Why …..HATS ?

Why …..HATS ?

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In our very lucky country, ‘slip, slop, slap’ is a no-brainer.

In a country where skin cancer kills thousands of people

every year, hats are very important. A good quality, widebrimmed hat is essential for outdoor activities.

But some hats protect us in other ways. Tradespeople wear hard hats to protect themselves from falling or loose objects. Lifesavers wear hats to make sure they can be seen while in the water.

Some hats are worn to show a level of authority in a group or club. People wear hats to show support for their team. There are even dunce hats to symbolise someone’s (lack of) intelligence.

Some hats are worn as part of people’s religious beliefs, such as a turban or a yarmulke. Other hats are worn only for special events, such as the Melbourne Cup, a student’s graduation day or by the mother of the bride on her daughter’s wedding day.

A lot of sports even have their own specific type of hat that enhances the experience of the sport and/or the wearer’s performance.

In our beautiful part of the world, one thing is for sure –

S02 fitness :  why hats  why hats why hats why hats  why hats why hats

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The 7 Worst Diet and Fitness

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Myths serve a purpose. At least the ‘traditional’ kind do. There were lessons to be learned from the classic Greek and Roman myths, and still are, despite the fact that today we know they are nothing more than fanciful stories.

The problem with diet  and fitness myths; however, is that they get passed around so much, and even appear in print and on the internet, that people start to accept them as truth. And nothing can get in the way of your weight loss and fitness goals more

than not being able to separate fact from fiction – except maybe an angry Minotaur! So here, in no particular order, are Henry the Health Hound’s 7 Worst Diet and Fitness Myths – BUSTED!

 

1 Dieting and Working Out Turns Fat Into Muscle

Muscle and fat are two completely different kinds of tissue in your body. You can no more turn fat into muscle than you can turn straw into gold. Think of it this way: muscle is like your body’s engine and gears, and it takes energy

to run the machine. Fat can be one source of that energy so, when you work out, you build muscle and reduce fat by consuming that energy. Conversely, when you laze around and eat, your body stores fat rather than using it for energy, and your muscles degrade from not being used. But in either case one does not and cannot turn into the other.

2  All Carbs a re Bad - PERIOD

A lot of dieters, and even some trainers and nutritionists insist that ‘all carbs are bad’. The truth is, your muscles crave carbs. In fact, carbohydrates are the main source of fuel used by the body to function properly; not only physically but

mentally as well. Without carbs, you would not have the strength and stamina to work out, and even if you did, you would likely be disappointed in the results. There

are good carbs and bad carbs though, so the trick is to learn to tell the difference. Fruits, veggies and whole grains are good carbs. Anything ‘white’ as in breads, rice and pastas are bad carbs. Of course alcohol, soda, sweets and other  junk are all bad carbs; however, even certain bad carbs can be good under certain circumstances because they are absorbed by the body quickly and burned slowly. This is why marathon runners will often load up on pasta.

3 Crunches and Ab Machines Will Give You a Six-Pack

You can pretty much dismiss any ab machine or device sold on late night TV that promises to bust belly-fat and build six-pack abs, as a myth. But a lot of people also think doing this kind of workout on legitimate machines in a gym will turn that spare tyre into a washboard! This goes back to myth Number One. You can’t turn fat into

muscle. Working out will help you burn fat, but you cannot pick and choose

where it will do so. Crunches will help strengthen the muscles around your midsection and improve your posture, but you won’t be able to see your

abdominal muscles until you reduce your overall percentage of body fat.

4 Five Fruits A Day

This is one of my favourites. I constantly run into people that think eating five servings of fruit a day is an antidote to eating burgers, fries and other junk. It isn’t. Yes, it

is a good idea to eat five servings of fruit a day, but not on top of other junk! The recommendation is meant to be taken as a substitute for high fat and high starch foods.

5 Fat Free is A-OK

Speaking of high fat foods, this is another one of my favourites. People think as long as a food is ‘fat free’ it’s a diet food, and will not mak you put on weight. The food marketing industry loves to play on this and proudly emblazons bags of marshmallows and jelly beans as ‘fat free’. Yes, maybe they are, but they are loaded with sugar

– and will wreak havoc on any diet!

6 If You’re Not Sweating, You’re not Working Out

I hear gym rats say all the time, if you are not working up a sweat you are not

burning any calories. That is just not true. Sweating is the way your body cools itself, not how it burns calories.

You can be active, healthy and burn plenty of calories by doing simple exercises like walking or light weight training and never break a sweat!

 7 Woman Will Look Like Men if They Strength Train

This is a terrible myth that keeps many women from strength training.

They’re afraid that if they strength train by weightlifting, they will look like men. No way! The truth is weightlifting and strength training is the surest way for men and women to burn fat, build lean muscle, and boost resting metabolism.

 02 fitness 02 fitness 02 fitness 02 fitness 02 fitness  by Henry the Health Hound

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SIGNS AND SYMPTOMS OF DIABULIMIA

It’s important for RDs to know that diabulimia may be an issue for the type 1 diabetes patients they counsel. They must ask appropriate questions to determine whether it exists and be ready to make appropriate referrals so patients can get the help they need. The following signs and symptoms of diabulimia can provide important clues:

• hyperglycemia;

• a hemoglobin A1c value much higher than would be expected, given recorded blood glucose values;

• changes in eating habits (eating more but still losing weight);

• dramatic shifts in weight;

• low energy;

• unusual food patterns;

• bingeing on carbohydrates and sweets;

• obsession with food and body image;

• anxiety about weight or avoidance of being weighed;

• delay in puberty or sexual maturation;

• irregular or no menses;

• severe family stress;

• frequent hospitalizations for diabetic ketoacidosis;

• preoccupation with label reading beyond typical dia­betes care;

• excessive exercise;

• hiding food;

• smell of ketones on the breath and in urine;

• frequent urination (eg, using the restroom during a counseling session); and

• physical signs of malnutrition (eg, hair loss, dry skin).

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UNDERSTANDING DIABULIMIA

Know the Signs and Symptoms to Better Counsel Female Patients

Samantha considered herself a master of deception. At the age of 13, she was diagnosed with type 1 diabetes shortly after experiencing the telltale symptoms: increased thirst, frequent urination, blurry vision, a ravenous appetite, and unexplained weight loss.

It quickly became clear to her that if her blood glucose levels remained elevated, she would lose weight. “What an amazing discovery,” she thought. Now Samantha could eat anything she wanted and still lose (UNDERSTANDING DIABULIMIA)
weight as long as she restricted or omitted her insulin injections.

She knew the consequences of uncontrolled blood sugar but felt invincible, as many teens do. She couldn’t control her diag­nosis, but she could use her disease to manipulate her body weight. This eating disorder, called diabulimia, doubled Saman­tha’s hemoglobin A1c levels, sent her to the emergency depart­ment numerous times, caused episodes of ketoacidosis, and landed her in an eating disorders treatment center for an entire summer.

This article will provide background on diabulimia, discuss its prevalence, and offer strategies RDs can use to counsel patients and get them the help they need.

Diabulimia Explained

As you remember from biology class, the body needs insu­lin to sweep glucose from the blood into the cells so the body can use it as fuel. Since the pancreas no longer produces insulin in people with type 1 diabetes, glucose accumulates in the bloodstream, causing the kidneys to work overtime through frequent urination to rid the body of excess sugar. As the body is starved of glucose and the calories associated with it, rapid weight loss results.

Diabulimia patients exhibit behaviors characteristic of the eating disorder bulimia nervosa by bingeing on large amounts of sugary or carbohydrate-rich foods and purging the excess sugar through urination. Individuals with bulimia nervosa who don’t have diabetes binge on large amounts of food but purge with the use of laxatives, self-induced vomiting, or excessive exercise to lose weight

.

Currently, the medical community doesn’t consider diabu­limia an official diagnostic term, but it’s been used to describe the eating disorder in which type 1 diabetes and bulimia nervosa collide. The first case reports emerged in 1983 when diabulimia was defined as an eating disorder in type 1 diabetes patients who skipped or limited required insulin doses to lose weight.

Who’s at Risk?

While preteen and teenage girls generally are preoccu­pied with their appearance, those with type 1 diabetes are even more so and, therefore, have a greater risk of developing diabulimia. Girls with type 1 diabetes tend to have a poorer self-image because of the disease.

 To make matters worse, they’re encouraged to focus intently on their diet because of their condition. The constant monitoring of blood sugar levels and carbohydrate intake that’s required may create a near-obsessive relationship with food and trigger a full-blown eating disorder. Add to this the tendency toward weight gain due to insulin use and the likelihood of an eating disorder developing increases.

The American Diabetes Association (ADA) states that women with diabetes are nearly three times more likely to develop an eating disorder than women without diabetes.3 It’s estimated that 30% to 40% of young girls and women with type 1 diabe­tes already have developed or will develop an eating disorder at some point in their lives.4 According to the National Diabetes Fact Sheet released by the ADA in 2011, 25.8 million children and adults in the United States have diabetes, creating a large potential for eating disorder cases.5

Prevalence of Diabulimia

Studies have shown that up to 30% of adolescents with type 1 diabetes skip or restrict insulin to lose weight.2,3 Unsurprisingly, these individuals tend to have poorly controlled diabetes, with a higher risk of developing microvascular and macrovascular complications, such as heart disease, stroke, neuropathy, reti­nopathy, and nephropathy. In addition, they have three times the mortality risk compared with those who don’t restrict insulin and are estimated to have a 13-year-shorter life expectancy.

The practice of withholding insulin has been seen in girls as young as 13 and in women as old as 60.2

Health Consequences

No matter the age, diabulimia can have devastating and per­manent effects on the body. Those with the eating disorder have an increased risk of early comorbidities. And while long-term consequences are the same for anyone who has uncontrolled diabetes, adverse health effects are seen much sooner in those with diabulimia. Short-term consequences include dehydration,

frequent urination and glucosuria, insatiable thirst, increased appetite, high blood glucose levels, fatigue, decreased con­centration, electrolyte imbalance, and weight loss. Long-term consequences include heart attack, stroke, retinopathy, nephropathy, neuropathy, gastroparesis, vascular disease, gum disease, and infertility. There’s also the possibility of death.

Treatment Approaches for the RD

The cornerstone of care for any eating disorder is work­ing with a healthcare team, say Marissa Kent, MS, RD, CDE, of Mission Viejo, California, and Janice Baker, MBA, RD, CDE, CNSC, of San Diego. Both agree that this team should include a mental health professional, a nurse, an endocrinologist, and an RD. Baker says if the patient is an athlete, the patient’s coach, a physical therapist, and/or an exercise physiologist should be added to the treatment team. She recommends patients receive a complete medical evaluation and an assessment of family dynamics and all external pressures at the onset of treatment.

Kent suggests creating a contract with the patient, which is beneficial for liability purposes and holding the patient account­able. This contract may include specific carbohydrate and insulin dosages recommended by the healthcare profession­als involved. In some instances, the parents of a minor patient will need to be involved with the contract, possibly agreeing to administer the insulin injections or monitor food intake.

If RDs are working with patients who have diabulimia, Kent recommends having a good working knowledge of diabetes and eating disorders. She says using motivational interview­ing and cognitive behavioral therapy (CBT) works best with her patients. CBT helps patients understand the thoughts and feel­ings that influence their behaviors. Kent informs patients that they don’t have to restrict food because of diabetes but match carbohydrate intake with insulin doses instead.

Baker says education from the outset is imperative for type 1 diabetes patients. “Individuals should be told they’ll gain weight with the initiation of insulin. Extreme elevations in blood glu­cose leads to dehydration. Insulin initiation and rehydration will restore weight. This process should be normalized, and a mental health professional should be seen at diagnosis to sup­port body image concerns.

Keeping It Real

Health professionals and researchers know plenty about the benefits of controlled blood glucose. We can calculate the appropriate amount of insulin to go with the textbook recom­mendation for carbohydrate intake. However, our patients aren’t robots. They have emotions and taste buds and often grapple with body image concerns and sometimes depression. Therefore, RDs must be realistic, practical, and sympathetic when making recommendations during counseling sessions. RDs need to meet people where they are and work with them to improve their short- and long-term health one step at a time.

                                                                            (UNDERSTANDING DIABULIMIA)   By Janice H. Dada, MPH, RD, CSSD, CDE, CHES

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