Diabetic Living 2017 Summer

Nutrition Info with Every Recipe

40

CARB-SMART DISHES

POWER SALADS For Weight Loss

p. 50

Steak and Chimichurri Salad, p. 55

ICY TREATS LESS! p. 73

Summer 2017 DiabeticLivingOnline.com

SNACK SMARTER! We’ll Show You How p. 48

FROM THE EDITOR

JENNIFER WILSON Editor of Diabetic Living®

WHAT WE’RE SNACKING ON Whether you prefer yours black or sweet, these iced coffee drinks keep their cool with less than 15 grams of carb per serving. Serve over ice and enjoy. Starbucks Iced

When it comes to my favorite habits, I don’t like change. I want coffee first thing in the morning, something sweet about 3 p.m., and most nights, I like to pile the kids beside me and watch something awesome on TV, spending an hour laughing, talking, watching … and snacking. OK, so not a great habit, the snacking part. It’s fine for the kids, who swim daily. Not so much for Mom and Dad, who both have desk jobs. “Aging slows down your metabolism,” my doctor told me recently. Then she said to cut the night snacking. Or try to. It was no small task to follow her advice without ruining my entire life. Running a health magazine gives me lots of ideas, but I needed one that worked for all of us. Here’s what I came up with: I asked the family not to snack in the living room anymore. If they’re truly hungry, they can grab food in the kitchen, so they’re not waving It’s not perfect, and I’m pretty sure they cheat when I’m

FAT 0 g, CHOL 0 mg,

CARB 14 g (0 g fiber, 11 g sugars), PRO 3 g

Cold Brew Coffee FAT 3 g (0 g sat. fat), CARB 13 g (1 g fiber, 10 g sugars), PRO 1 g $6; califiafarms.com

4

Changing bad habits isn’t easy. But it’s never impossible.

[email protected]

BACK TO THE BASICS Diabetes What to Eat™ is a reader fave, and it’s back on newsstands! Brush up on simple strategies for meal planning, diabetes nutrition and healthy recipes, plus dietitian-approved grocery picks. Grab your copy at the store or visit: DiabeticLivingOnline.com/What-To-Eat

photos Jacob Fox (portrait), Marty Baldwin (coffee drinks)

$6; starbucks.com

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SUMMER 2017

CONTENTS FEATURES

SUPPORT 16 TWICE THE VICTIM Childhood abuse is linked to weight issues later in life. Three women fight the odds and find healing.

NOURISH 50 OUR BEST SALADS  Spur weight loss with these filling power salads.

81

Pinterest! Find our top icy treats, drinks, and more on our Favorite Summer Recipes board.

60 WELCOME TO

CUBAN CUISINE Step into chef Ronaldo Linares’ kitchen for deliciously healthy twists on Cuban classics.

73 POP STARS 

All under 100 calories, our easy homemade ice pops will keep you cool all summer long. DEPARTMENTS

11 INSPIRATION PWD type 2 James Earl Jones says help from loved ones is key.

52

12 FEEL BETTER Neuropathy pain? Learn how to ease it.

ON THE COVER 

63 6

photo Blaine Moats styling Jennifer Peterson

SUMMER 2017

DEPARTMENTS

14 10,000 STEPS Take a hike on one of these five easy national park trails.

48 SNACK BAR  Liven up popcorn with these toppers.

24 I DID IT! Genevieve

our dietitian-approved store-bought salsas.

Jerome makes a body—and life—transformation.

29 GOOD TO KNOW Get started today on these 10 simple healthy habits. 32 MED NEWS The latest in

diabetes treatment.

34 ASK US ANYTHING

“What is non-alcoholic fatty liver disease?”

36 TECHNOLOGY Is your

diabetes mobile app safe?

58 SHOP SMART Get 68 HEALTHY IN A HURRY Whip up better-than-takeout Asian cuisine.

IN EVERY ISSUE

4

70 WASTED Use up old bananas for more than bread.

Editor’s Letter

83 GEAR & GADGETS

Advisory Board

Slip on these fun, flattering swimsuits for every body.

84 VICTORIES How one man manages type 2 diabetes through cycling.

24 102

9

89

Recipe Cookbook

104

DiaBasics

38 MONEY SMARTS How to 86 DIET TRENDS Should save on medications and more.

41 JUST TRY IT! Get hearthealthy fats with avocados. 42 BETTER BASICS

you cleanse? Here’s what our experts say.

88 TELL ME WHAT TO EAT This issue’s 1,500-calorie oneday meal plan.

Learn how to make healthier tomato sauce.

102 SWEET ENDING

Indulge in perfectly portioned citrus custard.

Nutrition Info with Every Recipe

40

CARB-SMART DISHES

POWER SALADS Steak and Chimichurri Salad, p. 55

ICY TREATS LESS! p. 73

Summer 2017

GUIDE TO ABBREVIATIONS

$5.99 U.S.

Display until Aug. 1 Vol. 14, No. 2

AADE: American Association of Diabetes Educators. ADA: American Diabetes Association. AHA: American Heart Association. CDC: Centers for Disease Control and Prevention. CDE: certified diabetes educator. FDA: Food and Drug Administration. NIH: National Institutes of Health. PWD: person with diabetes. RD/RDN: registered dietitian. USDA: Department of Agriculture.

84 GET CONNECTED Like us on Facebook and follow us on Pinterest, Twier (@DiabeticLiving), and Instagram (@DiabeticLivingMag). Purchase our digital edition at DiabeticLivingOnline.com/Digital

DiabeticLivingOnline.com

7

SUMMER 2017

®

Editor JENNIFER WILSON Creative Director MICHELLE BILYEU

MEREDITH CORE MEDIA Editorial Content Director DOUG KOUMA Assistant Managing Editor JENNIFER SPEER RAMUNDT

EDITORIAL Senior Associate Editor CAITLYN DIIMIG, RD Associate Editor BAILEY MCGRATH Contributing Editor HOPE WARSHAW, RD, CDE Editorial Apprentice KAILI MEYER Contributing Copy Editor CARRIE TRUESDELL Contributing Proofreader GRETCHEN KAUFFMAN Administrative Assistant LORI EGGERS

ADVERTISING Publisher ANDY AMILL Account Director STEVEN CARDELLO New York Manager ILLENE ROMAN Midwest Advertising Sales Manager CHIP WOOD Midwest Integrated Account Manager ERICA ALPERS Western Manager CHERYL SPEISER Detroit Director, Corporate Sales KAREN BARNHART Direct Media Business Development Manager SAMANTHA GIORDANO Advertising Sales Assistant (Los Angeles) BLAIR SHALES

ART Art Director NIKKI SANDERS Contributing Designers LAUREN NORTHNESS, EMMA WILLCOCKSON Contributing Prop Stylist TARI COLBY FOOD Test Kitchen Director LYNN BLANCHARD Test Kitchen Chef CARLA CHRISTIAN, RD, LD EDITORIAL ADMINISTRATION Business Manager, Editorial CINDY SLOBASZEWSKI Lead Business Office Assistant GABRIELLE RENSLOW Business Office Assistant KIM O’BRIEN-WOLETT Director, Premedia Services AMY TINCHER-DURIK Director of Quality JOSEPH KOHLER Director of Photography REESE STRICKLAND Photo Studio Set Construction Manager DAVE DECARLO Photo Studio Business Manager TERRI CHARTER Prepress Desktop Specialist JILL M. HUNDAHL Color Quality Analyst TONY HUNT

“Summer food is the best. Fresh herbs!” Kim, Business Office Assistant

MARKETING Group Marketing Director KRISTEN STUCCHIO-SUAREZ Associate Marketing Director KATHARINE ETCHEN Associate Marketing Manager RENEE KIM Design Director ALYSSA DAINACK Art Director SARAH FERRETTI Senior Manager, Events and Partnerships MELISSA MCINERNEY ADVERTISING OPERATIONS 1716 Locust St., Des Moines, IA 50309-3023 Associate Production Director APRIL BRACELIN Production Manager DEBBIE REYNOLDS CIRCULATION Consumer Marketing Manager BLAINE ROURICK Director, Newsstand JENNIFER HAMILTON

INTERACTIVE & LICENSING Senior Director, Health & Wellness Content Licensing RENÉE LAUBER Associate Director, Health & Wellness Content Licensing CARRIE CRESENZI Content Director, Custom Publishing & Licensing NICCI MICCO, M.S. Director of Business Development DAVID GRAY Director, Food Content Licensing GRACE WHITNEY Senior Content Licensing Account Manager PAULA B. JOSLIN Web Application Developer MICAH MUTRUX Front-End Developer BRIAN CLIFFORD Software Developer ETHAN ELDRIDGE UI/UX Designer NAT WOODARD FINANCIAL ADMINISTRATION Associate Business Director JENNA BATES Business Manager TONY ROUSE Product Sales HEATHER NORMAN

Vice President and Group Publisher SCOTT MORTIMER Executive Account Director DOUG STARK

Meredith National Media Group President | JON WERTHER President and General Manager of Meredith Magazines | DOUG OLSON President of Meredith Digital | STAN PAVLOVSKY President of Consumer Products | TOM WITSCHI Chief Revenue Officer | MICHAEL BROWNSTEIN Chief Marketing Officer | NANCY WEBER Chief Data and Insights Officer | ALYSIA BORSA Executive Vice President, Group Publisher| CAREY WITMER SENIOR VICE PRESIDENTS Consumer Revenue | ANDY WILSON Digital Sales | MARC ROTHSCHILD Research Solutions | BRITTA CLEVELAND Digital Video | MELINDA LEE Chief Digital Officer | MATT MINOFF VICE PRESIDENTS Finance | CHRIS SUSIL Business Planning and Analysis | ROB SILVERSTONE Content Licensing | LARRY SOMMERS Corporate Sales | BRIAN KIGHTLINGER Digital Sales | MARLA NEWMAN Direct Media | PATTI FOLLO Brand Licensing | ELISE CONTARSY Human Resources | DINA NATHANSON Strategic Sourcing, Newsstand, Production | CHUCK HOWELL Consumer Marketing | STEVE CROWE

Chairman and Chief Executive Officer | Stephen M. Lacy President and Chief Operating Officer | Tom Harty President, Meredith Local Media Group | Paul Karpowicz Chief Financial Officer | Joseph Ceyranec Chief Development Officer | John Zieser Vice Chairman | Mell Meredith Frazier In Memoriam | E. T. Meredith III, 1933–2003

The Recipe Center at BHG.com/Food contains hundreds of recipes and tips, all tested in the Better Homes and Gardens® Test Kitchen. SUBSCRIBER PLEASE NOTE: Our subscribers list is occasionally made available to carefully selected firms whose products may be of interest to you. If you prefer not to receive information from these companies by mail or by phone, please let us know. Send your request along with your mailing label to Magazine Customer Service, P.O. Box 37508, Boone, IA 50037-0508. All content in Diabetic Living, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this magazine and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others. SUBSCRIPTION HELP: Our DiabeticLivingOnline.com/MyAccount, dlvcustserv@cdsfulfillment.com, 866-261-6866 For reuse and reprint requests, contact [email protected].

ADVISORY BOARD

Qa ASK AN ADVISER

MEET OUR EXPERTS

How can I get involved in diabetes advocacy?

The following experts review articles that appear in Diabetic Living® magazine. Sheri R. Colberg, Ph.D., FACSM, professor emerita of exercise science at Old Dominion University; 2016 ADA Outstanding Diabetes Educator Marjorie Cypress, Ph.D., CNP, CDE, Albuquerque-based consultant; past president of health care and education, ADA Joanne Gallivan, M.S., RDN, former NIH National Diabetes Education Program director J. Michael Gonzalez-Campoy, M.D., Ph.D., FACE, medical director and CEO, Minnesota Center for Obesity, Metabolism and Endocrinology, PA (MNCOME) Sharonne N. Hayes, M.D., FACC, FAHA, cardiologist and founder of the Women’s Heart Clinic at Mayo Clinic

Marty Irons, RPh, CDE, community pharmacist; author; served in industry and military Evan Sisson, Pharm.D., M.H.A., BCACP, CDE, FAADE, associate professor at VCU School of Pharmacy in Richmond Chef Art Smith, star of Bravo’s Top Chef Masters and former personal chef for Oprah Winfrey Toby Smithson, M.S., RDN, LD, CDE, founder of DiabetesEveryDay.com; author of Diabetes Meal Planning and Nutrition for Dummies Hope S. Warshaw, M.M.Sc., RD, CDE, author of ADA books Diabetes Meal Planning Made Easy and Eat Out, Eat Well

TWEET US! Questions for our experts? Ask away.

At a basic level, you can like, comment, and share advocacy posts online. People are more likely to support issues they understand. More involved: Sign a petition; write to or call your elected officials. Sign up to help the efforts of groups like ADA, JDRF, AADE, Diabetes Hands Foundation, and the Patient Advocacy Coalition. And remember: Your voice counts! Together we create enough volume to get the attention of decision makers and let them know what we care about and how to act on it.

@DiabeticLiving

John Zrebiec, M.S.W., CDE, director of Behavioral Health Services at the Joslin Diabetes Center and lecturer in psychiatry at Harvard Medical School

DiabeticLivingOnline.com

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“If you want to lift yourself up, lift up someone else.” —Booker T. Washington, educator

SUPPORT

INSPIRATION

WHAT I KNOW NOW ...

writing Bailey McGrath; photo Janssen Pharmaceuticals

Aer a surprise type 2 diagnosis more than 20 years ago, actor James Earl Jones says he’s learned to raise his own awareness.

“It is so much better to be the director of my health rather than the victim of my health problems.” JAMES EARL JONES Actor, person with type 2 diabetes, age 86

“My diagnosis hit me like a thunderbolt. I was raised on a farm and ate good and worked out. I was also in the Army, and we skied uphill, so we were all very fit. The idea of having diabetes really was a surprise for me.”

 “Strawberry shortcake. We grew strawberries in Michigan, and that was my favorite—but I can’t do it anymore. Giving up sweets wasn’t easy; it still isn’t easy. I just know beer now.”

 “My family had been trying to encourage me to eat well all along. I said, Oh sure, I’m very healthy. You know, blowing it off. But when I realized I had type 2 diabetes, I knew I had to listen to them and solicit their input because there were clues I was missing. The more family members involved with my health, the less I’d miss.”

 relationships. You have to engage your whole family in the maintenance of your health.”

 “My son prey much monitors everything I eat. We pack a lunch together, or he will go out and get food for me during breaks. He’s a big help. He does all the stuff that I had a hard time doing on my own.”

James Earl Jones partners with Janssen Pharmaceuticals and Invokana to raise type 2 diabetes awareness. Visit icanimagine.com

DiabeticLivingOnline.com

11

FEEL BETTER

For mild symptoms, use OTC medications such as nonsteroidal anti-inflammatories (Advil, Aleve) if your doc gives you the OK. If you’re experiencing debilitating pain, prescriptions such as anti-seizure meds or antidepressants might help.

Ease Nerve Pain Peripheral neuropathy hurts. It causes pain, tingling, numbness, and loss of feeling. There’s no cure, but you can ease the pain. Talk to your doctor to find out if one of these methods could work for you. 12

Therapies Transcutaneous electrical nerve stimulation (TENS) sends tiny electrical currents through your body that may help to ease nerve pain. Working with a physical therapist can help reduce muscle weakness and improve movement.

This form of nerve damage affects 60–70% of PWDs.

Supplements Oral supplements alphalipoic acid and acetyl-Lcarnitine have been shown to reduce nerve pain associated with neuropathy. Consider taking vitamin B or D supplements if you’re deficient in either.

Control blood glucose Wide variations in glucose can worsen neuropathic pain.

SUMMER SMARTS  Wear supportive, well-fitting shoes that protect skin and prevent rubbing (avoid strappy sandals).  Apply sunscreen to prevent burning.  Keep feet dry and protected with good-fitting socks.  Wear breathable, moisture-wicking clothing to keep skin dry and prevent irritation.

Topical treatments Capsaicin creams and lidocaine patches applied directly to the affected area may help to numb pain. Some people experience a slight burning sensation when using capsaicin; diluting it in cold cream can reduce this.

Exercise Staying active can help regulate blood glucose levels and stimulates blood flow. Research suggests that regular exercise might help ease nerve pain. sources Marjorie Cypress, Ph.D., CNP, CDE, Albuquerque-based consultant; Foundation for Peripheral Neuropathy; Mayo Clinic; National Institute of Diabetes and Digestive and Kidney Diseases

writing Kaili Meyer; photo Getty Images

Medication

Color reveals more The OneTouch Verio Flex meter and OneTouch Reveal mobile app make testing more meaningful. ®

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Compared to a meter without a color range indicator and a paper logbook. Based on a study conducted in 2015 in the UK of 40 patients with Type 2 Diabetes using a simulated model of the OneTouch Verio Flex meter. ‡ A high pattern will only include results tagged “before meal”; no tagging is needed to trigger a low pattern. © 2017 LifeScan, Inc. NACO/VFX/0317/0152 †

®

10,000 STEPS

National Parks Yosemite National Park

You don’t have to scale a mountain for breathtaking views in these national parks. Check your blood sugar, then head out on one of these gorgeous, popular hikes.

14

Find more national park hikes at nps.gov. Look for trails rated easy or moderate.

1

Yosemite National Park, California Mirror Lake Trail Distance: 5-mile loop The shallow Mirror Lake is fed by melting mountain snow. When the water is calm, it lives up to its name, reflecting Half Dome (a colossal rock formation hovering 5,000 feet above) and Mount Watkins rising in the distance. A shuttle will bus you to the trailhead, paved for the first mile until you reach the unpaved loop

along the rushing water of Tenaya Creek—a nice spot for a snack and a drink. Visit late spring to early summer; by late July, the lake dries up. (nps.gov/yose)

2

Great Smoky Mountains National Park, Tennessee Abrams Falls Trail Distance: 5 miles One of the Smokies’ most popular hikes, the trail follows a creek through dense pine and oak forest, where

writing Bailey McGrath; photos NPS (Yosemite), NPS/Kristi Rugg (Acadia), NPS/Michael Quinn (Grand Canyon)

Scenic Walks in

whitetail deer, elk, and fox frolic. About 2 ½ miles in you’ll reach Abrams Falls—a roaring 20-foot waterfall (strong currents make swimming dangerous; don’t do it). An open area near the falls is a fine spot to lounge and lunch. (nps.gov/grsm)

Grand Canyon National Park

3

Apostle Islands National Lakeshore, Wisconsin Lakeshore Trail Distance: 4.5 miles Tourists visit for the famous sandstone sea caves carved by centuries of wave action on Lake Superior. A paved boardwalk for the first mile, this super-accessible trail allows you to find your own rhythm. From there, a dirt path meanders over the caves. Two miles in is the first lookout point to the artfully carved, red-orange sea caves. (nps.gov/apis)

4

Acadia National Park, Maine Ocean Path Distance: 4.4 miles The majestic combination of ocean, mountains, and wildlife makes Acadia a top-visited park. This out-and-back trail rambles along Mount Desert Island

shore and provides many places to rest and test. Two must-sees: Thunder Hole, an inlet named for crashing waves; and Otter Cliff, where pink granite juts out 110 feet above sea level. Extend your step count on short side trails along the way. (nps.gov/acad)

PACK SMART Keep blood sugar in check during a hike with these diabetes essentials:

5

Grand Canyon National Park, Arizona Rim Trail Distance: up to 13 miles Take in miles of canyon views on the easy South Rim trail. Scenic overlooks such as Hopi Point (great sunset views) and Yavapai Point (glass observation area) offer awe-inspiring resting retreats for photos and blood glucose checks. Simply pick a starting point with the shuttle service.

Hike hack: Wear synthetic fiber socks to wick moisture from your feet.

 Water Drink 12–24 ounces per hour.  Snacks Choose good sources of carbohydrate: granola bars, trail mix, fresh fruit. Sports drinks offer carbs, electrolytes, and hydration. A rule of thumb is 30–60 grams of carb per hour, but talk with your health care provider for specifics.  Fast-acting carb source Think glucose tablets, glucose gel, or fruit juice.  Monitoring supplies Bring extra. You’ll need to check your blood sugar more oen and should have backups in case of emergency (baeries for devices, too).  Any prescribed medications or insulin  First-aid kit source Don Kain, M.A., RD, LD, CDE, diabetes program education and outreach manager at Oregon Health & Science University in Portland.

The single best predictor of type 2 diabetes is obesity—which research links strongly to childhood trauma. These women faced the past to find a healthier future. writing Michelle Theall | illustrations Joe Magee

16

F

For Lucie Linder, the weight gain started early. The 49-year-old from New York City says that as a girl, she would lock herself in the basement closet of her family’s house with boxes of Little Debbie Oatmeal Creme Pies—up to 120 pies in one sitting, 350 calories apiece. “My pain seemed to disappear when I was gorging on food,” Linder says. The ritual started at the age of 5, when she says someone close began forcing sex on her. She lived in terror, telling no one while the abuse continued for seven years. “At 8 years old, my weight shot to over 200 pounds,” she says. When her pediatrician scolded her for being obese, Linder says, “I already knew I had a problem with overeating. And I knew why.”

Linder has lost and gained over the years. “It’s been an eternal struggle with my body,” she says. Those of us who have grappled with weight have heard it all before—from friends, family, physicians, and the unkind voices inside our own heads: You have no self-control. Can’t you just exercise more? Stop eating so much. But what if losing weight isn’t just a question of willpower? Medical research is pointing us in exactly that direction. And considering the single best predictor of type 2 diabetes is obesity, according to the Obesity Society, undoing the knots of our mental health and personal history may be key in saving our physical health.

LUCIE LINDER, 49 New York City

An overwhelming connection Research shows that the comfort of food and the protective layer of extra pounds are often coping devices for childhood sexual abuse victims. According to the Nurses’ Health Study— the largest, longest-running study on women’s health—women who suffered severe physical and repeated sexual abuse as children and adolescents were 90 percent more likely to develop a food addiction. In fact, survivors were twice as likely to have a current food addiction than those who didn’t suffer past abuse. While putting on extra weight spells future health problems, for many victims, the benefits are immediate, says Vincent Felitti, M.D., FACP, clinical professor of medicine at the University of California,

San Diego and internist at Kaiser Permanente Medical Care Program, who has studied childhood trauma and obesity for more than 20 years. “If you need to desexualize yourself, gaining 100 pounds works fairly well,” he says. Plus, the near inevitability of struggling with food as an adult is closely related to other types of childhood traumas, too. “Food is the most commonly used method to manage stress or emotional distress, and the most commonly used nonprescription way to treat anxiety and depression,” says John Zrebiec, M.S.W., CDE, director of behavioral health services at Joslin Diabetes Center in Boston. Landmark research conducted by the joint efforts of the CDC and Kaiser Permanente in the Adverse Childhood

Experiences Study (ACE Study) shows an undisputed relationship between adverse childhood experiences (ACEs) and negative health and well-being as adults, including obesity and diabetes. These findings are supported by additional ACE data gathered by the CDC from 32 states. Experiences considered ACEs include things like childhood emotional, physical, and sexual abuse, as well as childhood exposure to intimate partner violence, household substance abuse, household mental illness, parental separation or divorce, and incarceration of a household member. ACEs cause a stress response in the body. Prolonged stress can disrupt a child’s nervous, immune, and metabolic systems. This can lead to a lifetime of physical and mental health issues that show up in adolescence and continue into adulthood, according to the CDC. “Every day I see the evidence and correlations in my real-life practice. In a sense, the trauma begins to live in your body,” Zrebiec says. CDC-Kaiser research shows that abused kids, or those who have been exposed to significant household dysfunction, are more likely to develop health problems in adulthood, including heart disease, asthma, stroke, and diabetes. “Food works extraordinarily well in providing comfort, but of course later there may be the unwanted consequences of remorse, weight gain, or higher blood glucose levels,” Zrebiec says.

them to make sense of her years of binge eating and struggling with anorexia. Mehta says her mother regularly battered her with cruel words as a little girl, hurling profanities or calling her stupid. At 15, the cycle kept going when her parents divorced and home became more chaotic. Mehta says her mom eventually tossed her belongings on the porch and changed the locks, leaving her to live in a car with a much-older boyfriend who she says beat and controlled her, feeling the hood of the car to see if it was warm from being driven, making sure she didn’t defy him. When he pinned her to the floor, trying to crush her windpipe with his knee, Mehta finally broke free by defending herself with a knife. But the damage of the abusive relationships remained with her. In college, Mehta drank and gained weight, blowing past 250 pounds during her freshman year. Since that time, food has been a big issue—either too much or not enough. At age 25, she was diagnosed with type 2 diabetes. “I can’t even remember what it was like to not be aware of everything I put in my mouth,” she says. “It’s a constant struggle to manage.” During her 30s, the pendulum swung to anorexia, and Mehta was down to 105 pounds. She lost half her hair. Her heart literally began to consume itself. “I was on a quest to prove I could do and be anything, but it ended up as a desire to literally disappear,” she says. Mehta’s experience is consistent with ACE research findings that show as the number of ACEs increases, so do the risks for chronic health problems.

“MY PAIN SEEMED TO DISAPPEAR WHEN I WAS GORGING ON FOOD.”

More trauma, more struggle Jessica Mehta of Portland, Oregon, hit several of those ACE markers, and she follows the line of history right back to

WHAT’S AN ACE?

Adverse childhood experiences (ACEs) are stressful or traumatic events experienced during childhood that increase the likelihood of certain health problems later in life. ACEs include  Emotional, physical, and sexual abuse  Childhood exposure to intimate partner violence, household substance abuse, household mental illness, parental separation or divorce, and incarceration of a household member  Emotional and physical neglect

DiabeticLivingOnline.com

19

JESSICA MEHTA, 36 Portland, Oregon

For example, compared to people with no ACEs, the odds for obesity increased by 50 percent among people who reported any childhood abuse. Those with four or more ACEs were 1.6 times more likely to be diagnosed with diabetes. In short, if you had a tough childhood, the chances that you’ll struggle with obesity or diabetes as an adult are high. “Not everyone ends up with obesity. Some will end up with heavy smoking, alcoholism, promiscuity, et cetera,” says Felitti, who was also the co-principal investigator of the CDC-Kaiser Permanente ACE Study. “But basically the idea is the same with each of them: Each is an unconscious mechanism for trying to gain relief of symptoms.” So all of your struggles with the scale, your health problems, those bad eating habits you just can’t kick—they could have more t0 do with a negative past than your willpower. And what’s more: Someone you know is likely grappling with similar issues. Reframing the problem Consider that in America, one in three girls and one in six boys are victims of sexual abuse before they turn 18, according to the Administration for Children and Families. That’s just one ACE. The Department of Justice notes that almost 40 percent of American children are victims of two or more violent acts, and more than 25 percent have been exposed to family violence. “Obese adults are told by physicians to lose weight, diet, and exercise, which also insinuates blame,” says William H.

Dietz, M.D., Ph.D., an obesity expert at Milken Institute School of Public Health in Washington, D.C. But statistics like these indicate the need to reframe the entire discussion regarding weight loss and obesity, he says. After collecting data from ACE Study patients for 20 years, Felitti says the research is clear: Obesity can be the consequence of a traumatic past. It seems to confirm something that many of us have suspected all along: Obesity just can’t be a simple matter of genetics or a lack of willpower. But now, he says, it’s time to start using these insights to help people. “The most useful thing we have found is understanding why a person became obese, not how. How is obvious—by overeating,” Felitti says. “The real question is why?” Felitti suggests doctors ask patients two key questions: 1) How old were you when you first began putting on weight? And, 2) why do you think it began then? For many, understanding that a troubled past could be contributing to health problems today just might be the first step toward healing.

“IN A SENSE, THE TRAUMA BEGINS TO LIVE IN YOUR BODY.”

20

Moving forward in health For Amber Malcom, 36, it took a major life time-out to begin the healing process. When Malcom was a child, she says her mother shamed and demeaned her with hurtful, abusive words that still haunt her. She says she lived with her mother’s destructive tendencies with money and with food, binge-eating and using it as a comfort and a treat. Then, Malcom says, “She would attack any part of my body that didn’t look perfect. She told me I

I WAS ON A QUEST TO PROVE I COULD DO AND BE ANYTHING, BUT IT ENDED UP AS A DESIRE TO LITERALLY DISAPPEAR.

AMBER MALCOM, 36 Duncan, Oklahoma

22

was fat, when I clearly wasn’t. Once that started, I ate what I wanted.” Well, I’m already fat, she thought. No point in denying myself anything now. Having struggled with her weight all her life, she says she’s never felt like anything less than an ogre. She can barely look in a mirror. She shies away from cameras. “I’m not sure I could be more insecure about how I look,” Malcom says. But in her 20s, she battled a near-fatal blood infection while pregnant. She lost 80 pounds, and felt so much better without the extra weight. The life time-out forced perspective. She knew she had to come to grips with her childhood to stay on a healthy path. Malcom has been in therapy ever since and reads a lot on the topic of healing. She says she surrounds herself with wise, caring friends who hold her accountable when she strays down a negative road.

“When old wounds don’t heal properly, you have to go back in and fix the damage,” Malcom says. Dietz suggests that it may be time for physicians treating patients with obesity to ask a simple question: Did anything adverse happen to you as a child? That question worked for Linder. Two years ago, Linder began to write. Page by page, word by word, she pieced together that her eating disorder, weight, health, and body image were all tied to the cruelties she’d endured as a child. “I took charge and got real with myself,” Linder says. In 2016, she released her memoir, Big Bottom Blues, letting go of all the heavy memories that were holding her back. Lighter in spirit, she took up a happy sport she’d long considered “child’s play”—she was finally ready to have fun like a healthy kid.

She started working out with a jump rope, then training for competitions, eventually winning gold medals as Team Lucie B at the USA Jump Rope National Championship. She opened Lucie B’s Jump N Fun gym in Woodmere, New York, for kids and adults. “I tell my story to help free others,” she says. Mehta found a therapist who would listen to her without judgment. She also kept her pen to paper, authoring three collections of poetry, a novel, and a number of other published works. “Writing provides the catharsis I need to process, digest, and let go of the past,” she says. Mehta says one of the hardest parts has been learning to let go of others’ judgment and focus on her health and happiness. In the process, she found loved ones who were with her at any

dress size. “The ones who matter are there regardless,” she says. For Malcom, motivation to continue healing comes from her 11-year-old son, recently diagnosed with type 1 diabetes. They focus on the future together, eating smart, and working toward wellness, which for Malcom includes processing the past. “It’s hard to relive those moments. I want to pretend they didn’t happen,” she says. “But the damage does not define me. I lost everything, and I came back better than ever.”

HEALING BOOKS  The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk, M.D. (Penguin Books, 2015)  The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse by Ellen Bass and Laura Davis (William Morrow Paperbacks, 2008)  A Grief Observed by C.S. Lewis (HarperOne, 2001)  Scared Sick: The Role of Childhood Trauma in Adult Disease by Robin Karr-Morse (Basic Books, 2012)  The Secret by Rhonda Byrne (Atria Books/Beyond Words, 2006)  You Can Heal Your Life by Louise Hay (Hay House, 1984)

WHAT’S NEXT?

People who have a history of ACEs can take maers into their own hands. Carol Redding, editor of the ACE Reporter, and John Zrebiec of the Joslin Diabetes Center have advice:

1

Ask for a referral.

Good treatment for trauma is available. Most therapists will not be judgmental. Ask your family doctor to recommend a licensed therapist who has a background in treating people who have experienced trauma. Contact your health insurer for names of mental health providers covered by your plan.

2

Use a helpline. I f you live in the

U.S., call 2-1-1, a resource that helps people with problems related to ACEs.

3

Reach out.

Contact your nearest children’s hospital or advocacy center and ask to be put in touch with a trauma-informed, licensed therapist.

DiabeticLivingOnline.com

23

I DID IT!

Transforming Her Life

Aer a cruel comment from a listener, a radio personality works toward a healthy lifestyle and a career change.

Start weight

246 lb. Current weight

130 lb. 24

writing Karla Walsh; photos Priscilla Gragg

before

WHAT WORKED Snack aack

F

For 13 years, 5-foot-1-inch Genevieve Jerome was unhappy with her appearance. “I was so ashamed of my size-20 body,” Jerome says. She tried to exercise, but a few jogs a week couldn’t make up for her diet. “I always had seconds, and I ate burgers, fries, and burritos.” Because Jerome worked as a radio personality, people tended to focus more on what she said than how she looked. But when her producer posted a picture of her on the show’s website in 2011, she was crushed by the reactions. “Someone tweeted, ‘She’s a fat cow with a face made only for radio,’” Jerome recalls. It was a stupid comment, and mean. But instead of ruining her, it empowered her. “I’d been thinking about making a career switch, but I realized that I needed a

whole-life transformation.” So Jerome got to work. She focused on her eating habits, consuming more produce, lean protein, and water. “I ate small meals throughout the day so I wasn’t starving at dinner,” she says. Jerome then discovered fitnessblender.com, a website with hundreds of free workouts. “The instructors were motivating, and I appreciated the variety,” she says. Within five months, Jerome was doing five 40-minute, high-intensity cardio or strength routines a week, and the pounds melted off. Next came a career reinvention. She quit radio to launch her own photography business. Now she loves to capture special moments and is finally comfortable in front of the camera herself. “I even take selfies,” she says.

“Pre-cut fruits and veggies, and stash them in BPA-free bags in the fridge. That way you’ll always have healthy snacks on hand.”

“I always have two hard-boiled eggs with me. I’m never without a healthy nibble.”

Mix master “A tablespoon of coconut oil makes a smoothie so satisfying.”

Smart sweets “I portioned out half-cup servings of my favorite ice cream and stuck them in the freezer so they were ready when my sweet tooth struck.”

The mantra “Nothing is over until you quit trying.”

Beyond the scale “Staying fit helps me keep my anxiety in check, and overall, I’m a happier person.”

We love this reusable aqua Stasher storage bag. It’s durable, easy to clean, and a great BPA-free alternative to plastic bags. $12; stasherbag.com

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25

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“Success consists of going from failure to failure without loss of enthusiasm.” —Winston Churchill

MANAGE

GOOD TO KNOW

10

GREAT HABITS FOR HEALTH

Time to get back to the basics. We gathered 10 simple habits to help you beer manage diabetes and stay healthier longer.

writing Kaili Meyer; photo Pete Krumhardt

1

GET MOVING Studies show that being active 30 minutes a day most days of the week can slow the progression of type 2 diabetes. It could be as simple as going for a family walk through your neighborhood after dinner instead of sitting down to watch TV.

2 Log it: The app MapMyWalk lets you track walks and follow preplanned route templates.

GET FIVE A DAY

Fruits and vegetables add texture, color, and disease-fighting nutrients to your diet. Research from the Nurses’ Health Study shows that a diet rich in whole fruits lowers risk of type 2 diabetes. Aim for 5 servings of fruits and veggies a day. Stash easy-to-carry produce like apples, bananas, and baby carrots in your bag for snacking at work or on the go.

DiabeticLivingOnline.com

29

GOOD TO KNOW

6

3

DRINK SMARTER

EAT BREAKFAST

The average 20-ounce soda contains 15–18 teaspoons of added sugar and 240-plus calories. The ADA says ditch the sugar to reduce weight gain and diabetes-related risk factors. Instead, cut up your favorite citrus or berries and add them to your water bottle or a can of fizzy water.

5

CUT BACK ON MEAT

4

GO WHOLE Whole grains contain more fiber than refined, which keeps you full longer. Boil a pot of whole grain noodles for your next pasta night.

Add ½ cup whole grain rice or quinoa to your favorite

Researchers from the Harvard School of Public Health have linked red meat consumption to an increased risk of type 2 diabetes. You can still enjoy small portions a few times a week, but look for other sources of protein, such as beans and nuts. Try going meatless for one meal a day and explore protein-packed foods like almonds, cottage cheese, and kidney beans.

Starting your day with foods rich in whole grains, fruits, and dairy can help keep the pounds off long-term. Plus, skipping breakfast increases your likelihood to overeat later on, which can cause blood sugar spikes. Not a morning person? Make tomorrow’s breakfast tonight.

7

LIMIT SALT

Keep the saltshaker off the table and processed foods to a minimum. Too much sodium increases your risk for heart attack and stroke, both common diabetes complications. Experiment with fresh herbs and spices to flavor your food instead.

8

KNOW PORTIONS American Journal of Clinical Nutrition research shows that adults are eating larger portions without feeling fuller—bad news for our waistlines. Follow our guide to portion sizes: Diabetic LivingOnline.com/Servings

9

CHECK YOUR EYES

Diabetes is the leading cause of new blindness in adults, according the ADA. Eye disease often shows no early symptoms, which makes annual eye exams super important. Schedule an eye exam every May to celebrate Healthy Vision Month. To learn more: nei.nih.gov/hvm

10

EAT OUT LESS Preparing meals at home gives you complete control over ingredients and serving sizes, a lost luxury when eating out. Studies show restaurant meals are higher in sodium, fat, and calories. Cook at home to be sure of what you’re eating and better manage your blood sugars. Look for lightenedup versions of your favorite restaurant recipes and have fun re-creating them at home.

Nearly one-third of PWDs over age 40 have diabetic retinopathy. —CDC

Planning ahead can help with weight loss. Try our freeze-forlater recipes: DiabeticLiving Online.com/ Freeze-It

SET GOALS Write down goals to increase your likelihood of success. You can hone in even sharper on a target with the actionoriented SMART goal method. Here’s how:

Specific: I’m going to walk tomorrow morning.

Measurable: I’m going to walk five blocks.

photos Getty Images (woman), Marty Baldwin (whole grains, beans)

Achievable: I have to wake up earlier and put my walking shoes next to the bed.

Realistic: If I’m going to wake up earlier, I need to be in bed by 10 p.m.

Timeline: I’m going to wake up at 8 a.m. and be out the door walking by 8:15. I’ll be back taking a shower by 8:35. source Charles Duhigg, author of Smarter Faster Better (Random House, 2016)

DiabeticLivingOnline.

MED NEWS

What’s New in Diabetes Care Synjardy XR approved An easier-to-take version of the type 2 medication Synjardy has been approved by the FDA. The new Synjardy XR combines two medications— empagliflozin (Jardiance) and metformin—into a once-daily pill. If you have type 2 diabetes and already take metformin, this med may help improve blood sugar control. (But avoid it if you have kidney disease.)

Mini pump for type 2 New technology may provide a less burdensome way to deliver GLP-1 agonists, a class of type 2 diabetes meds. Intarcia Therapeutics has submitted a matchstick-size mini pump for patients with type 2 for FDA approval. It’s placed under the skin of the abdomen to deliver a continuous flow of the GLP-1 medication exenatide. The device is replaced by a doctor every six months. Exenatide is currently available as a twice-daily injection (Byetta) and a once-weekly injection (Bydureon).

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Watch the heat: Keep your insulin stored below 86°F.

NEW INSULIN OPTION FOR KIDS The FDA recently extended its approval of Novo Nordisk’s long-acting insulin Tresiba to children ages 1 and older with type 1 and type 2 diabetes (the insulin was already approved for adults).

The Spring 2017 Diabetic Living reported that a BMJ study found type 2 med pioglitazone (Actos) does not cause bladder cancer. After press time, the FDA concluded that Actos may indeed be linked to increased bladder cancer risk, trumping the previous study’s findings. Conflicting studies, TV ads, or even talk among friends can leave you confused about your meds. It’s crucial to educate yourself and make sure your information comes from a reputable source.  Bring questions or concerns to a diabetes expert (doctor, pharmacist, or CDE). Drugs affect everyone differently, so bring to this conversation a full list of your prescriptions and over-the-counter meds as well as a full medical history.  When your prescriber suggests a new medication, always ask three questions: 1) What is this medicine for? 2) How do I take it? 3) What are the side effects? If you’re uncomfortable with any of the answers, speak up and ask about other options. Source Susan Cornell, Pharm.D., CDE, associate professor of pharmacy practice, Midwestern University, Chicago College of Pharmacy

DISPOSAL SAFETY Unsure how to properly discard diabetes testing and injection supplies? Call your local health department for guidelines.

writing Marty Irons, RPh, CDE, Bailey McGrath; photo Marty Baldwin

Take control

WAYS FOR YOU TO STAY POSITIVE

IMPROVING HER MOOD

ASK US ANYTHING

NAFLD

(NONALCOHOLIC FATTY LIVER DISEASE) PROTECT YOUR LIVER

“My friend with type 2 diabetes has nonalcoholic fay liver disease. I also have type 2, but I’ve never heard of it— am I at risk, too?”

 Keep A1C below 7 percent  Attain healthy cholesterol and triglyceride levels  Limit intake of sugar and other refined carbs (which can raise triglycerides)  Eat healthy fats: omega-3s in fish, extra virgin olive oil, avocados, and nuts  Limit alcohol  Don’t smoke

N

Nonalcoholic fatty liver disease (NAFLD) is a close cousin of type 2 diabetes. If you have one of these conditions, you won’t automatically have the other, but you’re at higher risk. NAFLD also runs in families.

What’s involved? With NAFLD, fat builds up in the liver to unhealthy levels. Over time, as the liver swells with fat, scars develop and liver function declines. NAFLD is different from fatty liver, which occurs from drinking too much alcohol. Risk factors for NAFLD overlap those for type 2 diabetes. Both are more likely if you’re overweight and have excess belly fat, insulin resistance, unhealthy triglyceride and cholesterol levels, and high blood pressure. NAFLD may start before diabetes.

34

Signs and symptoms

Having both type 2 and NAFLD increases risk of diabetes complications.

NAFLD can be a silent disease. Symptoms might include discomfort in the upper right side of your abdomen, fatigue, and indigestion. A blood test that shows elevated liver enzymes might be due to NAFLD. Imaging tests are also used to help diagnose it. PWDs aren’t automatically screened for NAFLD, but some experts think they should be. NAFLD tends to progress more rapidly in PWDs. A liver biopsy may be used to determine that.

To prevent or manage NAFLD, follow a healthy eating plan, control your weight, and exercise most days of the week, including cardio and strength training. If you’re overweight, gradually losing 5–10 percent of your weight can improve fatty liver. There aren’t any meds currently FDA-approved to treat NAFLD, but more than 50 are in development or testing. sources Michelle Lai, M.D., M.P.H., hepatologist at Beth Israel Deaconess Medical Center in Boston and coauthor of The Liver Healing Diet (Ulysses Press, 2015); Rohit Loomba, M.D., M.H.Sc., director of the NAFLD Research Center and director of hepatology at the University of California, San Diego; Metabolism, August 2016.

writing Marsha McCulloch, M.S., RDN; illustration Sam Ward

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TECHNOLOGY

IS YOUR APP SAFE? Health apps are intended to help, but most aren’t veed. Make sure yours are reliable.

I

Imagine a random stranger offers you untested medical advice about your insulin dosage. Would you take it? That’s what happens if you rely on one of thousands of unregulated health apps available in app stores. While some are benign—helping you log carbs, calories, or glucose levels— others weigh in on crucial matters such as when and how much insulin to take. Only a handful are FDA-regulated, and you won’t find flags in the app store marking any as risky or dangerous. But you and your care team can evaluate the quality and safety of any app. Follow our chart to learn how.

Determine app’s purpose

how many carbs to eat to correct a low)?

YES

NO

Proceed with caution and do your research. Visit the Mobile Medical Applications section at fda.gov or the manufacturer’s website

Most apps used for general wellness— calorie trackers, blood glucose logs—are safe. But continue through this chart to evaluate the app’s quality.

Do a background check for red flags. What do you see?

36

Go to the next step if the site is professional and organized, and if the app is made by a reputable company with other FDA-approved diabetes devices or has distinguished partners in the medical community. If it’s giving specific medical advice (i.e., insulin calculations), look for FDA approval.

 FDA regulates only U.S.-created health apps considered high-risk—those that work in conjunction with a medical device (like a glucose monitor) or act as a medical device (such as an in-app bolus calculator).

Check country of origin

writing Bailey McGrath; illustrations Getty Images

Where an app is created maers; global measurements and regulations differ. Was it developed in the U.S.?

NO

YES

Many apps (like those unregulated insulin calculators) are approved in their country of origin, but that doesn’t mean they’ve goen the OK in the U.S.

Continue veing—read terms of use and privacy policy. Are the terms reasonable? Do access requests make sense? For example, a food-logging app may want access to your camera so you can photograph meals (reasonable), but also your contacts (not reasonable).

NO

YES

Keep looking for the right app.

Great! Now bring in the professionals. Go over the app with your provider or diabetes educator, who can ensure its safety. He or she may also have app recommendations.

STOP HERE if you find red flags such as a messy, amateur website; apps created by an individual person; no medical partners; no contact information. Don’t use these apps for diabetes management.

FDA REGULATIONS: WHAT TO KNOW

 FDA does not regulate apps that pose lesser risk—say a coaching app for prediabetes or a med-reminder app.  Report it if you have a harmful experience with a medical app. Visit MedWatch on fda.gov to do so. Flag bad apps as innapropriate in the Google Play store or use reportaproblem.apple.com for iOS.  FDA-approved insulin dosage apps As of early 2017 the following are available: BlueStar Rx, Accu-Chek Connect, Insulia, and Go Dose. All require a doc’s prescription. Others are in the works.

sources Molly McElwee-Malloy, RN, CDE, AADE media spokesperson; Stephanie Caccomo, FDA press officer; fda.gov

MONEY SMARTS

Generic drugs are considered a “bargain” in health care—though the costs of some have skyrocketed. In December 2016, 20 states filed a civil complaint accusing several generic drug companies of pricefixing. So can you still save with generic drugs? Short answer: Most of the time. 38

Generics make up nearly 90% of U.S. prescriptions.

The FDA requires generic drugs to be nearly equivalent to brand-name versions, which means manufacturers don’t have to repeat expensive clinical trials. And as more companies produce the same drug, competition increases. Generally, that knocks prices down. In 2015 alone, generics saved the U.S. $227 billion, according to the Generic Pharmaceutical Association. But “for a variety of reasons, at times the generic drugs can be more expensive than brand-name,” says Evan Sisson, Pharm.D., M.H.A., CDE, associate professor at Virginia Commonwealth University School of Pharmacy and AADE spokesperson. “Patients should consider shopping around.” The good news: New diabetes drugs continue to be released, giving providers options. “This dilutes the market share and helps restore competitive pricing,” Sisson says.

writing Bailey McGrath; photo Getty Images; illustration Fortuna Todisco

Generics: still the best deal

MARTY IRONS RPh, CDE, community pharmacist

6

CASH-BACK APPS Eating well is good medicine, too, and rebate apps help you save on healthy groceries:

Diabetic Living® adviser Marty Irons shares his top tips for cutting medication costs.

1 Go local.

Community pharmacies can be more flexible than chains with pricing. Find one in your area: ncpanet.org/home/ find-your-local-pharmacy

2 Connect.

Get to know your pharmacist. Forming a relationship allows your pharmacist to understand your needs and look at your drug therapy regimen in the big picture, which helps him or her determine how to simplify it and save you money.

3

WAYS TO SAVE ON PRESCRIPTIONS

Shop around.

Two pharmacies might charge vastly different amounts for the same drug, so check pricing at several (the free app GoodRX can help). A caveat: It’s best to fill all prescriptions in one place so your pharmacist can review your entire regimen. Find one that has great prices for most of your meds and stick with it.

 IBOTTA Sort deals by retailer or scan barcodes as you shop to unlock rebates. Transfer cash to PayPal, Venmo, or gi cards. iboa.com

4 Use coupons.

If you’re taking a brand-name drug, use manufacturer coupons to cut your copay. You can get them from your pharmacist, doctor, CDE, or manufacturer websites.

5

 SAVINGSTAR Save 20 percent on select produce with the weekly healthy offer. Cash out when you earn at least $5. savingstar.com

Review meds.

If you’re on Medicare, check your part D formulary (list of covered drugs) during open enrollment to make sure your meds are still covered—it changes every year.

 CHECKOUT 51 Browse offers that are updated every Thursday. Earn cash back via check once your account reaches $20. checkout51.com

6 Find help.

If you can’t afford your meds, contact Partnership for Prescription Assistance (pparx.org or 888/4PPA-NOW), which connects underinsured patients with programs for free or nearly free meds. If you’re a senior, visit the National Council on Aging (ncoa.org/map/ncoa-map) to find a local program to help you navigate health care costs.

TWEET US! What do you want to know about drug costs? @DiabeticLiving

“Work with your care team to figure out how to get the best outcome at the lowest cost.” —Evan Sisson, Pharm.D., M.H.A., CDE

DiabeticLivingOnline.com

39

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“For happy health, fuel yourself with dreams and greens.” —Terri Guillemets

NOURISH

JUST TRY IT!

Avocado Most Americans eat too much saturated fat. Replace it with healthy monounsaturated fat found in creamy avocados.

recipe Lisa Appleton; photos Jacob Fox; styling Jennifer Peterson

TIP-TOP TICKER Avocados contain monounsaturated fat, which reduces cholesterol levels when it replaces some of the saturated fat in a diet. But the calories add up quickly: ½ cup avocado slices equals 117 calories. Still, its fiber content—5 grams per ½ cup—slows digestion, so you’ll feel full longer. Toss it into salads or salsas, or mash for guacamole (just add lime juice to prevent browning).

or a melon baller, carefully hollow out tomatoes. Invert

STEP TWO: For filling, in a food processor combine ½ of a medium avocado, peeled and cut up; 2 oz. cream cheese, soened; 2 Tbsp. basil pesto; and 1 tsp. lemon

juice. Cover and process until smooth. If desired, line a serving platter with fresh basil leaves. Spoon filling into tomatoes and place on platter. If desired, sprinkle with cracked black pepper. Serve immediately or loosely cover filled tomatoes with plastic wrap and chill up to 4 hours. SERVES 15 (2 stuffed tomatoes each) CAL 36, FAT 2 g (2 g sat. fat), CHOL 4 mg, SODIUM 32 mg, CARB 2 g (0 g fiber, 2 g sugars), PRO 0 g

DiabeticLivingOnline.com

41

BETTER BASICS

COOKING SCHOOL:

A Perfect Go-To Sauce Many store-bought tomato sauces have heaps of added sugar to tame the natural acidity of tomatoes. Plus, they’re usually loaded with sodium. But if you can turn on an oven, you can make a healthy sauce from scratch. And it tastes really good, too.

Pick your tomato Any type will work. Romas are our favorite. Their mild-sweet flavor is consistent from tomatoes have more

longer. And,

tomatoes can color.

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WHAT YOU’LL NEED KITCHEN TOOLS  15×10-inch baking pan  Aluminum foil  Basting brush  Cutting board  Chef’s knife  Large saucepan  Wooden spoon  Measuring spoons

Aer washing and drying tomatoes, remove stems. To do this, hold the tomato firmly and with a small paring knife, remove stem by slicing and rotating the knife in a circular motion. You don't have to cut very deep to remove it. Discard stems.

STEP 2: Seed the tomatoes.

Cut each tomato in half along its equator. Squeeze halves over a bowl. The seeds and excess juice will pop right out; discard seeds and juice.

 4 lb. tomatoes  1 red sweet pepper  Olive oil  1–2 sweet onions  4 cloves garlic  White balsamic vinegar  Salt  Black pepper  Fresh basil, Italian parsley, and/or oregano

Broil the tomatoes and sweet pepper.

Stem the tomatoes.

 Small ladle  Canning jar

LIST

STEP 3:

STEP 1:

Once the vegetables are charred, wrap them in foil and let stand 20 minutes. This will loosen the skins. Then use tongs or your fingers to peel. For the best sauce texture, you must remove the skins.

No immersion blender? Transfer small, slightly cooled batches of sauce to a blender or food processor.

STEP 4: Cook the aromatics.

In a saucepan sauté onion and garlic in oil. Add the peeled tomatoes and sweet pepper, the vinegar, salt, and black pepper. Bring to boiling, then reduce heat and simmer, uncovered, 20 to 30 minutes.

STEP 5:

Blend it up. Let the sauce cool slightly, then blend with an immersion blender until smooth. Stir in fresh herbs such as basil, Italian parsley, and oregano.

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BETTER BASICS

STEP 6: Pick your protein.

If you prefer meat sauce, stir in one of these: 9 oz. cooked lean chicken sausage links, sliced; 12 oz. cooked lean ground pork, turkey, or beef; or 3 cups shredded cooked chicken breast. Serve over pasta or vegetable noodles (p. 47).

FREEZE YOUR ASSETS Store frozen sauce up to 3 months in a freezer-safe container, such as a resealable plastic bag or glass container with a lid, leaving an inch of room up top. To serve, thaw overnight in the fridge, then reheat in a saucepan over medium-low.

Zoodles with Tomato Sauce and Chicken Sausage for full recipe and nutrition information, see p. 93

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NUTRITIOUS NOODLES

For a healthier take on pasta, opt for spiralized veggie noodles you make yourself. All the sauce-sopping yum but far fewer carbs and calories.

SPIRALIZERS: What We Recommend

Sweet Potato In a large saucepan cook 12 oz. peeled whole sweet potatoes in enough boiling water to cover 5 minutes. Remove from pan. Cool potatoes. Use a spiralizer to cut potatoes into long strands (about 3 cups lightly packed). Return cooking water to boiling. Add potato strands; cook 2 to 3 minutes. Drain.

The manual Oxo Spiralizer has a suction cup on the boom that anchors it to your countertop, which makes it much easier to use. It also has a container to hold the blades so you don’t lose them or risk cuing yourself on them when not in use. $40; oxo.com

SERVES 6 (½ cup sweet potato noodles each) CAL 90, FAT 0 g, CHOL 0 mg, SODIUM 133 mg, CARB 21 g (3 g fiber, 6 g sugars), PRO 2 g

Carla Christian, RD, LD Diabetic Living® Test Kitchen Chef and Nutrition Specialist

Zucchini Use a spiralizer to cut zucchini into about 24 cups strands (they’ll cook with nonstick cooking spray; heat over medium-high. Add half the vegetable noodles; cook and toss 2 to 3 minutes or until tender. Repeat with remaining vegetable noodles. SERVES 6 (2 cups zucchini noodles each) CAL 75, FAT 1 g (0 g sat. fat), CHOL 0 mg, SODIUM 23 mg, CARB 15 g (5 g fiber,

Spaghetti Squash Halve two 5-lb. spaghei squash lengthwise; remove down, on two baking pans lined Bake at 350°F 1 hour. Scrape pulp with a fork to create strands. SERVES 6 (2 cups squash each) CAL 63, FAT 1 g (0 g sat. fat), CHOL 0 mg, SODIUM 34 mg, CARB 14 g (3 g fiber, 6 g sugars), PRO 1 g

Most spiralizers have several blades. You can make spaghetti, fettuccine, and ribbon noodles.

The Oster Electric Spiralizer is easy to use. The pieces fit together seamlessly and hold food securely. I always felt like the blades were safe to work with. I love its size—it doesn’t take up much counter space, and cleanup is easy. $50; target.com Linda Brewer, RD Diabetic Living Test Kitchen Culinary Specialist

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SNACK BAR

Start Poppin’

From savory to sweet, there’s a popcorn snack for you. And these come in a range of carb counts to work for your individual needs. Shop smart. Ditch store-bought buer-flavor microwave popcorn for the plain air-popped version—an air popper or a covered pot and a stove top are all you need. You’ll save about 27 calories, 3 grams fat, and 65 milligrams sodium per cup.

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Shrimp and Edamame Salad with Ginger Dressing, p. 97

ChickenBroccoli Salad with Buttermilk Dressing, p. 92

OUR BEST SALADS Simplify weight loss with these delicious salads brimming with hunger-satisfying protein, healthy fats, and powerful disease-fighting fruits and vegetables.

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Pretzel-Crusted Tofu Salad, p. 98

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This versatile vinaigrette works well with chicken, shrimp, and tuna, too.

Salmon Salad with Orange-Balsamic Vinaigrette, p. 97

Barbecue Chicken Salad, p. 92

CHEF CARLA CHRISTIAN, RD, LD:

3 WAYS TO LIVEN UP A BORING SALAD For a hearty, fiber-filled salad, add ⅓ cup whole grains like brown rice, quinoa, or farro. Whole grains add texture and pack an extra punch of nutrients such as B vitamins and iron.

Seared Sesame Tuna with FennelApple Slaw, p. 97

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2 Try aromatics.

Fresh herbs, such as cilantro, green onion, and parsley, and citrus zest boost flavor without adding calories and carbs. Sprinkle them directly on your greens or whisk them into a dressing.

3 Get nuy.

Toasted nuts and seeds add a deep, meaty flavor and a tasty crunch to salads. They also pack in protein and healthy fats. But stick to 1 Tbsp. per serving to keep calories reasonable.

Make a double batch of the chimichurri and use it to dress other salads or brown rice.

Steak and Chimichurri Salad, p. 91

DiabeticLivingOnline.com

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Cauliflower Salad with Dill-Shallot Dressing, p. 98

Properly cooked Brussels sprouts will have a sweet, caramelized flavor.

Potato and Sprouts Salad with Lemon Vinaigrette, p. 91

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Grilled PortobelloChicken Row Salad, p. 92

HEALTHY SALAD KITS These DL-approved Beer Choice™ salad kits provide convenience and diabetesfriendly ingredients:

1

Eat Smart Southwest Vegetable Salad Kit is packed with carrots, kale, radishes, and just enough chipotle dressing, cheese, and tortilla chips to satisfy without overdoing it on calories. For more info: eatsmart.net

2

Dole Chopped! Poppy Seed Salad Kit contains a mix of crunchy greens, pumpkin seeds, dried cranberries, and a sweet poppy seed Greek yogurt dressing—all for 15 grams carb. For more info: dole.com

SHOP SMART

Not all salsa brands are created equal. We have the scoop on selecting those with the most diabetesfriendly ingredients.

Find the fridge.

Skip added sugars.

Start your salsa search in the refrigerated section of the grocery store. Look for pico de gallo—a chunky, raw, fresh style of salsa. This style often contains less sodium than jarred versions; a shorter shelf life means less added salt as a preservative.

Most salsas have zero added sugars, but that’s rarely true with fruit salsas. Check the ingredients and avoid things like corn syrup, sucrose, nectar, honey, and dextrose.

Be carb conscious. TER BEHTOICE ™ C

Typical flavors, such as mild, medium, and spicy, are great choices for PWDs. They’re naturally low in carbs—only 2–3 grams per serving—and contain only 5–10 calories per 2 tablespoons. But if the salsa contains add-ins, such as peaches, pineapple, mango, black beans, or corn, the carbs and calories may double. And that’s before considering what’s in the chips often served with it.

Spare the sodium. Some brands contain as much as 300 mg sodium per serving—not counting the tortilla chips (for lowersodium homemade chips, see below). Too much sodium can lead to high blood pressure, so skip brands with more than 140 milligrams per serving.

Control portions. A serving of salsa is only 2 tablespoons, which goes fast as a condiment or snack. Measure one to two servings before eating to stay within nutrient goals.

Healthier homemade chips: Preheat oven to 375°F. Place two 6-inch corn tortillas, cut into wedges, in a single layer on a baking sheet. Coat with nonstick cooking spray. Bake 10 to 13 minutes.

writing Katie Shields, M.S., RD, LD; photos Marty Baldwin; styling Jennifer Peterson

SALSA SLEUTH

A BETTER CHOICE Mild, spicy, green, fruity—we have a DL-approved salsa for you. In general, 2 tablespoons should contain less than 20 calories, 140 milligrams sodium, and 4 grams carb.

Green Salsa Arriba! Fire Roasted Mexican Green Salsa Per 2 Tbsp.

Mild Salsa Pace Restaurant Style Salsa Original Recipe Per 2 Tbsp.

CAL 10, FAT 0 g, SODIUM 100 mg, CARB 2 g (0 g fiber, 0 g sugars)

CAL 10, FAT 0 g, SODIUM 130 mg, CARB 2 g (0 g fiber, 1 g sugars)

Spicy Salsa Frontera Gourmet Mexican Salsa Chipotle Per 2 Tbsp. CAL 10, FAT 0 g, SODIUM 140 mg, CARB 2 g (1 g fiber, 2 g sugars)

SMART SALSA SCOOPS  Radishes. Smoky salsas and peppery fresh radish slices pair really well.  Carrots. Pack your snack with vitamin A. Pick crunchy baby carrots or julienne large carrots.  Sweet peppers. Their subtle sweetness tames super spicy salsas.

These recipes are adapted from Chef Ronaldo’s cookbook Sabores de Cuba (ADA, 2016). $17; shopdiabetes.org

FLAVORS FROM CUBA If your idea of Cuban food is heavy on the fat and carbs, then you need to step into Chef Ronaldo Linares’ kitchen. In his cookbook Sabores De Cuba, he transforms Cuban food into simple, diabetes-friendly recipes any home cook can make.

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“You can trust a fit chef.” That’s what Ronaldo Linares, chef and Crossfit coach in Piscataway, New Jersey, wants the whole world to know. “I was born in the kitchen. My parents are chefs. I watched them at a young age and got the itch for it,” Linares says. His earliest memories are of his parents bustling around the kitchen, his Cuban father and Colombian mother teaching him the language of food, showing him proper knife skills and even how to butcher a chicken. It made his future as a chef and restaurant owner a natural fit. The inheritance of cooking with family was multigenerational recipes, but when his sister-in-law and several friends were diagnosed with type 2 diabetes, Linares realized the family table needed an update if they were going to live long, healthy lives together.

“Having a young boy, I wanted to be an example for him,” he says. It’s working. Three-year-old Liam is particularly fond of the CilantroWatermelon Salad (p. 69). In fact, recipes weren’t likely to make the cut for Linares’ new cookbook if they didn’t pass the Liam taste test. According to the CDC, Hispanic and Latino people are more likely than Caucasians to develop type 2 diabetes. Linares really took that statistic to heart. His cookbook shatters the myth that Cuban cuisine can’t be healthy. “Cuban food is nothing fancy. It’s just simple ingredients full of personality,” he says. “There are no set rules. Get creative and think outside the box. Have fun with flavor.” While there may not be rules, there are definitely tricks to keeping the Cubano kitchen healthy. We scooped up Linares’ best.

FLAVOR WITH FRUIT Fruit is a versatile kitchen staple. It’s used in sangria— wine infused with fresh fruit—to add sweetness without excess sugar. Linares adds lime juice to a hot skillet to infuse more flavor into a dish. And when he craves dessert, he’ll reach for fresh mango first.

Lady’s Sangria, p. 94

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COOK WITH HEART Heart disease is a common complication for PWDs, which is why Linares keeps heart-healthy ingredients on hand, such as avocados and olive oil. It’s easy to see why guacamole makes a regular appearance at the Linares house. But he doesn’t always serve it as a dip—Linares says he loves guac as a low-carb topper for lean chicken breast, too.

Turkey Bacon Chunky Guacamole, p. 99

SWAP IN BETTER INGREDIENTS Chef Ronaldo Linares breaks down the healthier Cuban sandwich. You can apply these tricks for swapping and subbing to different recipes, too.

 “Traditional white bread is way too

 “A mix of salty ham and a fay pork

high in carbs. Still, a good Cuban should have bread with a crunch.” Check out sandwich thins for a diabetes-friendly health hack— Diabetic Living® uses them oen in sandwich recipes to cut carbs.

cut traditionally make up a Cuban sandwich. I use lean deli turkey and ham to keep calories low, but the sandwich is still flavorful. Ask the deli counter for help finding low-sodium varieties.”

 “Most Cuban sandwiches are

 “Swiss cheese is another traditional ingredient. Look for one with lower sodium and fat content.”

slathered in buer. I spread avocado on mine for flavor and creaminess loaded with heart-health benefits.”

 “For even more flavor and nutrition, I add a salad. This one has tomato, arugula, red onion, cucumber, and cilantro dressed with fresh lime juice and cracked black pepper—delicious as a side or another sandwich layer.”

Ronaldo’s Cuban Sandwich, p. 91

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Black Beans and Rice, p. 98

DON’T RELY ON SALT 66

Dry seasonings and fresh herbs amp up flavor without excess salt. Linares’ black beans and rice are cooked in onion, garlic, dried oregano, cumin, and bay leaves, then sprinkled with fresh cilantro or oregano.

HEALTHY SHOULD BE EASY Linares recommends simplifying prep work so in a time crunch, you won’t rely on unhealthy quick fixes, such as adding salt or too much fat. Buy prepped produce or spice blends, such as the chili powder in this Cilantro-Watermelon Salad, if you need to simplify a recipe. Another prep tip we love: Cook once, eat all week. Big batches of this salad will make a side today and a snack or breakfast dish tomorrow.

Cilantro-Watermelon Salad, p. 99

HEALTHY IN A HURRY

Better Than

t u o e k Ta 20

minutes

We’ve made over Asian takeout favorites with less carbs and sodium. Even beer? They'll be on the table faster than delivery.

We love the subtle sweetness of Roland Lite Coconut Milk. Use Gourmet Garden Thai Stir-In Seasoning Paste to add fresh flavor without excess sodium to any dish.

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Thai Pork Stir-Fry In a bowl stir together ½ cup canned light coconut milk and 1 Tbsp. each flour and Thai stir-in seasoning paste. In a 10-inch nonstick skillet heat 1 tsp. olive oil over medium-high. Add one 14-oz. pkg. thawed and drained frozen sweet pepper and onion stir-fry mix; cook, covered, 4 minutes or until crisp-tender, stirring occasionally. Remove vegetables. Add 2 tsp. olive oil and 1 lb. boneless pork loin roast, trimmed and cut into thin bite-size strips, to skillet. Cook and stir over mediumhigh 4 minutes. Return vegetables to skillet; add coconut milk mixture. Cook and stir until sauce is thick. Serve with 1 ⅓ cups hot cooked brown rice. SERVES 4 (¾ cup meat mixture + ⅓ cup rice each) CAL 281, FAT 8 g (3 g sat. fat), CHOL 74 mg, SODIUM 321 mg, CARB 23 g (2 g fiber, 4 g sugars), PRO 26 g

20

20

minutes

minutes

Korean Beef Lettuce Rolls

Asian Noodles with Chicken Sausage

In a 12-inch skillet cook 12 oz. extra-lean ground beef over medium-high until browned. Stir in 3 Tbsp. reducedsodium soy sauce, 1 Tbsp. chili garlic sauce, and 2 tsp. sesame oil. Stir in one 12-oz. pkg. broccoli slaw. Cook and stir over medium 2 to 3 minutes or just until slaw is wilted. Spoon meat mixture onto 8 large leuce leaves. Top with ½ cup chopped sweet pepper and, if desired, drizzle with additional chili garlic sauce. Fold bottom edge of lettuce over filling. Fold in opposite sides and roll up. Secure with toothpicks.

Prepare 4 oz. brown rice noodles according to package directions; drain. Drain one 20-oz. can juice-pack pineapple chunks, reserving 3⁄4 cup of the juice. Stir into reserved juice 1 tsp. cornstarch and ½ tsp. each ground ginger and crushed red pepper. Coat a 10-inch nonstick skillet with nonstick cooking spray; heat over medium-high. Add 4 cooked chicken sausage links, sliced, and one 6-oz. pkg. fresh pea pods; cook 4 minutes or until sausage is browned and pea pods are crisp-tender, stirring occasionally. Add pineapple juice mixture. Cook and stir over medium until thick. Stir in 1 cup of the pineapple (save the remaining pineapple for another use). Stir in noodles.

Always look for the green cap. La Choy Lite Soy Sauce adds plenty of tasty takeout flavor but with less sodium than traditional soy sauce. It packs a serious umami punch, so a lile goes a long way.

To get dinner on the table fast, use quickcooking Annie Chung’s Brown Rice Noodles and precooked Simply Balanced Chicken Sausage. We love the spinach and garlic flavor.

SERVES 4 (2 leuce cups each) CAL 185, FAT 7 g (2 g sat. fat), CHOL 53 mg, SODIUM 567 mg, CARB 9 g (3 g fiber, 5 g sugars), PRO 21 g

EXPERT TIP Replace tortillas with leuce wraps to cut carbs. Try sturdy Bibb leuce. —Caitlyn Diimig, RD, Diabetic Living® Food Editor

SERVES 4 (1 ⅓ cups each) CAL 253, FAT 4 g (1 g sat. fat), CHOL 50 mg, SODIUM 523 mg, CARB 41 g (2 g fiber, 13 g sugars), PRO 16 g

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Store ripe bananas in the fridge so they last longer. The peel turns brown, but the banana will still be tasty.

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Pineapple, Kiwi, and Honeydew Ice Pops There’s a whole serving of fruit in this tropical treat. Yes, really! It’s loaded with pineapple, kiwifruit, and honeydew—all the good vacation vibes without the airfare. We love the layered look, but you can puree the ingredients instead if you like. See recipe, p. 96

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BerryLemon Ice Pops Look at these bright beauties! Such deep color and a sweet-tart taste. For a smoother pop, press the blended berries through a fine-mesh sieve first. See recipe, p. 93

Iced Coconut Latte Pops We dare you to find an iced coffee that’s this carb-smart and tasty. A touch of sugar and light coconut milk sweeten this lae-on-a-stick. Use cold brew or chilled hotbrew coffee. See recipe, p. 94

Peaches and Cream Ice Pops Cool off on sun-drenched summer days with this dessert duo. Sugar-free vanilla instant pudding mix keeps it low-carb but still extra creamy. You can sub in Greek yogurt, but it will have a slightly icier texture. Fresh peach chunks and a drizzle of honey add just enough sweetness. See recipe, p. 96

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Strawberry Swirl Cheesecake Ice Pops Get the decadence of cheesecake for far fewer calories with this sweet finale you’ll savor. We make it light using sugar-free instant pudding mix and real strawberries. See recipe, p. 96

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Creamy Chocolate Pie Ice Pops Iced. Chocolate. Pie. Will you ever enjoy a beer dessert on a hot day? And you won’t even break the calorie bank, thanks to sugar-free instant pudding mix, unsweetened almond milk, and light whipped dessert topping. See recipe, p. 93

Watermelon, Raspberry, and Lime Ice Pops Take a momentary beach retreat with these fragrant ice pops made with just four ingredients — three of which are fresh fruit. See recipe, p. 96

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FreshSqueezed Lemonade Ice Pops This icy twist on a summer classic uses just five ingredients—real lemon juice among them. Add a squeeze of red food coloring if you prefer your lemonade pink. See recipe, p. 94

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VICTORIES

Taking a Different Path

writing Bailey McGrath; photos Matt Dixon (Reprinted with permission from Omaha World-Herald.)

Poor health put Harry Baulisch in jeopardy. He reclaimed his body—and his life— through cycling.

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A

At age 50, Harry Baulisch wasn’t the confident guy he’d always been. A heart attack that deadened half his heart function, nearly putting him in assisted living, left him feeling scared, limited, and sluggish. A few years later, he battled colon cancer. “I was just kind of surviving,” Baulisch says. But a type 2 diabetes diagnosis in 2014 shocked him into action. “It was like getting hit upside the head,” he says. “I took a serious look at what diabetes could do to me if I left it unchecked.” The next day, Baulisch met with a dietitian and health coach and began logging activity, food, and blood sugars to chip away at his 40-inch waist. It helped, but it wasn’t until he moved back to his hometown of Omaha in 2015 and took up his childhood hobby of bicycling that things really changed.

“It’s about a lifestyle change. It’s doing something that benefits me both physically and mentally.” Baulisch began biking 15 miles at a time, treks that left him too sapped to get off the couch the rest of the day.

BAULISCH TALKS PEDALING Find the right fit

Then he started hanging around a local bike shop, where he connected with other cyclists—most of them 20–30 years younger—and joined their rides. When Baulisch fell behind, his new friends cheered him on. When his blood sugar was low, they stopped while he grabbed a snack. Soon a daily ride became something he never wanted to miss— pedaling 30 miles or more. “I stepped into a group of people who, without knowing it, became my support system to enable me to go out and do things that I didn’t know I could do,” he says. As Baulisch improved his endurance and cardiovascular health, the pounds dropped. Now, having finished 100-mile races, it’s normal for the 63-year-old to pedal 50 miles in a day. “To have a heart condition and diabetes and pedal without fear? To come home and not be worn out, tired, or have aches and pains? I experience these every day,” Baulisch says. “And I’m really grateful.”

“Visit a local bicycle shop. Shop around until you find one you feel comfortable dealing with. Ask questions to determine what size bike and type of saddle you need. You should ‘fit’ your bike. Pain and discomfort are signs of an improperly fied bicycle.”

Start small “Go slow at first. Enjoy the experience of pedaling. Take notice of everything around you that you missed while driving 50–60 mph. Once you have confidence, go out and pedal a few miles a day for a week. Slowly increase distance and time. Learn to explore your neighborhood, city, and state.”

Stay positive “It’s not how fast you go or how far you go—it is important that you go.”

Biker buddies “Seek others who ride bikes, participate in your local biking community, and be ready to meet some fascinating people you may have otherwise overlooked.”

DiabeticLivingOnline.com

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DIET TRENDS

Drastic, shortterm “cleansing” is trendy. We have the scoop on how extreme detox diets can affect diabetes management.

86

PWDs need a consistent, healthy lifestyle.

Drink only lemon water, maple syrup, and cayenne pepper. Just have this green smoothie three times a day. No grains, no sugars, no beans. Cleanse and detox diets sell—that’s why you see so many in the headlines and on bookshelves. They come in as many variations as there are diet “experts.” Most promise to clean out your digestive system and help you drop weight—fast. But you’ll notice a trend with hard-core cleanses: They lack scientific research to support their claims (in fact, a 2014 review in the Journal of Human Nutrition and Dietetics found no evidence that detox diets help with weight loss at all). And how safe are they for people with type 2 diabetes? Short answer: not very.

writing Debbie Koenig; photo Getty Images

Should I Cleanse?

The diabetes effect When you have diabetes, “Medication and diet and exercise all work together,” says Toby Smithson, M.S., RDN, LD, CDE, a spokesperson for the Academy of Nutrition and Dietetics. By going on a drastic cleanse, such as an all-juice diet, you’re taking balance out of that equation. Changing your diet can cause negative side effects such as nausea, dehydration, and shakiness. Plus, Smithson says, your meds could work differently because you’re providing your body with less or different fuel than it’s used to. And then there’s the fact that nobody really needs to cleanse because our bodies do it naturally. “Detoxification occurs 24/7 by various organs in our bodies—they’re great machines,” Smithson says.

Clean those pipes safely OK, so you’ll skip the trendy cleanses. But what if you still want to feel refreshed and jump-start your weight loss? Maybe break a few bad eating habits along the way? “Do it in a manner that’s going to keep your blood sugar stable,” says Joanne Rinker, M.S., RD, LDN, CDE, FAADE, senior director for community health improvement at Population Health Improvement Partners in Morrisville, North Carolina, and an AADE spokesperson.

VEGGIES

them toward a two-day, modified version based on whole foods: fruits and vegetables paired with unprocessed vegetable dried beans, for example. So one meal could be grilled asparagus and mushrooms and spicy black beans with a side of mixed berries; a handful of almonds for a snack later. This whole-food approach

FRUITS

DRIED BEANS

modified version of a cleanse, make sure you’re seing yourself up for success: RAW NUTS

much of the weight you’ll lose will be fluid, and you don’t want to risk dehydration. You’ll be running to the bathroom more often, and after two days your pipes should be clearer—without the risk that comes with a drastic cleanse.

CHECK, PLEASE! Talk to your diabetes care team before making changes to your eating plan. If you get the OK, check blood sugar two hours after meals to see the effects the diet modification is having and to adjust for the next meal.

You can enjoy all of these whole foods on a d-friendly “cleanse.” Really!

your 1 Control environment.

Si through your cupboards and fridge, and toss highly processed foods, which are harder to digest. If it’s not there, you can’t eat it. Then fill your grocery cart with whole foods.

2 Be mindful.

Think about every bite that goes into your mouth. “Don’t eat in front of the TV or out of the bag. They’re terrible for portion control,” Smithson says. Look at restaurant menus online ahead of time to avoid impulsive orders.

3 Be commied. We’re not talking about just two days here. “If you just go back to the same diet you were eating before, your body will go back to the same results in terms of blood sugar,” Rinker says. Plus, you’ll likely gain back any weight you lost.

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87

TELL ME WHAT TO EAT Breakfast: ½ cup plain low-fat Greek yogurt + 1 cup blueberries + 2 Tbsp. unsalted slivered almonds

Midmorning snack: 1 serving StrawberryBanana FroYo Cups (p. 70) + 2 Tbsp. lightly salted cashews

Lunch: 1 serving Barbecue Chicken Salad (p. 92) + 1 cup cubed watermelon

Afternoon snack: 1 serving Tropical Popcorn (p. 49)

Dinner:

Dessert: 1 serving Pineapple, Kiwi, and Honeydew Ice Pops (p. 96)

1,500

- CALORIE

1-DAY MEAL PLAN

This meal plan features low-carb, produce-packed versions of some summertime favorites—think barbecue, tacos, and ice cream. Enjoy! 88

*This meal plan is ideal for people trying to lose weight. You might need more calories than this. Ask your health care team for a caloric goal that’s right for you.

TOTAL CAL 1,516, FAT 42 g (9 g sat. fat), CHOL 161 mg, SODIUM 1,028 mg, CARB 182 g (29 g fiber, 91 g sugars), PRO 86 g

writing Caitlyn Diimig, RD; photos Marty Baldwin; styling Jennifer Peterson

1 serving Fish Tacos with RaspberryPineapple Salsa (p. 99) + 1 serving Lady’s Sangria (p. 94)

DIABETIC LIVING

SUMMER RECIPES

RECIPE GUIDE High-standards testing This seal assures you that every recipe in this issue has been tested by the Better Homes & Gardens® Diabetic Living® Test Kitchen. This means each recipe is practical, reliable, and meets our high standards of taste appeal.

SAVVY INGREDIENT SWAPS

Many recipes are adaptable. You can substitute what you have on hand for what you’re missing. Here are a few swap ideas to get you started.

BUTTERHEAD

SPINACH

If you don’t have buerhead leuce, use . . .

This green has a so and tender texture, too.

EDAMAME

PEAS

If you can’t find these frozen soybeans, then try . . .

They have similar carb and fiber content.

CRANBERRIES

RAISINS

This dried fruit adds a hint of sweetness, but so do . . .

Just be sure to use unsweetened varieties.

WHITE WINE VINEGAR

RED WINE VINEGAR

This vinegar adds bright flavor, but so does . . .

Use a lile less—it has a more pronounced flavor.

GARBANZO BEANS

GREAT NORTHERN

This white bean has a hardy texture, but try . . .

Also a white bean, it has a neutral flavor.

WALNUTS

PECANS

These nuts contain healthy fats, but you can use . . .

These nuts have a similar hey crunch.

FETA

GOAT CHEESE

This briny cheese adds bold flavor, but so does . . .

It also has a tangy and salty flavor.

Inside our recipes We list precise serving sizes to help you manage portions. Test Kitchen tips and sugar subs are listed after recipe directions. If kitchen basics such as ice, salt, black pepper, oil, and nonstick cooking spray are not listed in the ingredients list, then they are italicized in the directions.

Nutrition information Nutrition facts per serving are noted with each recipe; ingredients listed as optional are not included. When ingredient choices appear, we use the first one to calculate the nutrition analysis.

Key to abbreviations CAL = calories CARB = carbohydrate CHOL = cholesterol PRO = protein

Test Kitchen tip: Handling hot chile peppers Chile peppers can irritate skin and eyes. Wear gloves when working with them. If your bare hands do touch the peppers, wash your hands with soap and warm water.

BEEF & PORK

PER SERVING (2 cups each) CAL 246, FAT 8 g (2 g sat. fat), CHOL 7 mg, SODIUM 351 mg, CARB 34 g (6 g fiber, 10 g sugars), PRO 11 g

Steak and Chimichurri Salad SERVES 4

Potato and Sprouts Salad with Lemon Vinaigrette

TOTAL 45 min.

Ronaldo’s Cuban Sandwich

SERVES 6

SERVES 6

TOTAL 40 min.

TOTAL 25 min.

12 oz. red potatoes, quartered 1 recipe Lemon Vinaigree 6 slices lower-sodium, less-fat bacon, chopped 2 cups fresh Brussels sprouts, trimmed and quartered ½ cup thinly sliced red onion 1 cup chopped tomatoes 1 15-oz. can no-salt-added garbanzo beans, rinsed and drained 6 cups torn buerhead leuce ½ cup crumbled reduced-fat feta cheese (2 oz.) 1. In a saucepan cook potatoes in boiling water, covered, 12 minutes or until tender; drain. 2. Meanwhile, prepare Lemon Vinaigree. In a 10-inch skillet cook bacon over medium until crisp, stirring occasionally. Drain bacon on paper towels; discard drippings. 3. Add Brussels sprouts, onion, and 3 Tbsp. water to skillet. Cook, covered, over medium 5 minutes or until sprouts are crisp-tender, stirring occasionally. Add tomatoes. Cook, uncovered, 2 to 3 minutes or until tomatoes are soened, stirring occasionally. Remove from heat. Stir in potatoes and beans. 4. Top leuce with potato mixture; drizzle with vinaigree. Sprinkle with cheese and the reserved bacon.

3 multigrain thin sandwich rolls, split 4 oz. sliced reduced-fat Swiss cheese 1 avocado, halved, pied, peeled, and sliced 4 oz. deli-style sliced lowersodium cooked turkey 4 oz. deli-style sliced lowersodium cooked ham 1½ cups baby arugula 1 medium roma tomato, sliced ⅓ cup sliced red onion ⅓ cup sliced cucumber 2 Tbsp. snipped fresh cilantro 2 Tbsp. lime juice ¼ tsp. cracked black pepper 1. Preheat oven to 350°F. Line a baking sheet with parchment paper. Place roll halves, cut sides up, on the prepared baking sheet. Layer three of the roll halves with cheese, avocado, turkey, and ham. Bake 10 minutes or until rolls are toasted and cheese is melted. 2. In a medium bowl combine the remaining ingredients. Arrange mixture on roll halves. Top with the remaining roll halves. Cut sandwiches in half. PER SERVING (½ sandwich each) CAL 192, FAT 8 g (2 g sat. fat), CHOL 30 mg, SODIUM 407 mg, CARB 17 g (5 g fiber, 3 g sugars), PRO 17 g

12 1 4 4

oz. beef flank steak, trimmed recipe Chimichurri Sauce cups fresh arugula oz. whole grain bagueestyle French bread, cut into ½-inch cubes and toasted 1½ cups cherry tomatoes, halved ½ cup thinly sliced red onion 1. Make shallow diagonal cuts at 1-inch intervals in a diamond paern on both sides of meat. Sprinkle with ¼ tsp. each salt and black pepper. Let stand 5 minutes. Prepare Chimichurri Sauce. 2. Grill meat, covered, over medium 13 to 18 minutes or until desired doneness (145°F for medium rare), turning once. Brush with 2 Tbsp. of the sauce during the last 5 minutes. 3. In a large bowl combine arugula, bread, tomatoes, onion, and the remaining sauce; toss gently to coat. 4. Thinly slice meat across the grain. Divide arugula mixture among plates and top with meat.

Chimichurri Sauce In a blender combine ¾ cup each firmly packed fresh parsley and cilantro; ¼ cup lime juice; 2 Tbsp. red wine vinegar; 1 Tbsp. each olive oil and water; 3 cloves garlic, minced; and ¼ tsp. each salt and crushed red pepper. Cover; pulse until nearly smooth. Tip To toast bread cubes, spread

Lemon Vinaigrette In a screw-top

bread in a 15×10-inch baking pan. Bake in a 350°F oven 10 minutes or until golden, stirring once.

jar combine ⅓ cup lemon juice, 2 Tbsp. each olive oil and honey, 2 tsp. Dijon-style mustard, and ⅛ tsp. salt. Cover and shake well.

PER SERVING (1¾ cups each) CAL 284, FAT 12 g (4 g sat. fat), CHOL 49 mg, SODIUM 514 mg, CARB 22 g (2 g fiber, 3 g sugars), PRO 23 g

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CHICKEN

Barbecue Chicken Salad

5. Meanwhile, for dressing, in a small bowl combine ranch dressing, barbecue sauce, and vinegar. 6. Place romaine in a shallow bowl. Slice chicken. Top romaine with corn, tomatoes, chicken, and beans. Sprinkle with queso fresco and serve with dressing. PER SERVING (1 ¾ cups salad + 3 ¾ oz. chicken + about 1 Tbsp. dressing each) CAL 347, FAT 11 g (2 g sat. fat), CHOL 80 mg, SODIUM 435 mg, CARB 31 g (8 g fiber, 6 g sugars), PRO 33 g

Grilled Portobello-Chicken Row Salad SERVES 4 TOTAL 45 min.

SERVES 4 TOTAL 35 min.

1 to 1¼ lb. skinless, boneless chicken breast halves 2 tsp. chili powder 1 tsp. dried oregano, crushed 1 tsp. dried thyme, crushed ¼ tsp. salt ¼ tsp. black pepper 1 Tbsp. canola oil 1 15-oz. can no-salt-added black beans, rinsed and drained 1 cup frozen whole kernel corn, thawed 2 Tbsp. light ranch salad dressing 2 Tbsp. reduced-sodium barbecue sauce 1 Tbsp. white wine vinegar 4 cups chopped romaine leuce 1 cup cherry tomatoes, halved ¼ cup crumbled queso fresco or shredded Monterey Jack cheese (1 oz.) 1. Using the flat side of a meat mallet, flaen chicken between two pieces of plastic wrap until ½ inch thick. 2. Preheat broiler. Line a 15×10-inch baking pan with foil. In a bowl stir together the next five ingredients (through pepper). Sprinkle half of the spice mixture over chicken; rub in with your fingers. 3. Combine oil and the remaining spice mixture; stir half into beans. 4. Place chicken on one side of prepared pan. Add corn to other side of pan and drizzle with the remaining oil-spice mixture. Broil 4 to 5 inches from heat 6 to 8 minutes or until chicken is done (165°F), turning chicken and stirring corn once.

92

Chicken-Broccoli Salad with Buttermilk Dressing SERVES 4 HANDS ON 20 min. TOTAL 2 hr. 20 min.

3 cups shredded broccoli slaw mix 2 cups coarsely chopped cooked chicken breast ½ cup dried cherries ⅓ cup thinly sliced celery ¼ cup finely chopped red onion ⅓ cup buermilk ⅓ cup light mayonnaise 1 Tbsp. honey 1 Tbsp. cider vinegar 1 tsp. dry mustard ½ tsp. salt ⅛ tsp. black pepper 4 cups fresh baby spinach 1. In a large bowl combine the first five ingredients (through onion). In a small bowl whisk together the next seven ingredients (through pepper). Pour buermilk mixture over broccoli mixture; toss gently. Cover and chill 2 to 24 hours. 2. Before serving, add spinach and toss gently. PER SERVING (2 cups each) CAL 278, FAT 7 g (2 g sat. fat), CHOL 64 mg, SODIUM 585 mg, CARB 29 g (4 g fiber, 19 g sugars), PRO 26 g

1 tsp. fennel seeds, finely crushed 1 tsp. dried Italian seasoning, crushed ⅛ to ¼ tsp. crushed red pepper 12 oz. skinless, boneless chicken breast halves 4 large fresh portobello mushrooms, stemmed 1 medium red sweet pepper, halved and seeded 1 small red onion, cut into 1-inch slices 3 cups torn kale 3 cups torn romaine leuce ½ cup shredded reduced-fat Italian-blend cheeses (2 oz.) ½ cup torn fresh basil ½ cup light balsamic vinaigree dressing 2 Tbsp. chopped walnuts, toasted 1. In a bowl combine fennel seeds, Italian seasoning, and crushed red pepper. Sprinkle over chicken. 2. Grill chicken, mushrooms, sweet pepper, and onion, covered, over medium until chicken is done (165°F) and vegetables are tender (8 to 12 minutes for vegetables, 15 to 18 minutes for chicken). Cut chicken, mushrooms, and pepper into bite-size strips. Coarsely chop onion. 3. On a plaer arrange rows of chicken, vegetables, greens, cheese, and basil. Drizzle with dressing and sprinkle with walnuts.

Tip To finely crush fennel seeds, use a spice grinder or clean coffee grinder. PER SERVING (2 ½ cups salad + 2 Tbsp. dressing each) CAL 266, FAT 9 g (2 g sat. fat), CHOL 70 mg, SODIUM 392 mg, CARB 18 g (5 g fiber, 10 g sugars), PRO 29 g

3. Serve half the sauce mixture over zucchini noodles. Use remaining sauce for another use.

Tip To freeze leover sauce,

Zoodles with Tomato Sauce and Chicken Sausage SERVES 6 HANDS ON 30 min. TOTAL 1 hr. 45 min.

4 lb. tomatoes, cored, halved, and seeded 1 red sweet pepper, halved and seeded 1 cup chopped sweet onion 4 cloves garlic, minced 1 Tbsp. white balsamic vinegar ¼ tsp. salt ¼ tsp. black pepper 9 oz. cooked chicken sausage links, bias-sliced ½ cup chopped fresh basil, Italian parsley, and/or oregano 12 cups cooked zucchini noodles

transfer to a freezer container and freeze up to 3 months. To serve, thaw overnight in refrigerator. Reheat in a saucepan over medium-low until heated through. PER SERVING (⅓ cup sauce + 2 cups vegetable noodles + ½ sausage link each) CAL 192, FAT 7 g (2 g sat. fat), CHOL 30 mg, SODIUM 307 mg, CARB 23 g (6 g fiber, 16 g sugars), PRO 13 g

DESSERTS & DRINKS

Berry-Lemon Ice Pops SERVES 8 HANDS ON 15 min.

1. Preheat broiler. Brush tomatoes and sweet pepper with 1 Tbsp. olive oil. Arrange half of the tomatoes and the sweet pepper, cut sides down, in a 15×10-inch baking pan. Broil 5 to 6 inches from heat 8 to 10 minutes or until charred. Remove from pan; wrap sweet pepper in foil. Repeat with the remaining tomatoes. Let tomatoes and sweet pepper stand 20 minutes or until cool enough to handle. Peel off and discard skins. Chop tomatoes and sweet pepper. 2. In a large saucepan heat 1 Tbsp. olive oil over medium. Add onion and garlic; cook 5 minutes or until onion is tender, stirring occasionally. Add tomatoes, sweet pepper, vinegar, salt, and black pepper. Bring to boiling; reduce heat. Simmer, uncovered, 20 to 30 minutes or until tomatoes have broken down and mixture is slightly thick, stirring occasionally. Cool slightly. Blend with an immersion blender until smooth. Return to saucepan; add chicken sausage. Heat through. Stir in herbs.

TOTAL 8 hr. 15 min.

1 lemon 1½ cups fresh strawberries, quartered 1½ cups fresh blueberries ¼ cup water ¼ cup honey 1. Remove 2 tsp. zest and squeeze 1 Tbsp. juice from lemon. In a blender combine the berries and the water. Cover; blend until nearly smooth. Add lemon zest, juice, and honey. Cover; blend until combined. 2. Pour mixture into ice-pop molds; insert sticks. Or pour into eight 3-oz. paper cups; cover each cup with foil. Cut a small slit in foil; insert wooden sticks. Freeze overnight or until firm.

Tip For a smoother pop, blend fruit as directed in Step 1, then press through a fine-mesh sieve to remove seeds. Continue as directed. PER SERVING (1 ice pop each) CAL 53, FAT 0 g, CHOL 0 mg, SODIUM 1 mg, CARB 14 g (1 g fiber, 12 g sugars), PRO 0 g

Creamy Chocolate Pie Ice Pops SERVES 9 HANDS ON 15 min. TOTAL 8 hr. 15 min.

1 4-serving-size pkg. fat-free, sugar-free, reduced-calorie chocolate instant pudding mix 2 cups unsweetened almond milk or fat-free milk 1 cup frozen light whipped topping, thawed 1 oz. dark chocolate, melted 1 Tbsp. crushed graham crackers 1. In a medium bowl whisk together pudding mix and milk 2 to 3 minutes or until thick. Fold in whipped topping. 2. Spoon mixture into ice-pop molds; insert sticks. Or spoon into nine 3-oz. paper cups; cover each cup with foil. Cut a small slit in foil; insert wooden sticks. Freeze overnight or until firm. 3. Unmold pops. Working with one pop at a time, drizzle with melted chocolate and immediately sprinkle with graham crackers. PER SERVING (1 ice pop each) CAL 60, FAT 3 g (1 g sat. fat), CHOL 0 mg, SODIUM 175 mg, CARB 9 g (1 g fiber, 2 g sugars), PRO 1 g

CHOCOLATE SWAP For rich flavor, choose a dark chocolate with at least 70% cacao. You can use milk chocolate, but it has slightly more carbs.

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Fresh-Squeezed Lemonade Ice Pops

Iced Coconut Latte Pops

Lady’s Sangria

SERVES 8

SERVES 8

SERVES 7

HANDS ON 20 min.

HANDS ON 15 min.

HANDS ON 15 min.

TOTAL 8 hr. 20 min.

TOTAL 2 hr. 15 min.

TOTAL 8 hr. 15 min.

1¾ cups water ¾ cup lemon juice ⅓ cup sugar* Red food coloring (optional) Snipped fresh basil or small fresh basil leaves (optional) 1. In a bowl combine the water, lemon juice, and sugar, stirring until sugar is dissolved. If desired, tint with food coloring and add basil (it will float on top initially). 2. Pour mixture into ice-pop molds; insert sticks. Or pour into seven 3-oz. paper cups; cover each cup with foil. Cut a small slit in foil; insert wooden sticks. Freeze 1 ½ hours, gently shaking molds or stirring mixture in cups to disperse basil. Freeze overnight or until firm. PER SERVING (1 ice pop each) CAL 43, FAT 0 g, CHOL 0 mg, SODIUM 2 mg, CARB 11 g (0 g fiber, 10 g sugars), PRO 0 g

¾ cup canned unsweetened light coconut milk ⅓ cup sugar* 2 cups brewed coffee, chilled 1. In a bowl stir together ½ cup of the coconut milk and 1 Tbsp. of the sugar. Pour into ice-pop molds or eight 3-oz. paper cups. Freeze 2 hours or until firm. 2. In a medium bowl combine coffee, the remaining ¼ cup coconut milk, and the remaining sugar. Pour over coconut layer. Insert sticks into molds. If using paper cups, cover each cup with foil. Cut a small slit in foil; insert wooden sticks. Freeze overnight or until firm. PER SERVING (1 ice pop each) CAL 52, FAT 2 g (2 g sat. fat), CHOL 0 mg, SODIUM 20 mg, CARB 9 g (0 g fiber, 8 g sugars), PRO 0 g

1 ¾ ½ ¼ 1 2 1

750-ml bole white wine cup orange juice cup triple sec cup gold rum Tbsp. lime juice cups chopped peaches cup raspberries, slightly crushed 1 cup chopped apple 2 cups diet tonic water

1. In a pitcher combine the first five ingredients (through lime juice). Stir in peaches, raspberries, and apple. Cover and chill at least 2 hours. Before serving, stir in tonic water. PER SERVING (1 ¼ cups each) CAL 194, FAT 0 g, CHOL 0 mg, SODIUM 14 mg, CARB 18 g (2 g fiber, 9 g sugars), PRO 1 g

*Sugar Sub Choose Splenda Granular. Follow package directions

*Sugar Sub sugar sub for this recipe.

ICE POP MOLDS: What We Recommend

1 94

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Mastrad Silicone, $11; target.com

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Tovolo Groovy, $12; target.com

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Peaches and Cream Ice Pops SERVES 16 HANDS ON 20 min. TOTAL 8 hr. 20 min.

2 4-serving-size pkg. fat-free, sugar-free, reduced-calorie vanilla instant pudding mix 3½ cups fat-free milk 3 cups chopped fresh peaches 2 Tbsp. honey 1 cup frozen light whipped topping, thawed 1. In a medium bowl whisk together pudding mixes and milk 2 minutes or until slightly thick. Stir in peaches and honey. Fold in whipped topping. 2. Pour into ice-pop molds; insert sticks. Freeze overnight or until firm. Let stand 10 minutes before serving.

1. In a bowl stir together the water and sugar until sugar is dissolved. In a blender combine pineapple and 1 Tbsp. of the sugar mixture. Cover; blend until smooth. 2. Pour into ice-pop molds or eight 5-oz. paper cups. Press kiwi slices down sides of molds or cups. Freeze 2 hours or until thick and slushy. 3. In a blender combine honeydew and the remaining sugar mixture. Cover; blend until smooth. Pour over pineapple layer. Insert sticks into molds. For paper cups, cover each cup with foil. Cut a small slit in foil; insert wooden sticks. Freeze overnight or until firm. PER SERVING (1 ice pop each) CAL 71, FAT 0 g, CHOL 0 mg, SODIUM 15 mg, CARB 18 g (2 g fiber, 15 g sugars), PRO 1 g

1. In a food processor or blender combine strawberries and sugar. Cover and process or blend until smooth. In a bowl whisk together pudding mix and milk 2 minutes or until thick. Fold in whipped topping. 2. Spoon pudding mixture into ice-pop molds or eight 5-oz. paper cups. Top with pureed strawberries; swirl slightly. In a small bowl combine graham crackers and melted buer; top strawberry layer. 3. Insert sticks into molds. If using paper cups, cover each cup with foil. Cut a small slit in foil; insert wooden sticks. Freeze overnight or until firm. PER SERVING (1 ice pop each) CAL 99, FAT 3 g (2 g sat. fat), CHOL 5 mg, SODIUM 197 mg, CARB 16 g (0 g fiber, 9 g sugars), PRO 2 g

*Sugar Sub Choose Splenda

*Sugar Sub Choose Splenda Sugar

Granular. Follow package directions to use 2 Tbsp. equivalent.

Blend. Follow package directions to use 2 Tbsp. equivalent.

PER SERVING WITH SUB Same as above, except CAL 60, CARB 15 g (12 g sugars)

PER SERVING WITH SUB Same as above, except CAL 95, CARB 15 g (7 g sugars)

PER SERVING (1 ice pop each) CAL 60, FAT 1 g (1 g sat. fat), CHOL 1 mg, SODIUM 173 mg, CARB 12 g (0 g fiber, 8 g sugars), PRO 2 g

Strawberry Swirl Cheesecake Ice Pops

Watermelon, Raspberry, and Lime Ice Pops SERVES 8

SERVES 8

HANDS ON 20 min.

HANDS ON 30 min.

TOTAL 8 hr. 20 min.

TOTAL 8 hr. 30 min.

Pineapple, Kiwi, and Honeydew Ice Pops SERVES 8 HANDS ON 25 min. TOTAL 8 hr. 25 min.

¼ 2 2 2

cup water Tbsp. sugar* cups cubed fresh pineapple fresh kiwifruits, peeled and cut into 16 slices 3½ cups cubed honeydew melon

96

1 cup chopped fresh or frozen strawberries, thawed 2 Tbsp. sugar* 1 4-serving-size pkg. fat-free, sugar-free, reduced-calorie cheesecake instant pudding mix 2 cups fat-free milk 1 cup frozen light whipped topping, thawed ⅓ cup crushed graham crackers 1 Tbsp. buer, melted

1 lime 3 cups chopped seedless watermelon ½ cup fresh raspberries 1 Tbsp. lime juice 1 cup lime fat-free yogurt 1. Remove 1 ½ tsp. zest and squeeze 1 Tbsp. juice from lime. In a blender combine lime juice, watermelon, and raspberries. Cover and blend until smooth. Press through a fine-mesh sieve into a 4-cup liquid measure; discard seeds. Stir in 1 tsp. of the lime zest. Pour into eight ice-pop

molds. Freeze 2 hours or until thick and slushy. 2. In a small bowl combine yogurt and the remaining ½ tsp. lime zest. Spoon onto watermelon layer. Insert sticks into molds. Freeze overnight or until firm.

Drizzle with vinaigree and, if desired, sprinkle with almonds. PER SERVING (1 salmon fillet + 2 cups salad + 2 Tbsp. vinaigree each) CAL 290, FAT 14 g (2 g sat. fat), CHOL 62 mg, SODIUM 286 mg, CARB 15 g (3 g fiber, 10 g sugars), PRO 25 g

PER SERVING (1 ice pop each) CAL 34, FAT 0 g, CHOL 1 mg, SODIUM 17 mg, CARB 8 g (1 g fiber, 6 g sugars), PRO 2 g

vinegar, 2 Tbsp. snipped fresh mint, 4 tsp. canola oil, ¼ tsp. salt, ¼ tsp. toasted sesame oil (optional), and ⅛ tsp. crushed red pepper. Toss dressing with fennel mixture. PER SERVING (2 ¼ oz. tuna + ¾ cup slaw + 1 cup spinach each) CAL 251, FAT 10 g (1 g sat. fat), CHOL 28 mg, SODIUM 435 mg, CARB 16 g (5 g fiber, 6 g sugars), PRO 22 g

FISH & SEAFOOD

Seared Sesame Tuna with Fennel-Apple Slaw SERVES 4 TOTAL 30 min.

Salmon Salad with OrangeBalsamic Vinaigrette SERVES 4 TOTAL 30 min.

3 3 2 2 4

oranges Tbsp. balsamic vinegar Tbsp. snipped fresh mint Tbsp. olive oil 4- to 5-oz. fresh or thawed frozen skinless salmon fillets, about 1 inch thick Nonstick cooking spray 8 cups mixed salad greens ¼ cup thinly sliced red onion 2 Tbsp. sliced almonds, toasted (optional) 1. For vinaigree, remove ¼ tsp. zest and squeeze 3 Tbsp. juice from one of the oranges. In a screw-top jar combine orange zest and juice, vinegar, mint, oil, and ⅛ tsp. salt. Cover and shake well. 2. Rinse salmon; pat dry. Sprinkle with ¼ tsp. each salt and black pepper. Coat both sides of salmon with cooking spray. Grill salmon, covered, over medium 8 to 12 minutes or just until salmon flakes, turning once. 3. Divide salad greens among plates. Peel and thinly slice the remaining 2 oranges. Top greens with oranges, onion, and salmon.

1 recipe Fennel-Apple Slaw 2 5- to 6-oz. fresh or thawed frozen tuna steaks, cut ¾ inch thick 2 egg whites ¼ cup panko bread crumbs 2 Tbsp. sesame seeds 1 Tbsp. canola oil 4 cups fresh spinach leaves 1. Prepare Fennel-Apple Slaw. Rinse tuna; pat dry. Sprinkle with ¼ tsp. each salt and black pepper. 2. In a shallow dish combine egg whites and 1 Tbsp. water. In another shallow dish combine bread crumbs and sesame seeds. Dip both sides of tuna in egg white mixture, then in crumb mixture to coat; press lightly. 3. In a 10-inch nonstick skillet heat oil over medium-high. Add tuna; cook 5 to 7 minutes or just until tuna flakes, turning once (tuna will be pink in center). Cut into ¼-inch slices. 4. Divide spinach among plates; top with slaw and tuna. If desired, sprinkle with reserved fennel tops.

Fennel-Apple Slaw Trim and core ½ of a medium fennel bulb, reserving feathery tops (if desired). Thinly slice fennel. In a bowl combine fennel, 1 cup thin strips green apple, ½ cup shredded carrot, and ⅓ cup thinly sliced radishes. For dressing, in a bowl whisk together 3 Tbsp. rice

Shrimp and Edamame Salad with Ginger Dressing SERVES 4 TOTAL 45 min.

½ cup frozen edamame 2 oz. dried radiatore or rotini pasta (1 cup) 6 oz. cooked medium shrimp, halved lengthwise 3 cups shredded napa cabbage 2 cups shredded romaine leuce 1 cup halved fresh strawberries ¾ cup julienned carrots ¾ cup fresh snow pea pods, trimmed, strings removed, and halved 1 small yellow sweet pepper, cut into thin bite-size strips ¼ cup thinly sliced green onions 3 Tbsp. rice vinegar 2 Tbsp. reduced-sodium soy sauce 1 Tbsp. canola oil 4 cloves garlic, minced 2 tsp. grated fresh ginger 1 tsp. toasted sesame oil ⅛ tsp. crushed red pepper 1. Cook edamame according to package directions; drain. Cook pasta according to package directions; drain. Rinse with cold water; drain again.

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2. In an extra-large bowl combine edamame, pasta, and the next eight ingredients (through green onions); toss to combine. 3. For dressing, in a screw-top jar combine the remaining ingredients. Cover and shake well. 4. Drizzle dressing over salad. Toss gently to coat. PER SERVING (2 cups each) CAL 224, FAT 6 g (1 g sat. fat), CHOL 80 mg, SODIUM 351 mg, CARB 25 g (5 g fiber, 8 g sugars), PRO 17 g

MEATLESS MAIN DISHES

cauliflower and 2 Tbsp. water to casserole. Microwave, covered, 6 to 9 minutes or until crisp-tender. Drain and cool slightly. 3. In a large bowl toss spinach and watercress with ¼ cup of the dressing; divide among plates. In a bowl combine asparagus, cauliflower, sweet pepper, and the remaining dressing; spoon over greens. Top with the remaining ingredients.

Dill-Shallot Dressing In a bowl combine ⅓ cup each minced shallots and white wine vinegar. Let stand, covered, 15 minutes. Stir in 2 Tbsp. light mayonnaise, 1 Tbsp. olive oil, 2 tsp. snipped fresh dill or ½ tsp. dried dill, 1 tsp. Dijon-style mustard, and ⅛ tsp. salt. PER SERVING (3 ½ cups salad + 3 Tbsp. dressing each) CAL 229, FAT 12 g (3 g sat. fat), CHOL 146 mg, SODIUM 485 mg, CARB 18 g (6 g fiber, 7 g sugars), PRO 14 g

tofu in egg whites, then in pretzel mixture to coat. 2. Coat a 12-inch nonstick skillet with nonstick cooking spray. Add 1 tsp. olive oil to skillet; heat over medium-high. Add tofu; cook 5 minutes or until crisp, turning once. 3. For dressing, in a screw-top jar combine 4 tsp. canola oil, the vinegar, mustard, honey, and ¼ tsp. salt. Cover and shake well. 4. On a plaer arrange spinach, apple, and cranberries. Top with tofu and serve with dressing. PER SERVING (1 ½ cups salad + 2 slices tofu + about 1 Tbsp. dressing each) CAL 259, FAT 12 g (2 g sat. fat), CHOL 0 mg, SODIUM 353 mg, CARB 26 g (5 g fiber, 12 g sugars), PRO 12 g

SIDES & SNACKS

Cauliflower Salad with Dill-Shallot Dressing SERVES 4 TOTAL 40 min.

1 recipe Dill-Shallot Dressing 12 oz. fresh asparagus, trimmed and cut into bite-size pieces 6 cups small cauliflower florets 3 cups fresh baby spinach 3 cups fresh watercress, tough stems trimmed and chopped 1 cup thin bite-size strips desired-color sweet pepper 3 hard-cooked eggs, peeled and sliced ¼ cup thinly sliced, pied black or Kalamata olives 1 oz. Parmesan cheese, shaved Cracked black pepper 1. Prepare Dill-Shallot Dressing. Meanwhile, in a 2-qt. casserole combine asparagus and 2 Tbsp. water. Microwave, covered, 2 to 4 minutes or until crisp-tender. Drain. 2. Place cauliflower, in batches, in a food processor. Cover; pulse until chopped into rice-size pieces. Add

98

Black Beans and Rice SERVES 18 HANDS ON 15 min.

Pretzel-Crusted Tofu Salad

TOTAL 1 hr. 55 min.

SERVES 4 TOTAL 25 min.

8 oz. extra-firm tub-style tofu, drained and cut into 8 slices 2 egg whites, beaten ¼ cup crushed unsalted pretzels 3 Tbsp. chopped pistachio nuts 2 Tbsp. white wine vinegar 2 Tbsp. horseradish mustard 1 tsp. honey 6 cups fresh baby spinach 1 cup thinly sliced apple ¼ cup dried cranberries 1. Pat tofu dry. Add egg whites to a shallow dish. In another shallow dish combine pretzels and pistachios. Dip

10 oz. dried black beans (1½ cups), rinsed and drained 5 cups water 1½ cups finely chopped red sweet peppers 1 cup finely chopped onion ½ cup dried long grain brown rice 3 bay leaves 12 cloves garlic, minced 1 Tbsp. avocado oil 2 tsp. dried oregano, crushed 1½ tsp. ground cumin 1¼ tsp. coarse sea salt ¼ cup snipped fresh cilantro 1. In a 6-qt. electric or stove-top pressure cooker combine beans and the water. Cover with lid; lock. Set

electric cooker on high; cook 20 minutes. Or bring stove-top cooker to pressure over mediumhigh according to manufacturer’s directions; reduce heat to maintain pressure. Cook 20 minutes. Remove from heat. Allow pressure to release. Unlock; remove lid. Drain beans, reserving cooking liquid. Return beans to cooker. 2. Add the next nine ingredients (through salt); stir in 1 cup of the reserved cooking liquid. Cover with lid; lock. Set electric cooker on high; cook 15 minutes. Or bring stove-top cooker to pressure over mediumhigh; reduce heat to maintain pressure. Cook 15 minutes. Remove from heat. Allow pressure to release. Unlock; remove lid. Top with cilantro. PER SERVING (⅓ cup each) CAL 89, FAT 1 g (0 g sat. fat), CHOL 0 mg, SODIUM 167 mg, CARB 16 g (3 g fiber, 1 g sugars), PRO 4 g

Cilantro-Watermelon Salad SERVES 6 TOTAL 20 min.

6 cups cubed watermelon 1 oz. queso fresco, crumbled 1 Tbsp. snipped fresh cilantro and/or mint 1 Tbsp. lime juice ¼ tsp. chili powder

Turkey Bacon Chunky Guacamole SERVES 18 TOTAL 30 min.

2 limes 3 avocados, halved, pied, peeled, and cut into ¼-inch pieces 6 tomatillos, husks removed and finely chopped 1 cup finely chopped onion 1 cup finely chopped cilantro ½ cup finely chopped fresh poblano chile pepper (tip, p. 90) 1 tsp. kosher salt 1 tsp. fennel seeds, crushed ¼ tsp. cracked black pepper 2 oz. sliced turkey bacon, finely chopped 1. Remove 1 tsp. zest and squeeze ¼ cup juice from limes. In a large bowl combine the lime zest and juice and the next eight ingredients (through black pepper). 2. Heat an 8-inch skillet over medium. Add bacon; cook and stir 5 minutes. Drain on paper towels. Stir bacon into avocado mixture. PER SERVING (¼ cup each) CAL 59, FAT 4 g (1 g sat. fat), CHOL 3 mg, SODIUM 137 mg, CARB 4 g (2 g fiber, 1 g sugars), PRO 2 g

1. In a large bowl combine all of the ingredients. If desired, let stand 5 minutes before serving to blend the flavors.

CHILE PEPPER SWAP PER SERVING (1 cup each) CAL 61, FAT 1 g (1 g sat. fat), CHOL 3 mg, SODIUM 40 mg, CARB 12 g (1 g fiber, 10 g sugars), PRO 2 g

Poblano chile peppers offer a smoky undertone to this dip. But you can use jalapeños, too. If you want more heat, chop up a serrano chile pepper.

BERRY SEASON Make this fun take on fruit salsa using high-fiber raspberries tonight.

Fish Tacos with Raspberry-Pineapple Salsa SERVES 4 HANDS ON 30 min. TOTAL 45 min.

3 limes 1 lb. fresh or thawed frozen tilapia, flounder, or cod fillets 2 tsp. chili powder ½ cup plain fat-free Greek yogurt 1 cup fresh raspberries, halved 1 cup chopped fresh pineapple 2 Tbsp. sliced green onion ½ of a fresh jalapeño chile pepper, seeded (if desired), and minced (tip, p. 90) 8 6-inch corn tortillas, warmed 1 cup finely shredded cabbage ¼ cup fresh cilantro leaves 1. Remove zest and juice from limes. Place fish in a resealable plastic bag set in a dish. For marinade, combine 2 Tbsp. lime juice, 1 Tbsp. canola oil, the chili powder, ¼ tsp. salt, and ⅛ tsp. black pepper; pour over fish. Seal bag; marinate in the refrigerator 15 to 30 minutes. 2. Combine yogurt and 2 Tbsp. lime juice. For salsa, in a bowl combine raspberries, pineapple, green onion, jalapeño, 1 tsp. lime zest, 1 Tbsp. lime juice, 1 Tbsp. canola oil, and ¼ tsp. each salt and black pepper. 3. Coat a 12-inch nonstick skillet with nonstick cooking spray; cook fish over medium-high 5 minutes per ½-inch thickness, turning once. Serve fish in tortillas with cabbage, salsa, yogurt mixture, and cilantro. PER SERVING (2 tacos each) CAL 337, FAT 11 g (1 g sat. fat), CHOL 57 mg, SODIUM 413 mg, CARB 34 g (7 g fiber, 9 g sugars), PRO 29 g DiabeticLivingOnline.com

99

RECIPE INDEX BEEF & PORK Korean Beef Leuce Rolls  ....... 69 Potato and Sprouts Salad with Lemon Vinaigree ....................... 91 Ronaldo’s Cuban Sandwich  .................................. 91 Steak and Chimichurri Salad  ............................................. 91 Thai Pork Stir-Fry  ...................... 68

CHICKEN Asian Noodles with Chicken Sausage  ............. 69 Barbecue Chicken Salad  ........... 92

Pretzel-Coated Tofu Salad recipe, p. 98

RECIPES IN THIS ISSUE From sides to mains, there’s a recipe for everyone in our Summer 2017 issue. Use our color-coded key to find recipes with less than 30 grams of carb, recipes that take less than 30 minutes to make, and gluten-free recipes (check ingredients lists to make sure the store-bought foods you use are gluten-free).

 30 g carb or less  30 minutes or less  Gluten-free

100

“I make an effort to eat less meat. And this crunchy tofu makes it easy (and tasty) to do!”

Chicken-Broccoli Salad with Buermilk Dressing  ................. 92 Grilled Portobello-Chicken Row Salad  ................................. 92

Watermelon, Raspberry, and Lime Ice Pops  ................... 96

FISH & SEAFOOD Fish Tacos with RaspberryPineapple Salsa ........................... 99 Salmon Salad with OrangeBalsamic Vinaigree  ............. 97 Seared Sesame Tuna with Fennel-Apple Slaw  ................... 97 Shrimp and Edamame Salad with Ginger Dressing  .................. 97

MEATLESS MAIN DISHES Cauliflower Salad with Dill-Shallot Dressing  ................ 98 Pretzel-Crusted Tofu Salad  ..... 98

Zoodles with Tomato Sauce and Chicken Sausage  ........................ 93

SIDES & SNACKS

DESSERTS & DRINKS

Avocado and Pesto Stuffed Tomatoes  .................................. 41

Banana-Split Sundae  ............... 70

Banana Energy Bites  ............... 70

Berry-Lemon Ice Pops  ............. 93

Barbecue Popcorn ................... 49

Citrus Custard  ............................ 102

Black Beans and Rice .............. 98

Creamy Chocolate Pie Ice Pops ........................................ 93

Cilantro-Watermelon Salad  ....................................... 99

Fresh-Squeezed Lemonade Ice Pops  ................. 94

Cranberry White Chocolate Popcorn ............... 49

Iced Coconut Lae Pops ......... 94

Dark Chocolate and Peanut Popcorn  .................... 48

Lady’s Sangria  .......................... 94 Peaches and Cream Ice Pops ..................................... 96 Pineapple, Kiwi, and Honeydew Ice Pops ................. 96 Strawberry-Banana FroYo Cups  ............................... 70

CAITLYN DIIMIG, RD Food Editor, Diabetic Living®

Strawberry Swirl Cheesecake Ice Pops  ................. 96

Italian Popcorn  ...................... 48 Salted Caramel and Pretzel Popcorn  ..................... 48 Sweet Chili Popcorn  ............. 49 Tropical Popcorn  ................... 49 Turkey Bacon Chunky Guacamole  .............. 99

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Orange Crush Citrus Custard STEP ONE: In a medium saucepan stir together ¼ cup sugar* and 2 Tbsp. cornstarch; stir in 2 ½ cups low-fat milk. Cook and stir over medium until thick and bubbly; cook and stir 2 minutes more. Remove from heat.

STEP THREE: To serve, layer custard and ¼ cup crushed shortbread cookies into dish(es). If desired, top with citrus slices and/or zest. SERVES 4 (⅔ cup each) CAL 212, FAT 7 g (3 g sat. fat), CARB 28 g (0 g fiber, 22 g sugars)

*Sugar Sub We do not recommend a sugar sub for this recipe.

Have a little dessert! Petite serving dishes help with portion control.

102

recipe Nancy S. Hughes; photo Marty Baldwin; styling Jennifer Peterson

STEP TWO: Stir 1 cup of the hot mixture into 4 egg yolks, lightly beaten; return to saucepan. Bring just to boiling; remove from heat. Stir in ½ tsp. orange zest and ½ tsp. vanilla. Pour into a large bowl; cover surface with plastic wrap. Chill at least 4 hours; do not stir.

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DIABASICS Your guide to the basics of managing diabetes writing Marsha McCulloch, M.S., RDN

BLOOD GLUCOSE Amount of sugar in the blood. Goals* for a person with diabetes (PWD):  Fasting: 80–130 mg/dl  Before a meal: 80–130 mg/dl  1–2 hours after a meal:

<180 mg/dl * ADA standards

D-Vocabulary Complications: Diabetes side effects such as damage to heart, blood vessels, eyes, nerves, and kidneys. Hypoglycemia: Low blood sugar. Occurs when blood glucose is lower than normal, generally <70 mg/dl. Signs: hungry, shaky, nervous, sweaty, dizzy, tired, confused.

COUNT CARBS 15 g CARB EQUALS:

A

C

B

A1C

Blood Pressure

Cholesterol

Average blood glucose. This blood test shows glucose control over the past few months. A normal A1C is <5.7%. Goal: Based on the individual. But in general, for a nonpregnant PWD: <7%

Force of the blood flow in your blood vessels. Goal: <140/90 mmHg

A waxy, fatlike substance in all body cells.

TIP: 2 out of 3 PWDs report having high blood pressure. Be sure to have yours checked at every health care visit.

1 small

 Total cholesterol Goal: <200 mg/dl  LDL (bad)

cholesterol Goal: <100 mg/dl  HDL (good) cholesterol Women: >50 mg/dl Men: >40 mg/dl

WHAT ARE CARBS? 1⁄

Hyperglycemia: Blood glucose above target range (see above). Early signs: blurry vision, frequent peeing, thirst, fatigue, headache. Advanced: fruity breath, dry mouth, breathless, stomach pain, nausea, vomiting, weakness, confusion, risk for coma.

KNOW YOUR NUMBERS

3 cup pasta

4 oz. juice

1. Sugars 2. Starches 3. Fibers Sugars and starches raise blood glucose. Some fibers can slow sugar absorption postmeal. General guidelines for carb consumption: Women: Meal 45–60 g; snack 15 g Men: Meal 60–75 g; snack 15–30 g

 Triglycerides A type of fat that circulates in the blood. Elevated levels increase risk for heart disease. Goal: <150 mg/dl

FIND SUPPORT. Your diabetes care team should include a doctor and certified diabetes educator (CDE). For a CDE near you: diabeteseducator.org/patient-resources/find-a-diabetes-educator

104

Diabetic Living® (ISSN 1552-8065), May (Summer) 2017, Volume 14, No. 2. Diabetic Living is published quarterly in February, May, August, and November by Meredith Corp., 1716 Locust St., Des Moines, IA 50309-3023. Periodicals postage paid at Des Moines, IA, and at additional mailing offices. SUBSCRIPTION PRICES: $19.97 per year in the U.S.; $23.97 (U.S. dollars) per year in Canada and overseas. POSTMASTER: Send all UAA to CFS. (See DMM 507.1.5.2). NON-POSTAL AND MILITARY FACILITIES: Send address corrections to Diabetic Living, P.O. Box 37508, Boone, IA 50037-0508. In Canada: Mailed under Publications Mail Sales Product Agreement No. 40069223. Canadian BN 12348 2887 RT. Return undeliverable Canadian addresses to: Diabetic Living, 2835 Kew Dr., Windsor, ON N8T 3B7. Diabetic Living is a registered trademark in the United States and Australia. © Meredith Corp. 2017. All rights reserved. Printed in the U.S.A.

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