, and torn from a common academic three-ring binder. I sheepishly asked her whether she had a proper receipt, from the store in which she had purchased the vegetables. Then Anna tells me the most fascinating story.

Every week, she gets a call from a fruit and vegetable vendor asking whether he should come by on Saturday. Most weeks Anna says yes.

Around mid-day she hears someone knock at her front door. She descends the stairs of her own home, and proceeds to shop for good looking vegetables and fruits in the bed of this man’s pick-up truck! Indeed, the vendor brings his best vegetables and fruits to peoples’ doorsteps every Saturday for sale.

When I asked why she shops with him, as opposed to going to the store just over a mile from her home, she asks with patience how, exactly, she should shop without transportation? ‘ “Besides,” she explains, “he knows what we cook and always have exactly what we need for our favorite meals.”

Incredible the kinds of resources people with difficult circumstances create for themselves to meet their needs. If we continued to tap into this informal network, perhaps we could get even more vegetables and fruits on people’s tables on a daily basis, thereby lowering their risk for diet-related chronic disease!

The ingredients receipt!

Photo Food Diaries

In Food Diaries, Nutrition Class on March 29, 2011 at 10:22 AM

The FHCHC Diabetes Prevention Program is testing the effectiveness of photo food diaries, and comparing the results with written food diaries. According to the NIH:

“All participants are asked to record their intake daily…because of the extensive evidence that self-monitoring is highly correlated with success in reaching dietary change goals. Numerous studies have shown a dose-response relationship between frequency of self-monitoring and level of success in losing weight and/or improving cardiovascular risk factors. Many experts consider self-monitoring the single most effective approach to changing dietary intake.” NIH DPP

For many FHCHC DPP participants, writing their daily food intake and the amounts of those foods they consume, occurs as very challenging. Indeed, it is rare that 100% of participants present their food diaries in any given week. Knowing the importance of self-monitoring, and the challenging nature of food diaries for our participants, we handed out disposable cameras with explicit directions on how to document their food consumption. Use the flash! Take a picture of everything you eat, even if it’s a snack or beverage. Bring it back next week.
Below are some examples of the photos women took in the first couple weeks of their participation in the FHCHC DPP program. In a week, participants will return their second set of disposable cameras, and the Lead Provider and nutritionist will analyze the results to see whether photo food diaries are a more effective self-monitoring strategy than written food diaries. They will look at rate of return, as well as glean any changes in food consumption that may have taken place since the first couple weeks of the program.






NY Times Connecting Nutrition and Clinician

In Diabetes Prevention Resources on September 22, 2010 at 12:19 PM

Check this out:

“Dr. Preston Maring, left, who began a farmers’ market at Kaiser Permanente in Oakland, with his son, Ben.”

Published: September 21, 2010


A Weed by any Other Name…

In Community Garden on August 6, 2010 at 12:19 AM

There is a weed that loves our garden. It is not picky, growing underneath the heavy shade of our tomato forest, in the crevices of our wooden fence, and not the least down our wide open walkway. One day, when one of our lovely gardeners saw me dumping them with little regard, she patiently explained that “en Mexico, comimos estos!” In the chinese store downtown, apparently, they are sold at a fine price. I handed her the plants formerly known as weeds that remained in my hands.

The next week, at 9am sharp, that same gardener strolled over to the tomato plants, where I had already begun what I like to call my sucker removal ritual. She motioned for me to come with her back towards the enterance of the garden. She proceeded to remove, Mary Poppins-like, tortas and a plastic nescafe now filled with something other than nescafe.

‘El Euite!’ She exclaimed. The dear woman had stuffed homemade tortillas with the plant, and along with our tomatoes and jalapeno proved that a weed by any other name, is definitely not a weed!

One of our gardeners disposing of 'real' weeds.

Basil: Low Cost and Low Calorie Recipe

In Community Garden on July 14, 2010 at 12:57 PM

Basil is a very prolific herb, and yet because the ingredients in many basil dishes are expensive and high in calories it is an impractical herb for many with financial and metabolic constraints.

Here is an alternative recipe:

How to Introduce Food Diaries to Diabetes Prevention Program Participants

In Nutrition Class on June 23, 2010 at 5:25 PM

Elizabeth begins cultivating Diabetes Prevention Program participants’ investment in using Food Diaries from Session I.

“Not knowing exactly what you eat or how much you exercise every day is like trying to buy a bicycle without knowing how much money you have in the bank; you wouldn’t know how much to spend, save, or borrow! Being aware of what you ate yesterday, however, makes it possible for you to know what would be wise for you to eat today. Knowing how much you exercised yesterday makes it easy for you to decide how to exercise today.”

People’s interest is peaked at this point, but owning the Diary as their personal tool for healthy living is not yet present.

“What did you eat for breakfast yesterday, Lucy?”

“A piece of toast.”

Elizabeth nods solemnly. ” Thank you! A piece of toast. Anything else?”

“Um, a cup of coffee also.”

“Thank you!” Elizabeth smiles. ” Anything else?”

Elizabeth teaches Diabetes Prevention Program participants how to use Food Diaries

“No. I don’t think so.” Lucy responds quickly.

The whole group is now listening intently, suspicious of Elizabeth’s grin and apparent enthusiasm.

“Was there anything else you had for breakfast yesterday?” She asks.

Lucy, somewhat surprised, takes a moment to think. “Ah yes, I had a glass of orange juice. I think I also tasted my mom’s torta.”

Elizabeth turns to the rest of the group, and declares with compassion and intensity, “It is difficult to remember what we eat, isn’t it? For that reason, it is sometimes easy to fool ourselves when it comes to our own health. But you ladies are committed to living long and vital lives, no?” Everyone concurs. “I am going to therefore provide you with a tool to use for the next 12-weeks of the program and on an ongoing basis as well. It’s called the Food Diary.”

Elizabeth then gages one of the more important factors influencing the efficacy of the Food Diary tool: participant literacy rate. Although their ability to use the Food Diaries will become abundantly clear within the next few weeks, she likes to get a general sense of people’s comfort levels from the start. “Who here likes to read or write?” A few people raise their hands. Elizabeth, in true form, thanks them for their candor.

At this point everyone is given a Food Diary, and Elizabeth proceeds to describe how to fill it out. Because the assignment is so unfamiliar and often jarring for people in the beginning, Elizabeth requests that they simply document the contents of their meals and physical activities from day to day. She coaches them to ignore portions and nutrition facts for the time being.

Elizabeth closes that component of the class with a reminder that using the Food Diary is central to avoiding diabetes, and their participation is correlated closely with their success in the program.

Food Diaries – What are They and Why are They Important in Diabetes Prevention?

In Nutrition Class on June 18, 2010 at 6:37 PM

A food diary is a simple notebook that participants use to declare their short-term physical fitness and dietary goals, daily exercise regimen, and food and beverage intake. Distinct from the recall method, where subjects chronicle their activities on a weekly or even monthly basis, studies have shown that lifestyle interventions are more effective when subjects account for their performance on a daily basis.

It is important to note here that the Food Diary does not single handedly change dietary and physical fitness behavior; nor is it presented as such by the program administrators. Indeed it is one of a series of interventions, the combination of which make the Diabetes Prevention Program as successful as it is.

The following english version of a food diary comes directly from the NIH:

Elizabeth explains how to use a Food Diary to DPP participants

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