November is Diabetes Awareness Month

November is Diabetes Awareness Month! 

Did you know that 1 in 3 Canadians are living with diabetes or prediabetes? So many lives are touched by this chronic disease, yet so few Canadians know they are at risk for developing diabetes. 

What is Diabetes?

It’s a chronic disease where the body cannot make enough insulin or cannot use insulin properly. Insulin is a hormone that helps to control blood sugars. A high amount of sugar in the blood over a long period of time can damage organs, blood vessels, and nerves.  

Are you at risk?

Not much is known about definite risk factors for Type 1 Diabetes, but there are quite a few risk factors for developing Type 2 Diabetes. Some we can have some control over, but some we cannot. 

Here’s a list of risk factors for developing Type 2 Diabetes:

• Have a parent, brother, or sister living with diabetes.

• Member of high-risk group (Indigenous, Hispanic, South Asian, Asian, African descent)

• Have given birth to a baby weighing more than 4kg or 9lb

• Have had gestational diabetes (diabetes during pregnancy)

• Prediabetes diagnosis

• Have high blood pressure

• Have high cholesterol  or high blood fats

• Have extra weight around abdomen, overweight

• Have polycystic ovarian syndrome (PCOS) diagnosis

• Have acanthosis nigricans diagnosis

• Have obstructive sleep apnea diagnosis

• Have diagnosed psychiatric disorders: schizophrenia, depression

Ask your doctor to test if you have diabetes if you are over 40 years old or if you have several risk factors after taking this risk test: https://www.healthycanadians.gc.ca/en/canrisk

Don’t have a doctor?  Find one here: www.albertafindadoctor.ca

Fight the Risk

Here are some healthy habit ideas that can help lower your risk of diabetes:

• Eat a high fibre breakfast everyday

• Eat 1 cup of vegetables at each of your meals

• Eat 2-3 servings of fruit each day (1 serving =0.5 cup or tennis ball size piece of fruit)  

• Go for a 10-15 minute walk at lunch everyday

• Try deep breathing or visualization technique to manage your stress or check out other stress management techniques at https://myhealth.alberta.ca/Health/tests-treatments/pages/conditions.aspx?hwid=rlxsk&

Your Team

You have a team of Registered Dietitians, Exercise Specialist, Registered Nurses, Behavioural Health Consultants and Mental Health Therapists that can support your health journey through the Team-Based Care program at the PCN.  You can access this team for support by asking for a referral from your family doctor.  

Fall 2019 Workshops

To register for Grief & Loss, Your Best Weight, Child/Teen Anxiety or Happiness Basics, please visit our website at www.lbdpcn.com or call the office at 780-986-6624.

To register for Heart Health, Diabetes Healthy Eating, Taking Charge: Daily Management of Type 2 Diabetes, Better Choices, Better Health Chronic Pain Self-Management, please call Alberta Health Services at 780-401-2665.

Fall 2018 Health Education Classes now available!

Our Fall 2018 health education classes and workshops are now available for registration!
Register online at www.lbdpcn.com or call our office at 780-986-6624.

I eat healthy food and I am active but I still am not losing weight. Why?

Ask the Dietitian

Submitted by Andrea Shackel – LBD PCN Registered Dietitian, Certified Diabetes Educator

I eat healthy food and I am active but I still am not losing weight. Why?

We often hear people say “eat less, move more” in order to lose weight but this does not take into account many other issues that are just as important in reaching or maintaining a healthy weight. Consider these other factors:

Healthy Eating – Healthy eating is a complex term and does it not always equal weight loss. Healthy eating refers to what we eat and weight loss refers to eating foods that are providing a calorie decrease from our everyday diet.  Not all “healthy foods” are weight friendly.  For example: 1 tbsp oil a day is considered“healthy oil” however could add up to over 12 pounds a year!

If weight loss is the goal, it’s important to use a lifestyle journal.  Lifestyle journaling is the cornerstone for determining what’s going on as well as help problem solve. It is the #1 tool for long term behaviour change and weight management.  You can journal everything from food, calories, exercise, sleep, mood, stress on a variety of online, phone apps and handwritten journals. 

Activity – Activity has many great health benefits such as lowering blood pressure and cholesterol levels and reducing the risk of chronic diseases and it can play a role in weight maintenance; however it does not play a large role in weight loss.  The majority of the population does not meet the requirements for physical activity of 150 minutes per week – the amount needed to achieve health benefits.  In order to make an impact on weight, a person would need to be doing 250 minutes or more of moderate to vigorous activity per week.  The majority of the population does not “work off” what they eat. One can of pop has 140 calories which equates to 1 hour of walking to burn off. Is it really worth it?

Medical –Certain health conditions such as sleep apnea, high blood pressure and diabetes can make it difficult to lose or maintain weight. Many medications can also impact your weigh loss efforts.  It is important to follow up with your family physician or health care team should you have any of these concerns with managing your health conditions.

Psychological - Mental health concerns such as depression, anxiety, ADHD/ADD or stress can make it more challenging to loose weight and make it more difficult to maintain lifelong changes.  Often, people tend to go for “comfort food” to help deal with the issues above.

Environment –Access to fast food, eating on the run (or while driving), working at a desk or sitting all day, access to 24 hour screen time and messages from the media all play a factor into our personal weight loss or maintenance goals.

It’s overwhelming to take all aspects into our lives into account when working on weight loss or maintenance goals. Identifying the issues that may be impacting efforts and working on them is very important. 

Check out our new PCN class called “Getting Started: Your Best Weight”. This class will address all of these factors, how they impact weight and what to do about it.

Our website offers resources and support for your use. Our PCN also offers classes on dealing with emotional eating and a series of other weight, nutrition, activity and stress management classes. Visit our website to see the calendar of classes; all are open to the public!

To access any of the healthcare team members, please talk to your PCN family doctor or call 780-986-6624.

Have a question for our healthcare team? Please send it to info@lbdpcn.com

For more information on the PCN’s programs and services, please visit www.lbdpcn.com

Ask the Healthcare Team offers trusted, evidence-based healthcare information to our patients and the public. This information is provided to you by the multidisciplinary team at the Leduc Beaumont Devon Primary Care Network. This monthly column will answer common questions our team members hear from patients. 

This article was printed in the Leduc Representative and Beaumont News on September 18, 2015.

New FREE class offered at the PCN!

A new class is now being offered - Getting Started: your Best Weight. This 2 part class will focus on identifying the medical, psychological, social and lifestyle factors that contribute to weight. Participants will learn essential tools and skills for making lifestyle changes. Participants will also discuss the role of motivation, thoughts and emotions in long term behaviour change and will learn how to problem solve and develop a personalized plan for change. 

Getting Started: Your Best Weight (2 part class)

September 16 & 23, 1:00 - 3:30
October 2 & 9, 1:00 - 3:30
November 6 & 13, 1:00 - 3:30

To register, participants can call the PCN office at 780-986-6624.

**All PCN classes and workshops are now open to the public; a referral from the family doctor is no longer required. All classes have been added to the public calendar on our website. Our website will soon be updated to a new template and this template will allow the public to reserve a spot at any of these classes and workshops with a click of the mouse. We will keep you updated on the progress of this update.**

November is Diabetes Awareness Month - Exercise

Diabetes and the Effectiveness of Regular Physical Activity 

The short-term benefits of increasing physical activity for a person with diabetes:

• Lowers your blood glucose within one hour.
• Increases your energy and strength during the day
• Decreases stress, anxiety and fatigue
• Improves relaxation and sleep
• Improves overall well being  

The long-term benefits if activity is sustained:

• Improved blood glucose (sugar) control.
• Helps to maintain or lose weight.
• Lowered blood pressure.
• Stronger bones and muscles.
• Lower risk of diabetes complications such as eye, heart, and kidney disease.
• Improved quality of life.

One of the most effective aerobic activities with the lowest dropout rate is walking.  It can be as simple as going for a brisk walk in your neighborhood.  Click here for an example of a walking plan if you are just starting out. Feel free to print it for your own use or share it with others.  

Both aerobic and resistance exercises are important when it comes to decreasing the risk of developing or advancing Type 2 Diabetes as both help to improve the bodies insulin sensitivity.      

The following facts were taken from the Canadian Diabetes Association website:

• Low physical fitness is as strong a risk factor for mortality as smoking.
• Fitness level is one of the strongest predictors of all-cause mortality in people with diabetes.
• Physical activity can be as powerful as glucose-lowering medication… with fewer side effects.
• Regular physical activity, in conjunction with healthy eating and weight control, can reduce type 2 diabetes incidence by 60 per cent.

If you require help with getting started on an exercise or activity plan, ask your PCN family doctor for a referral to the Exercise Specialist on the SMILE team.      

Corinne Cutler is an Exercise Specialist at the Leduc Beaumont Devon Primary Care Network.                                                                                                                                                                                                                                                                                                                                                                

Prevent Weight Gain Before Losing Weight

Prevention of weight gain is often overlooked when we talk about weight management or weight loss. Many times people do not concern themselves with preventing weight gain until physical symptoms of pain or discomfort show. Or, some people forget the step of preventing weight from gaining further before they can start to see a reasonable amount weight-loss. After all, you cannot run until you have learned to walk.

Obesity is a chronic condition just like diabetes is a chronic condition. Chronic conditions are chronic partly because they progress over time. So why not stop obesity in its tracks before pain emerges and risk for developing associated diseases increases.

How?  With nutrition!

A significant portion of preventing weight gain involves being aware of what you eat, and the quality of food you put in your body, and particularly, how many calories you consume in a day.

What are calories? And where are they found?

Calories are units of energy found in food and drink. If you are eating and drinking more calories than your body can use or burn, then you will gain weight. If you are eating and drinking the same amount of calories that your body can use or burn, then you would stay at the same weight. This is called weight maintenance. You need to achieve weight maintenance before weight loss can be a sustainable goal. That is part of the reason why yo-yo diets do not work.

How many calories do I need?  

That’s very individual as not everyone’s age, muscle mass, metabolism, health condition, hormonal balance and other factors that affect our energy needs, are the same. The most practical way to know how many calories you need is paying attention to how many calories you are eating and how your body weight responds over the course of weeks to months. Our body’s weight fluctuates on a day-to-day basis because of fluids, food in our stomachs, and stool in our bowels. So tracking our weight over time gives you a better idea of whether you are gaining or losing body weight. That is part of the reason why family doctors measure your weight yearly at your physical exams.

Generally speaking, most people need about 1500-1800 Calories per day to normal day-to-day activity. Unless you are exercising intensely for more than 150 minutes per week, do not eat or drink extra for the calories you burn from physical activity. Meaning, do not justify that chocolate bar or slush with “because I exercised…”

The steps:

1) Track your food intake:
I know people often loathe tracking food intake, but think about it this way.  You have a calorie budget to spend on food and drink, just like how you have a money budget to spend on essentials like rent and “fun” things.  If you overspend money on “fun” items like a cute pair of shoes that are more pretty than functional, and still need to pay rent, you are going to be carrying debt.  Along the same lines, calorie debt is accumulated around your belly if you overspend your calorie budget.
So unless you know where you’re “overspending,” you will not know where to cut back.

If you do not like numbers and calories, then track based on portions compared to Eating Well with Canada’s Food Guide for your gender and age group.  

The foods that do not fit into the food groups, are ones you want to limit as much as you can.  And no, potato chips are not a vegetable….unfortunately.

2) Read nutrition facts labels for calorie information and record these on your food journal:
I will be writing a blog entry on label reading in the near future, but for now, track those numbers so you know how much you’re “spending.”

3) Review your food journal to spot trends.  If you do not know how to, get the help of a dietitian:
Click here to find a dietitian or ask for a referral to a dietitian from your family doctor who is part of a Primary Care Network.

4) Be as active as you possibly can: 
Any safe form of movement that is more than what you would do is increasing your physical activity.  You do not need to go to a gym to obtain that.

Overall, the key is awareness - calorie and food awareness.  When you are aware, you can cut back on portions or calories, and prevent weight gain.

Good nutrition helps you attain health, and physical activity helps you maintain health.

~Sally Ho, Registered Dietitian
Leduc Beaumont Devon Primary Care Network

Weight Management - It Takes Time

In this day and age, time is a valuable commodity.  There never seems to be enough time in a day to do all the things that we want or need to do.  Very often time for ourselves is the first thing to go.  Making time to look after our health often takes that back seat to the various other demands of the day.

When it comes to managing our weight, time management is very important for success.  Making those necessary healthy lifestyle changes requires time and attention but often competes with work, family, activities, volunteering and socializing commitments.   Being aware of the need to set time aside for these changes will enable you to move forward in your weight loss efforts.

• It takes time to eat healthy.  Planning meals, grocery shopping and food preparation takes an average 60 minutes each day.
• Sitting down and eating 3 meals per day takes time.
• It takes time to fit in regular physical activity each day.  The Canadian Physical Activity Guidelines suggest at least 30 minutes of activity 5 days per week.
• We should also strive for 6-8 hours of uninterrupted sleep each night.
• Food journaling what you eat and drink in a day provides valuable insight into your eating habits and is a necessary activity for making healthy changes, but also requires time.

While it seems like this might be a lot of things to consider, the time you invest in yourself and in your health will be well worth it.

Remember, there are 1440 minutes a day. Take time to look after yourself!

Christina Vesty is a registered nurse and is the Chronic Disease Management Coordinator at the Leduc Beaumont Devon Primary Care Network.  

Obesity management - root causes, factors and treatment

An Obesity Expert’s Message

Obesity affects 61% of Canadian adults and 26% of Canadian children and has recently been categorized as a chronic disease by the American Medical Association.

The public, and even healthcare professionals, often think that eating less and moving more is the simple answer to addressing obesity. We now understand that obesity is a complex, chronic disease that requires the same specialized, medical care treatment that other chronic diseases have. This includes identifying and addressing root causes and barriers to weight management.

Dr. Sharma, Professor of Medicine and Chair in Obesity Research and Management at the University of Alberta, is touring throughout Canada and recently spoke to a group of approximately  80 people in Leduc. He brings a humorous twist to discussing obesity while addressing key points to understanding the complexities of the disease. Many factors affect weight gain including:

• Nutrition
• Activity level
• Sleep issues  (lack of REM sleep, shift work, sleep apnea)
• Untreated mental health conditions (depression, ADHD, anxiety, stress, eating disorders)
• Medications
• Income, access to resources
• Other health conditions (chronic pain, PCOS, chronic disease, etc.)

In his presentation, Dr. Sharma asked the audience to start thinking differently about obesity and weight management. The success of obesity management should be measured by improvements to overall health and well being rather than the amount of weight loss. Success should not only be defined by numbers on a scale.  It was stressed that successful obesity management involves addressing all of the factors mentioned above.    The first step to success is stopping the weight gain itself.

Leduc Obesity Clinic

The Leduc Beaumont Devon Primary Care Network is proud to offer the area’s first weight management clinic. The Leduc Obesity Clinic (LOC) is a locally offered, medically supervised weight management clinic that offers patients, who are willing to make healthy lifestyle changes, a new treatment pathway for obesity management. Dr. Sharma’s thoughts and opinions form the foundation of the LOC. The clinic identifies underlying factors to obesity management and offers evidence-based treatment plans through our interdisciplinary team. The LOC provides patients with regular group medical appointments and classes and regular appointments with team members. The team consists of a medial physician, two registered nurses, two registered dietitians, a registered psychologist and registered pharmacist, an exercise specialist and administrative assistant.

For more information on the Leduc Obesity Clinic and to find out how to access it, please visit our website at www.lbdpcn.com

References:

Alberta Health Services 

Alberta Health Services - Obesity Initiative

Alberta Health Services - CDM Resource Centre

Canadian Obesity Network 

Canadian Physical Activity Guidelines 

Dr. Sharma

LBD PCN Registered Dietitian Andrea Shackel

LBD PCN Chronic Disease Management Coordinator Christina Vesty

New specialty clinics now accepting patients!

The Leduc Beaumont Devon Primary Care Network is proud to announce the launch of two, locally offered and medically supervised specialty clinics to our PCN patients.

Leduc Obesity Clinic

The Leduc Obesity Clinic offers patients who are willing to or already making healthy lifestyle changes a new treatment pathway for obesity management.

Screening assessments will be done to determine if this clinic is right for you.

Patients must be able to commit to 1 year of involvement with the interdisciplinary team.  This will involve participating every two weeks in group medical appointments/ classes as well as regular meetings with team members and regular weights and measurements.

Evidence based treatment plans for obesity have been developed by the interdisciplinary team.  This may include but not limited to addressing exercise, depression, diet, medication adjustments, sleep or referral to specialists as needed, etc. 

The Leduc Obesity Clinic – Weight Support Team includes a LBD PCN member Physician, Registered Nurse, Mental Health Professional, Registered Pharmacist, Registered Dietitian, Exercise Specialist and an Administrative Assistant.

Leduc Cardiac Rehabilitation Program

In response to the growing need to support cardiac patients in a local setting and in partnership with the Glenrose Rehabilitation Hospital’s Cardiac Rehabilitation Program, the Leduc Beaumont Devon Primary Care Network (LBD PCN) is also proud to announce the introduction of the Leduc Cardiac Rehabilitation Program. 

This program will operate out of the LBD PCN office and the Leduc Recreation Centre (LRC). The program includes support from a LBD PCN member physician and the LBD PCN Exercise Specialist. Patients will also have access to the LBD PCN's Registered Dietitian. This program will help reduce fears about physical activity and may improve quality of life.

If you have experienced a recent cardiac event or procedure and think you would benefit from supervised exercise and heart health education, ask your LBD PCN family physician for a referral to the Leduc Cardiac Rehabilitation Program. 

To access the Leduc Obesity Clinic or the Leduc Cardiac Rehabilitation Program, please ask your LBD PCN family physician for a referral.

New Year's Resolutions - be specific!

When it comes to New Year’s resolutions, try to keep in mind that making those plans and goals as specific as possible will help with following through.  So many of us come up with general wants and wishes such as:

I want to lose weight

I wish to be more active

I want to eat better

It is a common mistake to make the resolutions too big and too much to change at one time:

I am going to go to the gym every day

I am going to start eating healthier

These goals are too broad and too much to change all at once.  Gyms and fitness centres are jam packed with people in January and then look like a deserted wasteland by March.  When it comes to eating healthier, we tend to go with the all or nothing mindset so one setback can often send everything off the rails.   Sound familiar? 

Instead of setting such lofty general goals that are setting us up for failure, think about making your goals specific. This will give you a better chance of success and sustainability. A good example is:

I will go for a walk on my lunch hour for 15 minutes three days per week. 

In the winter months, dress properly for walking outdoors. Walk in the stairwells or hallways if the weather does not permit, that is better than nothing! When meeting a friend at the mall, plan to walk for 15 minutes at a brisk pace before you do your shopping.  There are multiple ways to get those 15 minutes in, even in our harsh Canadian winters.

Another specific goal is to join an exercise class one or two days a week. Signing up for a registered class for a pre-determined number of weeks is often a good way to stay motivated.  Knowing there is an end date and having paid for the class upfront can is often enough motivation to keep you going.  Schedule your day around this class and plan ahead.

Almost all of us want to be healthier, be more active and lose weight but those are all end results of what may come from making lifestyle changes with setting more specific goals and sticking with those changes.  

Corinne Cutler is the Exercise Specialist at the LBD PCN.  

How important is regular physical activity to your health?

So many of us associate regular and structured physical activity and/or exercise with weight loss.  Why is this?  For so long now society has placed images into our brains by way of media.  “Workout to lose weight!”, “Lose weight in 21 days with this workout!”, “In just 10 days you can have abs of steel through this workout!” We have heard it all. 

The truth is, the focus of exercise or increased physical activity should be on the health benefits and living longer, better quality lives.  Not only is there strong evidence that regular physical activity can help to manage most chronic conditions such as diabetes, hypertension, heart disease,  high cholesterol, high blood pressure  and some cancers,  but it can also help prevent them as well. 

“People who are active and fit, live longer, healthier lives”       ~ Dr. Robert Sallis 

The time has come to change the focus on the importance of increasing our daily physical activity.  Let’s start with changing the idea of “if I work out more or walk more often I will lose weight.”  Instead, think “if I walk regularly at a brisk pace for 30 minutes, gradually working up to 5 days per week, then my heart will work more efficiently, my energy level will improve and I will start to feel better overall.”

Of course starting off with what you are able to tolerate is important. If walking for 5 or 10 minutes is your limit now, start there and set monthly goals to increase gradually over time.

When it comes to health, activity level is vital.  Yes, it would be a bonus if some weight loss was to occur, but let’s remember that these health benefits, just to name a few, will happen overtime with regular and consistent activity, regardless of weight loss:

- Improved circulation
- Improved cardiovascular fitness
- Increased insulin sensitivity
- Increased HDL (good cholesterol)
- Increased energy level
- Improved quality of life
- Reduced stress and anxiety
- Reduced blood pressure
- Reduced risk of chronic conditions
- Decreased cognitive decline

Just like prescribed medicine, physical activity should be thought of as a prescription to take in order to be effective.

Corinne Cutler BPE, CSEP 

Certified Exercise Physiologist

Leduc Beaumont Devon Primary Care Network