BetterU – Week 9 Information & Action Steps

Welcome to week 9 of the BetterU Challenge! (New here or want to find out more about this program? Jump back to the week 1 information here!)

Week 9

Week 9 of the BetterU 12-week health challenge…can you believe it! Reflect on the positive changes you have made in your lifestyle since starting this challenge 9 weeks ago. You’ve come a long way baby! 🙂

Little changes, big changes, a complete lifestyle overhaul…whatever you have done, congratulate yourself and think about the impact that change, no matter how small, will impact your heart health. It has been a wonderful thing to witness!

This week the focus of the BetterU challenge is on diabetes . When asked  to raise our hands to show if we ourselves were affected by diabetes, or knew someone close that was, almost all of our hands raised. Not surprising giving the statistics shared below, from 2011 research.

I shared that I was diagnosed as having pre-diabetes when I was in my early 20’s, over 100 pounds overweight and also having high blood pressure, high cholesterol and high triglycerides. The number that scared me the most was my blood sugar. I have a family history of diabetes (also a history of obesity, heart disease and other lifestyle related conditions) and I remember watching my dad have to poke his fingers several times every day to monitor his blood sugar, checking his feet for circulation issues and other conditions brought on by diabetes. I didn’t want to live like that. I carried a lot of weight in my stomach (which plays a part in developing chronic inflammation in the body), I had a dark ring around my neck which is a common sign of insulin resistance, (they can also appear on knuckles, elbows, knees and armpits) and in combination with the high triglycerides and other numbers, I knew for certain that if I didn’t make some changes I was heading right for diabetes.

The good news is it is largely controllable through lifestyle choices, I got mine under control within about one month when I began living a heart-healthy lifestyle! Implementing what we are learning in the BetterU program every week can help you lower your risk factors, or manage your diabetes.

Given these facts, we really want to manage diabetes, right? Check them out:

Total prevalence of diabetes

Total: 25.8 million children and adults in the United States—8.3% of the population—have diabetes.

Diagnosed: 18.8 million people

Undiagnosed: 7.0 million people

Prediabetes: 79 million people

New Cases: 1.9 million new cases of diabetes are diagnosed in people aged 20 years and older in 2010.

Under 20 years of age

215,000, or 0.26% of all people in this age group have diabetes

About 1 in every 400 children and adolescents has diabetes

Age 20 years or older

25.6 million, or 11.3% of all people in this age group have diabetes

Age 65 years or older

10.9 million, or 26.9% of all people in this age group have diabetes


13.0 million, or 11.8% of all men aged 20 years or older have diabetes


12.6 million, or 10.8% of all women aged 20 years or older have diabetes

In 2007, diabetes was listed as the underlying cause on 71,382 death certificates and was listed as a contributing factor on an additional 160,022 death certificates. This means that diabetes contributed to a total of 231,404 deaths.

Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes. The risk for stroke is 2 to 4 times higher among people with diabetes.

People who are obese or who have metabolic syndrome, insulin resistance, type 2 diabetes, or prediabetes often also have low-level inflammation throughout the body and blood clotting defects that increase the risk of developing blood clots in the arteries.

High blood pressure

In 2005-2008, of adults aged 20 years or older with self-reported diabetes, 67% had blood pressure greater than or equal to 140/90 mmHg or used prescription medications for hypertension.


Diabetes is the leading cause of new cases of blindness among adults aged 20–74 years.

In 2005-2008, 4.2 million (28.5%) people with diabetes aged 40 years or older had diabetic retinopathy, and of these, almost 0.7 million (4.4% of those with diabetes) had advanced diabetic retinopathy that could lead to severe vision loss.

Kidney disease

Diabetes is the leading cause of kidney failure, accounting for 44% of new cases in 2008.

In 2008, 48,374 people with diabetes began treatment for end-stage kidney disease in the United States.

In 2008, a total of 202,290 people with end-stage kidney disease due to diabetes were living on chronic dialysis or with a kidney transplant in the United States.

Nervous system disease (Neuropathy)

About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage.


More than 60% of nontraumatic lower-limb amputations occur in people with diabetes.

In 2006, about 65,700 nontraumatic lower-limb amputations were performed in people with diabetes.

Cost of Diabetes

Updated March 6, 2013

$245 billion: Total costs of diagnosed diabetes in the United States in 2012

$176 billion for direct medical costs

$69 billion in reduced productivity


Now that we have these facts, let’s see exactly what diabetes is and how we can manage it.


What is diabetes?

Being diagnosed as having diabetes means your body doesn’t make enough insulin, or your body can’t use it’s own insulin as well as it should. This causes sugars to build up too high in your blood.

When you eat, most of the food you eat is turned into glucose, or sugar, for your body to use for energy. Your body then uses insulin, a necessary hormone, to convert that glucose into energy and help get the glucose into your body’s cells.

“When we eat foods high in refined carbohydrates, insulin levels surge to remove the sugar from the blood and get it into your cells. This mechanism works very well for the most part. But if insulin spikes too often from a diet rich in the high-carb foods that trigger insulin secretion, your cells respond by decreasing the reactivity and number of insulin receptors on their surfaces. Eventually, this prevents glucose from getting into your cells, leading to high blood sugar and depriving your cells of the energy they need to function.  Down the road, your body’s capacity to generate insulin appropriately becomes depleted, and the result is type 2 diabetes.” (From

From the AHA: Type 2 is the most common. About 90 percent to 95 percent of Americans diagnosed with diabetes have type 2 diabetes. It most often develops in middle-aged and older adults. It’s often linked with being overweight, obese and physically inactive. Type 2 diabetes develops when the body doesn’t make enough insulin and doesn’t efficiently use the insulin it makes (insulin resistance).

Type 1 diabetes usually starts early in life. It results from  the body’s failure to produce insulin. People with it must take insulin each day to control their levels of blood glucose (sugar).

Normal blood sugar levels: From the American Diabetes Association “Fasting (no food or water for 8 hours) levels should be no higher than 100 mg/dl. A diagnosis of diabetes is made if your blood glucose reading is 126 mg/dl or higher after two consecutive blood tests. For a “random” blood glucose test ( taken at any time)  a normal range is in the low to mid 100s. A diagnosis of diabetes is made if your blood glucose reading is 200 mg/dl or higher and you have symptoms of disease such as fatigue, excessive urination, excessive thirst or unplanned weight loss.

Who is at risk?

The number of people with diabetes is increasing.  This is because more people are overweight or obese,

don’t get enough physical activity and are getting older.  However, many younger people are developing diabetes at an alarming rate. This is probably because being  overweight; obese and not getting enough physical activity are increasing problems for this group too. People in several ethnic groups seem to be more likely to develop type 2 diabetes. These include:

• Hispanics

• African Americans

• Native Americans

• Asians (especially South Asians)

Symptoms of diabetes:

Type 1 Diabetes: Frequent urination, unusual thirst, extreme hunger, unusual weight loss, extreme fatigue and irritability.

Type 2 Diabetes: Any of the type 1 symptoms, frequent infections, blurred vision, cuts/bruises that are slow to heal, tingling/numbness in the hands/feet, recurring skin, gum, or bladder infections.

What does diabetes have to do with heart disease and stroke?

Diabetes is a major risk factor for stroke and heart disease. That means it can be as serious as smoking,

high blood cholesterol, high blood pressure, physical inactivity or obesity. If you have diabetes, it’s very important to have regular check-ups. Work closely with your healthcare provider to manage your diabetes and reduce any other risk factors.

How can I manage my diabetes, or live a lifestyle that helps reduce my chances of getting diabetes?

  • Manage your weight, blood pressure and blood cholesterol with a heart healthy eating plan that is low in saturated fat, trans fat, cholesterol, salt (sodium) and added sugars. *A Mediterranean diet, which includes more foods that have a lower glycemic impact such as more fiber-rich whole grains or legumes, healthy fats, lean protein and a focus on lots of vegetables and fruits is shown to be greatly affective at lowering insulin resistance. Further, eating smaller amounts, often, helps regulate blood sugar.
  • Be physically active. Aim for at least 150 minutes (2 hours and 30 minutes) of moderate-intensity physical activity such as brisk walking, or 75 minutes (1 hour and 15 minutes) of vigorous-intensity, aerobic exercise each week.
  • *Build muscle! From a study published in the Journal of Clinical Endocrinology and Metabolism: “For each 10% increase in the skeletal muscle index (ratio of muscle mass to total body weight) there is an 11% reduction in insulin resistance and a 12% reduction in pre diabetes.” Muscle stores glycogen which improves how your body uses glucose. While cardio is imperative for working the heart muscle, we do need to do resistance training to help build our other muscles too! If you’re not seeing the scale go down but you’re eating the appropriate amounts of healthy foods, getting appropriate cardio and building muscle, don’t be discouraged. Keep at it and know that your health is improving on the inside, even it isn’t reflected on the scale. This is what our focus should be on.
  • If you drink alcohol, don’t have more than one drink per day for women or two per day for men.
  • Lower your blood pressure, if it’s too high. People with diabetes should keep blood pressure under 130/80 mm Hg.
  • Don’t smoke, and avoid second-hand smoke.
  • If you take medications to help control your blood pressure, cholesterol or blood glucose, take them exactly as directed.

Eat to live!

This week we had a great guest speaker, Amy Reuter. Amy is a registered dietician and owner of Amy does a lot of volunteering for the American Heart Association, especially doing the wonderful “Simple Cooking with Heart” demonstrations! Amy showed us the creation of a delicious Spicy Asian Chicken Lettuce Cups made with convenient items to keep on hand and heart-healthier swaps. Here is the recipe. As Amy pointed out this would be delicious with shredded rotisserie or leftover cubed cooked chicken or even tuna instead. I would also consider swapping the mayo for an equal amount of fat free plain yogurt for some tang and even more protein! Yum! You could also serve this with some whole grain crackers or as a wrap or sandwich too.

Spicy asian lettuce cups

Spicy Asian Lettuce Cups

1/2 cup light mayonnaise

1 1/2 teaspoons Dijon mustard

1 teaspoon Chinese chili sauce

2 (12.5 oz) cans salt-free white meat chicken packed in water, drained

1 (8 oz) can water chestnuts, drained and chopped

4 green onions, chopped

2 tablespoons unsalted chopped nuts (cashews, almonds or walnuts)

¼ teaspoon black pepper

Juice of 1 lime or 2 teaspoons from jar

12 lettuce leaves (iceberg, green leaf, bib, etc.)

In a medium mixing bowl, combine mayonnaise, mustard, and chili sauce.

Stir in chicken, chestnuts, onions, nuts, pepper, and lime juice.

Spoon equally into lettuce leaves (“cups”) and serve.

Breaking it down on your plate:

Amy pointed out the way of making up your plate. This is a great thing to do if you go for the “three square meals” approach. Instead of the older food pyramid, the USDA has a recommendation of using your plate as a guide for creating a healthy meal. ¼ fruit, ¼ vegetable, ¼ grains (with at least half of them coming from whole grains), ¼ protein and a serving of dairy.


You can find more recipes and videos showing you great basic cooking techniques over at the Simple Cooking with Heart website here!

Thank you so much to Amy for her wonderful information, and delicious snacks!

Healthy dinner

A day in the life:


So, what does a heart-healthy, Mediterranean inspired, AHA guideline (at the end of every BetterU program book chapter before the journal part) day of meals and exercise look like when you’re eating to keep risk factors low for diabetes, heart disease and other chronic lifestyle-related disease?

I want to share with you a sample of what my day looked like as I started on my journey to live for a heart-healthy future. I will include some delicious recipes from the American Heart Association sites as well. This is how I started off when I was over 100 pounds overweight, insulin-resistant, many other risk factors of heart disease and extremely low energy. I took it one delicious day at a time. Every week I sat down on Sunday evenings to menu plan for the entire week and shopped according to that list. I made a lot of cook-once/eat-twice meals, planned my exercise at the same time. I wrote down everything I ate, even if I picked up a candy bar and wrote down my emotions at the time to try to figure out why I made that choice. This is how I lived to drop all of my important numbers, then the side effect was also the 100 pound weight loss on top of all of that. Why didn’t I gain it all back? Because I still do this! This is a lifestyle…not a diet. Here is an example of one of my days:

Morning – get 10 minutes of walking or elliptical. Then I could have breakfast! An example is 1 egg plus 1 egg white scrambled with 1 tsp olive oil, ½ cup leftover cooked quinoa or some black beansand 2 cups of spinach. Topped with salsa and served with a cup of strawberries. Coffee with light milk.

Mid-morning snack, about 3 hours after breakfast – 1 orange and a serving of almonds, for me about 10 almonds.

Afternoon – 10 more minutes of walking or elliptical then 5 minutes doing pushups, lifting weights, doing squats and crunches. Then I had my lunch! Something like this delicious Mediterranean salad , some bell peppers and cucumbers and a serving of hummus.

Mid-afternoon snack, about 3 hours after lunch – 1 apple and 1 Tb natural peanut butter

Dinner – I would enjoy a delicious dinner that was light but satisfying. Perhaps a Simple Shrimp Stir-fry like this one served up with a side of roasted asparagus.

Late evening, about 2-3 hours before bed – After dinner I would often take my daughter on a walk. If not I would get back on the elliptical for 10 more minutes then do a few yoga-style moves that tone the core and build strength, or more often a 10 minute Pilates routine on video. Then I would enjoy a snack like a little bit of blueberries drizzled with 2 Tb plain yogurt, a tiny drizzle of honey, some cinnamon and a few chopped pecans on top for crunch.


Week 9 Action Items

Activity goals:

  •  Keep trying for at least 150 minutes of moderate activity and stay active!
  •  Try something new! Grab a new workout video, take a different trail, jump on the bike if you’re used to walking.
  • Add in some resistance! Grab some weights or bands or even use your own body weight as resistance and incorporate some muscle-building movement into your week.  Go back to Week 3 for more information about what we covered on the topic.

Nutrition goals:

  • Celebrate every positive choice you’ve made by looking over your food journal for the last week!
  •  Try a new recipe this week from the Simple Cooking with Heart site!
  •  Amy pointed out some great information about figuring out whether a product truly is heart healthy, or is using the “whole grain” stamp as a marketing technique. For every 10 grams of carbohydrates make sure there is at least 1 gram of fiber. No? Ditch that product and try to find something else or see if you can find a completely unprocessed alternative. Example: Cheerios vs. steel cut oats for breakfast. Regular “wheat” bread vs. Ezekiel 4:9 brand sprouted grain bread.

Week 9 Highlights

  • This week we were honored to have Amy Reuter as a guest speaker talk about diabetes but also do a healthy cooking demo! Thanks so much Amy! You can find out more about Amy at her website,! 
  • Kirsten’s recipe of the week: A delicious, heart-healthy chili! This is your basic chili…done right! Tons of flavor from low-sodium all natural herbs and spices, tons of rich flavor, the technique is what sets it apart..that and tons of veggies! Give it a try, here is the recipe!

Amy Reuter 1

Have a wonderful week and congratulations on Week 9 towards a BetterU!

Chef Kirsten Signature

Special thanks to our sponsors:

Verdant Health Commission

Lynnwood Rec center


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