Beating Diabetes: The First Complete Program Clinically Proven to Dramatically Improve Your Glucose Tolerance
by David M. Nathan, MD and Linda M. Delahanty, MS, RD.
Copyright © 2005 by McGraw-Hill Company, Inc.
Excerpted with permission of the publisher, McGraw-Hill Company, Inc.
Buy Beating Diabetes from the McGraw-Hill Company.
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Excerpted from Chapter 7: Preparing Your Environment For Change and Success
Eating is a complex behavior that, in human beings, is influenced by internal and external factors, or cues. Meals are social occasions, and our environment can influence what and how much we eat.
Why do we eat? If we ate only when we were hungry and stopped when we were full, far fewer people would be overweight. In fact, many overweight people have been eating for so many reasons other than hunger that they can't remember the last time they actually felt hungry. It is important to identify the eating "cues" in your physical, emotional, and cognitive environment so that you can manage them and set up your environment for success.
Your Physical Environment
People overeat primarily because food is easily available and all around them. Everywhere you look, you see food. And the sight and smell of food can trigger you to eat whether you are hungry or not. As kids, lots of us were told not to waste food because people were starving in other countries. If you grew up as amember of the "clean-plate club," you probably developed a habit of eating and not stopping until the food was all gone. We have been programmed from an early age to eat the food in front of us so long as it looks good, tastes good, and smells good. Sometimes we eat only because the full-color poster looks so good, even though the actual food is lukewarm, gray, and tasteless. When the food is all gone, we often feel uncomfortably full, but this becomes our normal experience of eating. An important part of creating an environment for success is to survey your immediate surroundings (including your home, office, car, and so forth) to see where, how, and when food is available to you.
Food Choices and Portion Size
Which kinds of foods do you purchase and keep handy? Will these foods help you to achieve a healthy weight, or are they more likely to sabotage your efforts? If you are serious about losing weight, then you must make a commitment to do an "environmental cleanup" of your eating environment. Here's how to get started at home:
- Remove tempting and unhealthy foods from your immediate environment. Banish them from your sight. Replace them with healthy foods, and keep them readily available for meals and snacks. (See Appendix C for shopping list ideas.)
- Determine the appropriate amount of food to cook and serve yourself and others at meals. Immediately put extra unnecessary portions in the refrigerator or freezer for another meal. Serve meals using smaller plates, bowls,and glasses.
- Keep individually wrapped portions of healthy snacks available so that you will not be tempted to overeat. These might include single servings of popcorn, pretzels, yogurt, or fruit. (See Appendix E for healthy snack suggestions.)
It may not always be easy, but at home you can control the food you buy and how much you serve (and eat). But most of us eat outside the home on a regular basis. (Most surveys show that the average American eats out at least three or four times per week.) So, the next challenge is to develop strategies for eating outside your home.
As we discussed in Chapter 1, we live in a difficult eating environment. Much of our food—and often unhealthy food—is marketed aggressively and is widely available at all times of the day and night, making it extremely challenging to change our habits. All-you-can-eat buffets and all-inclusive menus or vacation packages offer an overabundance of food—and we want to get our money's worth. Unfortunately, while these deals are financial bargains, they result in a calorie glut that contributes to weight gain. Even if you avoid all-you-can-eat setups, there are still plenty of challenges to sensible eating.
In today's society, we have a major portion-distortion problem (see Figure 7.1). Over the years, the plates, bowls, and cups we use have at least doubled in size. If we fill the plate and then empty it by eating everything on it, it's no wonder that we are gaining weight. Let's take a look at a few examples.
- A four-ounce juice glass with a one-cup bowl of cereal used to be standard serving sizes. Now it is more likely that you will drink juice from an eight- to twelve-ounce glass, and your bowl probably holds at least two cups of cereal. If you clean those plates, you'll also have doubled or tripled your calories.
- A standard bagel used to weigh two ounces and contain about 160 calories. Today's bagels weigh from four to seven ounces and pack 320 to 560 calories—that's before the cream cheese! And of course, it will take more cream cheese to cover a bigger bagel, so you'll pile on even more extra calories.
- Restaurant meals are now 25 percent larger than they were fifteen years ago. And even when you choose well in a restaurant, you can easily consume at least one thousand calories. If you don't choose carefully, that couldmean more than two thousand calories in a single restaurant meal.
As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...