Lose Weight Sensibly

If you are overweight, losing even 5 to 10 pounds can improve your blood cholesterol levels. But don't go on a crash diet: The healthiest and longest-lasting weight loss happens when you take it slowly, losing 1/2 to 1 pound a week. If you cut 500 calories a day by eating less and being more active, you should lose 1 pound (which amounts to about 3,500 calories) in a week. (Overweight children and adolescents should not be put on strict weight loss diets; consult your family doctor if this is a concern.)

A heart-healthy eating plan can help you lose weight because cutting down on fat is a good way to cut down on calories. And, if you are overweight, you should take care to eat foods high in starch and fiber (like vegetables, fruits, and breads and cereals) instead of high fat foods. Choose low fat and low calorie items from each food group; table 1 will help. Finally, you'll need to limit the amount--or serving sizes--as well.

But there's more to losing weight than just eating less. The most successful weight-loss programs are those that combine diet and increased physical activity. A low fat, low calorie way of eating combined with increased physical activity can help you lose more weight and keep it off longer than either way can achieve alone. See the box for some ideas for physical activities.

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Make Physical Acitivity Part of Your Routine.

Make Physical Activity Part of Your Routine

Regular physical activity improves cholesterol levels: It helps to lower LDL and raise HDL. It can also help you lose weight, if you are overweight. But you don't have to train like a long distance runner to benefit: Even doing any physical activity for just a few minutes each day is better than none at all.

Try to build physical activity into your daily routine in ways like these:

• Take a walk at lunch time or after dinner.
• Use the stairs instead of the elevator.
• Get off the bus one or two stops early and walk the rest of the way.
• Park farther away from the store.
• Ride a bike.
• Work in the yard or garden.
• Go dancing.

Try to be active as a family: Take trips that include hiking, swimming, or skiing. Use your back yard or the park for games like badminton, basketball, football, or volleyball.
Vigorous activities like brisk walking, running, swimming, or jumping rope are called "aerobic." They are especially good for the health of your heart and can burn off extra calories. Aerobic activities can condition your heart if you do them for at least 30 minutes, three to four times a week. But even if you don't have 30 minutes, three to four times a week, try to find two 15-minute periods or even three 10-minute periods.
Most people do not need to see a doctor before they start being active, especially if they start off slowly and work up gradually to a sensible plan. But you should get advice from your doctor beforehand if any of these conditions apply to you: if you have a medical condition; if you have pains or pressure in the chest or shoulder area; if you tend to feel dizzy or faint; if you get very breathless after a mild workout; and if you are middle-aged or older, have not been physically active, and plan a fairly strenuous exercise program.

Why Blood Cholesterol Matters

Blood cholesterol plays an important part in deciding a person's chance or risk of getting coronary heart disease (CHD). The higher your blood cholesterol level, the greater your risk. That's why high blood cholesterol is called a risk factor for heart disease. Did you know that heart disease is the number one killer of men and of women in the United States? About a half million people die each year from heart attacks caused by CHD. Altogether 1.25 million heart attacks occur each year in the United States.

Even if your blood cholesterol level is close to the desirable range, you can lower it and reduce your risk of getting heart disease. Eating in a heart-healthy way, being physically active, and losing weight if you are overweight are things everyone can do to help lower their levels. This fact sheet will show you how. But first, a few things you ought to know . . .

The Blood Cholesterol--Heart Disease Connection
When you have too much cholesterol in your blood, the excess builds up on the walls of the arteries that carry blood to the heart. See figure 1. This buildup is called "atherosclerosis" or "hardening of the arteries." It narrows the arteries and can slow down or block blood flow to the heart. With less blood, the heart gets less oxygen. With not enough oxygen to the heart, there may be chest pain ("angina" or "angina pectoris"), heart attack ("myocardial infarction"), or even death. Cholesterol buildup is the most common cause of heart disease, and it happens so slowly that you are not even aware of it. The higher your blood cholesterol, the greater your chance of this buildup.

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Diabetes Basics - Who's at Risk?

Type I Diabetes
Type I diabetes is more common among whites than Asian, Hispanic, Native and African Americans. If you have a close relative with the disease, you are more likely to develop Type I.

Type II Diabetes
Type II diabetes also tends to run in families. In fact there seems to be even stronger evidence for some kind of genetic cause for Type II than for Type I diabetes. Type II is more common among Asian, Hispanic, Native and African Americans.
Although Type II diabetes usually develops after age 40, about half of all people diagnosed with the disease are older than 55. This may be because as people age, they tend to become more sedentary and to gain weight. Eating too much food and being inactive can make you obese and you are more likely to develop Type II diabetes if you are obese. Obesity is, by far, the greatest risk factor for this kind of diabetes.
Where the weight is distributed seems to be a factor, too. If you tend to have an apple-shaped body in which you store fat around the tummy, you are more at risk for Type II diabetes. Those with a pear shape in which fat is stored in the hips are somewhat less at risk.

Gestational Diabetes
Any woman can develop gestational diabetes during pregnancy, but some women are more at risk than others. Some risk factors include obesity, a family history of diabetes, having previously given birth to a very large baby, a stillbirth, a child with a birth defect or having too much amniotic fluid. Women who are older than 25 are at higher risk than younger women. About 135,000 women develop gestational diabetes every year.

Diabetes Basics - What is Diabetes?

Diabetes is a chronic disease that affects as many as 16 million Americans. For reasons that are not yet clear, diabetes is increasing in our population to the point where public health authorities are calling diabetes an "epidemic" that requires urgent attention.

Of the 16 million people with diabetes, about one-third of them don't even know they have it. Every year, 800,000 additional cases are diagnosed. It affects over six percent of the population now, and it is projected that nearly nine percent of all Americans will have diabetes by the year 2025. Health care costs for diabetes are estimated to be nearly $100 billion per year in the US.

People with diabetes are unable to use the glucose in their food for energy. The glucose accumulates in the bloodstream, where it can damage the heart, kidneys, eyes and nerves. Left untreated, diabetes can develop devastating complications. It is one of the leading causes of death and disability in the United States.

However, the good news is that with proper care, people with diabetes can lead normal, satisfying lives. Much of this care is "self-managed," meaning that if you have this condition, you must take day-to-day responsibility for your own care.

Most important to managing the disease is to know as much about it as you can. The first thing to know is what kind of diabetes you have. There are three types:

• Type 1 diabetes
• Type 2 diabetes
• Gestational diabetes

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Medications for Diabetes - Unproven Therapies

Unproven Therapies
Many of the alternative therapies have proven their value and have become accepted by healthcare professionals. There are some, however, which remain unproven and could be dangerous. Here’s how to spot those:

• Unproven therapies tend to be developed and promoted in isolation from established scientific facilities and associations.
• Their developers generally do not have strong clinical or scientific credentials.
• Claims about these therapies are often exaggerated or unrealistic.
• The therapies have the potential to be financially profitable to those who have developed, promoted, or endorsed them.
• The details of the treatment are often secretive.
• Those who are promoting them may discourage or refuse consultation with reputable doctors or scientists.
• The developers often claim that there is a medical or scientific conspiracy at work against them.

It is understandable that people with chronic conditions such as diabetes can get discouraged and seek a “miracle” treatment. But it’s important to recognize that sometimes alternative therapies remain out of the mainstream for good reason: they may not be of any help and they can be dangerous if they impact blood glucose. Be sure to let your doctor or healthcare provider know if you are trying remedies other than those prescribed for you.

Medications for Diabetes - Alternative Therapies

Alternative Therapies

People with chronic conditions often try alternative therapies, treatments that are considered to be outside the mainstream of medical practice. A study of diabetes educators in the western states found that nearly two-thirds recommend alternative therapies for their patients with diabetes. In addition to activity, diet, and self-help groups, those most often recommended were laughter and humor, relaxation therapy, prayer, imagery and visualization, meditation, massage, and music therapy. Megavitamin therapy was also recommended.

The National Institute of Diabetes and Digestive and Kidney Diseases has published the following positions about alternative therapies used by diabetic patients:

Acupuncture has been shown to offer relief from chronic pain and is sometimes used by people suffering from diabetic nerve damage.

Biofeedback emphasizes relaxation and stress-reduction techniques to help people learn to deal with the body’s response to pain.

Guided imagery is a relaxation technique in which a person thinks of peaceful images or images that foster a sense of control over diabetes.

Herbs and MineralsHerbal and mineral products that are sometimes recommended:

• Chromium has been reported to improve diabetes control by enhancing production of glucose tolerance factor, which helps improve the activity of insulin.
• Magnesium is often recommended, since a deficiency of this mineral may hamper blood glucose control. Scientists believe that a magnesium deficiency interrupts insulin secretion in the pancreas and increases insulin resistance. There is also evidence that such a deficiency may contribute to some diabetes complications.
• Vanadium, which is found in plants and animals, has been shown to normalize blood glucose levels in animals with diabetes. In a human study, people who took vanadium developed a modest increase in insulin sensitivity and were able to decrease their insulin requirements. However, vanadium, which is taken in the form of Vanadyl Sulfate, is toxic to the liver. The problem is that the optimum dose to take that is both safe and effective is not known.

Research into these and other compounds is under way to help determine how they work in the body to affect glucose control and also to established safe dosages and discover any side effects. None of these claims have been approved by the FDA.
If you are taking these or other dietary supplements, it is very important that you tell your healthcare provider.